The Effect of Latrine Features and Characteristics on Latrine Use in Rural Odisha, India Restricted; Files Only

Koehne, William (Spring 2019)

Permanent URL: https://etd.library.emory.edu/concern/etds/fx719n514?locale=en
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Abstract

Open defecation is common worldwide, being practiced by 892 million people, and is of particular concern in rural India where it is estimated that half of the population practices open defecation. A lack of sanitation and open defecation contribute to a variety of acute and chronic diseases and poor health outcomes. While there have been large scale efforts by the Indian government to improve latrine coverage, these programs often do not have the desired effect on decreasing levels of open defecation, in part due to latrine construction that does not meet the needs or align with the desires of users.

This study is a secondary analysis of the baseline data collected as part of a cluster randomized trial evaluating the impact of an intervention designed to increase latrine use in rural Odisha, India with a household’s latrine being in use as the outcome of interest. 3676 households and their latrines were analyzed using both generalized estimating equation (GEE) multivariate logistic regression and conditional inference trees (CIT), a form of recursive partitioning.

Various latrine characteristics were identified to be associated with a latrine being in use by both multivariate regression and CIT, including the presence of hand washing stations (odds ratio of 2.78, 95% CI: 2.13, 3.62), and doors (odds ratio of 1.98, 95% CI: 1.41, 2.79). The presence of lights inside of the latrine, though not statistically significant in the multivariate analysis (odds ratio of 1.92, 95% CI:0.96, 3.85), was identified by CIT as associated with latrines being in use for certain households. Tiled latrine floors were not identified in CIT, but were associated with a latrine being in use (odds ratio 1.94, 95% CI: 1.19, 3.17) in the multivariate model.

Though some of these latrine characteristics are not necessary for the latrine to hygienically separate feces from humans and the environment, they may be important drivers of latrine use. This study adds to research that show efforts to decrease open defecation should take into account latrine features and improvements that serve the user experience.

Table of Contents

Background ........................................................................................................................................1

Introduction ..................................................................................................................................... 11

Methods .......................................................................................................................................... 13

Results ............................................................................................................................................. 19

Discussion ........................................................................................................................................ 26

Figures ............................................................................................................................................. 32

References ....................................................................................................................................... 33

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