Hygiene promotion behavioral change interventions on household latrine construction and utilization in rural sub-Saharan Africa: Systematic review

BACKGROUND: Safe sanitation is a basic human right and is essential to improve public health. Ninety percent of the 673 million people who continue to practice open defecation live in the countryside of Asia and sub-Saharan Africa. METHODS: The review was done using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was used to assess quality of articles. RESULT: The study summarizes evidence from 22 studies conducted in eight countries in sub-Saharan Africa. Most of the studies reported that behavioral change interventions are effective in promoting latrine construction and use in rural areas. Contextual, psychological, and other factors interact to influence an individual's decision to construct and use a latrine. Theory-based behavior change interventions provide a systematic and evidence-based approach to addressing complex challenges in rural sanitation. CONCLUSION: The review covers a range of interventions aimed at promoting behavior change related to hygiene practices, with a specific focus on latrine construction and utilization. These interventions included educational campaigns, community mobilization with community-led total sanitation, infrastructure improvements, and other strategies designed to encourage the adoption of hygienic behaviors. Participatory methods, practical demonstrations, and community involvement can improve communities' hygiene practices and motivate individuals to adopt healthier behaviors. It is important to recognize that contextual, psychological, and other factors interact with the structural and design elements of latrines to influence an individual's decision to build and use them. Theory-based behavior change interventions offer a systematic approach to addressing complex challenges such as rural sanitation by identifying the underlying factors that influence behavior and designing interventions that effectively target those factors. Therefore, combining behavior change interventions with community-led approaches can promote latrine construction and use and help reduce the burden of hygiene-related diseases in rural communities.