As part of its scaling up rural sanitation and domestic private sector participation programmes, the water and sanitation program (WSP) of the World Bank has been commissioning formative research studies among households. WSP has utilised a conceptual framework, called sanitation focus, opportunity, ability, motivation (Sani- FOAM), to help programme managers and implementers analyse sanitation behaviours to inform effective sanitation programmes.
Three specific sanitation behaviours are covered in the review: open defecation, acquisition of toilets, and improvement of latrines. This review collects the results from formative quantitative and qualitative research reports and presentations from eight countries: Cambodia, India (Rajasthan, Meghalaya, and Bihar), Indonesia (East Java), Kenya, Malawi, Peru, Tanzania, and Uganda. Studies were conducted from 2006 until 2012. The studies reviewed used a variety of methods, including focus group discussions, in-depth interviews, and structured interviews using questionnaires.
The review followed standard qualitative methodologies of thematic ordering and interpretation to identify factors that can positively or negatively influence the behaviours of interest. Findings presented in this report illustrate themes that were consistently found across regions and countries.
The most salient factors influencing rural sanitation behaviours that emerged from the review include access to and availability of functioning latrines, sanitation products, and services; latrine product attributes (for example, perceptions of cleanliness and durability); social norms around open defecation; perceptions of latrine affordability; self-efficacy to build latrines; and competing priorities for other household items. The review also identified a number of emotional, social, and physical drivers. These include shame and embarrassment associated with open defecation, as well as perceptions of improved social status, privacy, and convenience associated with latrine ownership and use.