Analysis of behavioral change techniques in community-led total sanitation programs

Area of Science:

• Public Health
• Environmental Health
• Behavioral Science

Background:

• Diarrheal diseases, a major child mortality cause, are linked to poor sanitation and open defecation (OD).
• Community-led total sanitation (CLTS) is a widely adopted behavioral change approach to increase rural sanitation coverage.
• Understanding CLTS activity adaptation and effectiveness across diverse contexts is crucial.

Purpose of the Study:

• Identify common behavior change frameworks and techniques in CLTS interventions.
• Describe the implementation of CLTS activities by region and context.
• Determine which activities are most valued by practitioners for achieving and sustaining open defecation-free (ODF) status.

Main Methods:

• Qualitative analysis of CLTS interventions across various regions.
• Review of implemented behavior change activities within CLTS programs.
• Surveys or interviews with CLTS practitioners regarding activity value and sustainability.

Main Results:

• CLTS interventions utilize a broad spectrum of activities, often exceeding standard CLTS protocols.
• Practitioners identify follow-up and monitoring as essential for achieving ODF status.
• A significant gap exists, with only 10% of organizations consistently conducting monitoring and follow-up.

Conclusions:

• CLTS programs employ diverse activities, with a need for more empirical research on effectiveness.
• Sustaining open defecation-free status requires consistent monitoring and follow-up, which are frequently under-resourced.
• Further investigation is needed to identify specific, effective behavioral change activities for ending and sustaining OD.