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Changing Sanitation Priority: Attitudes before Infrastructure
Written by Maarten Nijhof, Samantha Efrusy and Dr Angela Chaudhuri
Are building toilets really the ticket to solving the problem of open defecation in India? Open defecation is
almost customary in rural India, with over 70% of individuals exercising this practice. Several villages associate
toilets and latrines with being ritually impure, especially if they are located near the household. Often, there is
the endorsement that open defecation is healthier and more enjoyable particularly among the men. For those
who use toilets, have responsibility to empty the latrine, which is an added headache given that there are very
limited facilities available.
India has prioritized sustainable sanitation as a core development goal, striving to achieve more open
defecation free villages and zones. Open defecation is detrimental to public health, causing high mortality and
morbidity rates in children. In order to see a transformation to open defecation free villages in India, behavior
and attitude change need to be prioritized, taking in account culture, beliefs, and education.
Image 1: Village members standing in front of their constructed latrines
As evaluators we examined a long-standing WASH program in one of the northern states in India. The program
included the goal of creating Open Defecation Free villages, or ODF villages as many like to call it. These were
implemented in small villages and hamlets with between 20 to 300 households. The program intervention
included provision of materials for latrine construction and about 10,000 Rupees. We observed that much of
the construction material was left unused, and many latrines were in an incomplete stage of construction for a
long period of time. Some of the latrines were built were never used. Many toilets were built far away from the
homes, and ended up being on rocky terrains, where the pits were only 50 centimeters deep, rendering them
useless. Many did not even have access to water.
The reason for initiating toilet construction in several of the villages seemed to be, aspirational, as a status
symbol, since the neighboring higher caste villages were constructing toilets. They were less inclined to
construct them due to any other reason, as the knowledge and awareness linking to health and sanitation
seemed to be tenuous at best. It was apparent that they did not understand the importance of adequate
sanitation. Even with the monetary incentives, households of several villages did not think it worth their effort to
construct and routinely clean latrines; the idea of cleaning toilets seemed far less culturally acceptable than
open defecation practices. Several households also claimed that they had not received the monetary
incentives on time, and hence halted any construction of latrines. In addition, while latrine construction in
schools and Anganwadi centers were made a priority for the communities, these latrines were frequently seen

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unconstructed, used for storage, or permanently locked. For girls, the
forgotten latrines within schools were extremely detrimental to their
attendance. Many girls, at the start of menstruation, would drop out
because they had nowhere to maintain the necessary hygiene.
Figure 2: Latrine in Aganwadi center used for roof tile storage
Fortunately, there were some villages that did successfully become
open defecation free. In these villages, behavior change was obvious
and it was apparent that the community members understood the
benefits of using a latrine. The latrines were well maintained, even if
they were not built to prescribed standards. The community members
exhibited a sense of pride and there was excitement over latrine use.
Before program implementation, it was understood that the conversion
to open defecation free would be difficult as many community
members had been accustomed to open defecation for their entire
lives, and had never used a toilet or latrine.
Behavior change is a daunting task. It would be nice to think that the simple infrastructure of a latrine could
cause behavior change and fix the open defecation problem, but that is too ideal. Behavior and attitude change
is essential for a successful conversion to open defecation free, and a monetary incentive is clearly not the
silver bullet. Future interventions need to take in account the pre-existing cultures and conditions, terrain, and
willingness from the community. Why are some villages more successful in terms of sanitation than others?
What are some strategies they adopted to get most if not all the households to change their sanitation
behaviors?
Whatever the strategies are, in order for investments on infrastructure to have any impact, one must invest and
prioritize awareness followed by behavior change for the chance of any impact on sustainable sanitation.
Something to mull over: If you have seen successful sanitation program, what do you think are some of the
pre-existing conditions for successful behavior change? Why do you think some villages have been successful
at making themselves open defecation free than the others, and how can we utilize this information to achieve
maximum impact from investments in sanitation.
Please email queries, and inputs to: contactus@swasti.org