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The study aims to assess whether a multi-level community intervention can increase latrine use in communities that received the intervention compared to those that did not.
Odisha has one of the lowest rates of sanitation coverage in India, with over 50 per cent of rural households in need of latrines. Despite the recent declaration of Puri district being 100 per cent open defecation free, it was found that many of the latrines were being used for unintended purposes.
Findings from this study can inform the government of India's efforts to be open defecation free by 2 October 2019.
- Is latrine use, among people who own a functional latrine that received the intervention, significantly different from people who own a latrine but did not receive the intervention?
- Is latrine construction, among households that do not own a latrine in communities that received the intervention, significantly different from those who do not own a latrine in communities that did not receive the intervention?
- Are behavioural determinant scores (for social norms, abilities, physical opportunity, risk perception, motivation, and self-regulation) significantly different among owners of functional latrines in intervention villages compared to latrine owners in control villages?
- Are behavioural determinant scores associated with latrine use?
The multi-level intervention being evaluated includes community level activities: palla (folk performing art) performance, transect walk, community meetings for men and women, and identification of positive deviant households via banners and a community map. Household-level activities will include: repairs to latrines as appropriate, meetings with latrine owning households to motivate latrine use, and meetings with caregivers of children under age five to encourage safe child faeces disposal.
Theory of change
Formative research and a literature review showed that latrine use in the rural Puri District of Odisha State is influenced by: risk perceptions, ability to use a latrine, social norms, motivations, behavioural self-regulation, and physical opportunity (i.e. presence of a functional latrine in household).
The intervention is expected to have an impact on these behavioural determinants and encourage latrine use. Specifically, the intervention aims to make people aware of risks associated with open defecation and the health benefits of latrine use; instruct individuals as to how to use latrines and potties for safe child faeces disposal; shift social norms around latrine use; motivate latrine use; encourage continued use; and provide facilities (latrine repairs) and hardware (potties, scoops) to enable use by all.
This evaluation uses a randomised controlled trial that includes 66 villages (33 intervention, 33 control villages) in the Puri district of Odisha. Latrine-use data will be collected from all latrine-owning households at baseline and endline. Observations of latrines will be conducted to assess their use and functionality. A subset of 20 households in each village will receive a survey that aims to understand drivers of latrine use behaviour. Qualitative research will be conducted post-endline to understand findings of quantitative research. Six additional villages (3 receiving the intervention, 3 control) will be engaged in qualitative research only to assess the intervention within a few months of delivery.
This study will capture information on age, sex, and caste of all users to determine differences. It will assess capability to access latrines independently and freedom of movement.