Who is likely to own a latrine in rural areas? Findings from formative research studies
Kathryn A. O’Connell | Jacqueline Devine
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.
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.
Devine, J. (2009) ‘Introducing SaniFOAM: a framework to analyze sanitation behaviors to design effective sanitation programs’, Washington, DC: World Bank Water and Sanitation Program.
Dreibelbis, R., Winch, P., Leontsini, E., Hulland, K., Ram, P., Unicomb, L. and Luby, S. (2013) ‘The integrated behavioural model for water, sanitation, and hygiene: a systematic review of behavioural models and a framework for designing and evaluating behaviour change interventions in infrastructure-restricted settings’, BMC Public Health, 13(1): 1–13 <http://dx.doi.org/10.1186/1471-2458-13-1015>.
Fewtrell, L., Kaufmann, R., Kay, D., Enanoria, W., Haller, L. and Colford, J. (2005) ‘Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis’, The Lancet Infectious Diseases, 5(1): 42–52 <http://dx.doi.org/10.1016/S1473-3099(04)01253-8>.
Frias, J. and Mukherjee, N. (2005) ‘Harnessing market power for rural sanitation’, Field Note, Jakarta: World Bank Water and Sanitation Program.
Jenkins, M. and Curtis, V. (2005) ‘Achieving the good life: Why some people want latrines in rural Benin’, Social Science & Medicine, 61(11): 2446–59 <http://dx.doi.org/10.1016/j.socscimed.2005.04.036>.
Jenkins, M. and Scott, B. (2007) ‘Behavioral indicators of household decision-making and demand for sanitation and potential gains from social marketing in Ghana’, Social Science & Medicine, 64(12): 2427–42 <http://dx.doi.org/10.1016/j.socscimed.2007.03.010>.
Joint Monitoring Programme (JMP) (2014) Progress on Drinking Water and Sanitation: 2014 Update, Geneva: World Health Organization and UNICEF.
Mara, D., Lane, J., Scott, B. and Trouba, D. (2010) ‘Sanitation and health’, PLoS Med, 7(11): e1000363 <http://dx.doi.org/10.1371/journal.pmed.1000363>.
Mosler, H. (2012) ‘A systematic approach to behavior change interventions for the water and sanitation sector in developing countries: a conceptual model, a review, and a guideline’, International Journal of Environmental Health Research, 22(5): 431–49 <http://dx.doi.org/10.1080/09603123.2011.650156>.
Nelson, K., Karver, J., Kullman, C. and Graham, J. (2014) ‘User perceptions of shared sanitation among rural households in Indonesia and Bangladesh’, PLoS ONE, 9(8): e103886 <http://dx.doi.org/10.1371/journal.pone.0103886>.
Nimoh, F., Poku, K., Ohene-Yankyera, K., Konradsen, F., and Abaidoo, R.C. (2014) ‘Households latrine preference and financing mechanisms in peri-urban Ghana’, Journal of Economics and Sustainable Development, 5(16): 63–73.
O’Brien, R.M. (2007) ‘A caution regarding rules of thumb for variance inflation factors’, Quality & Quantity, 41(5): 673–90 <http://dx.doi.org/10.1007/s11135-006-9018-6>.
O’Connell, K. (2015) ‘What influences open defecation and latrine ownership’, Learning Note [online] Washington, DC: World Bank Water and Sanitation Program <http://www.wsp.org/sites/wsp.org/files/publications/WSP-What-Influences-Open-Defecation-Global-Sanitation-Review.pdf> [accessed 11 March 2015].
O’Connell, K.A. and Devine, J. (2014) ‘Factors associated with latrine use and ownership among rural populations: findings from a desk review and analysis of multi-country formative research studies’, Water and Health Conference, University of North Carolina <http://whconference.unc.edu/files/2014/11/devine-2.pdf> [accessed 6 April 2015].
O’Connell, K. and Skevington, S. (2012) ‘An international quality of life instrument to assess wellbeing in adults who are HIV-positive: a short form of the WHOQOL-HIV (31 items)’, AIDS and Behavior, 16(2): 452–60 <http://dx.doi.org/10.1007/s10461-010-9863-0>.
O’Reilly, K. (2010) ‘Combining sanitation and women’s participation in water supply: an example from Rajasthan’, Development in Practice, 20(1): 45–56 <http://dx.doi.org/10.1080/09614520903436976>.
O’Reilly, K. and Louis, E. (2014) ‘The toilet tripod: Understanding successful sanitation in rural India’, Health & Place, 29: 43–51 <http://dx.doi.org/10.1016/j.healthplace.2014.05.007>.
Pullan, R., Freeman, M., Gething, P. and Brooker, S. (2014) ‘Geographical inequalities in use of improved drinking water supply and sanitation across sub-Saharan Africa: Mapping and spatial analysis of cross-sectional survey data’, PLoS Med, 11(4): e1001626 <http://dx.doi.org/10.1371/journal.pmed.1001626>.
Rutstein, S.O. and Johnson, K. (2004) The DHS Wealth Index, DHS Comparative Reports No. 6, Calverton, MD: ORC Macro.
Sara, S. and Graham, J. (2014) ‘Ending open defecation in rural Tanzania: Which factors facilitate latrine adoption?, International Journal of Environmental Research and Public Health, 11(9): 9854–70 <http://dx.doi.org/10.3390/ijerph110909854>.
Shakya, H., Christakis, N. and Fowler, J. (2015) ‘Social network predictors of latrine ownership’, Social Science and Medicine 125: 129–38 <http://dx.doi.org/10.1016/j.socscimed.2014.03.009>.
Streiner, D. and Norman, G. (1994) Health Measurement Scales, Oxford: Oxford University Press.
Thys, S., Mwape, K., Lefevre, P., Dorny, P., Marcotty, T., Phiri, A., Phiri, I. and Gabriel, S. (2015) ‘Why latrines are not used: communities perceptions and practices regarding latrines in a taenia solium endemic rural area in eastern Zambia’, PLOS Neglected Tropical Diseases, 9(3): e0003570 <http://dx.doi.org/10.1371/journal.pntd.0003570>.
World Bank Water and Sanitation Program (WSP) (2012) Marketing Lessons from Cambodia: A Market-Based Approach to Delivering Sanitation, Washington, DC: World Bank Water and Sanitation Program.
Yimam, Y., Gelaye, K. and Chercos, D. (2014) ‘Latrine utilization and associated factors among people living in rural areas of Denbia district, northwest Ethiopia, 2013, a cross-sectional study’, Pan African Medical Journal, 18: 1–10 <http://dx.doi.org/10.11604/pamj.2014.18.334.4206>.
Devine, J. (2009) ‘Introducing SaniFOAM: a framework to analyze sanitation behaviors to design effective sanitation programs’, Washington, DC: World Bank Water and Sanitation Program.
Dreibelbis, R., Winch, P., Leontsini, E., Hulland, K., Ram, P., Unicomb, L. and Luby, S. (2013) ‘The integrated behavioural model for water, sanitation, and hygiene: a systematic review of behavioural models and a framework for designing and evaluating behaviour change interventions in infrastructure-restricted settings’, BMC Public Health, 13(1): 1–13 <http://dx.doi.org/10.1186/1471-2458-13-1015>.
Fewtrell, L., Kaufmann, R., Kay, D., Enanoria, W., Haller, L. and Colford, J. (2005) ‘Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis’, The Lancet Infectious Diseases, 5(1): 42–52 <http://dx.doi.org/10.1016/S1473-3099(04)01253-8>.
Frias, J. and Mukherjee, N. (2005) ‘Harnessing market power for rural sanitation’, Field Note, Jakarta: World Bank Water and Sanitation Program.
Jenkins, M. and Curtis, V. (2005) ‘Achieving the good life: Why some people want latrines in rural Benin’, Social Science & Medicine, 61(11): 2446–59 <http://dx.doi.org/10.1016/j.socscimed.2005.04.036>.
Jenkins, M. and Scott, B. (2007) ‘Behavioral indicators of household decision-making and demand for sanitation and potential gains from social marketing in Ghana’, Social Science & Medicine, 64(12): 2427–42 <http://dx.doi.org/10.1016/j.socscimed.2007.03.010>.
Joint Monitoring Programme (JMP) (2014) Progress on Drinking Water and Sanitation: 2014 Update, Geneva: World Health Organization and UNICEF.
Mara, D., Lane, J., Scott, B. and Trouba, D. (2010) ‘Sanitation and health’, PLoS Med, 7(11): e1000363 <http://dx.doi.org/10.1371/journal.pmed.1000363>.
Mosler, H. (2012) ‘A systematic approach to behavior change interventions for the water and sanitation sector in developing countries: a conceptual model, a review, and a guideline’, International Journal of Environmental Health Research, 22(5): 431–49 <http://dx.doi.org/10.1080/09603123.2011.650156>.
Nelson, K., Karver, J., Kullman, C. and Graham, J. (2014) ‘User perceptions of shared sanitation among rural households in Indonesia and Bangladesh’, PLoS ONE, 9(8): e103886 <http://dx.doi.org/10.1371/journal.pone.0103886>.
Nimoh, F., Poku, K., Ohene-Yankyera, K., Konradsen, F., and Abaidoo, R.C. (2014) ‘Households latrine preference and financing mechanisms in peri-urban Ghana’, Journal of Economics and Sustainable Development, 5(16): 63–73.
O’Brien, R.M. (2007) ‘A caution regarding rules of thumb for variance inflation factors’, Quality & Quantity, 41(5): 673–90 <http://dx.doi.org/10.1007/s11135-006-9018-6>.
O’Connell, K. (2015) ‘What influences open defecation and latrine ownership’, Learning Note [online] Washington, DC: World Bank Water and Sanitation Program <http://www.wsp.org/sites/wsp.org/files/publications/WSP-What-Influences-Open-Defecation-Global-Sanitation-Review.pdf> [accessed 11 March 2015].
O’Connell, K.A. and Devine, J. (2014) ‘Factors associated with latrine use and ownership among rural populations: findings from a desk review and analysis of multi-country formative research studies’, Water and Health Conference, University of North Carolina <http://whconference.unc.edu/files/2014/11/devine-2.pdf> [accessed 6 April 2015].
O’Connell, K. and Skevington, S. (2012) ‘An international quality of life instrument to assess wellbeing in adults who are HIV-positive: a short form of the WHOQOL-HIV (31 items)’, AIDS and Behavior, 16(2): 452–60 <http://dx.doi.org/10.1007/s10461-010-9863-0>.
O’Reilly, K. (2010) ‘Combining sanitation and women’s participation in water supply: an example from Rajasthan’, Development in Practice, 20(1): 45–56 <http://dx.doi.org/10.1080/09614520903436976>.
O’Reilly, K. and Louis, E. (2014) ‘The toilet tripod: Understanding successful sanitation in rural India’, Health & Place, 29: 43–51 <http://dx.doi.org/10.1016/j.healthplace.2014.05.007>.
Pullan, R., Freeman, M., Gething, P. and Brooker, S. (2014) ‘Geographical inequalities in use of improved drinking water supply and sanitation across sub-Saharan Africa: Mapping and spatial analysis of cross-sectional survey data’, PLoS Med, 11(4): e1001626 <http://dx.doi.org/10.1371/journal.pmed.1001626>.
Rutstein, S.O. and Johnson, K. (2004) The DHS Wealth Index, DHS Comparative Reports No. 6, Calverton, MD: ORC Macro.
Sara, S. and Graham, J. (2014) ‘Ending open defecation in rural Tanzania: Which factors facilitate latrine adoption?, International Journal of Environmental Research and Public Health, 11(9): 9854–70 <http://dx.doi.org/10.3390/ijerph110909854>.
Shakya, H., Christakis, N. and Fowler, J. (2015) ‘Social network predictors of latrine ownership’, Social Science and Medicine 125: 129–38 <http://dx.doi.org/10.1016/j.socscimed.2014.03.009>.
Streiner, D. and Norman, G. (1994) Health Measurement Scales, Oxford: Oxford University Press.
Thys, S., Mwape, K., Lefevre, P., Dorny, P., Marcotty, T., Phiri, A., Phiri, I. and Gabriel, S. (2015) ‘Why latrines are not used: communities perceptions and practices regarding latrines in a taenia solium endemic rural area in eastern Zambia’, PLOS Neglected Tropical Diseases, 9(3): e0003570 <http://dx.doi.org/10.1371/journal.pntd.0003570>.
World Bank Water and Sanitation Program (WSP) (2012) Marketing Lessons from Cambodia: A Market-Based Approach to Delivering Sanitation, Washington, DC: World Bank Water and Sanitation Program.
Yimam, Y., Gelaye, K. and Chercos, D. (2014) ‘Latrine utilization and associated factors among people living in rural areas of Denbia district, northwest Ethiopia, 2013, a cross-sectional study’, Pan African Medical Journal, 18: 1–10 <http://dx.doi.org/10.11604/pamj.2014.18.334.4206>.
Devine, J. (2009) ‘Introducing SaniFOAM: a framework to analyze sanitation behaviors to design effective sanitation programs’, Washington, DC: World Bank Water and Sanitation Program.
Dreibelbis, R., Winch, P., Leontsini, E., Hulland, K., Ram, P., Unicomb, L. and Luby, S. (2013) ‘The integrated behavioural model for water, sanitation, and hygiene: a systematic review of behavioural models and a framework for designing and evaluating behaviour change interventions in infrastructure-restricted settings’, BMC Public Health, 13(1): 1–13 <http://dx.doi.org/10.1186/1471-2458-13-1015>.
Fewtrell, L., Kaufmann, R., Kay, D., Enanoria, W., Haller, L. and Colford, J. (2005) ‘Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis’, The Lancet Infectious Diseases, 5(1): 42–52 <http://dx.doi.org/10.1016/S1473-3099(04)01253-8>.
Frias, J. and Mukherjee, N. (2005) ‘Harnessing market power for rural sanitation’, Field Note, Jakarta: World Bank Water and Sanitation Program.
Jenkins, M. and Curtis, V. (2005) ‘Achieving the good life: Why some people want latrines in rural Benin’, Social Science & Medicine, 61(11): 2446–59 <http://dx.doi.org/10.1016/j.socscimed.2005.04.036>.
Jenkins, M. and Scott, B. (2007) ‘Behavioral indicators of household decision-making and demand for sanitation and potential gains from social marketing in Ghana’, Social Science & Medicine, 64(12): 2427–42 <http://dx.doi.org/10.1016/j.socscimed.2007.03.010>.
Joint Monitoring Programme (JMP) (2014) Progress on Drinking Water and Sanitation: 2014 Update, Geneva: World Health Organization and UNICEF.
Mara, D., Lane, J., Scott, B. and Trouba, D. (2010) ‘Sanitation and health’, PLoS Med, 7(11): e1000363 <http://dx.doi.org/10.1371/journal.pmed.1000363>.
Mosler, H. (2012) ‘A systematic approach to behavior change interventions for the water and sanitation sector in developing countries: a conceptual model, a review, and a guideline’, International Journal of Environmental Health Research, 22(5): 431–49 <http://dx.doi.org/10.1080/09603123.2011.650156>.
Nelson, K., Karver, J., Kullman, C. and Graham, J. (2014) ‘User perceptions of shared sanitation among rural households in Indonesia and Bangladesh’, PLoS ONE, 9(8): e103886 <http://dx.doi.org/10.1371/journal.pone.0103886>.
Nimoh, F., Poku, K., Ohene-Yankyera, K., Konradsen, F., and Abaidoo, R.C. (2014) ‘Households latrine preference and financing mechanisms in peri-urban Ghana’, Journal of Economics and Sustainable Development, 5(16): 63–73.
O’Brien, R.M. (2007) ‘A caution regarding rules of thumb for variance inflation factors’, Quality & Quantity, 41(5): 673–90 <http://dx.doi.org/10.1007/s11135-006-9018-6>.
O’Connell, K. (2015) ‘What influences open defecation and latrine ownership’, Learning Note [online] Washington, DC: World Bank Water and Sanitation Program <http://www.wsp.org/sites/wsp.org/files/publications/WSP-What-Influences-Open-Defecation-Global-Sanitation-Review.pdf> [accessed 11 March 2015].
O’Connell, K.A. and Devine, J. (2014) ‘Factors associated with latrine use and ownership among rural populations: findings from a desk review and analysis of multi-country formative research studies’, Water and Health Conference, University of North Carolina <http://whconference.unc.edu/files/2014/11/devine-2.pdf> [accessed 6 April 2015].
O’Connell, K. and Skevington, S. (2012) ‘An international quality of life instrument to assess wellbeing in adults who are HIV-positive: a short form of the WHOQOL-HIV (31 items)’, AIDS and Behavior, 16(2): 452–60 <http://dx.doi.org/10.1007/s10461-010-9863-0>.
O’Reilly, K. (2010) ‘Combining sanitation and women’s participation in water supply: an example from Rajasthan’, Development in Practice, 20(1): 45–56 <http://dx.doi.org/10.1080/09614520903436976>.
O’Reilly, K. and Louis, E. (2014) ‘The toilet tripod: Understanding successful sanitation in rural India’, Health & Place, 29: 43–51 <http://dx.doi.org/10.1016/j.healthplace.2014.05.007>.
Pullan, R., Freeman, M., Gething, P. and Brooker, S. (2014) ‘Geographical inequalities in use of improved drinking water supply and sanitation across sub-Saharan Africa: Mapping and spatial analysis of cross-sectional survey data’, PLoS Med, 11(4): e1001626 <http://dx.doi.org/10.1371/journal.pmed.1001626>.
Rutstein, S.O. and Johnson, K. (2004) The DHS Wealth Index, DHS Comparative Reports No. 6, Calverton, MD: ORC Macro.
Sara, S. and Graham, J. (2014) ‘Ending open defecation in rural Tanzania: Which factors facilitate latrine adoption?, International Journal of Environmental Research and Public Health, 11(9): 9854–70 <http://dx.doi.org/10.3390/ijerph110909854>.
Shakya, H., Christakis, N. and Fowler, J. (2015) ‘Social network predictors of latrine ownership’, Social Science and Medicine 125: 129–38 <http://dx.doi.org/10.1016/j.socscimed.2014.03.009>.
Streiner, D. and Norman, G. (1994) Health Measurement Scales, Oxford: Oxford University Press.
Thys, S., Mwape, K., Lefevre, P., Dorny, P., Marcotty, T., Phiri, A., Phiri, I. and Gabriel, S. (2015) ‘Why latrines are not used: communities perceptions and practices regarding latrines in a taenia solium endemic rural area in eastern Zambia’, PLOS Neglected Tropical Diseases, 9(3): e0003570 <http://dx.doi.org/10.1371/journal.pntd.0003570>.
World Bank Water and Sanitation Program (WSP) (2012) Marketing Lessons from Cambodia: A Market-Based Approach to Delivering Sanitation, Washington, DC: World Bank Water and Sanitation Program.
Yimam, Y., Gelaye, K. and Chercos, D. (2014) ‘Latrine utilization and associated factors among people living in rural areas of Denbia district, northwest Ethiopia, 2013, a cross-sectional study’, Pan African Medical Journal, 18: 1–10 <http://dx.doi.org/10.11604/pamj.2014.18.334.4206>.
Devine, J. (2009) ‘Introducing SaniFOAM: a framework to analyze sanitation behaviors to design effective sanitation programs’, Washington, DC: World Bank Water and Sanitation Program.
Dreibelbis, R., Winch, P., Leontsini, E., Hulland, K., Ram, P., Unicomb, L. and Luby, S. (2013) ‘The integrated behavioural model for water, sanitation, and hygiene: a systematic review of behavioural models and a framework for designing and evaluating behaviour change interventions in infrastructure-restricted settings’, BMC Public Health, 13(1): 1–13 <http://dx.doi.org/10.1186/1471-2458-13-1015>.
Fewtrell, L., Kaufmann, R., Kay, D., Enanoria, W., Haller, L. and Colford, J. (2005) ‘Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis’, The Lancet Infectious Diseases, 5(1): 42–52 <http://dx.doi.org/10.1016/S1473-3099(04)01253-8>.
Frias, J. and Mukherjee, N. (2005) ‘Harnessing market power for rural sanitation’, Field Note, Jakarta: World Bank Water and Sanitation Program.
Jenkins, M. and Curtis, V. (2005) ‘Achieving the good life: Why some people want latrines in rural Benin’, Social Science & Medicine, 61(11): 2446–59 <http://dx.doi.org/10.1016/j.socscimed.2005.04.036>.
Jenkins, M. and Scott, B. (2007) ‘Behavioral indicators of household decision-making and demand for sanitation and potential gains from social marketing in Ghana’, Social Science & Medicine, 64(12): 2427–42 <http://dx.doi.org/10.1016/j.socscimed.2007.03.010>.
Joint Monitoring Programme (JMP) (2014) Progress on Drinking Water and Sanitation: 2014 Update, Geneva: World Health Organization and UNICEF.
Mara, D., Lane, J., Scott, B. and Trouba, D. (2010) ‘Sanitation and health’, PLoS Med, 7(11): e1000363 <http://dx.doi.org/10.1371/journal.pmed.1000363>.
Mosler, H. (2012) ‘A systematic approach to behavior change interventions for the water and sanitation sector in developing countries: a conceptual model, a review, and a guideline’, International Journal of Environmental Health Research, 22(5): 431–49 <http://dx.doi.org/10.1080/09603123.2011.650156>.
Nelson, K., Karver, J., Kullman, C. and Graham, J. (2014) ‘User perceptions of shared sanitation among rural households in Indonesia and Bangladesh’, PLoS ONE, 9(8): e103886 <http://dx.doi.org/10.1371/journal.pone.0103886>.
Nimoh, F., Poku, K., Ohene-Yankyera, K., Konradsen, F., and Abaidoo, R.C. (2014) ‘Households latrine preference and financing mechanisms in peri-urban Ghana’, Journal of Economics and Sustainable Development, 5(16): 63–73.
O’Brien, R.M. (2007) ‘A caution regarding rules of thumb for variance inflation factors’, Quality & Quantity, 41(5): 673–90 <http://dx.doi.org/10.1007/s11135-006-9018-6>.
O’Connell, K. (2015) ‘What influences open defecation and latrine ownership’, Learning Note [online] Washington, DC: World Bank Water and Sanitation Program <http://www.wsp.org/sites/wsp.org/files/publications/WSP-What-Influences-Open-Defecation-Global-Sanitation-Review.pdf> [accessed 11 March 2015].
O’Connell, K.A. and Devine, J. (2014) ‘Factors associated with latrine use and ownership among rural populations: findings from a desk review and analysis of multi-country formative research studies’, Water and Health Conference, University of North Carolina <http://whconference.unc.edu/files/2014/11/devine-2.pdf> [accessed 6 April 2015].
O’Connell, K. and Skevington, S. (2012) ‘An international quality of life instrument to assess wellbeing in adults who are HIV-positive: a short form of the WHOQOL-HIV (31 items)’, AIDS and Behavior, 16(2): 452–60 <http://dx.doi.org/10.1007/s10461-010-9863-0>.
O’Reilly, K. (2010) ‘Combining sanitation and women’s participation in water supply: an example from Rajasthan’, Development in Practice, 20(1): 45–56 <http://dx.doi.org/10.1080/09614520903436976>.
O’Reilly, K. and Louis, E. (2014) ‘The toilet tripod: Understanding successful sanitation in rural India’, Health & Place, 29: 43–51 <http://dx.doi.org/10.1016/j.healthplace.2014.05.007>.
Pullan, R., Freeman, M., Gething, P. and Brooker, S. (2014) ‘Geographical inequalities in use of improved drinking water supply and sanitation across sub-Saharan Africa: Mapping and spatial analysis of cross-sectional survey data’, PLoS Med, 11(4): e1001626 <http://dx.doi.org/10.1371/journal.pmed.1001626>.
Rutstein, S.O. and Johnson, K. (2004) The DHS Wealth Index, DHS Comparative Reports No. 6, Calverton, MD: ORC Macro.
Sara, S. and Graham, J. (2014) ‘Ending open defecation in rural Tanzania: Which factors facilitate latrine adoption?, International Journal of Environmental Research and Public Health, 11(9): 9854–70 <http://dx.doi.org/10.3390/ijerph110909854>.
Shakya, H., Christakis, N. and Fowler, J. (2015) ‘Social network predictors of latrine ownership’, Social Science and Medicine 125: 129–38 <http://dx.doi.org/10.1016/j.socscimed.2014.03.009>.
Streiner, D. and Norman, G. (1994) Health Measurement Scales, Oxford: Oxford University Press.
Thys, S., Mwape, K., Lefevre, P., Dorny, P., Marcotty, T., Phiri, A., Phiri, I. and Gabriel, S. (2015) ‘Why latrines are not used: communities perceptions and practices regarding latrines in a taenia solium endemic rural area in eastern Zambia’, PLOS Neglected Tropical Diseases, 9(3): e0003570 <http://dx.doi.org/10.1371/journal.pntd.0003570>.
World Bank Water and Sanitation Program (WSP) (2012) Marketing Lessons from Cambodia: A Market-Based Approach to Delivering Sanitation, Washington, DC: World Bank Water and Sanitation Program.
Yimam, Y., Gelaye, K. and Chercos, D. (2014) ‘Latrine utilization and associated factors among people living in rural areas of Denbia district, northwest Ethiopia, 2013, a cross-sectional study’, Pan African Medical Journal, 18: 1–10 <http://dx.doi.org/10.11604/pamj.2014.18.334.4206>.
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