Case studies on promotion of appropriate sanitation systems

In this paper twenty-one case studies are presented in which appropriate sanitation systems for safe excreta disposal have been introduced. The aim is to identify the different methodologies used to promote these systems to the public. From this review of case studies, summary tables have been set up analysing the following factors: initiator of the programme, methods used for promotion, health education, materials used, contributions made by the community, unit of decision, and selection of technology. Seven methodologies have been distinguished in this analysis; namely, sanitation systems or services are sold to the user and the emphasis is on technology, not improved hygienic behaviour; government sets up demonstration areas but only limited attention is paid to the hygiene component; government or NGO contacts the community and offers a predefined programme; government or NGO contacts the community and uses social marketing strategies to identify people's needs and responds to them; government trains private builders and initiates hygiene education programmes; NGO initiates hygiene education programme to promote latrines; and NGO promotes improved health behaviour in the media. The article concludes that in the majority of cases an outside agency contacts a community and offers a package but that project staff is not always assisted by community volunteers and that hygiene education is seen as a separate activity in most programmes. It also points out that social marketing and social mobilization are more effective methods of changing hygiene behaviour than the promise of health benefits.