Empirical Analysis of Theatre for Development Effectiveness in Addressing Open Defecation in Nasarawa State

Open defecation remains a persistent public health challenge in rural North Central Nigeria, and empirically evaluating Theatre for Development as a behaviour change mechanism provides evidence for integrating arts-based approaches into sanitation programming. This study empirically evaluated the effectiveness of Theatre for Development interventions in reducing open defecation in rural communities in Lafia, Doma, and Awe Local Government Areas, Nasarawa State. A cluster-randomised controlled design assigned 10 communities to TfD programming (n = 300 households) and 10 communities to standard community-led total sanitation (n = 295 households). Open defecation rates and latrine construction rates were measured at baseline and 6-month follow-up through household observation and community mapping. Open defecation rates decreased by 62 percent in TfD communities compared to 41 percent in CLTS communities at 6 months (p < 0.001). Latrine construction rates were significantly higher in TfD communities (47 percent versus 28 percent, p < 0.01). TfD community members cited collective shame messaging embedded in community performances as motivating behaviour change. Men showed larger behaviour change responses in TfD communities than women, reversing the pattern in CLTS communities. The study provides the first randomised evidence on TfD versus CLTS for open defecation in North Central Nigeria and recommends integrating TfD approaches into Nasarawa State WASH programming as a complementary strategy to CLTS, with male-targeted cultural messaging as a priority design feature. Keywords: Theatre for Development, open defecation, Nasarawa State, WASH, cluster randomised trial