Tembo M – Mzuzu University. Department of AgriBussiness. P/Bag 21, Luwinga, Mzuzu

Chidya, R – Mzuzu University Department of Water and Sanitation. P/Bag 21, Luwinga, Mzuzu

Email: lastonkamwana@gmail.com

Abstract: Malawi adopted Community-Led Total Sanitation (CLTS) in 2008 with the aim of achieving open defecation-free (ODF) status nationwide by 2015. Balaka District was certified ODF in 2017 but regressed to open defecation in 2019. This study assessed the community’s stage of change (SoC) in behaviour, readiness to change (RtC), and committed action to change (CAtC) for four sanitation behaviours: latrine construction, hand washing facility (HWF) construction, latrine use, and hand washing with soap (HWWS) after defecation four years post-certification. A descriptive cross-sectional study was conducted using a structured questionnaire adapted from the University of Rhode Island Change Assessment (URICA). Data were collected from household heads. Principal Component Analysis and reliability testing (Cronbach’s α = 0.82) were conducted. Means and standard deviations were calculated for Stages of Change (SoC: 1 = pre-contemplation to 4 = maintenance), RtC (range 1–12), and CAtC (range -1 to +1).Results showed that the community was at the action stage for latrine construction (Mean = 4.308 ± 0.003), latrine use (Mean = 4.335, SD = 0.076), and HWF construction (Mean = 4.349, SD = 0.076), but at pre-contemplation for HWWS (Mean = 3.171, SD = 0.065). Readiness to change was intermediate for latrine (Mean = 9.340) and HWF construction (Mean = 9.665), moderate for latrine use (Mean = 9.549), and low for HWWS (Mean = 6.660). Committed action to change scores were lowest for HWF construction (Mean = 0.017), latrine construction (Mean = 0.027), and latrine use (Mean = 0.113), and negative for HWWS (Mean = –0.055). In conclusion, the community maintains moderate engagement with latrine-related behaviours but shows low readiness and commitment to HWWS. Sustainable sanitation in Balaka requires renewed investment in behaviour change strategies, especially for hand washing with soap, focusing on motivation, habit formation, and social norm reinforcement.

Abstract: Community-Led Total Sanitation is a sanitation behaviour change approach aimed at stopping open defecation. It compels communities to sustainably construct latrines, use them and wash their hands with soap after open defecation. Change of behaviour for the Sustainability of these practices is a challenge as communities return to open defecation. The study evaluated community knowledge and attitude toward Community-Led Total Sanitation in Balaka District, the first Open Defecation Free certified model District in Malawi four years after Open Defecation Free status certification. Descriptive cross-sectional study design adopting both quantitative and qualitative data collection methods was used. Data was collected from heads of household (438) and Focused Group Discussion (6) sessions. Communities have adequate knowledge on Community-Led Total Sanitation and Open defecation status and a positive attitude towards Community-Led Total Sanitation implementations and open defecation status despite having very low hand washing facility coverage (36%, n=158) and hand washing with soap after defecation (24% n = 105). Knowledge has no influence on latrine use and hand washing facility construction (p >0.05) while attitude has influence on hand washing facility constriction (p <0.05) in Balaka. Emphasis is required on health promotion on hand-washing facility construction and washing hands with soap to to ensure sustainable sanitation practices beyond ODF certification.