To reduce open defecation, many implementers use the intervention strategies of Community-
Led Total Sanitation (CLTS), which focuses on initial latrine construction rather than ongoing latrine maintenance, repair and rebuilding. However using data from a cross-sectional survey, this article shows how physical, personal, social context and psychosocial factors from the RANAS model (risks, attitudes, norms, abilities, and self-regulation) are associated with participation in CLTS interventions, and how these factors connect to ongoing latrine maintenance and rebuilding.

The authors suggest that the long-term goals of both latrine construction and latrine maintenance could be better achieved by including the behaviour change issues and techniques identified in this study. For example, in 2015, heavy rains hit the north of Mozambique and many latrines collapsed. Subsequently, 640 household interviews were conducted in the affected region. Logistic regression and mediation analyses revealed that latrine rebuilding depended on education, soil conditions, social cohesion, and a feeling of being safe from diarrhoea, the perception that many other community members own a latrine, and high confidence in personal ability to repair or rebuild a broken latrine.