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• 1. [Article] Combining Sensor Monitoring and Ethnography to Evaluate Household Latrine Usage in Rural India

  This paper advances research on methods used to evaluate sanitation usage and behavior. The research used quantitative and qualitative methods to contribute to new understanding of sanitation practices ...

  Citation × Citation Citation Abstract Copy Title: Combining Sensor Monitoring and Ethnography to Evaluate Household Latrine Usage in Rural India Author: O'Reilly, Kathleen, Louis, Elizabeth, Thomas, Evan A., Sinha, Antara Year: 2015 This paper advances research on methods used to evaluate sanitation usage and behavior. The research used quantitative and qualitative methods to contribute to new understanding of sanitation practices and meanings in rural India. We estimated latrine usage behavior through ethnographic interviews and sensor monitoring, specifically the latest generation of infrared toilet sensors, Portland State University Passive Latrine Use Monitors (PLUMs). Two hundred and fifty-eight rural households in West Bengal (WB) and Himachal Pradesh, India, participated in the study by allowing PLUMs to be installed in their houses for a minimum of 6 days. Six hundred interviews were taken in these households, and in others, where sensors had not been installed. Ethnographic and observational methods were used to capture the different defecation habits and their meanings in the two study sites. Those data framed the analysis of the PLUM raw data for each location. PLUMs provided reliable, quantitative verification. Interviews elicited unique information and proved essential to understanding and maximizing the PLUM data set. The combined methodological approach produced key findings that latrines in rural WB were used only for defecation, and that low cost, pit latrines were being used sustainably in both study areas. Title: Combining Sensor Monitoring and Ethnography to Evaluate Household Latrine Usage in Rural India Author: O'Reilly, Kathleen, Louis, Elizabeth, Thomas, Evan A., Sinha, Antara Year: 2015 This paper advances research on methods used to evaluate sanitation usage and behavior. The research used quantitative and qualitative methods to contribute to new understanding of sanitation practices and meanings in rural India. We estimated latrine usage behavior through ethnographic interviews and sensor monitoring, specifically the latest generation of infrared toilet sensors, Portland State University Passive Latrine Use Monitors (PLUMs). Two hundred and fifty-eight rural households in West Bengal (WB) and Himachal Pradesh, India, participated in the study by allowing PLUMs to be installed in their houses for a minimum of 6 days. Six hundred interviews were taken in these households, and in others, where sensors had not been installed. Ethnographic and observational methods were used to capture the different defecation habits and their meanings in the two study sites. Those data framed the analysis of the PLUM raw data for each location. PLUMs provided reliable, quantitative verification. Interviews elicited unique information and proved essential to understanding and maximizing the PLUM data set. The combined methodological approach produced key findings that latrines in rural WB were used only for defecation, and that low cost, pit latrines were being used sustainably in both study areas. Close

• 2. [Article] Designing and Piloting a Program to Provide Water Filters and Improved Cookstoves in Rwanda

  Background: In environmental health interventions addressing water and indoor air quality, multiple determinants contribute to adoption. These may include technology selection, technology distribution ...

  Citation × Citation Citation Abstract Copy Title: Designing and Piloting a Program to Provide Water Filters and Improved Cookstoves in Rwanda Author: Barstow, Christina K., Ngabo, Fidele, Rosa, Ghislaine, Majorin, Fiona, Boisson, Sophie, Clasen, Thomas, Thomas, Evan A. Year: 2014 Background: In environmental health interventions addressing water and indoor air quality, multiple determinants contribute to adoption. These may include technology selection, technology distribution and education methods, community engagement with behavior change, and duration and magnitude of implementer engagement. In Rwanda, while the country has the fastest annual reduction in child mortality in the world, the population is still exposed to a disease burden associated with environmental health challenges. Rwanda relies both on direct donor funding and coordination of programs managed by international non-profits and health sector businesses working on these challenges. Methods and Findings: This paper describes the design, implementation and outcomes of a pilot program in 1,943 households across 15 villages in the western province of Rwanda to distribute and monitor the use of household water filters and improved cookstoves. Three key program design criteria include a.) an investment in behavior change messaging and monitoring through community health workers, b.) free distributions to encourage community-wide engagement, and c.) a private-public partnership incentivized by a business model designed to encourage ‘‘pay for performance’’. Over a 5- month period of rigorous monitoring, reported uptake was maintained at greater than 90% for both technologies, although exclusive use of the stove was reported in only 28.5% of households and reported water volume was 1.27 liters per person per day. On-going qualitative monitoring suggest maintenance of comparable adoption rates through at least 16 months after the intervention. Conclusion: High uptake and sustained adoption of a water filter and improved cookstove was measured over a five-month period with indications of continued comparable adoption 16 months after the intervention. The design attributes applied by the implementers may be sufficient in a longer term. In particular, sustained and comprehensive engagement by the program implementer is enabled by a pay-for-performance business model that rewards sustained behavior change. Title: Designing and Piloting a Program to Provide Water Filters and Improved Cookstoves in Rwanda Author: Barstow, Christina K., Ngabo, Fidele, Rosa, Ghislaine, Majorin, Fiona, Boisson, Sophie, Clasen, Thomas, Thomas, Evan A. Year: 2014 Background: In environmental health interventions addressing water and indoor air quality, multiple determinants contribute to adoption. These may include technology selection, technology distribution and education methods, community engagement with behavior change, and duration and magnitude of implementer engagement. In Rwanda, while the country has the fastest annual reduction in child mortality in the world, the population is still exposed to a disease burden associated with environmental health challenges. Rwanda relies both on direct donor funding and coordination of programs managed by international non-profits and health sector businesses working on these challenges. Methods and Findings: This paper describes the design, implementation and outcomes of a pilot program in 1,943 households across 15 villages in the western province of Rwanda to distribute and monitor the use of household water filters and improved cookstoves. Three key program design criteria include a.) an investment in behavior change messaging and monitoring through community health workers, b.) free distributions to encourage community-wide engagement, and c.) a private-public partnership incentivized by a business model designed to encourage ‘‘pay for performance’’. Over a 5- month period of rigorous monitoring, reported uptake was maintained at greater than 90% for both technologies, although exclusive use of the stove was reported in only 28.5% of households and reported water volume was 1.27 liters per person per day. On-going qualitative monitoring suggest maintenance of comparable adoption rates through at least 16 months after the intervention. Conclusion: High uptake and sustained adoption of a water filter and improved cookstove was measured over a five-month period with indications of continued comparable adoption 16 months after the intervention. The design attributes applied by the implementers may be sufficient in a longer term. In particular, sustained and comprehensive engagement by the program implementer is enabled by a pay-for-performance business model that rewards sustained behavior change. Close