Behavioural determinants of landlord decisions on household wastewater management in urban Dhaka, Bangladesh

Access to safe sanitation remains a challenge in urban areas globally, particularly in low-and middle-income countries. In cities like Dhaka, Bangladesh, despite efforts to expand sewer connections, uptake among households remains low. This PhD synthesises findings from primary and secondary data to explore the drivers and motivators to sewer connection, identify enablers and barriers to sewer connection, and develop interventions to increase sewer connections in urban Dhaka.

I conducted a mixed-methods cross-sectional study across five Dhaka zones operated by the Dhaka Water and Sewerage Authority (DWASA). I surveyed 384 landlords, conducted 8 Key Informant Interviews with DWASA and other stakeholders, 10 In-Depth Interviews, and 2 Focus Group Discussions with landlords. Survey participants included households whose toilets were connected to the sewer, and those whose toilets were connected to stormsewer or drainage. I used the Risks, Attitudes, Norms, Abilities, and Self-regulation (RANAS) framework to examine socio-demographics, and psychological factors determining connection behaviour. I followed the thematic analysis technique for qualitative data analysis.

Evidence from the literature review indicated that behaviour change campaigns alone had limited effectiveness unless combined with financial incentives and community engagement strategies. Evidence from primary data indicated that individual-level barriers to sewer connection included the lack of knowledge about connection procedures and perceived low risks of disease transmission among households without sewer connections. Organisational-level barriers included complex administrative procedures, high installation costs, bureaucratic delays, inadequate support from DWASA, and outdated infrastructure, thus impeding the uptake of sewer connections.

To improve uptake, an integrated intervention model is proposed, which includes targeted educational campaigns to improve health knowledge, role model-based interventions to shift social norms, and technical support to facilitate the connection process. A holistic approach that combines educational efforts, behaviour change strategies, active community participation, and infrastructural improvements, can successfully overcome barriers to sewer connections.

Since the traditional behaviour change theories are more individual-focused, I also propose a broader, more integrated framework for sewer research and practice, a ‘behavioural informed system approach’ - that considers the complex interplay of infrastructural availability, financial investment, institutional trust, and social relations.