A socio-ecological analysis of barriers to sustained adoption of rural sanitation in Ethiopia, a qualitative study

The objective of the study was to explore barriers influencing the sustained adoption and use of sanitation facilities. A qualitative study was conducted in rural Ethiopia using in-depth interview and focus group discussion techniques. A social-ecological model and IBM-WASH framework were employed for the designing and analysis. Barriers for sustained adoption and use of sanitation facilities were categorized into1)individual level (past latrine experience, lack of demand to improved latrine), 2) household level factors (unaffordability, lack of space and, absence of physically strong family member), 3) community level factors (lack of access to public latrine, lack of shared rules against open defecation, lack of financial access for the poor) and, 4) societal level factors (lack of strong local leadership, flooding, soil condition, lack of appropriate sanitation technology, lack of promotion and demand creation on improved latrine). Hence, there is a need to consider multi-level intervention to address the identified barriers.