title: Adopt or Adapt: Sanitation Technology Choices in Urbanizing Malawi.
abstract: This paper presents the results of a mixed-methods study examining adaptation strategies that property owners in low-income, rapidly urbanizing areas in Malawi adopt to address the limitations of pit latrines, the most common method of disposing human excreta. A particular challenge is lack of space for constructing new latrines as population density increases: traditional practice has been to cap full pits and simply move to a new site, but increasing demands on space require new approaches to extend the service life of latrines. In this context, we collected data on sanitation technology choices from January to September 2013 through 48 in-depth interviews and a stated preference survey targeting 1,300 property owners from 27 low-income urban areas. Results showed that property owners with concern about space for replacing pit latrines were 1.8 times more likely to select pit emptying service over the construction of new pit latrines with a slab floor (p = 0.02) but there was no significant association between concern about space for replacing pit latrines and intention to adopt locally promoted, novel sanitation technology known as ecological sanitation (ecosan). Property owners preferred to adapt existing, known technology by constructing replacement pit latrines on old pit latrine locations, reducing the frequency of replacing pit latrines, or via emptying pit latrines when full. This study highlights potential challenges to adoption of wholly new sanitation technologies, even when they present clear advantages to end users. To scale, alternative sanitation technologies for rapidly urbanising cities should offer clear advantages, be affordable, be easy to use when shared among multiple households, and their design should be informed by existing adaptation strategies and local knowledge.
authors.affiliation: Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Chunga
authors.affiliation: Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Jeroen H J
authors.initials: JH
authors.lastname: Ensink
authors.affiliation: Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.|Department of Civil and Environmental Engineering, University of California at Davis, Davis, California, United States of America.
authors.forename: Marion W
authors.initials: MW
authors.lastname: Jenkins
authors.affiliation: School of Civil & Environmental Engineering, Georgia Institute of Technology, Atlanta, United States of America.
authors.forename: Joe
authors.initials: J
authors.lastname: Brown
mesh_terms: D002755:Choice Behavior; D005191:Family Characteristics; D006801:Humans; D006920:Hygiene; D008295:Malawi; D011203:Poverty; D012499:Sanitation / Q000379:methods*; D012722:Sewage / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014038:Toilet Facilities / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*; D014507:Urbanization
chemical_list: D012722:Sewage