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Diffusion and adoption of sanitation facilities among urban poor: navigating challenges

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Abstract

India’s expanding urban slums require sanitation policy expansion to address inadequate infrastructure and growing population living without proper sanitation and hygiene services. This study aims to identify the barriers to sanitation that contribute to inadequate accessibility and adoption of sanitation and hygiene practices in urban slums, while also identifying drivers that can promote the diffusion of sanitation innovation. Objective of this study was achieved by comparing two urban slum populations in Delhi, India, characterized by similar socioeconomic conditions but differing sanitation and hygiene practices. Quantitative and qualitative data were collected through household surveys and interviews with various stakeholders. Statistical analysis was performed to the quantitative data, while a framework based on structural and social barriers was employed for analyzing the qualitative data. Result indicates that segments of the population with similar socioeconomic status may exhibit diverse sanitation and hygiene adoption behaviors due to various social and structural barriers. Social barriers can be effectively addressed through education, training, and awareness programs, while structural barriers require coherent planning and bridging the gap between policy intentions and implementation. Taking a holistic approach, active social participation and empowering slum communities can serve as effective and sustainable strategies for managing inequities. By implementing these measures, it is possible to create a transformative impact and promote equitable access to sanitation and hygiene services in urban slums. This study suggests that policymakers should formulate comprehensive policies or programs to enhance sanitation and hygiene adoption in urban slums, emphasizing the need for a holistic approach to address these barriers effectively.

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Fig. 1
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Fig. 4

Source: Household survey. Note: Chi-Square value and df: Male education (1.363, 3); Female education (1.368, 3): Male occupation: (= 0.368, 3); Female occupation (2.020, 1): Income (3.152, 1). NS: not significant for p > 0.05

Fig. 5

Source: Household survey. Note: Chi-Square value and df: 75.356 and 1. **p < 0.01

Fig. 6

Source: Household survey. Note: Chi-square and df a household or community toilet used by members (75.40, 6); b open defecation pattern—male (22.83, 1); female (56.38, 1); children (46.12, 1)

Fig. 7

Source: Household survey. Note: Chi-square and df a garbage handling/disposal practice (108.767, 3); b drainage cleaning practices: (136.105, 3); c drainage situation: (120.128, 1); d waterlogging nearby: (134.987, 1). **p < 0.001

Fig. 8

Source: Household survey. Note: Chi-Square value and df a sources of water for drinking and domestic purposes (0.268, 2); b use of product for handwashing (77.007, 4). NS not significant for p > 0.05, ***p < 0.001

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References

  • Aboud FE, Singla DR (2012) Challenges to changing health behaviours in developing countries: a critical overview. Soc Sci Med S0277–9536(12):00349–00358

    Google Scholar 

  • Adegbie FF, Ajayi A, Aguguom TA, Otitolaiye ED (2023) Diversification of the economy, tax revenue and sustainable growth in Nigeria. Int J Innov Res Sci Stud 6(1):115–127

    Google Scholar 

  • Appiah-Effah E, Duku GA, Azangbego NY, Aggrey RKA, Gyapong-Korsah B, Nyarko KB (2019) Ghana’s post-MDGs sanitation situation: an overview. J Water Sanit Hygiene Dev 9(3):397–415

    Google Scholar 

  • Ayran G, Köse S, Sarıalioğlu A, Çelebioğlu A (2022) Hand hygiene and mask-wearing behaviors and the related factors during the COVID 19 pandemic: a cross-sectional study with secondary school students in Turkey. J Pediatr Nurs 62:98–105

    Google Scholar 

  • Behera MR, Pradhan HS, Behera D, Jena D, Satpathy SK (2021) Achievements and challenges of India’s sanitation campaign under clean India mission: a commentary. J Educ Health Promot 10:1

    CAS  Google Scholar 

  • Bell K, Fahmy E, Gordon D (2016) Quantitative conversations: the importance of developing rapport in standardised interviewing. Qual Quant 50:193–212

    Google Scholar 

  • Bhuiyan MI, Haque A (2023) Role of NGOs in providing available and affordable health care services to the slum people in Dhaka. Clin Epidemiol Global Health 2023:101478

    Google Scholar 

  • Buttenheim AM (2008) The sanitation environment in urban slums: implications for child health. Popul Environ 30:26–47

    Google Scholar 

  • Carrard N, Pedi D, Willetts J, Powell B (2009) Non-government organisation engagement in the sanitation sector: opportunities to maximise benefits. Water Sci Technol 60(12):3109–3119

    CAS  Google Scholar 

  • Chathuranika IM, Sachinthanie E, Zam P, Gunathilake MB, Denkar D, Muttil N, Rathnayake U (2023) Assessing the water quality and status of water resources in urban and rural areas of Bhutan. J Hazardous Mater Adv 2023:100377

    Google Scholar 

  • Coffey D, Spears D, Vyas S (2017) Switching to sanitation: understanding latrine adoption in a representative panel of rural Indian households. Soc Sci Med 1982(188):41–50. https://doi.org/10.1016/j.socscimed.2017.07.001

    Article  Google Scholar 

  • Crocker J, Saywell D, Bartram J (2017) Sustainability of community-led total sanitation outcomes: evidence from Ethiopia and Ghana. Int J Hygiene Environ Health 220(3):551

    Google Scholar 

  • Dearing JW, Cox JG (2018) Diffusion of innovations theory, principles, and practice. Health Aff 37(2):183–190

    Google Scholar 

  • Edmonds-Wilson SL, Nurinova NI, Zapka CA, Fierer N, Wilson M (2015) Review of human hand microbiome research. J Dermatol Sci 80(1):3–12

    Google Scholar 

  • Gayawan E, Somo-Aina O, Kuti O (2023) Analysis of the space-time trends in open defecation in Nigeria. Environ Sci Pollut Res 2023:1–12

    Google Scholar 

  • Gupta A, Sengar M, Manar M, Bansal U, Singh SK, Sengar M, Singh SK (2023) Tracking Water, sanitation, and hygiene practices: waste management and environmental cleaning in the slums of North India. Cureus 15(7):1

    Google Scholar 

  • Hammarberg K, Kirkman M, Lacey S (2016) Qualitative research methods: when to use them and how to judge them. Hum Reprod 31(3):498–501

    CAS  Google Scholar 

  • Harter M, Lilje J, Mosler HJ (2019) Role of implementation factors for the success of community-led total sanitation on latrine coverage. A case study from rural Ghana. Environ Sci Technol 53(9):5466–5472

    CAS  Google Scholar 

  • Howaldt J, Kopp R, Schwarz M (2013) Social innovations as drivers of social change—Tarde’s disregarded contribution to Social innovation Theory Building. Technische Universität Dortmund, Germany

    Google Scholar 

  • Hueso A, Bell B (2013) An untold story of policy failure: the Total Sanitation Campaign in India. Water Policy 15:1001–1017

    Google Scholar 

  • Jenkins MW, Curtis V (2006) Achieving the “good life”: why some people want latrines in rural Benin. Soc Sci Med 61(11):2446–2459

    Google Scholar 

  • Jones GE (1963) The diffusion of agricultural innovations. J Agric Econ 15(3):287–409

    Google Scholar 

  • Kadam P, Bhalerao S (2010) Sample size calculation. Int J Ayurveda Res 1(1):55–57

    Google Scholar 

  • Kanungo S, Chatterjee P, Saha J, Pan T, Chakrabarty ND, Dutta S (2021) Water, sanitation, and hygiene practices in urban slums of Eastern India. J Infect Dis 224(Supplement_5):S573–S583

    Google Scholar 

  • Kapur A, Deshpande D (2018) Swachh Bharat mission-Gramin. Budget Brief. Account Initiat 10(3):1

    Google Scholar 

  • Kotoku G, Kumasi TC (2022) Rethinking the sustainability of rural water delivery under the community ownership and management model. Sustain Water Resour Manag 8(5):164

    Google Scholar 

  • Liu X, Burnett D (2022) Insider-outsider: methodological reflections on collaborative intercultural research. Human Soc Sci Commun 9(1):1–8

    Google Scholar 

  • Manisha M (2015) Swachh Bharat: a scheme or dream. Indian J Occupat Environ Med 19(1):66

    Google Scholar 

  • Manisha M (2016) Sustainable sanitation for India. J Public Health Policy 37(1):121–122

    Google Scholar 

  • Manisha M, Verma K, Ramesh N, Anirudha TP, Santrupt RM, Rao L (2023) Water, sanitation, and hygiene implications of large-scale recycling of treated municipal wastewater in semi-arid regions. Sci Total Environ 904:166631

    CAS  Google Scholar 

  • Mara D, Lane J, Scott B, Trouba D (2010) Sanitation and health. PLoS Med 7(11):e1000363

    Google Scholar 

  • Maruta E, Matsa M, Mupepi O, Dzawanda B (2023) Water safety and associated public health impacts in upcoming and informal urban settlements in Zimbabwe: case of Amsterdam Park in Harare. Sustain Water Resour Manag 9(5):138

    Google Scholar 

  • McHugh ML (2013) The chi-square test of independence. Biochem Med 23(2):143–149

    CAS  Google Scholar 

  • McPherson M, Smith-Lovin L, Cook JM (2001) Birds of a feather: homophily in social networks. Ann Rev Sociol 27(2):415–444

    Google Scholar 

  • Melville N, Ramirez R (2008) Information technology innovation diffusion: an information requirements paradigm. Inf Syst J 18:247–273

    Google Scholar 

  • Milan BF (2017) Clean water and sanitation for all: interactions with other sustainable development goals. Sustain Water Resour Manag 3(4):479–489

    Google Scholar 

  • Mittal S, Ahlgren EO, Shukla PR (2018) Barriers to biogas dissemination in India: a review. Energy Policy 112:361–370

    CAS  Google Scholar 

  • Nayar R, Patel R (2021) Rural water quality monitoring and exploring low-cost treatment technology with water hyacinth. Edelweiss Appl Sci Technol 5(1):9–13

    Google Scholar 

  • Nirmalkumar K, Sivasankar V (2022) Sanitation and hand washing behavior of urban slum dwellers in Vellore Corporation of Tamil Nadu, India: during coronavirus disease. MGM J Med Sci 9(4):553–559

    Google Scholar 

  • Pandya MN, Shukla PS (2018) Role of women led sanitation in community development. J Content Commun Commun 7(4):1

    Google Scholar 

  • Petry JF, Sebastião SA, Martins EG (2019) Innovation and the diffusion of technology in agriculture in floodplains in the State of Amazonas. Rev Adm Contemp 23(5):1

    Google Scholar 

  • Pickering AJ, Djebbari H, Lopez C, Coulibaly M, Alzua ML (2015) Effect of a community-led sanitation intervention on child diarrhoea and child growth in rural Mali: a cluster-randomised controlled trial. Lancet Glob Health 3(11):e701–e711

    Google Scholar 

  • Qamar K, Nchasi G, Mirha HT, Siddiqui JA, Jahangir K, Shaeen SK, Essar MY (2022) Water sanitation problem in Pakistan: a review on disease prevalence, strategies for treatment and prevention. Ann Med Surg 2022:104709

    Google Scholar 

  • Ramani SV (2019) On consortium driven sanitation interventions to end open defecation: insights from an Indian village study. Innov Develop 10(2):245–261

    Google Scholar 

  • Ramani SV, SadreGhazi S, Gupta S (2017) Catalysing innovation for social impact: the role of social enterprises in the Indian sanitation sector. Technol Forecast Soc Chang 121:216–227

    Google Scholar 

  • Rao SS (2009) Role of ICTS in India rural communities. J Commun Inform 5(1):1

    Google Scholar 

  • Rivas S, Hernandez R, Jose JL (2003) Evaluation and prediction of noise pollution levels in urban areas of Cdiz. J Acoust Soc Am 114(2439):1

    Google Scholar 

  • Routray P, Schmidt WP, Boisson S, Clasen T, Jenkins MW (2015) Socio-cultural and behavioural factors constraining latrine adoption in rural coastal Odisha: an exploratory qualitative study. BMC Public Health 10(15):1

    Google Scholar 

  • Routray P, Torondel B, Clasen T, Schmidt WF (2017) Women’s role in sanitation decision making in rural coastal Odisha. India Plos One 12(5):e0178042

    Google Scholar 

  • Roy D, Palavalli B, Menon N, King R, Pfeffer K, Less M, Sloot MAP (2018) Survey-based socio-economic data from slums in Bangalore, India. Sci Data 170200(5):1

    Google Scholar 

  • Sahin I (2006) Detailed review of Rogers’ diffusion of innovations theory and educational technology-related studies based on Rogers’ theory. Turk Online J Educ Technol TOJET 5(2):14–23

    Google Scholar 

  • Saleem MS (2018) Modified Kuppuswamy scale updated for year, 2018. Community Med 7(3):435–436

    Google Scholar 

  • Sara S, Graham J (2014) Ending open defecation in rural Tanzania: which factors facilitate latrine adoption?. Int J Environ Res Public Health 11(9):9854–9870

    Google Scholar 

  • Saxena S, Saxena AK (2018) Pan in the Van: an innovative women-centric approach for inclusive water, sanitation, and hygiene services. Sustain Water Resour Manag 4:761–766

    Google Scholar 

  • Sharma AK (2009) National rural health mission: time to take stock. Indian J Community Med 34(3):175–182

    Google Scholar 

  • Shrestha A, Bhattarai TN, Acharya G, Timalsina H, Marks SJ, Uprety S, Paudel SR (2023) Water, sanitation, and hygiene of Nepal: status, challenges, and opportunities. ACS ES&T Water 3(6):1429–1453

    CAS  Google Scholar 

  • Sigler R, Mahmoudi L, Graham JP (2014) Analysis of behavioral change techniques in community-led total sanitation programs. Health Promot Int 30(1):1–13

    Google Scholar 

  • Singh S, Jayaram R (2022) Attainment of water and sanitation goals: a review and agenda for research. Sustain Water Resour Manag 8(5):146

    Google Scholar 

  • Vliet BJM, Spaargaren G, Oosterveer P (2011) Sanitation under challenge: contributions from the social sciences. Water Policy 13:797–809

    Google Scholar 

  • Wu X, Schuyler R, Peri R (2016) Public–private partnerships (PPPs) in water and sanitation in India: lessons from China. Water Policy 18(S1):1

    Google Scholar 

  • Zeng C, Deng X, Dong J, Hu P (2016) Urbanization and sustainability: comparison of the processes in “BIC” countries. Sustainability 8(400):1

    CAS  Google Scholar 

  • Zhang X, Yu P, Yan J, Ton AM, Spil I (2015) Using diffusion of innovation theory to understand the factors impacting patient acceptance and use of consumer e-health innovations: a case study in a primary care clinic. BMC Health Serv Res 15(71):1

    Google Scholar 

  • Zuin V, Delaire C, Peletz R, Esteb AC, Khush R, Albert J (2019) Policy diffusion in the rural sanitation sector: lessons from community-led total sanitation (CLTS). World Dev 124:104643

    Google Scholar 

  • Akram M (2015) Sociology of sanitation, 1st edn. Kalpaz Publications, London. ISBN-10:&nbsp;9351281566

  • Banerjee A, Chandrasekhar AG, Duflos E, Jackson MO (2019) Using gossips to spread information: theory and evidence from two randomized controlled trials. Available at: http://stanford.edu/~arungc/BCDJ_gossip.pdf

  • Banerjee T, Mandal K (2011) Revisiting the Midnapore model after ten years of total sanitation campaign in India. Available from: SSRN:&nbsp;https://ssrn.com/abstract=1768687&nbsp;or&nbsp;https://doi.org/10.2139/ssrn.1768687Gellert

  • Bhattacherjee A (2012) Social science research: principles, methods, and practices. Textbooks Collection. 3. http://scholarcommons.usf.edu/oa_textbooks/3

  • Briceño B, Coville A, Martinez S (2015) Promoting handwashing and sanitation: evidence from a large-scale randomized trial in rural Tanazania, in policy research working paper; no WPS 7164; Impact evaluation series. World Bank Group, Washington, DC

  • Cain M, Mittman R (2002). Diffusion of innovation in health care. California health care foundation. Available at: http://www.ehealthstrategies.com/files/diffusionofinnovation.pdf

  • Dangah MM (2012) The role of NGOs in the provision of water and sanitation in northern Ghana: the case of pronet in the Nadowli district. Available at: http://ir.knust.edu.gh/bitstream/123456789/6217/1/MURIEL%20MAVIS%20DANGAH.pdf

  • Dickson E, Baker JL, Hoornweg D, Tiwari A (2012) Urban risk assessments: understanding disaster and climate risk in cities. World Bank Publications, The World Bank, number 12356

  • DUSIB (Delhi Urban Shelter Improvement Board) (2020) Housing. Available at: https://delhishelterboard.in/main/wp-content/uploads/2021/02/Plan-Write-up-DUSIB-2020-21-Housing.pdf

  • Hanlin R (2016) Health system strengthening rethinking the role of innovation. Globelics Book

  • Hopson B, Adams P (1976) Transition: understanding and managing personal change. In: Psychology for social workers. Psychology for Professional Groups. Palgrave Macmillan, Londo

  • Kapur A, Malhotra S (2020) Swachh Bharat Mission-Gramin (SBM-G): GOI, 2020-21. Budget Brief. Accountability initiative. Centre for Policy Research. Available at: https://cprindia.org/wp-content/uploads/2021/12/SBM-G-2020-21-1.pdf

  • Lewis R (1952) Edwin chadwick and the public health movement (Online). London: Longmans. Available from: https://www.researchgate.net/publication/308609164_Journal_of_Environmental_Health_Research

  • Manasi S, Latha N, Hemalatha R (2017) Sanitation challenges of the poor in urban and rural settings: case studies of Bengaluru City and rural North Karnataka. MERIT Working Papers&nbsp;026, United Nations University—Maastricht Economic and Social Research Institute on Innovation and Technology (MERIT)

  • Manisha M (2018) SDG-6 in India: challenges and innovation for sustainable sanitation. The Global Network for Economics of Learning, Innovation, and Competence Building System

  • Miller RL (2015) Rogers' innovation diffusion theory (1962, 1995). In: Information seeking behavior and technology adoption: theories and trends. IGI Global, London, pp 261–274

  • Murray R, Caulier-Grice J, Mulgan J (2010) The open book of social innovation, the process of social innovation, p 11. Available at: https://youngfoundation.org/wp-content/uploads/2012/10/The-Open-Book-of-Social-Innovationg.pdf

  • NIUA (National Institute of Urban Affair) (2015) Urban water supply and sanitation in Indian cities. Available from: https://pearl.niua.org/sites/default/files/books/GP-IN2_WATSAN.pdf

  • Rathnayke U, Srishantha U (2017) Sustainable urban drainage systems (SUDS)—What it is and where do we stand today? Eng Appl Sci Res 44(4):235–241. Retrieved from https://ph01.tci-thaijo.org/index.php/easr/article/view/76289

  • Rogers EM (2003) Diffusion of innovation, 3rd edn. Free Press, New York. Available at: file:///E:/Globelics/everett-m-rogers-diffusion-of-innovations.pdf

  • Sadanand N (2019) The Swachh Bharat Mission has built toilets but failed to get people to use them. Available at: https://scroll.in/article/939096/the-swachh-bharat-mission-has-built-toilets-but-failed-to-get-people-to-use-them

  • Sheikh S, Banda S, Mandelkern B (2023) Planning the slum: JJC resettlement in Delhi and the case of Savda Ghevra’. A report of the Cities of Delhi project, Centre for Policy Research, New Delhi. Available at: https://cprindia.org/wp-content/uploads/2021/12/JJC-Resettlement-in-Delhi-and-the-Case-of-Savda-Ghevra.pdf

  • Tsitsifli S, Kanakoudis V (2008) Best practices of PPP projects in the water services sector. In: Conference: 3rd international conference “management of international business & economics systems”, Larissa/Greece

  • Unicef (2023) Sanitation. Available at: https://data.unicef.org/topic/water-and-sanitation/sanitation/

  • WHO (2010) A conceptual framework for action on the social determinants of health, part-II (Online). World Health Organization. Available at: http://www.who.int/sdhconference/resources/ConceptualframeworkforactiononSDH_eng.pdf

  • World Bank Data Base (2023) Sanitation indicators. Available at: https://data.worldbank.org/indicator/SH.STA.BASS.ZS

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Acknowledgements

Financial support from the Council of Scientific and Industrial Research-Human Resource Development Group (CSIR-HRDG) for providing a research fellowship to the corresponding author are gratefully acknowledged. Corresponding author is grateful for the invaluable institutional guidance and support from the Academy of Scientific and Innovative Research (AcSIR) and CSIR – National Institute of Science Communication and Policy Research New Delhi, India during my doctoral studies, which significantly contributed to the findings presented in this paper.

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  1. Centre for Sustainable Technologies, Indian Institute of Science, Bengaluru, India

    Manjari Manisha

  2. Academy of Scientific and Innovative Research (AcSIR), CSIR – National Institute of Science Communication and Policy Research, New Delhi, India

    Y. Madhavi

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Manisha, M., Madhavi, Y. Diffusion and adoption of sanitation facilities among urban poor: navigating challenges. Sustain. Water Resour. Manag. 10, 64 (2024). https://doi.org/10.1007/s40899-024-01046-x

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