Work

Ten years on: a comparative study of women-led civic participation and sustainable sanitation in rural India

Year: 2026

Type: article

Abstract: Objectives Despite the wide use of community-led sanitation programs in low- and middle-income countries, there is still limited evidence on whether behavioral gains remain embedded over long periods and what helps sustain them. This study examined the ten-year legacy of a women-led sanitation champion program in rural Haryana, India. It asked whether outcomes differed between an Intervention Village and a neighboring Comparison Village approximately ten years after sanitation-specific activities ended at the study site, and whether long-term outcomes were better explained by individual sanitation engagement, household decision agency, social norms, or civic participation. Methods Using a comparative case study design with a convergent mixed-methods approach, 131 women were surveyed across two villages, both of which had achieved open defecation-free (ODF) status. Qualitative data were gathered through focus group discussions and key informant interviews. Village-level differences were estimated using covariance-adjusted models, and pathway associations were examined using multivariable regression. Results The Intervention Village showed large, significant advantages in menstrual waste management, civic action, and community participation in sanitation activities. Children's hygiene did not differ significantly between villages after covariate adjustment. Civic participation was the only significant predictor of menstrual waste management in the multivariable models, suggesting that community-level processes were more strongly associated with this outcome than individual engagement. No predictor domain significantly explained children's hygiene or toilet use and maintenance in the multivariable models. Qualitative findings help explain this pattern. In the Intervention Village, sanitation had become part of a wider social system, supported by women's self-help groups, continuing Panchayat engagement, and active reinforcement of sanitation norms. In the Comparison Village, sanitation was more individually managed and more vulnerable to weak public systems. Women described barriers such as pit-filling costs, water scarcity, and older male resistance to toilet use, along with fewer opportunities for collective action or effective engagement with local governance. Conclusion Long-term sanitation gains require more than just personal effort and individual behavioral change. They require a multi-pronged approach: strengthening women's roles in local governance, investing in physical infrastructure, and reinforcing the social norms that sustain healthy behaviors.

Source: Frontiers in Water

DOI: 10.3389/frwa.2026.1846195