• This record comes from PubMed

Barriers to transition to resource-oriented sanitation in rural Ethiopia

. 2025 Jan ; 32 (5) : 2668-2681. [epub] 20250114

Language English Country Germany Media print-electronic

Document type Journal Article

Grant support
GA19-10396S Grantová Agentura České Republiky

Links

PubMed 39808257
PubMed Central PMC11802593
DOI 10.1007/s11356-025-35887-6
PII: 10.1007/s11356-025-35887-6
Knihovny.cz E-resources

Recycling excreta resources through resource-oriented toilet systems (ROTS) holds transformative potential, yet adoption remains limited, especially where benefits could be high. This study aims to understand constraints hindering the adoption of ROTS in one such area in Ethiopia. Based on a survey among 476 households comprising 2393 individuals, we examine the plans to use ROTS and willingness to pay for ROTS and apply structural equation modelling to analyze the drivers of these two outcomes while comparing the explanative power of the extended technology acceptance model, extended theory of planned behaviour, and their combined model. While 40% of households expressed a plan to use ROTS and 20% reported willingness to pay for a subsidized ROTS with a biogas unit, merely 7% revealed both the plan to use and sufficient willingness to pay, highlighting the need to target both these complementary outcomes concurrently. The theory of planned behaviour showed the best explanative power, also revealing that these two outcomes are influenced by partly distinct sets of factors. Findings imply that common efforts to ease objective constraints through subsidies, which incentivize willingness to pay, are necessary but not sufficient for facilitating the adoption of ROTS. To simultaneously enhance intentions to use, it is also recommended to target psychosocial drivers, such as perceived behavioural control and perceived community support, through awareness creation, behaviour change activities, and community engagement techniques.

See more in PubMed

Abay KA, Abay MH, Amare M, Berhane G, Aynekulu E (2022) Mismatch between soil nutrient deficiencies and fertilizer applications: implications for yield responses in Ethiopia. Agric Econ 53(2):215–230

Abebe TA, Tucho GT (2020) Open defecation-free slippage and its associated factors in Ethiopia: a systematic review. Syst Rev 9(1):1–5 PubMed PMC

Abi M, Kessler A, Oosterveer P, Tolossa D (2020) How farmers’ characteristics influence spontaneous spreading of stone bunds in the highlands of Ethiopia: a case study in the Girar Jarso woreda. Environ Dev Sustain 22:317–335

Afework A, Beyene H, Ermias A, Tamene A (2022) Moving up the sanitation ladder: a study of the coverage and utilization of improved sanitation facilities and associated factors among households in Southern Ethiopia. Environmental Health Insights 16:11786302221080824 PubMed PMC

Ajzen I (1991) The theory of planned behavior. Organ Behav Hum Decis Process 50(2):179–211

Andersson JC, Zehnder AJ, Wehrli B, Jewitt GP, Abbaspour KC, Yang H (2013) Improving crop yield and water productivity by ecological sanitation and water harvesting in South Africa. Environ Sci Technol 47(9):4341–4348 PubMed

Andersson M, Minoia P. Ecological sanitation: a sustainable goal with local choices. A case study from Taita Hills, Kenya. In: Africa in the Post-2015 Development Agenda, 2018, Apr 19 (pp. 182–198). Routledge.

Arbuckle J (2019) Amos (version 26.0) [computer program]. Chicago: IBM SPSS

Balgah RA, Ketuama CT, Ngwabie MN, Roubík H (2023) Africa’s energy availability-deficiency paradox: lessons from small-scale biogas technology and policy implications. Environ Dev Sustain 27:1–9

Banamwana C, Musoke D, Ntakirutimana T, Buregyeya E, Ssempebwa J, Maina GW, Tumwesigye NM (2022) Complexity of adoption and diffusion of ecological sanitation technology: a review of literature. Journal of Water, Sanitation and Hygiene for Development 12(11):755–769

Banamwana C, Musoke D, Ntakirutimana T, Buregyeya E, Ssempebwa J, Wamuyu-Maina G, Tumwesigye NM (2023) Excreta disgust and adaptive use of ecological sanitation by-products: perspectives of rural farmers in Burera District, Rwanda. International Journal of Environmental Research and Public Health. 20(18):6743 PubMed PMC

Carrard N, Jayathilake N, Willetts J (2021) Life-cycle costs of a resource-oriented sanitation system and implications for advancing a circular economy approach to sanitation. J Clean Prod 307:127135

Chakraborty S, Novotný J, Das J, Bardhan A, Roy S, Mondal S, Patel PP, Santra S, Maity I, Biswas R, Maji A (2022) Geography matters for sanitation! Spatial heterogeneity of the district-level correlates of open defecation in India. Singap J Trop Geogr 43(1):62–84

Cheng EW (2019) Choosing between the theory of planned behavior (TPB) and the technology acceptance model (TAM). Education Tech Research Dev 15(67):21–37

Conroy KM, Mancl KM (2022) Understanding the adoption of urine-diverting dry toilets (UDDTs) in low-and lower-middle-income countries using the diffusion of innovation framework. Journal of Water, Sanitation and Hygiene for Development 12(12):905–920

Davis FDA (1985) A technology acceptance model for empirically testing new end-user information systems: theory and results. Massachusetts Institute of Technology. https://hdl.handle.net/1721.1/15192

Dickin S, Dagerskog L, Jiménez A, Andersson K, Savadogo K (2018) Understanding sustained use of ecological sanitation in rural Burkina Faso. Sci Total Environ 1(613):140–148 PubMed

Eelderink M, Vervoort J, Snel D, de Castro F (2017) Harnessing the plurality of actor frames in social-ecological systems: ecological sanitation in Bolivia. Dev Pract 27(3):275–287

Eom YS, Oh H, Cho J, Kim J (2021) Social acceptance and willingness to pay for a smart eco-toilet system producing a community-based bioenergy in Korea. Sustainable Energy Technol Assess 1(47):101400

Gebremariam B, Tsehaye K (2019) Effect of community led total sanitation and hygiene (CLTSH) implementation program on latrine utilization among adult villagers of North Ethiopia: a cross-sectional study. BMC Res Notes 12(1):1–6 PubMed PMC

Gedamu MT (2020) Soil degradation and its management options in Ethiopia: a review. Int J Res Innov Earth Sci 7:59–76

Genet A (2020) Population growth and land use land cover change scenario in Ethiopia. International Journal of Environmental Protection and Policy 8(4):77–85

Guzha E, Nhapi I, Rockstrom J (2005) An assessment of the effect of human faeces and urine on maize production and water productivity. Physics and Chemistry of the Earth, Parts a/b/c 30(11–16):840–845

Gwara S, Wale E, Odindo A, Buckley C (2021) Attitudes and perceptions on the agricultural use of human excreta and human excreta derived materials: a scoping review. Agriculture 11(2):153

Gwara S, Wale E, Odindo A (2022) Behavioral intentions of rural farmers to recycle human excreta in agriculture. Sci Rep 12(1):5890 PubMed PMC

Gwara S, Wale E, Lundhede T, Jourdain D, Odindo A (2023) Ex-ante demand assessment and willingness to pay for human excreta derived co-compost: empirical evidence from rural South Africa. J Clean Prod 15(388):135570

Haq G, Cambridge H (2012) Exploiting the co-benefits of ecological sanitation. Current Opinion in Environmental Sustainability 4(4):431–435

Hu M, Fan B, Wang H, Qu B, Zhu S (2016) Constructing the ecological sanitation: a review on technology and methods. J Cleaner Production 125:1–21

Ignacio JJ, Alvin Malenab R, Pausta CM, Beltran A, Belo L, Tanhueco RM, Era M, Eusebio RC, Promentilla MA, Orbecido A (2018) Perceptions and attitudes toward eco-toilet systems in rural areas: a case study in the Philippines. Sustainability 10(2):521

Irfan M, Zhao ZY, Li H, Rehman A (2020) The influence of consumers’ intention factors on willingness to pay for renewable energy: a structural equation modeling approach. Environ Sci Pollut Res 27:21747–21761 PubMed

Jensen PK, Phuc PD, Knudsen LG, Dalsgaard A, Konradsen F (2008) Hygiene versus fertiliser: the use of human excreta in agriculture–a Vietnamese example. Int J Hyg Environ Health 211(3–4):432–439 PubMed

Lamichhane KM, Babcock RW Jr (2013) Survey of attitudes and perceptions of urine-diverting toilets and human waste recycling in Hawaii. Sci Total Environ 15(443):749–756 PubMed

Langergraber G, Muellegger E (2005) Ecological sanitation—a way to solve global sanitation problems? Environ Int 31(3):433–444 PubMed

Laré F, Sossou SK, Konaté Y (2024) Determinants of biogas toilet adoption in rural Burkina Faso. Environ Dev Sustain 28:1–24

Leviton LC (2017) Generalizing about public health interventions: a mixed-methods approach to external validity. Annu Rev Public Health 20(38):371–391 PubMed

Machado GC, Maciel TM, Thiollent M (2021) An integral approach of ecological sanitation in traditional and rural communities. Cien Saude Colet 19(26):1333–1344 PubMed

Mamo BG, Novotný J, Ficek F (2023a) Barriers for upgrading of latrines in rural Ethiopia: disentangling a sanitation socio-technical lock-in. Local Environ 9:1–9

Mamo BG, Novotný J, Admasie A (2023b) Quality of latrines and willingness to improve them in rural Ethiopia. Journal of Water, Sanitation and Hygiene for Development 13(5):339–349

Mamo, B. G., & Novotný, J (2024) Promotion of market-based sanitation in Ethiopia: a case study from Wolaita zone. Health Promotion International. 39(2), daae034 PubMed PMC

Mariwah S, Drangert JO (2011) Community perceptions of human excreta as fertilizer in peri-urban agriculture in Ghana. Waste Manage Res 29(8):815–822 PubMed

McAlister MM, Namakula P, Annis J, Mihelcic JR, Zhang Q (2023) Rural sanitation sustainability dynamics: gaining insight through participatory and simulation modeling. Environ Sci Technol 58(1):400–409 PubMed

McConville JR, Kvarnström E, Ahlström M, Niwagaba CB (2022) Possibilities for changing to resource recovery in Kampala’s on-site sanitation regime. Resour Conserv Recycl 1(181):106275

McConville JR, Billger M, Niwagaba CB, Kain JH (2023) Assessing the potential to use serious gaming in planning processes for sanitation designed for resource recovery. Environ Sci Policy 1(145):262–274

Mengistu MG, Simane B, Eshete G, Workneh TS (2016) Factors affecting households’ decisions in biogas technology adoption, the case of Ofla and Mecha Districts, northern Ethiopia. Renewable Energy 93:215–227

Nawab B, Nyborg IL, Esser KB, Jenssen PD (2006) Cultural preferences in designing ecological sanitation systems in North West Frontier Province. Pakistan Journal of Environmental Psychology 26(3):236–246

Novotný J, Mamo BG (2022) Household-level sanitation in Ethiopia and its influencing factors: a systematic review. BMC Public Health 22(1):1448 PubMed PMC

Novotný J, Hasman J, Lepič M (2018) Contextual factors and motivations affecting rural community sanitation in low-and middle-income countries: a systematic review. Int J Hyg Environ Health 221(2):121–133 PubMed

Novotný J, Borde R, Ficek F, Kumar A (2024) The process, outcomes and context of the sanitation change induced by the Swachh Bharat Mission in rural Jharkhand, India. BMC Public Health 24(1):997 PubMed PMC

O’Cathain A, Croot L, Duncan E, Rousseau N, Sworn K, Turner KM, Yardley L, Hoddinott P (2019) Guidance on how to develop complex interventions to improve health and healthcare. BMJ Open 9(8):e029954 PubMed PMC

Ogato GS, Bantider A, Geneletti D (2021) Dynamics of land use and land cover changes in Huluka watershed of Oromia Regional State. Ethiopia Environmental Systems Research 10:1–20

Park YN, Lee CK, Mjelde JW, Kwon YJ (2022) Policy implications of willingness to pay for sustainable development of a world agricultural heritage site: the role of stakeholders’ sustainable intelligence, support, and behavioral intention. Sustain Dev 30(4):636–646

Roubík H, Mazancová J, Banout J, Verner V (2016) Addressing problems at small-scale biogas plants: a case study from central Vietnam. J Clean Prod 20(112):2784–2792

Sanchez-Garcia M, Zouaghi F, Lera-Lopez F, Faulin J (2021) An extended behavior model for explaining the willingness to pay to reduce the air pollution in road transportation. J Clean Prod 10(314):128134

Schniederjans DG, Starkey CM (2014) Intention and willingness to pay for green freight transportation: an empirical examination. Transp Res Part d: Transp Environ 31:116–125

Seyoum B (2016) Assessment of soil fertility status of Vertisols under selected three land uses in Girar Jarso District of North Shoa zone, oromia national regional state Ethiopia. Environ Syst Res 5:1–6

Shannon P, Markiel A, Ozier O, Baliga NS, Wang JT, Ramage D, Amin N, Schwikowski B, Ideker T (2003) Cytoscape: a software environment for integrated models of biomolecular interaction networks. Genome Res 13(11):2498–2504 PubMed PMC

Simha P, Ganesapillai M (2017) Ecological sanitation and nutrient recovery from human urine: how far have we come? A Review. Sustain Environ Res 27(3):107–116

Trimmer JT, Lohman HA, Byrne DM, Houser SA, Jjuuko F, Katende D, Banadda N, Zerai A, Miller DC, Guest JS (2020) Navigating multidimensional social–ecological system trade-offs across sanitation alternatives in an urban informal settlement. Environ Sci Technol 54(19):12641–12653 PubMed

Trimmer JT, Kisiangani J, Peletz R, Stuart K, Antwi-Agyei P, Albert J, Khush R, Delaire C (2022) The impact of pro-poor sanitation subsidies in open defecation-free communities: a randomized, controlled trial in rural Ghana. Environ Health Perspect 130(6):067004 PubMed PMC

Tucho GT, Weesie PD, Nonhebel S (2014) Assessment of renewable energy resources potential for large scale and standalone applications in Ethiopia. Renew Sustain Energy Rev 40:422–431

Tumwebaze IK, Orach CG, Nakayaga JK, Karamagi C, Luethi C, Niwagaba C (2011) Ecological sanitation coverage and factors affecting its uptake in Kabale municipality, western Uganda. Int J Environ Health Res 21(4):294–305 PubMed

Williams NB, Quilliam RS, Campbell B, Ghatani R, Dickie J (2022b) Taboos, toilets and biogas: socio-technical pathways to acceptance of a sustainable household technology. Energy Res Soc Sci 86:102448

Williams N B, Quilliam R S, Campbell B, Raha D, Baruah, D C, Clarke, M L, ... & Dickie J (2022a) Challenging perceptions of socio-cultural rejection of a taboo technology: narratives of imagined transitions to domestic toilet-linked biogas in India. Energy Research & Social Science, 92, 102802.

Winter S, Dreibelbis R, Barchi F (2018) Context matters: a multicountry analysis of individual-and neighbourhood-level factors associated with women’s sanitation use in sub-Saharan Africa. Tropical Med Int Health 23(2):173–192 PubMed

Zhou C, Liu J, Wang R, Yang W, Jin J (2010) Ecological-economic assessment of ecological sanitation development in the cities of Chinese Loess Plateau. Ecol Complex 7(2):162–169

Find record

Citation metrics

Loading data ...

Archiving options

Loading data ...