QUALITATIVE COMPARATIVE ANALYSIS OF WATER AND SANITATION PRACTICES FOR RAISING AWARENESS IN DEVELOPING NATIONS

Abstract

 Diarrheal diseases are still serious in low- to middle-income nations, and consuming inadequate water is suspected as one of the main factors. However, past interventions failed to significantly reduce diarrhea prevalence, as they often could not trigger behavior changes. Therefore, understanding local public health data and community backgrounds are considered important in planning intervention projects. However, few studies have comprehensively analyzed past projects to clarify sufficient practices for raising awareness on water and sanitation. Therefore, this study aims to analyze and propose combinations of practices to sustainably raise awareness on water and sanitation in developing nations, by evaluating ODA projects with crisp-set Qualitative Comparative Analysis (csQCA). Sixteen projects for the outcome of “Behavioral changes towards domestic water consumption”, and 13 for “Sustainable use and management of sanitation facilities” were selected. Eight and 13 causal conditions were also selected, respectively. csQCA examined individual and combinational relationship between each outcome and causal conditions. The results showed 3 potential combinations, with awareness-raising workshops to residents from health promotors being the main measures to be taken, for “Behavioral changes towards domestic water consumption”. Four combinations of practices, including sanitation awareness-raising workshops, education and capacitiy development of facility management committees, were suggested for “Sustainable use and management of sanitation facilities”, Results for both outcomes indicated the necessity for residents’ participation, while education was also an important factor in the latter outcome. These combinations provide multiple options of interventions for stakeholders to consider, depending on their community backgrounds and resources. Furthermore, they also showed the importance of community participation and basic education on sanitation, which both have been widely systemized and conducted in Japan, indicating that our basic governmental and educational systems may also bring about improvements in developing nations.