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Table 4 Reasons for members of households with GOI subsidized latrines to continue open defecation (OD)

From: Socio-cultural and behavioural factors constraining latrine adoption in rural coastal Odisha: an exploratory qualitative study

Topic Men Women
Socialising After the day’s work in the field, some men go to defecate in the fields with (a few) other friends. The male group size is small, 3-4 people at the most, comprising very close friends. Men use the moment for exchanging news and smoking cigarettes. For men, unlike women, going in groups is not a regular practice. Females go for OD in groups, especially in the afternoon/evening time. Group size for OD varies between 6-10 women. Defecation in the open, in groups, twice a day is common, but OD in the evening hours is mostly used for socialising, sharing information and stress release, and they like to take more time at this time of day. Even though some women will not defecate at this time, they still accompany others to the defecation sites, which tend to be farther away from the village. For daughters-in-law, evening OD can be a rare opportunity for them to leave the house and the control/command of their in-laws, and relax from chores.
Purity and health Containing faeces in the latrine pit inside the compound is perceived to be ‘impure’ and considered to be ‘disrespectful’ for the worship shrine at home. People feel latrine pits are the breeding grounds for mosquitoesa. With open defecation, they believe faeces (impurities) are left outside, away from homes and mosquitoes can’t breed. Perceptions regarding impurity are similar to those of men. During the day, women are often confined to the home and remain engaged in chores. They feel by going for open defecation, especially when they have more time in the evening, they can get fresh air and exercise, as this is the only time when women can walk for some distance. Thus, OD is seen as good for health, and walking long distances for defecation is not necessarily regarded as an inconvenience.
Convenience/extra work Men (adults and aged members, mostly the head of the household) are accustomed to going to farms or agricultural land immediately in the morning, after they are awake. All body cleaning activities like defecation and brushing teeth are done outside the house/property. On the way back from agricultural fields, they bathe and wash their clothes and return to the house for food in the afternoon. On account of these factors, using latrines for defecation in the morning does not suit their daily routines. Men are often concerned that the small pit (of subsidised latrines) will fill quickly if used by all family members regularly. They therefore preferred defecating in fields and letting women use the toilet. Emptying the pit was considered by some a constraint for latrine use, as only people belonging to lower caste groups can be engaged to do it. Fetching water for family members for latrine flushing is difficult. Often, the typical source used for personal hygiene is different from that used for drinking water, and is a local surface water body. Drinking water sources like a public tube well or public tap are located in public areas in each village, but these can be at some distance from many houses, making daily transport and storage of sufficient amounts of water necessary to be able to use the latrine at home, unless the household has installed their own private tube-well inside their compound. Daily transport and storage of non-drinking water at home for non-drinking domestic needs, such as bathing or latrine usage, was never observed in any study communities and reported not to be a local practice. Making or helping a child use the latrine and then having to flush it, is considered more time consuming for mothers as it requires extra effort including her own purification after entering the latrine. Therefore, they find it more convenient to have the child defecate in the back yard and throw the child’s faeces into a garbage heap, than to have them use or dispose their faeces in the latrine. Women felt it is more convenient if children defecated on the road side or in fields, and then cleanse themselves in the public pond or another open water body in and around the village. Traditionally, cleaning and maintaining hygiene in the household is a responsibility assigned to women (predominantly). Thus keeping toilets clean is also considered a women’s job, and is seen as adding to their existing household chores.
Structural and design problems (small toilet size, no roof, water availability, etc.) Overall, the construction of government subsidised latrines was of poor qualityb, and in many cases it was not complete. The latrine design intervention delivered was a pour flush latrine cubicle with a single on-set or off-set pit with three cement rings (each 25 cm height), but without a roof or water facility. The covers of latrine pits were of such bad quality that they were quickly damaged. In some case, the door and even the walls of the toilet were missing. For these reasons, both men and women abandoned the toilets. Those with a functional toilet but without a roof, lived with an expectation of receiving funds from the government someday for the roof, and so postponed using the latrine until its construction was completed. Some feared the NGO-sponsored masons when they returned to finish the structure, would not install the roof of a ‘used’ latrine. This prevented some from using the latrine until it was complete. Women prefer using latrines only if they are fully complete, i.e. have a roof, a water point nearby and a door that can be locked from inside. When children start consuming foods (such as rice) beside the mother’s milk, the child’s faeces tends to have an unpleasant odour. Mothers have discomfort in handling faeces and it is at this time they begin training their children. Additionally, mothers do not find toilet designs to be safe for young children to use on their own, and they delay training the child to use a latrine until they are about 5 years old. The latrine cubicle is too small for squatting or even keeping a water bucket. Unlike in open fields, they cannot move freely inside the latrine and so do not like using it. Water bodies are typically located close to open defecation sites, and so OD does not require fetching any water. Fetching water for toilet use is seen as a time consuming new chore. This hinders their use.
Privacy Men have a lower need for privacy than women. Defecating and urinating in the open even during the day is not shameful. Sometimes latrines are located near the house entrance, and anybody passing by can see members entering or leaving the latrine. Incomplete latrine structures do not provide sufficient privacy for women. Also, if the latrine is located within the compound it may be perceived as inappropriate to be seen by men while entering and leaving the latrine. Going to defecation sites is preferred, as men cannot see them there.
Habits Rural men have the habit of going for OD. Changing habits is very difficult especially among elderly men. Men have different habits prior to actual defecation or during it which are not suitable to using a latrine. These include smoking bidis (cigarettes) which they find doing in the latrine difficult, unlike at open defecation sites. Rural women especially the elderly are addicted to brushing guddakhu (tobacco paste) on their teeth before defecating. They believe guddakhu facilitates the bowel movement, which they feel freer and more comfortable doing in the open air or open field.
  1. aWe saw several subsidized pour flush household latrines in study villages, mostly on-set models, which were swarming with very small insects which may have been mosquitoes or flies
  2. bPoor quality construction which we observed included use of insufficient cement for constructing the walls and the pan platform floor, rings supplied by the NGO for the pit were of bad quality (poor cement), so that some were already broken at the time of delivery but still used, and in some households, because the pit had not been dug when the NGO arrived with the mason to install the subsidized latrine, the rings were left stacked on the ground