Abstract
To reduce open defecation, many implementers use the intervention strategies of Community-Led Total Sanitation (CLTS). But CLTS focuses on latrine construction and does not include latrine maintenance and repair damage or collapse. Some households rebuild their latrine while others return to open defecation. The reasons why are unknown. Using data from a cross-sectional survey, this article shows how physical, personal, and social context factors and psychosocial factors from the RANAS model are associated with CLTS participation, and how these factors connect to latrine rebuilding. In 2015, heavy rains hit the north of Mozambique and many latrines collapsed. Subsequently, 640 household interviews were conducted in the affected region. Logistic regression and mediation analyses reveal that latrine rebuilding depends on education, soil conditions, social cohesion, and a feeling of being safe from diarrhea, the perception that many other community members own a latrine, and high confidence in personal ability to repair or rebuild a broken latrine. The effect of CLTS is mediated through social and psychosocial factors. CLTS already targets most of the relevant factors, but can still be improved by including activities that would focus on other factors not yet sufficiently addressed.
Highlights
The sixth of the Sustainable Development Goals set by the United Nations is to “ensure availability and sustainable management of water and sanitation for all”, but in 2015 some 2.4 billion people still lacked access to improved sanitation facilities [1]
The results presented here indicate that rebuilding of decommissioned latrines is related to a) favorable personal and physical context factors such as education and soil conditions, b) Community-Led Total Sanitation (CLTS) strengthening the social structure and perceived latrine ownership of others within the community, and c) low risk perception by people owning and maintaining latrines, which is supported by information received during CLTS interventions
This study shows that other reasons can better explain why people rebuild their latrines, such as social and psychosocial factors
Summary
The sixth of the Sustainable Development Goals set by the United Nations is to “ensure availability and sustainable management of water and sanitation for all”, but in 2015 some 2.4 billion people still lacked access to improved sanitation facilities [1]. This lack has fatal consequences: 6.3 million children died before their fifth birthday in 2013, and the corresponding figure predicted for 2030 is 4.4 million. One answer to the problem of open defecation in rural areas in developing countries is Community-Led Total Sanitation (CLTS). This set of participatory and community-based activities successfully steers communities to change their behavior and become an open-
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