Campus Location

Dallas Campus (Online)

Date of Award


Document Type



Organizational Leadership

Degree Name

Doctor of Education

Committee Chair or Primary Advisor

Kristin O'Byrne

Second Committee Member or Secondary Advisor

Brian Cole

Third Committee Member or Committee Reader

Karmyn Downs


Poor sanitation behaviors, including open defecation, present risks for diarrhea, which is credited with 600,000 deaths a year in children under age five. Although CLTS is a solution to ending open defecation, more than half of the investment in producing open defecation free (ODF) communities is lost during the maintenance phase. The purpose of this qualitative, case study was to understand stakeholder perceptions of the facilitators and hindrances to becoming ODF certified and maintaining ODF status and sanitary behaviors in a small village community located in Uganda, East Africa. The researcher held individual interviews and in-person focus group discussions to gather data. Major thematic findings include that open defecation was no longer an issue, civic pride was significant, and continuous growth and generativity were present. Unity, seeing and experiencing the benefits of being ODF, and having access to durable construction materials and clean water supported the maintenance of ODF sanitation behaviors. In addition, becoming ODF was facilitated by supportive rather than punitive intervention methods by demonstrating open defecation results in “eating shit,” providing access to latrine construction tools and materials, and stacking programs with holistic teaching. While slippage was not a concern for this community, respondents provided advice for those that may struggle to become and remain ODF by inviting others to come to see their success, by serving as ambassadors, and building a unified front. This research is significant as it identified facilitators to becoming and remaining ODF, which has important quality of life and public health benefits. In addition, this research suggests that social outcomes, such as self-efficacy, growth, and generativity, may well move communities beyond maintenance to generate further community development to help stakeholders flourish. These findings are translatable into practice and provide insight for supportive, holistic community-building and visually rich intervention strategies in the context of CLTS that have the potential to save lives.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.



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