Can collective action strategies motivate behaviour change to reduce open defecation in rural India?

Hathi, Payal; Spears, Dean; Coffey, Diane

doi:10.3362/1756-3488.2016.011

Cited by 27 publications

(13 citation statements)

References 20 publications

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“…Due to the proximity of compound-shared latrines, this relationship with PTB is not likely due to physical stress, unless women relying on shared latrines use them infrequently (only 2% of our sample population reported using a compound-shared latrine) and experience similar exposures as women who rely on open defecation [ 51 , 52 ]. The infrequent use of latrines in India is due, in part, to the stigma associated with handling feces [ 53 ]. Therefore, there may be confounding socioeconomic or cultural factors associated with the use of a shared latrine.…”

Section: Discussionmentioning

confidence: 99%

Impact of social capital, harassment of women and girls, and water and sanitation access on premature birth and low infant birth weight in India

et al. 2018

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BackgroundGlobally, preterm birth (PTB) and low infant birth weight (LBW) are leading causes of maternal and child morbidity and mortality. Inadequate water and sanitation access (WASH) are risk factors for PTB and LBW in low-income countries. Physical stress from carrying water and psychosocial stress from addressing sanitation needs in the open may be mechanisms underlying these associations. If so, then living in a community with strong social capital should be able to buffer the adverse effects of WASH on birth outcomes. The objective of this study is to assess the relationships between WASH access and social conditions (including harassment and social capital) on PTB and LBW outcomes among Indian women, and to test whether social conditions modified the association between WASH and birth outcomes.Methods and findingsThis cohort study examined the effect of pre-birth WASH and social conditions on self-reported PTB status and LBW status for 7,926 women who gave birth between 2004/2005 and 2011/2012 Waves of the India Human Development Survey. PTB and LBW occurred in 14.9% and 15.5% of women, respectively. After adjusting for maternal biological and socioeconomic conditions, PTB was associated with sharing a building/compound latrine (Odds Ratio (OR) = 1.55; 95% Confidence Interval (CI) = 1.01, 2.38) versus private latrine access, but suggested an effect in the opposite direction for sharing a community/public latrine (OR = 0.67; CI = 0.45, 1.01). Open defecation, type of drinking water source, minutes per day spent fetching water, and one-way time to a drinking water source were not associated with PTB. LBW was associated with spending more than two hours per day fetching water compared to less than two hours (OR = 1.33; CI = 1.05, 1.70) and suggested an association with open defecation (OR = 1.22; CI = 1.00, 1.48), but was not associated with other types of sanitation, type of drinking water source, or time to a drinking water source. Harassment of women and girls in the community was associated with both PTB (OR = 1.33; CI = 1.09, 1.62) and LBW (OR = 1.26; CI = 1.03, 1.54). The data also showed a possible association of local crime with LBW (OR = 1.30; CI = 1.00, 1.68). Statistically significant (p<0.05) evidence of effect modification was only found for collective efficacy on the association between type of sanitation access and PTB. In addition, stratified analyses identified differences in effect size for walking time to the primary drinking water source and PTB by crime, sanitation access and PTB by harassment, and total hours per day fetching water and LBW by collective efficacy. Limitations of this observational study include risk of bias, inability to confirm causality, reliance on self-reported outcomes, and limited sub-group sample sizes for testing effect modification.ConclusionsThe relationship between adverse birth outcomes and sanitation access, domestic water fetching, crime, and gender-based harassment suggests physical and psychosocial stress are possible mechanisms by which WASH access affec...

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Section: Discussionmentioning

confidence: 99%

Impact of social capital, harassment of women and girls, and water and sanitation access on premature birth and low infant birth weight in India

et al. 2018

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“…Demand-side interventions aim to generate demand for latrines through information campaigns and behavior change programs, while supply-side interventions prioritize providing sanitation infrastructure [14,15]. Researchers have argued that building or subsidizing toilet construction is ineffective and unsustainable without behavior change [16,17]; that many Indians have a preference for OD over using latrines [18]; and that more efforts, therefore, are needed towards education, awareness-building and peer pressure to build demand [18][19][20]. The current literature on sanitation uptake therefore emphasizes demand-side approaches, and thus individual-and community-level attitudes and preferences as determinants of latrine adoption (see Dreibelbis et al, 2015) [21].…”

Section: Introductionmentioning

confidence: 99%

Understanding Open Defecation in the Age of Swachh Bharat Abhiyan: Agency, Accountability, and Anger in Rural Bihar

Jain

Wagner

Snell‐Rood

et al. 2020

IJERPH

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Swachh Bharat Abhiyan, India’s flagship sanitation intervention, set out to end open defecation by October 2019. While the program improved toilet coverage nationally, large regional disparities in construction and use remain. Our study used ethnographic methods to explore perspectives on open defecation and latrine use, and the socio-economic and political reasons for these perspectives, in rural Bihar. We draw on insights from social epidemiology and political ecology to explore the structural determinants of latrine ownership and use. Though researchers have often pointed to rural residents’ preference for open defecation, we found that people were aware of its many risks. We also found that (i) while sanitation research and “behavior change” campaigns often conflate the reluctance to adopt latrines with a preference for open defecation, this is an erroneous conflation; (ii) a subsidy can help (some) households to construct latrines but the amount of the subsidy and the manner of its disbursement are key to its usefulness; and (iii) widespread resentment towards what many rural residents view as a development bias against rural areas reinforces distrust towards the government overall and its Swachh Bharat Abhiyan-funded latrines in particular. These social-structural explanations for the slow uptake of sanitation in rural Bihar (and potentially elsewhere) deserve more attention in sanitation research and promotion efforts.

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“…However, this has yielded no fruit as the OD practices still persist in rural India despite India's strong economic growth. 19 There have been several interventions to end OD in Turkana such as Community-Led Total Sanitation (CLTS) introduced in 2007 and the ODF Rural Kenyan Campaign launched in the year 2011. These campaigns coupled with the expansion of sanitation facilities may not have been critical efforts to achieve meaningful health outcomes as OD cases are still rampant.…”

Section: Introductionmentioning

confidence: 99%

Open Defecation Practices in Lodwar, Kenya: A Mixed-Methods Research

Busienei

Ogendi

Mokua

2019

Environ�Health�Insights

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Background: As of the year 2014, about 2.5 billion people globally lacked access to improved sanitation. The situation is even worse in the sub-Saharan African countries including Kenya. The practice of open defecation (OD) peaks beyond 72% of the population in Turkana County, Kenya, despite various interventions to end it. Methods: This article reports on both qualitative and quantitative aspects of a cross-sectional study. A partially mixed sequential dominant (quantitative) status was used to understand various socioeconomic factors associated with OD practice in Lodwar’s human settlements, Turkana County. Simple random sampling technique was chosen to select participants for this study with the sample drawn from various administrative units of Lodwar. Standardized questionnaires, focus group discussions, and key informant interviews were used to collect data. Results: The quantitative findings revealed that culture was the leading factor as to why people practiced OD with a frequency of 44%. The findings further revealed that poverty was the major influencing factor for latrine ownership among the households (frequency 27%). Pearson χ 2 tests revealed that there was a significant association between latrine presence and education level of the household head (χ 2 = 107.317; P < .05), latrine sharing (χ 2 = 403; P < .05), and occupation of the household head (χ 2 = 74.51; P < .05). The quantitative findings showed that culture was by far the most common factor that contributed to the OD practice with a theme intensity of 31.1%. Further analyses identified 5 major cultural aspects that were associated with OD practice. This included sexual immorality, OD as a common habit, nomadic pastoralism, bride’s dignity and mixing of feces. Open defecation as a common habit among the respondents was the most cited factor that contributed to its rampant practice (theme intensity 31.3%) followed closely by nomadic pastoralism kind of life among the residents that limit latrine construction (theme intensity 28.1%). Conclusions: In addition to cultural aspects, high poverty levels influence latrine adoption and consequently OD practices. Future sanitation interventions addressing OD should assess and factor in these cultural aspects in such communities to come up with appropriate eradication measures which have otherwise been difficult to solve through poverty eradication and sanitation campaigns that have been in existence.

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Can collective action strategies motivate behaviour change to reduce open defecation in rural India?

Cited by 27 publications

References 20 publications

Impact of social capital, harassment of women and girls, and water and sanitation access on premature birth and low infant birth weight in India

Impact of social capital, harassment of women and girls, and water and sanitation access on premature birth and low infant birth weight in India

Understanding Open Defecation in the Age of Swachh Bharat Abhiyan: Agency, Accountability, and Anger in Rural Bihar

Open Defecation Practices in Lodwar, Kenya: A Mixed-Methods Research

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