Behavioural Systems Mapping of Solid Waste Management in Kisumu, Kenya, to Understand the Role of Behaviour in a Health and Sustainability Problem.

Poor solid waste management in Kisumu, Kenya, contributes to adverse health, social, and environmental outcomes as a result of open burning, illegal dumping, and reliance on landfills. Taking Kisumu as a case study, we use behavioural systems mapping (BSM) for the purpose of understanding the role of behaviour in this complex problem. We qualitatively analysed transcripts from focus groups and interviews with 45 stakeholders in Kisumu to construct a BSM of the perceived actors, behaviours, and behavioural influences affecting waste management, as well as causal links. Influences were analysed using the capability, opportunity, and motivation model of behaviour (COM-B). The resulting BSM connects 24 behaviours by 12 different actors and 49 unique influences (30 related to opportunity, 16 to motivation, and 3 to capability). It reflects three sub-systems: policy-making, public waste management, and the policy-public interface. Six key feedback loops are described, which suggest that cycles of underfunding are interlinked with problematic practices around the build-up, handling, and segregation of waste and conflicting public and political views around responsibility. We demonstrate how the BSM method can be used with transcript data and provide steps that others can follow to inform the design of systemic behaviour change interventions. Further research to validate and adapt this approach may extend the learnings to other countries and health and sustainability challenges.