Personal barriers include those resulting from lack of knowledge or awareness. For example, people may not be aware of the health dangers of contamination, and in particular that hands can contaminate water, and they may not know about all the critical times to wash hands. There may also be a lack of knowledge about appropriate disinfection procedures or of household water treatment and filtration devices and other products available, and limited awareness of the health dangers posed by decomposing waste.
People may not have the habit of regular bathing, or good handwashing behaviour because of a lack of time in busy households. It may also be that there is no scoop available in the household for moving faeces, or no jerrycan in the home to use for storing water.
Another personal barrier could be a perception that boiled or purified water has an unpleasant taste.
List the personal barriers to improved hygiene and sanitation that result from lack of knowledge or of awareness. Which three of these are the most important in your area? Which other personal barriers are particularly important in your area?
You might have included a lack of knowledge or limited awareness of:
- health dangers of contamination
- unwashed hands can contaminate water
- all the critical times to wash hands
- health dangers from decomposing waste
- methods for household water treatment
- products available for disinfection.
The three that are most important will vary from one area to another but it is likely that lack of awareness of the health dangers, of the fact that hands can contaminate water, and of all the critical times to wash hands will be among them. Other important personal barriers might be that there is no habit of bathing or of good handwashing behaviour.
There are a number of social and cultural or religious barriers which might prevent people from adopting good WASH behaviours. For example, many mothers believe that child faeces are harmless and hence they do not discard them properly. It is very common to see people washing their hands with only water even though soap is available. Figure 10.5 shows a woman cleaning a latrine – it is rare to find a man engaged in such activity, which may lead to lack of interest in the issues of cleanliness.
There may also be a preference for water from natural sources for drinking due to perceived taste differences when water has been treated (Figure 10.6).
Figure 10.7 shows water that has been left in a church to be blessed. Can you identify the health risk here and the barrier that is involved?
The water has been left in open containers, so could become contaminated. The barrier here is a religious one, arising from a belief that the water cannot be blessed unless it is in an open container. In the FOAM framework this is an ‘attitudes and beliefs’ determinant.
All these factors can lead to poor adoption of good hygiene and sanitation practice.
Service and infrastructure-related barriers
Some serious barriers in urban and peri-urban communities relate to issues of service and infrastructure (UNICEF, 2008). There may be inadequate sanitation and latrine facilities, in particular in schools. Public latrines are often not well kept and may be poorly ventilated and unclean, so people avoid using them because of an unpleasant stench. Moreover there are only a few child-friendly and disability-friendly latrines available. In households, there may be limited space for constructing latrines. Those who own houses which are rented may refuse to provide latrines. Poor ground conditions such as a high water table and loose soil may restrict design choices and technology options.
As for water supply, there may be an irregular flow of water in piped areas, and seasonal changes in water availability and quality. There may be high salinity or high fluoride content. Moreover there are often only a limited number of water sources, leading to long pipelines, and this can result in a long distance between water points and homes. Water points may be poorly maintained. There may also be limited availability of water purifying tablets or sachets.
With regard to waste disposal, municipal waste collection and sludge removal services may be absent or inadequate. Even if such services are present, they may be expensive. There may be only weak enforcement of municipal sanitation laws. In some urban areas, litter bins are provided (Figure 10.8) but in others there may be no litter bins, or they may be expensive to provide, or rarely emptied. There may not be the appropriate vehicles available for removing sludge regularly from public latrine facilities.
A number of economic barriers exist for urban communities and these include the high costs of obtaining a household pipe connection (Figure 10.9) and acquiring a latrine facility, the cost of water, and the cost of soap. In places where handwashing facilities and soap should be available (near latrines and kitchens, and in restaurants), it may be too expensive to provide them. Moreover the cost of removing sludge and of refuse collection may be prohibitively high.
There are often environmental constraints to provision of adequate latrine facilities. For example, hard rocks increase the cost of constructing latrines because it makes it difficult to dig a pit. Sandy soils or marshy environments are not suitable for construction of latrines. High rainfall and/or recurrent flooding can pose significant barriers to construction and use of latrines (UNICEF, 2008).
The existence of bushes and open spaces around communities can be a barrier to use of improved latrines, as open defecation can be an easy alternative in such areas. Bushes and other weedy growth in open spaces also tend to promote indiscriminate dumping of waste, and so constitute a barrier to safe solid waste disposal.
Identify the most significant barriers which are likely to prevent WASH behaviour improvement in your community.
The most significant barriers may be different from one community to another but are most likely to be economic ones, as outlined in Section 10.2.4. You may have identified some of the following:
- financial constraints in building a latrine
- high cost of obtaining a household piped water connection
- high cost of removing sludge
- high cost of refuse collection
- lack of or high cost of handwashing facilities at community latrines
- high cost of water
- high cost of soap, or unavailability of soap at community latrines.