Building toilets and getting people to use them is critical for public health. We deployed a political ecology approach specifically to identify the multi-scalar political, economic, and environmental factors influencing toilet adoption in rural India. The research used ethnographic and technical methods in rural villages of West Bengal and Himachal Pradesh over the period September 2012 to May 2013. The elements of successful sanitation adoption depended on three factors (i.e., toilet tripod): (1) multi-scalar political will on the part of both government and NGOs over the long term; (2) proximate social pressure, i.e., person-to-person contact between rural inhabitants and toilets; (3) political ecology, i.e., assured access to water, compatible soil type, and changing land use. This research contributes to studies of sustainable development and global public health by developing a theory and framework for successful sanitation.

The scientific literature has documented the growing risks of flooding posed for Asia's coastal cities by the combination of climate change, as reflected in sea level rise and intensified storms and storm surges, and ongoing urban growth in low-lying coastal zones. These issues were already elaborated in the 2007 IPCC (IPCC, 2007) reports but recent studies indicate that climate change, sea level rise and the sinking of the deltas on which most Asian mega urban regions have arisen, are all occurring at much faster rates than earlier projected and therefore pose even greater risks than previously indicated.Global warming appears to be accelerating and may increase to 4° C or more by the end of this century, twice the earlier IPCC projections. The sea level is now expected to rise by one meter or more by 2100; two or three times the earlier projections. The recent typhoons and rains striking Southeast Asia have been the most intense in decades as would be expected as a result of global warming.At the same time, Asia's urban population is increasing at the rate of 140,000 per day, with much of this growth occurring in low-lying coastal regions and on deltas characterized by land subsidence that is further contributing to flooding risks.While these risks and vulnerabilities have been increasingly detailed in the scientific literature, recognition and effective responses on the part of the urban planning and policy community have been slow to develop. Barriers to adaptation, policy formation and response are reviewed and possible steps forward are outlined. KeywordsClimate change, urban adaptation, risk and vulnerability, barriers to adaptation It is within urban centers and urban governments that so much of the battle to prevent climate change from becoming a global catastrophe will be won or lost.

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This paper advances research on methods used to evaluate sanitation usage and behavior. The research used quantitative and qualitative methods to contribute to new understanding of sanitation practices and meanings in rural India. We estimated latrine usage behavior through ethnographic interviews and sensor monitoring, specifically the latest generation of infrared toilet sensors, Portland State University Passive Latrine Use Monitors (PLUMs). Two hundred and fifty-eight rural households in West Bengal (WB) and Himachal Pradesh, India, participated in the study by allowing PLUMs to be installed in their houses for a minimum of 6 days. Six hundred interviews were taken in these households, and in others, where sensors had not been installed. Ethnographic and observational methods were used to capture the different defecation habits and their meanings in the two study sites. Those data framed the analysis of the PLUM raw data for each location. PLUMs provided reliable, quantitative verification. Interviews elicited unique information and proved essential to understanding and maximizing the PLUM data set. The combined methodological approach produced key findings that latrines in rural WB were used only for defecation, and that low cost, pit latrines were being used sustainably in both study areas.

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