IDEAS home Printed from https://ideas.repec.org/a/gam/jsusta/v13y2021i10p5440-d553654.html
   My bibliography  Save this article

How Do Rural Communities Sustain Sanitation Gains? Qualitative Comparative Analyses of Community-Led Approaches in Cambodia and Ghana

Author

Listed:
  • Jessica Tribbe

    (The Aquaya Institute, San Anselmo, CA 94960, USA)

  • Valentina Zuin

    (Division of Social Science, Yale-NUS College, Singapore 138527, Singapore)

  • Caroline Delaire

    (The Aquaya Institute, San Anselmo, CA 94960, USA)

  • Ranjiv Khush

    (The Aquaya Institute, San Anselmo, CA 94960, USA)

  • Rachel Peletz

    (The Aquaya Institute, San Anselmo, CA 94960, USA)

Abstract

Community-led Total Sanitation (CLTS) is a popular intervention for eliminating open defecation in rural communities. Previous research has explored the contextual and programmatic factors that influence CLTS performance. Less is known about the community-level conditions that sustain latrine coverage and use. We hypothesized three categories of community conditions underlying CLTS sustainability: (i) engagement of community leaders, (ii) follow-up intensity, and (iii) support to poor households. We evaluated these among communities in Cambodia and Ghana, and applied fuzzy-set Qualitative Comparative Analysis (fsQCA) to identify combinations of conditions that influenced current latrine coverage and consistent latrine use. In Cambodia, latrine coverage was highest in communities with active commune-level leaders rather than traditional leaders, and with leaders who used casual approaches for promoting latrine construction. Latrine use in Cambodia was less consistent among communities with intense commune engagement, higher pressure from traditional leaders, high follow-up and high financial support. In Ghana, by contrast, active leaders, high follow-up, high pro-poor support, and continued activities post-implementation promoted latrine coverage and consistent use. The different responses to CLTS programming emphasize that rural communities do not have homogenous reactions to CLTS. Accounting for community perceptions and context when designing community-led interventions can foster long-term sustainability beyond short-term achievement.

Suggested Citation

  • Jessica Tribbe & Valentina Zuin & Caroline Delaire & Ranjiv Khush & Rachel Peletz, 2021. "How Do Rural Communities Sustain Sanitation Gains? Qualitative Comparative Analyses of Community-Led Approaches in Cambodia and Ghana," Sustainability, MDPI, vol. 13(10), pages 1-23, May.
  • Handle: RePEc:gam:jsusta:v:13:y:2021:i:10:p:5440-:d:553654
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/2071-1050/13/10/5440/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/2071-1050/13/10/5440/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Maria Laura Alzua & Amy Janel Pickering & Habiba Djebbari & Carolina Lopez & Juan Camilo Cardenas & Maria Adelaida Lopera & Nicolas Osbert & Massa Coulibaly, 2015. "Impact Evaluation of Community-led Total Sanitation (CLTS) in Rural Mali," CEDLAS, Working Papers 0191, CEDLAS, Universidad Nacional de La Plata.
    2. Paul Gertler & Manisha Shah & Maria Laura Alzua & Lisa Cameron & Sebastian Martinez & Sumeet Patil, 2015. "How Does Health Promotion Work? Evidence From The Dirty Business of Eliminating Open Defecation," NBER Working Papers 20997, National Bureau of Economic Research, Inc.
    3. Myles Bateman & Susan Engel, 2018. "To shame or not to shame—that is the sanitation question," Development Policy Review, Overseas Development Institute, vol. 36(2), pages 155-173, March.
    4. Cameron, Lisa & Olivia, Susan & Shah, Manisha, 2019. "Scaling up sanitation: Evidence from an RCT in Indonesia," Journal of Development Economics, Elsevier, vol. 138(C), pages 1-16.
    5. Crocker, Jonny & Shields, Katherine F. & Venkataramanan, Vidya & Saywell, Darren & Bartram, Jamie, 2016. "Building capacity for water, sanitation, and hygiene programming: Training evaluation theory applied to CLTS management training in Kenya," Social Science & Medicine, Elsevier, vol. 166(C), pages 66-76.
    6. Cameron, Lisa A. & Olivia, Susan & Shah, Manisha, 2015. "Initial Conditions Matter: Social Capital and Participatory Development," IZA Discussion Papers 9563, Institute of Labor Economics (IZA).
    7. Zuin, Valentina & Delaire, Caroline & Peletz, Rachel & Cock-Esteb, Alicea & Khush, Ranjiv & Albert, Jeff, 2019. "Policy Diffusion in the Rural Sanitation Sector: Lessons from Community-Led Total Sanitation (CLTS)," World Development, Elsevier, vol. 124(C), pages 1-1.
    8. Dale Whittington & Mark Radin & Marc Jeuland, 2020. "Evidence-based policy analysis? The strange case of the randomized controlled trials of community-led total sanitation," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 36(1), pages 191-221.
    9. Jenkins, Marion W. & Scott, Beth, 2007. "Behavioral indicators of household decision-making and demand for sanitation and potential gains from social marketing in Ghana," Social Science & Medicine, Elsevier, vol. 64(12), pages 2427-2442, June.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Augsburg, Britta & Bancalari, Antonella & Durrani, Zara & Vaidyanathan, Madhav & White, Zach, 2022. "When nature calls back: Sustaining behavioral change in rural Pakistan," Journal of Development Economics, Elsevier, vol. 158(C).
    2. Abramovsky, Laura & Augsburg, Britta & Lührmann, Melanie & Oteiza, Francisco & Rud, Juan Pablo, 2023. "Community matters: Heterogeneous impacts of a sanitation intervention," World Development, Elsevier, vol. 165(C).
    3. Cameron, Lisa & Olivia, Susan & Shah, Manisha, 2019. "Scaling up sanitation: Evidence from an RCT in Indonesia," Journal of Development Economics, Elsevier, vol. 138(C), pages 1-16.
    4. Cameron, Lisa & Santos, Paulo & Thomas, Milan & Albert, Jeff, 2021. "Sanitation, financial incentives and health spillovers: A cluster randomised trial," Journal of Health Economics, Elsevier, vol. 77(C).
    5. Revilla, Ma. Laarni D. & Qu, Fangqi & Seetharam, K E & Rao, Bhanoji, 2021. "“Sanitation” in the Top Development Journals: A Review," ADBI Working Papers 1253, Asian Development Bank Institute.
    6. Pakhtigian, Emily L. & Pattanayak, Subhrendu K., 2024. "Social setting, gender, and preferences for improved sanitation: Evidence from experimental games in rural India," World Development, Elsevier, vol. 177(C).
    7. Gautam, Sanghmitra & Gechter, Michael & Guiteras, Raymond P. & Mobarak, Ahmed Mushfiq, 2024. "Encouraging Rural Sanitation Take-up: Insights from Experimental Evaluations of Interventions," CEnREP Working Papers 340057, North Carolina State University, Department of Agricultural and Resource Economics.
    8. Saraswat, Deepak, 2024. "Gender composition of children and sanitation behavior in India," Journal of Environmental Economics and Management, Elsevier, vol. 125(C).
    9. Pakhtigian, Emily L. & Dickinson, Katherine L. & Orgill-Meyer, Jennifer & Pattanayak, Subhrendu K., 2022. "Sustaining latrine use: Peers, policies, and sanitation behaviors," Journal of Economic Behavior & Organization, Elsevier, vol. 200(C), pages 223-242.
    10. Cameron, Lisa & Chase, Claire & Haque, Sabrina & Joseph, George & Pinto, Rebekah & Wang, Qiao, 2021. "Childhood stunting and cognitive effects of water and sanitation in Indonesia," Economics & Human Biology, Elsevier, vol. 40(C).
    11. Ross, Ian & Cumming, Oliver & Dreibelbis, Robert & Adriano, Zaida & Nala, Rassul & Greco, Giulia, 2021. "How does sanitation influence people's quality of life? Qualitative research in low-income areas of Maputo, Mozambique," Social Science & Medicine, Elsevier, vol. 272(C).
    12. Karen Setty & Ryan Cronk & Shannan George & Darcy Anderson & Għanja O’Flaherty & Jamie Bartram, 2019. "Adapting Translational Research Methods to Water, Sanitation, and Hygiene," IJERPH, MDPI, vol. 16(20), pages 1-31, October.
    13. Salinger, Allison P. & Charles, Isabel & Francis, Naomi & Batagol, Becky & Meo-Sewabu, Litea & Nasir, Sudirman & Bass, Audra & Habsji, Hamdan & Malumu, Losalini & Marzaman, Liza & Prescott, Michaela F, 2024. "“People are now working together for a common good”: The effect on social capital of participatory design for community-level sanitation infrastructure in urban informal settlements," World Development, Elsevier, vol. 174(C).
    14. Aziz, Sonia & Boyle, Kevin & Akanda, Ali S. & Hanifi, M.A. & Pakhtigian, Emily L., 2022. "Early Warning Systems, Mobile Technology, and Cholera Aversion: Evidence from Rural Bangladesh," RFF Working Paper Series 22-24, Resources for the Future.
    15. Khurshed Alam & Md. Habibur Rahman, 2019. "Post-disaster recovery in the cyclone Aila affected coastline of Bangladesh: women’s role, challenges and opportunities," Natural Hazards: Journal of the International Society for the Prevention and Mitigation of Natural Hazards, Springer;International Society for the Prevention and Mitigation of Natural Hazards, vol. 96(3), pages 1067-1090, April.
    16. Zuin, Valentina & Delaire, Caroline & Peletz, Rachel & Cock-Esteb, Alicea & Khush, Ranjiv & Albert, Jeff, 2019. "Policy Diffusion in the Rural Sanitation Sector: Lessons from Community-Led Total Sanitation (CLTS)," World Development, Elsevier, vol. 124(C), pages 1-1.
    17. Evan Plous Kresch & Molly Lipscomb & Laura Schechter, 2020. "Externalities and Spillovers from Sanitation and Waste Management in Urban and Rural Neighborhoods," Applied Economic Perspectives and Policy, John Wiley & Sons, vol. 42(3), pages 395-420, September.
    18. Valette, Héloïse & Colon, Marine, 2024. "Institutional change for the development of urban sanitation in the Global South: A social science review," Utilities Policy, Elsevier, vol. 88(C).
    19. Héloïse Valette & Marine Colon, 2024. "Institutional change for the development of urban sanitation in the Global South: A social science review," Post-Print hal-04561473, HAL.
    20. Michael Geruso & Dean Spears, 2018. "Neighborhood Sanitation and Infant Mortality," American Economic Journal: Applied Economics, American Economic Association, vol. 10(2), pages 125-162, April.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jsusta:v:13:y:2021:i:10:p:5440-:d:553654. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.