Community health clubs improve latrine construction through savings, lending, and income-generating activities

Improved sanitation is critical to both health and the achievement of the Sustainable Development Goals. In this multi-sectoral food security activity, community health clubs (CHC) were implemented by the Zimbabwe Government. Members met regularly to complete a hygiene and sanitation education curriculum. Early on, CHC members faced financial barriers to latrine construction. Members were encouraged to undertake savings, lending, and income-generating activities. 28 percent of CHCs in fact engaged in those activities. This qualitative study aimed to identify motivators of and barriers to latrine construction and to explore whether financial activities supported members in their efforts to overcome barriers. Ten focus group discussions with CHC members and 19 in-depth interviews with key informants were conducted. Data were analyzed using content analysis. Key motivators and enablers included health benefits; the desire to avoid disgust, shame, and embarrassment; access to materials and construction; and social support. Barriers to improvement included costs, water access, limited leadership support, and behavior change resistance. Financial activities helped CHC members overcome the costs of material and construction. Thus, integrating financial activities into CHCs may improve sanitation coverage and we recommend that such add-ons be considered in CHC training programs. To our knowledge, this is the first study in Zimbabwe to explore whether the integration of financial activities into the CHC model is an acceptable and feasible model for improving sanitation coverage. HIGHLIGHTS This study identified motivators of and barriers to latrine construction and explored the integration of financial activities with CHCs as a model to improve latrine coverage.; Key motivators and enablers included health benefits, disgust, shame, embarrassment, social norms, and access to materials and builders.; CHCs integrating financial activities reported that this helped them overcome barriers to latrine construction.;