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In many poor slums and rural villages, it is difficult to convince people to stop open defecation and try using indoor facilities, along with other hygienic practices (e.g., washing of hands, safe preparation of food). A combination of factors traps them into this practice, including tradition, lack of awareness about the importance of sanitation, and misconceptions about the costs involved.34 In addition, communities must learn that technologies, even simple ones, are not the monopoly of engineers and technocrats, before they have the confidence to use and manage their sanitation problems.35 For policymakers and program implementers, experience has shown that information, education, and communication (IEC) campaigns involving communities and grassroots organizations can accelerate the process of change and hasten the adoption of sanitary practices. These efforts must include addressing sociocultural attitudes toward owning a household toilet. In many cases, this will require educating SCs and STs, many of whom are illiterate, about the need to use latrines and the importance of hygiene. In this effort, it is important to understand that much of the demand for latrines comes from women, as they are the worst sufferers due to non-availability of these facilities. Women have, by far, the most important influence in determining household hygiene practices and in forming habits of their children.36 Thus, the social marketing of many sanitation programs often start with making house-to-house contact to educate and motivate women in target communities. Messages that appeal to the need for privacy and the social stigma of open defecation have been shown to work.37 Some of the more successful efforts focus on empowering people to analyze their own environment, instead of prescribing the right latrine models or telling people up front that their behavior is unhygienic. This grassroots approach of CLTS helps residents recognize that they need sanitation facilities; that they should mobilize themselves to build their own toilets; and that everyone in the village needs to contribute to make the effort successful, including planning, implementation, and monitoring.38 One innovation is socialized community fund-raising, which has been implemented with great success by Gram Vikas, an NGO that works with the rural poor to improve sanitation (see Box 2). Through its Rural Health and Environment Program (RHEP), the NGO has helped more than 200 rural villages in Orissa acquire good quality toilets and bathrooms, coupled with at least
In this section we discuss our ethnographic evidence that suggests toilet adoption occurs at the intersection of political will, proximate social pressure, and political
During the NGP drive, the majority of households in both WB1 and WB2 could not afford to build toilets. Low-cost plate paikhanas (cement pans with gooseneck trap) were made available for Rs 250 for most households. Below Poverty Line (BPL) households paid even less for them. The low-cost plates were manufactured by the NGOs and subsidized by the panchayat. These low-cost toilets were not people's ideal because their cabins were made of plastic sheeting that needed periodic reconstruction, and their pits were shallow, requiring the digging of a new pit often. However, the plate paikhana was preferred over a khata paikhana (dry pit toilet) and open defecation. One middle-aged Muslim woman who shares a toilet with her large extended family said that a plate paikhana was all they could afford even though they preferred a nicer toilet: “We built a plate paikhana. We are not so rich that we can spend Rs 20,000–25,000 on building a good sanitary paikhana o defecate in the canal.” Improved access to daily water at multiple sources was an important factor contributing to toilet use and adoption in HP. Over the last 30 years, the Irrigation and Public Health Department has worked to ensure better access to water. Water is “lifted” (i.e., pumped) to villages from streams below. Where settlements were at the tail end of a water supply line, their quantity and regularity of supply was negatively impacted. One woman interviewee from HP1 related: “We get an irregular supply of water. We have to get water from the hand pump and spring. The water from the hand pump is used only for the toilet as it is not suitable for drinking.” As this woman’s quote suggests, difficulties with water were not so extreme that people could not use their toilets. Households alleviated their water problems by building or buying large water storage containers, building subsidized rainwater harvesting systems, or collecting water from existing sources and carrying it back to their households.
Despite huge efforts to include the poorest and most marginalized, each study site had households that did not have toilets or struggled to sustain toilet use. These households were poor (i.e., political will), lived at a distance from the main settlement (i.e., proximate social pressure), had trouble accessing water, emptying their pits, and/or lived close to forests or river banks (i.e., political ecology). latrine design, pit emptying, sludge treatment, and the disposal or reuse of waste —have the potential to make sanitation services safe and affordable for everyone
Historically, people have rejected sanitation solutions offered by governments, donors, and NGOs when they are too expensive, unpleasant to use, or difficult to maintain. This makes it essential to invest in affordable, attractive,
Piped sewage systems and wastewater treatment plants serve only a small fraction of those in developing countries, leaving the poor with on-site systems, such as pit latrines, to collect and store their waste. However, waste does not decompose fast enough or completely, so the pits fill up, leading to flies, odors, and unpleasant conditions. Because replacing or emptying full pits is difficult and expensive, many people resort to defecating outdoors, which poses serious health risks and is socially demeaning..
1) Do you have a toilet for you and your family?
2) If No, Where do you go for your toilet requirements?
1. current availability of toilet
2. Number of Members of family that uses the toilet
3. If not available, where to go for toilets. What are factors that guide their natural choice of area. ( water availability, Secluded spot etc)
4. What are the reasons for people not going in for personal household toilets. -women not given enough power for decision making in the family -Money is a Big Problem - People find it difficult to use existing toilets for reasons like
-current toilets not in good shape/structure/ location issues.
- Maintenance of current toilets is a problem. -In general water is a problem. Water not available - Less space available at Home to built. - Preference change is a issue. (People in rural part tend to be sticky with their attitude)
- Are appropriate buckets and other essential items present in toilets or not. What is the frequency of replenishing the Items in the toilet.
- Responsibility/Authority for maintenance of toilets is not clear.
- Pit emptying is a challenge, it requires effort and dirty work, so do people find it easy at initial stages of usage, and when pit fill up , they resort to regular defecation practices. -current healthy sanitation practices the people follow in general. (Like hand washing, water spillage control)

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