Rethinking sanitation : adding behavioral change to the project mix

This study makes a case for letting the determination of what behavioral sanitation changes may reasonably be introduced within the cultural and religious milieu of the target community guide the introduction of new water and sanitation technologies. Key to this approach is an ongoing process of gathering extensive data on community sanitation practices and documenting project experiences; such a process provides continuous feedback and enables project staff to tailor activities to evolving needs. A behavioral model is presented for the promotion and implementation of sanitation behavioral change by field workers; the model is in six stages: community assessment; delineation of areas for change and prioritizing of these areas on the basis of epidemiological surveys and discussions with the community; development of intervention strategies; preparation for subsequent interventions; capacity building; and evaluation. The report concludes with recommendations regarding community participation, data collection, and the necessity of providing health and hygiene education in all water and sanitation projects. In sum, the authors advise planners and managers to determine current community behaviors, find out what behavioral changes will prove acceptable, and find ways to implement those changes.