Understanding barriers to and facilitators of latrine use in rural India

Abstract Toilet ownership in India has grown in recent years, but open defecation can persist even when rural households own latrines. There are at least two pathways through which social norms inhibit the use of toilets in rural India: (1) beliefs/expectations that others do not use toilets or latrines or find open defecation unacceptable; and (2) beliefs about ritual notions of purity that dissociate latrines from cleanliness. A survey in Uttar Pradesh, India, finds a positive correlation between latrine use and social norms at baseline. To confront these, an information campaign was piloted to test the effectiveness of rebranding latrine use and promoting positive social norms. The intervention targeted mental models by rebranding latrine use and associating it with cleanliness, and it made information about growing latrine use among latrine owners more salient. Following the intervention, open defecation practices went down across all treatment households, with the average latrine use score in treatment villages increasing by up to 11% relative to baseline. Large improvements were also observed in pro-latrine beliefs. This suggests that low-cost information campaigns can effectively improve pro-latrine beliefs and practices, as well as shift perceptions of why many people still find open defecation acceptable. Measuring social norms as described can help diagnose barriers to reducing open defecation, contribute to the quality of large-scale surveys and make development interventions more sustainable.

Download Full-text

Assessing Latrine Use in Rural India: A Cross-Sectional Study Comparing Reported Use and Passive Latrine Use Monitors

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.16-0102 ◽

2016 ◽

Vol 95 (3) ◽

pp. 720-727 ◽

Cited By ~ 22

Author(s):

Antara Sinha ◽

Corey L. Nagel ◽

Evan Thomas ◽

Wolf P. Schmidt ◽

Belen Torondel ◽

...

Keyword(s):

Cross Sectional Study ◽

Rural India ◽

Sectional Study ◽

Cross Sectional ◽

Latrine Use

Download Full-text

Measuring open defecation in India using survey questions: evidence from a randomised survey experiment

BMJ Open ◽

10.1136/bmjopen-2019-030152 ◽

2019 ◽

Vol 9 (9) ◽

pp. e030152 ◽

Cited By ~ 1

Author(s):

Sangita Vyas ◽

Nikhil Srivastav ◽

Divya Mary ◽

Neeta Goel ◽

Sujatha Srinivasan ◽

...

Keyword(s):

Question Type ◽

Household Member ◽

Rural India ◽

Open Defecation ◽

Indian States ◽

Household Level ◽

Individual Level ◽

Percentage Points ◽

The Individual ◽

Latrine Use

ObjectivesTo investigate differences in reported open defecation between a question about latrine use or open defecation for every household member and a household-level question.SettingRural India is home to most of the world’s open defecation. India’s Demographic and Health Survey (DHS) 2015–2016 estimates that 54% of households in rural India defecate in the open. This measure is based on a question asking about the behaviour of all household members in one question. Yet, studies in rural India find substantial open defecation among individuals living in households with latrines, suggesting that household-level questions underestimate true open defecation.ParticipantsIn 2018, we randomly assigned latrine-owning households in rural parts of four Indian states to receive one of two survey modules measuring sanitation behaviour. 1215 households were asked about latrine use or open defecation individually for every household member. 1216 households were asked the household-level question used in India’s DHS: what type of facility do members of the household usually use?ResultsWe compare reported open defecation between households asked the individual-level questions and those asked the household-level question. Using two methods for comparing open defecation by question type, the individual-level question found 20–21 (95% CI 16 to 25 for both estimates) percentage points more open defecation than the household-level question, among all households, and 28–29 (95% CI 22 to 35 for both estimates) percentage points more open defecation among households that received assistance to construct their latrines.ConclusionsWe provide the first evidence that individual-level questions find more open defecation than household-level questions. Because reducing open defecation in India is essential to meeting the Sustainable Development Goals, and exposure to open defecation has consequences for child mortality and development, it is essential to accurately monitor its progress.Trial registration numberRegistry for International Development Impact Evaluations (5b55458ca54d1).

Download Full-text

Tackling Open Defecation and Improved Sanitation in Developing Countries: A Toilet Talk from the State of Bihar, India

Current Research Journal of Social Sciences and Humanities ◽

10.12944/crjssh.2.1.06 ◽

2019 ◽

Vol 2 (1) ◽

pp. 47-57

Author(s):

Sandeep Kumar Sinha ◽

Pradeep Chaudhry

Keyword(s):

Open Study ◽

Behavioural Change ◽

The State ◽

Rural India ◽

Old People ◽

Open Defecation ◽

Improved Sanitation ◽

Sustainable Usage ◽

Latrine Use ◽

Free Status

Open defecation is a major blot on India’s overall reputation as an emerging economy as it still remains stubbornly widespread across rural India. The present paper outlines the economic and psychological aspects of toilets construction and their sustainable usage in two districts of the state of Biharviz. Gopalganj& Bhagalpur. Bihar’s performance is not up to the mark with respect to the sanitation figures among other states of India. It was found that households owning a government constructed latrine,still defecate in the open. Study evidences support a preference for open defecation; many survey respondents reported that open defecation was more comfortable and desirable than latrine use. Old people prefer going outside as they are used to this routineand do not mind defecating in the open for the rest of their lives.The study was conducted with an objective to better understand and assess the issues and strategies of behavioural change, policies present in the system and suggesting suitable recommendations to address the issue of sustenance of open defecation free status in the state.

Download Full-text