Table 2 Design of the Safe Disposal of Child Feces Care Group Module and Enabling Technology, Organized by IBM-WASH Dimension

 Access: Most households have their own pit latrine, which may facilitate disposal of child feces in the latrine.

Encouragement to always dispose of child feces in the latrine, either using a hoe or leaves. Recommendation to bury feces if latrine not available.

 Roles and responsibilities: Because caregivers are busy with other tasks or away from the home, there may be a delay in removing feces from the yard.

Pictorial instructions included in module recommending the adult caregiver (e.g. mother) to dispose of all child feces from the yard as soon as they return to the home.

 Beliefs: Caregivers believe that feces of a breastfed infant have fewer microbes than the feces of a child who is eating solid food.

Narrative illustration included in module describes how an infant’s feces can carry microbes, and how other family members can become ill from these microbes.

 Disgust and dirt reactivity: Caregivers have a disgust reaction to child feces, consider them dirty, and want to remove them from the yard.

Reinforcement of these feelings by showing illustrations of intestinal worms in feces in the module.

 Existing habits: Caregivers accustomed to using a shovel or hoe to remove feces from the yard; Caregivers previously accustomed to digging small holes beside the latrine for young children to defecate in; Child potties not in-use, but cloth diapers common; Some caregivers throw water from cleaning diapers in yard.

Hoe promoted as the enabling technology to remove child feces and dispose of it into the latrine. Leaves promoted to remove feces if hoe not available.

Pictorial instructions included in module reinforcing removal of child feces with hoe, plus instructions for cleaning hoe with detergent after disposal.

Narrative illustration included in module describes the dangers of throwing water with feces in the yard. Recommendation that water from cleaning feces or diapers be thrown in the latrine (or buried).

 Manufacturing/access: Child potties not available in markets accessible to rural populations.

Child potties not included as a candidate enabling technology.

 Convenience: Households typically have a hoe; households typically have a pit latrine.

Hoe promoted as the enabling technology to remove child feces and dispose into the pit latrine.