Abstract
Background Despite global efforts to combat the menace of open defecation, the phenomenon persists, particularly in developing nations. It is estimated that about 14% of Sub-Saharan Africa’s population still practice open defecation. Focus The study sought to examine the behavioral and psychological mechanisms that influence attitudes toward open-defecation-free behavior in Ghana by applying a behavior change theory. Key Hypotheses The following hypotheses were formulated and tested by this study: households’ attitude towards open defecation-free has a significant positive relationship with the actual open defecation-free behavior, household’s subjective norms towards open defecation-free have a significant positive relationship with their actual open defecation-free behavior and households’ perceived behavioral control over open defecation free has a significant positive relationship with their actual open defecation free behavior. Methods A cross-sectional survey was conducted involving 550 respondents. Data were analyzed using the structural equation modeling technique. Results All three variables of the theory of planned behavior were found to have a positive significant influence on Ghanaian households’ actual open defecation-free behaviors. Demographics such as income, educational level, and availability of latrines were found to moderate the relationships between subjective norms, perceived behavioral control, and households’ actual open defecation behavior. Importance to Social Marketing Field The study extends the current literature on social marketing by demonstrating that the theory of planned behavior could be used to predict people’s attitudes toward open-defecation-free behavior. Though the theory of planned behavior has been empirically proven as a good predictor of behavior, by moderating its relationship with open defecation-free behavior with demographic variables our model fleshes out more nuances of the theory, thereby contributing to the development of a social marketing theory. Recommendations for Research or Practice This study employed a cross-sectional survey; hence it may presume static relationships among the constructs which can be cured by a future longitudinal study that could explain the pattern of behavior change. The study recommends that government facilitates the provision of latrines for households by providing financial assistance to those who cannot afford the construction of latrines. A social marketing campaign should also be adopted to encourage the use of latrines.
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