Addressing the behavioural constraints to latrine uptake: effectiveness of a behaviour-change campaign in rural Cambodia
Cambodia has the lowest coverage of improved water and sanitation facilities in South-east Asia. Research suggests that rural Cambodians prefer a high-quality latrine over one provided for free. Market-based approaches are often used to increase sanitation coverage, but private operators lack sufficient incentives and resources to stimulate demand among households that are not immediately responsive to sales events. This study assessed the effectiveness of a Behaviour Change Communications (BCC) intervention designed to address behavioural factors that may limit uptake of latrines. The study applies a quasi-experimental matching technique to estimate the causal effect of the intervention on latrine uptake in rural areas. Communes that received both the BCC intervention and sanitation marketing were matched to similar communes where only sanitation marketing was carried out. Multivariate linear regression analysis is used to estimate the impact of the BCC intervention on latrine uptake. Results show that latrine uptake was slightly higher (0.55%) in BCC communes during the core period of the intervention, but wide variation in sales between communes made it difficult to detect a significant effect. Overall, coverage increased at a faster rate (3%) in BCC communes, but again, these results were not significant. Publicly subsidized sanitation promotion may help to reduce behavioural barriers to latrine adoption. In the absence of alternatives that address the financial constraints of households, such as toilet loans, or in situations where national policy discourages sanitation subsidies, government investment in BCC may be a worthwhile endeavour to strengthen parallel market development efforts, at least until sanitation businesses are well established.