Factors that influence individuals’ opportunity to handwash have often been overlooked in hygiene promotion initiatives, with much of the focus having been on motivation. This article summarizes findings from the Water and Sanitation's Global Scaling Up Handwashing Project and other research that suggest that convenient access to water and soap when and where needed and having a designated place for HWWS are also important determinants for handwashing. Enabling products such as handwashing stations provide such a designated place in addition to an environmental cue to action and a stable context for handwashing, factors that the literature highlights as critical for habits to form and be maintained. WSP recently conducted a landscape of enabling products and many identified to date are tippy-taps. However, the learning from a design consultancy for a handwashing station for rural Vietnamese households is that appearances may matter and that designing features that take into account user preferences and practices is essential.
From 2003 to 2006, International Development Enterprises piloted a rural sanitation marketing approach in two provinces of Vietnam. During this period, coverage of sanitary toilets grew from 16 per cent to 46 per cent. Some three years after the project ended, the Water and Sanitation Program initiated a research study to investigate the sustainability of outcomes achieved. The study was conducted in collaboration with IRC and ADCOM and used a variety of methods including focus group discussion and structured interviews with community members, suppliers and promoters. The study found that coverage had continued to grow in pilot communes and had reached 59 per cent two years later. Promoters had continued their activities, albeit at a lesser intensity level. Many suppliers had expanded their product range and customer base and reported that their revenues from sanitation increased. Lack of tailored information on more affordable toilet construction and financing were the main barriers for those who had not yet built a sanitary toilet, despite having been reached by the pilot project.
This study examined factors associated with latrine ownership across different formative research studies and the extent to which these may differ among households from the poorest quintiles. Cross-sectional data was collected between 2008 and 2012 from households in rural areas of Tanzania, Indonesia (East Java), and multiple states of India. A framework, SaniFOAM, guided factors theorized to influence latrine ownership. Multivariate analysis was used to build country-specific models predicting latrine ownership. Factors associated with latrine ownership included: satisfaction with the current place of open defecation, perceptions of the adequacy of water and land for latrine ownership, social norms, sanctions and enforcement, and perceived latrine affordability. Emotional, physical and social drivers also showed a significant positive adjusted association with latrine ownership. Apart from one exception, there was no interaction between the behavioural determinants and wealth on latrine ownership. We conclude that understanding the factors which prevent or facilitate the widespread construction of latrines will inform interventions aimed at changing collective behaviour and creating demand for improved sanitation.