When behavior change fails: evidence for building WASH strategies on existing motivations

Abstract

Despite increased efforts, an estimated 30-40% of rural drinking water initiatives in developing countries fail to provide sustainable solutions. The Sustainable Development Goal for water (SDG 6) challenges us to solve this problem to ensure availability and sustainable management of water and sanitation for all. In this paper, we explore one possible barrier to success: a potential misalignment between local and outside motivations. We address this problem by analyzing how strategies used to successfully (n ¼ 148) and unsuccessfully (n ¼ 70) deliver drinking water to rural areas align with known motivations of local stakeholders. As one tool and starting point, we use definitions in Maslow's theory of motivation to learn and share how to more consistently and successfully build comprehensive motivations into solutions. The results reveal that successful strategies rarely focus on physiological needs (2/148) and often focus on higher-level needs, including self-esteem (75/148), love and belonging (46/148), and safety (69/148). Successful strategies also typically address multiple needs and are designed to meet the actualization (fulfill potential) of both communities and donors.Unsuccessful strategies focus on needs of outside stakeholders above local stakeholders (46/70), fail to address higher-level or multiple needs, and/or unsuccessfully address existing needs.

Improving rural public health through ‘best practice’ water, sanitation and hygiene initiatives

“…Community ownership . Without full commitment to a bottom-up community-based, participatory approach, there is the risk that rural communities, not fully engaged, will not adopt and maintain changed practices (Hall et al, 2016; Marshall and Kaminsky, 2016). Bond et al (2015) found that many water management committees (WMC) were no longer active and that WMCs were more effective ‘ when the community determines their structures rather than them being imposed, when they have strong links to existing leadership structures and when they have the necessary skills ’.…”

“…Instead, it is preferable for community members to be trained in facilitation skills. Without this capacity for facilitation, key rWASH messages are not imparted, communities are not ‘triggered’ and projects can risk failure (Kar and Bongartz, 2006; Marshall and Kaminsky, 2016).…”

“… Source: Bond et al (2015), Botes and Van Rensburg (2000), Clarke et al (2014), Colin (2012), Edkarl (2017), Emerging Markets Consulting (2014), Hall et al (2016), Hulland et al (2015), Layton and Layton (2010), Marshall and Kaminsky (2016), Mutiro (2013), Quattri and Smets (2014), Ramesh et al (2015), Schwemlein et al (2016), UNICEF (2016) and Weidner (2014). SDG: Sustainable Development Goals; rWASH: rural water, sanitation and hygiene. …”

Continuation of Health Behaviors: Psychosocial Factors Sustaining Drinking Water Chlorination in a Longitudinal Study from Chad

“…Several factors at the personal and social level-such as social norms, status, self-efficacy convictions, and the like-have been shown to be important predictors for the success of promotion campaigns targeting a range of health-relevant behaviors [14][15][16][17]. Successful promotion strategies have also been shown to surpass outside stakeholders' project goals and definitions of outputs by rather taking into account multiple perspectives, especially local populations' views, attitudes, motivators, and fears [18].…”

Ecological Sanitation Opportunities in Rural Panamá: Effectiveness and Social Implications of Intrinsic Ammonia-Based Treatment for Pathogen Inactivation and Incorporation of Ferrocement Technology

“…Many studies point to the idea of "behavior change" as the main difficulty or, as some have posited, the main opportunity to ISF adoption and ultimately an improved quality of life Marshall 2016;Riboli-Sasco, 2015;Nawab, 2006, Bartram, 2010. This agrees with others (Evans, 2005;Jenkins and Scott, 2007;Peat et al, 2010) that latrine use has much more to do with other barriers like convenience, comfort, privacy and safety.…”