Latrine cleanliness is important to ensure the beneficial effects of access to sanitation on health and well-being. Behavior change interventions may be necessary to enhance the regular cleaning of facilities and therefore it is necessary to understand what influences cleanliness. Three empirical studies were conducted in rural Burundi to find contextual and psychosocial factors influencing latrine cleanliness, to plan and evaluate an intervention based on these findings, and to understand how general hygiene practice influences latrine cleanliness.
Overall, the results emphasize the importance of psychosocial and contextual factors for latrine cleanliness. It makes sense to promote behavior change, as habitual latrine cleaning was the most important predictor of latrine cleanliness. Latrine cleanliness was also related to characteristics of the quality of latrine construction and encouraging households to improve the quality of their latrines could further enhance cleanliness. Psychosocial factors, especially commitment strength and positive emotions towards cleaning, and satisfaction with latrine cleanliness were important predictors for habitual latrine cleaning and should therefore be targeted by behavior change promotions. Moreover, the results for general hygiene practice suggest that it is important to examine latrine cleanliness not in isolation but within the broader perspective of general hygiene as all kind of different hygiene behaviors were interrelated.