Beliefs, Behaviors, and Perceptions of Community-Led Total Sanitation and Their Relation to Improved Sanitation in Rural Zambia

The American Journal of Tropical Medicine and Hygiene
J Joseph LawrenceDavidson H Hamer

Abstract

Inadequate hygiene and sanitation remain leading global contributors to morbidity and mortality in children and adults. One strategy for improving sanitation access is community-led total sanitation (CLTS), in which participants are guided into self-realization of the importance of sanitation through activities called "triggering." This qualitative study explored community members' and stakeholders' sanitation, knowledge, perceptions, and behaviors during early CLTS implementation in Zambia. We conducted 67 in-depth interviews and 24 focus group discussions in six districts in Zambia 12-18 months after CLTS implementation. Triggering activities elicited strong emotions, including shame, disgust, and peer pressure, which persuaded individuals and families to build and use latrines and handwashing stations. New sanitation behaviors were also encouraged by the hierarchical influences of traditional leaders and sanitation action groups and by children's opinions. Poor soil conditions were identified as barriers to latrine construction. Taboos, including prohibition of different generations of family members, in-laws, and opposite genders from using the same toilet, were barriers for using sanitation facilities. CLTS, through commun...Continue Reading

Citations

Oct 26, 2016·International Journal of Hygiene and Environmental Health·Carmen AnthonjThomas Kistemann
Jul 13, 2016·The American Journal of Tropical Medicine and Hygiene·Rabson ZimbaDavid A Larsen
Feb 7, 2018·The American Journal of Tropical Medicine and Hygiene·Brie ReidRebecca Stoltzfus
Dec 15, 2017·International Journal of Environmental Research and Public Health·Mitsunori OdagiriYameha T Asamou
Oct 11, 2017·The American Journal of Tropical Medicine and Hygiene·Amy TiwariDavid A Larsen
Jun 6, 2018·The American Journal of Tropical Medicine and Hygiene·Brie ReidRebecca Stoltzfus
Feb 23, 2019·The American Journal of Tropical Medicine and Hygiene·Kojo Yeboah-AntwiDavidson H Hamer
Sep 8, 2017·International Journal of Environmental Health Research·Hans-Joachim Mosler, Ina Lucia Sonego
Jul 18, 2017·International Journal of Environmental Research and Public Health·Josef NovotnýHelena Humňalová
Oct 4, 2020·Global Health, Science and Practice·Eric Sarriot, Ali Nashat Shaar
Aug 25, 2020·The American Journal of Tropical Medicine and Hygiene·Charles Dickens OkolimongAbdullah Ali Halage
Jan 28, 2021·International Journal of Environmental Research and Public Health·Naomi E ClarkeSusana Vaz Nery
Feb 27, 2021·Environmental Science & Technology·Kara StuartCaroline Delaire

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