Factors Associated with Levels of Latrine Completion and Consequent Latrine Use in Northern Ghana

Nunbogu, Abraham Marshall; Harter, Miriam; Mosler, Hans‐Joachim

doi:10.3390/ijerph16060920

Cited by 24 publications

(34 citation statements)

References 42 publications

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“…They spread innovations by using their shared knowledge of the language, social, cultural and religious beliefs and their existing relationships with and within communities (30,31). Innovators and early adopters in a community include teachers (30,55), leaders (10,22,30,31,34,55,56), healthcare workers (30,42,55,57,58), and community committees (21,46,59,60). Diffusion can contribute to the three outcomes -access, change and sustainability.…”

Section: Diffusionmentioning

confidence: 99%

“…Access to resources such as latrines (8,11,31,46,56,61,62), water (33,50,60,63,64) and handwashing facilities (62) can be driven by diffusion. When these facilities or the idea of them are new (i.e.…”

Section: Accessmentioning

confidence: 99%

“…In such communities, innovators draw on the existing influence of leaders to set new social norms (11,31,56), and early adopters draw on the existing skills within the community to work on a resource or intervention (31,46,50,60). However, to have an impact on access within a community, diffusion does not need to occur across the whole community, it may just occur within sections of the community such as among women and other community groups (11,60).…”

Section: Accessmentioning

confidence: 99%

“…Social cohesion and connectedness are important enablers of household latrine construction because a level of cooperation and collective action it promotes can help overcome the inequality in resources and skills necessary to build latrines (11,23,30,34,46,56,61). Together they promote friendship and community respect, and an appreciation of social benefit of private goods that may help reduce open defecation (62).…”

Section: Accessmentioning

confidence: 99%

“…In these contexts the focus is on behaviour change at the community rather than individual level(45,55).SustainabilityThe sustainability of a water or sanitation resource or service may depend on the extent to which knowledge of its value diffuse and take root in the community, leading to greater understanding of the potential impact of sustaining the resource or service. The level of social cohesion and connectedness in a community in the form of shared norms, trust, a common sense of identity help facilitate spread information on new ideas(30,46,50,56). The perceived need to collectively mobilise resources to address water or sanitation problems is shared by committees and within committees(50,59,63,66,67).…”

mentioning

confidence: 99%

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How community engagement in water and sanitation interventions impacts human health, infrastructure and service longevity in low- and middle-income countries: a realist review

Nelson

Drabarek

Jenkins

et al. 2020

Preprint

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Background Access to safe water and sanitation is considered a basic human right and a focus of the Sustainable Development Goals. However, many water and sanitation interventions do not have long lasting impacts in communities and are generally associated with high levels of failure. Limited information is available to understand what types of interventions work for whom and under what circumstances. Methods A realist review to understand how, and under what circumstances community engagement in water and sanitation interventions impacts access (to safe water and sanitation), change (in health status or behaviour), and sustainability (of resources and services). We systematically searched PubMed, Web of Science and Scopus databases to identify studies from low- and middle-income countries.Results We reviewed 56 studies conducted in 25 countries. We identified five mechanisms that explain access, change and sustainability outcomes: 1) accountability (policies and procedures to hold communities and committees responsible for their actions and outcomes of an initiative), 2) diffusion (spread of an idea or behaviour by innovators over time through communication amongst members of a community), 3) market (the interplay between demand and supply of a service or resource), 4) ownership (sense of possession and control of the service or resource), and 5) shame (a feeling of disgust in one’s behaviour or actions). Contextual elements identified include: community location, communities with similar characteristics, communication, leadership, fines/penalties, seasonality, resource dependency, access to resources and funding, community financial and technical skills and knowledge, leadership, ongoing support and acknowledgement of change, community connectedness and social cohesion, community willingness to pay, committees that followed and understood responsibilities, rules and management plans, active committees with women and community/committee involvement in the design, planning or implementation of the intervention. Conclusion The findings highlight five key mechanisms, impacted by 19 contextual factors that explain outcomes of community-based water and sanitation interventions. Policy makers, program implementers and institutions need to consider community dynamics, location, resources, committees and level of community involvement, prior to the introduction of community-based water and sanitation interventions.

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