Rethinking community-led total sanitation for eradicating open defecation in rural Ebonyi state communities, Nigeria: practice considerations for social work practitioners and educators

Abstract

Nigeria is ranked number two in the world with the highest prevalence of open defecation (OD) despite the adoption of community-led total sanitation (CLTS) since 2007. Using some CLTS-triggered communities in Ebonyi State, this study investigated the awareness of CLTS, OD status, and its drivers as well as social workers' involvement in environmental sustainability. Study data generated from primary surveys included the socio-demographic characteristics of the study population and measurable behavioral elements of the SaniFOAM framework. Results of the statistical analyses show that more than 79% of the respondents were aware of CLTS, yet OD prevalence was 84.8%. While being married (odds ratio (OR): 0.036), being a civil servant (OR: 0.109), and having at least secondary education (OR: 0.119) were associated with lower odds of OD, whereas dislike for trekking (OR: 4.322), absence of laws (OR: 5.380), sanctions (OR: 4.715), and other SaniFOAM variables were associated with increased odds of OD. The results suggest that behavioral change toward OD under CLTS, with its focus on community mobilization for self-awareness and self-assessment for eliminating OD, may be a mirage without stricter approaches, laws, and sanctions for behavioral change. The domiciliation of these within grassroot governments and social workers' involvement in sanitation promotion are suggested.