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Sanitation Promotion in Developing Countries

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Sanitation Promotion in Developing Countries ABSTRACT This dissertation examines the decision of private households to install a pit latrine in rural Benin, West Africa. A conceptual framework for understanding sanitation choices in developing countries is derived from behavioral and consumer choice theories. Cultural foundations of consumption and defecation-related beliefs and behavior are integral parts of this explanatory framework. Findings from a qualitative investigation of household behavior in rural Benin are synthesized to construct a schematic model of the decision to adopt a latrine. The model asserts that the key conditions for latrines to be chosen in rural Benin are the presence of at least one active drive or dissatisfaction from among the 11 found to motivate adoption (concerning prestige, well-being, and two particular situations), and the absence of constraints on adoption among 13 related to awareness, physical implementation, and psycho-social issues. Lifestyle and village environment influence the presence of drives. Latrine adoption and other data for 520 villages in the study area are analyzed in models of village-level adoption to test hypotheses from the qualitative work about the factors that arouse desires for latrines. Village-level conditions and characteristics that stimulate demand for improved sanitation are identified. Finally, data on the adoption behavior of 320 households are collected in a survey, analyzed, and used to develop regression and logit models of preference for latrines, stated intention to adopt, and observed choice to install a latrine. These models indicate that the most important motives for adoption are distance to open defecation and prestige, in particular a desire to express new experiences and a new lifestyle acquired outside the ii village. The most important constraints are lack of finance, misunderstanding of latrines, and poor latrine design and performance. The research methodology and results have widespread implications for assessing sanitation demand and for developing demand- responsive and marketing approaches to promote improved sanitation in developing countries. iii CONTENTS FIGURES ........................................................................................................................... vi TABLES...........................................................................................................................viii ACKNOWLEDGEMENTS ............................................................................................... xi CHAPTER 1: INTRODUCTION ..................................................................................... 1 CHAPTER 2: UNDERSTANDING LATRINE ADOPTION AND SANITATION CHOICE IN DEVELOPING COUNTRIES Introduction ..................................................................................................................... 9 Models of Behavior and Consumer Decision Processes............................................... 11 Implementing Behavioral Models of Consumer Choice............................................... 29 Innovation Adoption and Diffusion .............................................................................. 39 Latrine Diffusion in Rural Benin .................................................................................. 44 Cultural Dimensions of Latrine Adoption Behavior..................................................... 49 Summary ....................................................................................................................... 57 CHAPTER 3: MOTIVES AND BARRIERS OF LATRINE ADOPTION IN RURAL BENIN Abstract ......................................................................................................................... 63 Introduction ................................................................................................................... 64 Understanding Latrine Adoption and Sanitation Choice Behavior............................... 66 The Data........................................................................................................................ 72 Motives for Adoption.................................................................................................... 80 Barriers to Adoption.................................................................................................... 113 Past Latrine Exposure and Experience........................................................................ 124 A Conceptual Model of Latrine Adoption Choice...................................................... 129 Summary ..................................................................................................................... 137 CHAPTER 4: VILLAGE MARKET SEGMENTS FOR PROMOTING LATRINE ADOPTION IN RURAL BENIN Abstract ....................................................................................................................... 143 Introduction ................................................................................................................. 144 Background ................................................................................................................. 147 The Data...................................................................................................................... 152 Village Factors and Variables ..................................................................................... 160 Regression Results ...................................................................................................... 172 Discussion ................................................................................................................... 181 Village Market Segments for Latrine Adoption.......................................................... 190 Summary ..................................................................................................................... 201 -iv- CHAPTER 5: RESULTS FROM A HOUSEHOLD SURVEY OF LATRINE ADOPTION CHOICE BEHAVIOR Executive Summary .................................................................................................... 205 Introduction ................................................................................................................. 208 Background and Survey Design .................................................................................. 212 Sampling Design and Data Collection ........................................................................ 218 Results......................................................................................................................... 223 Summary and Conclusions.......................................................................................... 267 CHAPTER 6: FACTOR ANALYSIS OF DRIVES AND CONSTRAINTS Introduction ................................................................................................................. 275 Methodological Considerations .................................................................................. 276 Demographic Characteristics of the Unweighted Sample........................................... 281 Drive Factors............................................................................................................... 285 Constraint Factors ....................................................................................................... 295 Stability of Factor Solutions........................................................................................ 303 Summary and Conclusion ........................................................................................... 307 CHAPTER 7: MODELING HOUSEHOLDS’ LATRINE ADOPTION BEHAVIORIN RURAL BENIN Introduction ................................................................................................................. 309 Variables and Model Formulations............................................................................. 311 Models of Preference for Latrines............................................................................... 321 Models of Intention to Adopt...................................................................................... 326 Models of Choice ........................................................................................................ 337 Heterogeneous Behavior and Data Collection Problems ............................................ 350 Discussion ................................................................................................................... 352 Summary and Conclusion ........................................................................................... 364 CHAPTER 8: CONCLUDING INSIGHTS AND IMPLICATIONS FOR SANITATION PROMOTION Insights for Understanding Sanitation Demand .......................................................... 369 Policy and Program Implications for Sanitation Promotion ....................................... 376 Methodological Contributions and Lessons................................................................ 383 REFERENCES................................................................................................................ 391 APPENDIX A: LATRINE DESIGN AND USE PREFERENCES IN THE STUDY AREA................................................................................................................ 401 APPENDIX B: SURVEY QUESTIONNAIRE .............................................................. 417 -v- FIGURES 1-1. Map of Benin.............................................................................................................. 4 1-2. Latrine
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