Efforts to prevent the practice of open defaecation : how sensitive are health promoters to local views and conditions?

Health promotion efforts to prevent the practice of Open Defaecation (OD) reflect current trends in other health promotion fields. The value accorded to community participatory approaches is widely recognised as well as an increasing appreciation of principles involved in the more commercially oriented field of marketing. Included in these principles are audience research, creation of demand versus supply and the incorporation of both communication and behaviour change theory. The first chapter gives an introduction and the justification for this research. This is followed by an outline of the main research question and sub-questions, and a brief description of the methodology is given. The second chapter provides a review of what has been found in the literature as well as relevant impressions gained in Nepal to support these findings. Headings used in the review are reflective of the research questions in an attempt to categorise the literature into a meaningful order. The third chapter begins with a brief ethnographic account of my short encounter with the RWSSP-WN, followed by a presentation of the findings from the field trip in an attempt to answer the main research question as well as those that emerged during this study. The fourth and final chapter will discuss findings in the literature and integrate these with impressions gained in Nepal. Headings used in the discussion will reflect the emergent themes that have been found. The chapter addresses the notion that sensitivity of health promoters to local views and conditions will enhance efforts to prevent the practice of open defaecation. Finally, conclusions of the findings and recommendations will be presented. [authors abstract]