Department of Social Geography and Regional Development, Faculty of Science, Charles University, Prague 12843, Czechia.
Xavier Institute of Social Service, Purulia Road, Ranchi, Jharkhand 834001, India.
Sci Total Environ. 2018 Dec 1;643:762-774. doi: 10.1016/j.scitotenv.2018.06.239. Epub 2018 Jun 27.
An estimated 56% of households in rural India defecated in the open in 2015, making India the most significant contributor to the global sanitation burden. This cross-sectional study uses data collected in 2016 from 499 households in rural Jharkhand to understand the constraints of latrine adoption and drivers of sanitation preferences (plans to adopt toilets and willingness to pay for toilets). Focusing on a region with a large tribal population, the study examines two types of predictors, namely structural factors (objective socioeconomic, sociocultural and ecological characteristics) and psychosocial drivers (perceived unaffordability of toilet, hygiene and sanitation knowledge, perceived health risks, attitudes, both descriptive and injunctive social norms, and perceived water stress). We find that structural constraints related to educational, economic and sociocultural inequalities predict toilet ownership. Low sanitation rates can neither be attributed to a lack of expressed demand nor lack of recognition of the disadvantages of open defecation. Similarly, variations in sanitation preferences are neither explained by differences in hygiene and sanitation knowledge nor by understandings of sanitation health risks. We find that perceived unaffordability, attitudes (perceived benefits of toilet and disadvantages of OD) and perceived descriptive social norms are of key importance. This implies a potential for persuasive strategies that manipulate social norms around sanitation, particularly if they simultaneously address perceptions around financial unaffordability of toilets and around the benefits of toilets. Importantly, however, attempts to change sanitation preferences by acting on forces of social (dis)approval (i.e. through perceived injunctive social norms) may be ineffective and generate negative unintended consequences.
2015 年，印度农村约有 56%的家庭随地大小便，使印度成为全球卫生负担的最大贡献者。本横断面研究使用 2016 年在印度恰尔肯德邦农村地区收集的 499 户家庭的数据，了解厕所采用的限制因素和卫生偏好的驱动因素（计划采用厕所和愿意为厕所付费）。该研究专注于一个拥有大量部落人口的地区，考察了两种类型的预测因素，即结构性因素（客观的社会经济、社会文化和生态特征）和心理社会驱动因素（感知厕所不可负担、卫生和环境卫生知识、感知健康风险、态度，包括描述性和指令性社会规范，以及感知水压力）。我们发现，与教育、经济和社会文化不平等相关的结构性约束预测了厕所的拥有情况。低卫生水平既不能归因于缺乏表达的需求，也不能归因于对随地大小便的不利影响缺乏认识。同样，卫生偏好的差异既不能用卫生和环境卫生知识的差异来解释，也不能用对卫生健康风险的理解来解释。我们发现，感知不可负担、态度（感知厕所的好处和随地大小便的坏处）和感知描述性社会规范非常重要。这意味着有潜力采取有说服力的策略来操纵围绕卫生的社会规范，特别是如果这些策略同时解决厕所不可负担和厕所好处方面的看法。然而，重要的是，通过社会（不）认可的力量（即通过感知的指令性社会规范）来改变卫生偏好的尝试可能无效，并产生负面的意外后果。
