Health Education and Behaviour Change Communication Strategies for Reducing Open Defecation in Rural Katsina State

Open defecation remains a persistent public health challenge in North West Nigeria, undermining gains in child health and contributing to the transmission of faecal-oral diseases. This study examined health education and behaviour change communication strategies for reducing open defecation in rural communities in Katsina State. A community-based quasi-experimental design was employed, with four intervention communities and four control communities selected across Katsina, Funtua, and Mashi local government areas. Intervention communities received a 16-week Community-Led Total Sanitation programme incorporating health education, community triggering, and follow-up monitoring. Data were collected from 280 household heads at baseline, mid-point, and post-intervention. Logistic regression and difference-in-differences analysis were applied. Results showed a significant reduction in open defecation rates in intervention communities (from 74 percent to 28 percent) compared to no meaningful change in controls. Community-triggering sessions were the most cited motivating factor for behaviour change. Sanitation behaviour change was sustained at three-month follow-up in communities that formed village sanitation committees. The study recommends scaling Community-Led Total Sanitation programmes as a core strategy in Katsina State's sanitation policy framework. Keywords: open defecation, behaviour change communication, health education, Katsina State, CLTS