Improved latrine cleanliness through behaviour change and changes in quality of latrine construction: a longitudinal intervention study in rural Burundi

Mosler, Hans‐Joachim; Sonego, Ina Lucia

doi:10.1080/09603123.2017.1373274

Cited by 11 publications

(32 citation statements)

References 31 publications

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“…55 On the other hand, several latrine cleanliness interventions have shown evidence of cleaner latrines, [56][57][58][59] and latrine coverage interventions cite cleaner latrines as being used more often. 32 Cleaning behavior, like latrine use, is complex and influenced by a host of factors, such as, psychosocial factors, 60 commitment to cleaning, 57 seasonality, 59 and the physical structure of the latrine. 56 Most often, women are regulated to cleaning tasks.…”

Section: Discussionmentioning

confidence: 99%

Determinants of Latrine Use Behavior: The Psychosocial Proxies of Individual-Level Defecation Practices in Rural Coastal Ecuador

Lopez

Berrocal

Angulo

et al. 2019

The American Journal of Tropical Medicine and Hygiene

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There is increasing appreciation that latrine access does not imply use-many individuals who own latrines do not consistently use them. Little is known, however, about the determinants of latrine use, particularly among those with variable defecation behaviors. Using the integrated behavior model of water, sanitation, and hygiene framework, we sought to characterize determinants of latrine use in rural Ecuador. We interviewed 197 adults living in three communities with a survey consisting of 70 psychosocial defecation-related questions. Questions were excluded from analysis if responses lacked variability or at least 10% of respondents did not provide a definitive answer. All interviewed individuals had access to a privately owned or shared latrine. We then applied adaptive elastic nets (ENET) and supervised principal component analysis (SPCA) to a reduced dataset of 45 questions among 154 individuals with complete data to select determinants that predict self-reported latrine use. Latrine use was common, but not universal, in the sample (76%). The SPCA model identified six determinants and adaptive ENET selected five determinants. Three indicators were represented in both models-latrine users were more likely to report that their latrine is clean enough to use and also more likely to report daily latrine use; while those reporting that elderly men were not latrine users were less likely to use latrines themselves. Our findings suggest that social norms are important predictors of latrine use, whereas knowledge of the health benefits of sanitation may not be as important. These determinants are informative for promotion of latrine adoption.

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Section: Discussionmentioning

confidence: 99%

Determinants of Latrine Use Behavior: The Psychosocial Proxies of Individual-Level Defecation Practices in Rural Coastal Ecuador

Lopez

Berrocal

Angulo

et al. 2019

The American Journal of Tropical Medicine and Hygiene

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“…To understand latrine completion and use decisions among households, we used the Risks, Attitudes, Norms, Abilities, and Self-regulation (RANAS) model of behaviour change [18] as a conceptual guide. The RANAS model underscores the importance of psychosocial factors in determining households’ sanitation behaviours [13,19,20,21,22]. The risk factors represent a person’s understanding of the health risk of open defecation, the person’s perceived perception of his or her risk of contracting diarrhoea, and his or her perception of the severity of diarrhoea and its consequences.…”

Section: Introductionmentioning

confidence: 99%

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

Nunbogu

Harter

Mosler

2019

IJERPH

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Open defecation is still a major health problem in developing countries. While enormous empirical research exists on latrine coverage, little is known about households’ latrine construction and usage behaviours. Using field observation and survey data collected from 1523 households in 132 communities in northern Ghana after 16 months of implementation of Community Led Total Sanitation (CLTS), this paper assessed the factors associated with latrine completion and latrine use. The survey tool was structured to conform to the Risk, Attitude, Norms, Ability and Self-regulation (RANAS) model. In the analysis, we classified households into three based on their latrine completion level, and conducted descriptive statistics for statistical correlation in level of latrine construction and latrine use behaviour. The findings suggest that open defecation among households reduces as latrine construction approaches completion. Although the study did not find socio-demographic differences of household to be significantly associated with level of latrine completion, we found that social context is a significant determinant of households’ latrine completion decisions. The study therefore emphasises the need for continuous sensitisation and social marketing to ensure latrine completion by households at lower levels of construction, and the sustained use of latrines by households.

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“…All included records were published since 2010 with the number of studies increasing exponentially, with a substantial rise from 2017 onwards. During that first modest increase (2010 – 2017), 12 studies were published [39, 41, 46, 49, 56, 59-61, 63-65, 67]. The exponential increase is most noticeable in 2018 resulting in 7 eligible studies [42, 43, 48, 50, 55, 57, 58], while in 2019, there were 9 included studies [38, 44, 45, 52, 54, 62, 66, 69, 70], and finally up until 6 th September 2020 we identified 5 additional studies [40, 47, 51, 53, 68].…”

Section: Resultsmentioning

confidence: 99%

Nudge strategies for behavior-based prevention and control of neglected tropical diseases: a scoping review and ethical assessment

Velde

Overgaard

Bastien

2020

Preprint

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BackgroundNudging, a strategy that uses subtle stimuli to direct people’s behavior, has recently been included as effective and low-cost behavior change strategy in low- and middle- income countries (LMIC), targeting behavior-based prevention and control of neglected tropical diseases (NTDs). Therefore, the present scoping review aims to provide a timely overview of how nudge interventions have been applied within health promotion research, with a specific focus on the prevention and control of NTDs. In addition, the review proposes a framework for the ethical reflection of nudges for behavior-based prevention and control of NTDs, or more broadly global health promotion.MethodsA comprehensive search was performed in the following databases: MEDLINE, PsycINFO, and Embase (Ovid), Web of Science Core Collection, CINAHL, ERIC and Econ.Lit (EBSCO), as well as registered trials and reviews in CENTRAL and PROSPERO to identify ongoing or unpublished studies. Additionally, studies were included through a handpicked search on websites of governmental nudge units and global health or development organizations. A PRISMA flow diagram was used to elaborate on the number of articles retrieved, retained, excluded and reasons for every action.ResultsThis scoping review of studies implementing nudge strategies for behavior-based prevention and control of NTDs identified 33 studies and a total of 67 nudge-type interventions. Most nudges targeted handwashing behavior and were focused on general health practices rather than targeting a disease in specific. The most common nudge techniques were those targeting decision assistance, such as facilitating commitment and reminder actions. The ethical assessment presented favorable results, certainly regarding the health benefits of the included nudges and the trust relationship for the implementers.ConclusionTwo key recommendations that should inform future research when implementing nudge strategies in global health promotion in general. Firstly, aim for the application of robust study designs including rigorous process and impact evaluation which allow for a better understanding of ‘what works’ and ‘how it works’. Secondly, consider the ethical implications of implementing nudge strategies, specifically in LMIC.

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Improved latrine cleanliness through behaviour change and changes in quality of latrine construction: a longitudinal intervention study in rural Burundi

Cited by 11 publications

References 31 publications

Determinants of Latrine Use Behavior: The Psychosocial Proxies of Individual-Level Defecation Practices in Rural Coastal Ecuador

Determinants of Latrine Use Behavior: The Psychosocial Proxies of Individual-Level Defecation Practices in Rural Coastal Ecuador

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

Nudge strategies for behavior-based prevention and control of neglected tropical diseases: a scoping review and ethical assessment

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