Understanding Rural Sanitation Sustainability Through System Dynamics

While there are many indications that the enabling environment for safely managed WASH in Uganda is improving, high-risk practices (open defecation, lack of hand hygiene, use of surface water) persist in rural regions. Among other factors, literacy, poverty, and cultural beliefs are believed to affect rural households’ sanitation behaviors.The purpose of this research was to learn more about rural sanitation dynamics with governance actors (through participatory modeling) and to explore mechanisms (through computer simulations) for sustainably achieving desired sanitation outcomes. We engaged with district-level sanitation actors in three USHA districts to build a System Dynamics model describing the drivers of sanitation coverage over time. Based on the participants’ inputs and the model structure, we generated hypotheses about what type of interventions might be required to reach and sustain universal sanitation at the district level. We found that, once households have adopted improved sanitation, their perception of its value should be directly and continually reinforced. We recommend that sanitation actors consider how systemic, structural changes can be incorporated into programs or policies so that desirable intervention outcomes are maintained through self-reinforcing processes.