Structural Determinants of Inadequate Sanitation Coverage in North East Nigeria: A Political Economy Analysis

Despite decades of investment in sanitation programs, North East Nigeria maintains the lowest sanitation coverage rates in the country, with open defecation remaining widespread. Explanations confined to technical, behavioral, or resource-limited perspectives have repeatedly failed to yield sustained improvements, suggesting that structural and political economy factors constitute the primary determinants of sanitation failure in this region. This dissertation applies a political economy analytical framework to examine the structural determinants of inadequate sanitation coverage across six states of North East Nigeria. The research employed a qualitative explanatory design, integrating theory of change analysis of forty-one sanitation program documents spanning 2005 to 2024, seventy-eight in-depth interviews with policymakers, program implementers, donors, community leaders, and affected community members, and ethnographic observation in four communities across the sanitation coverage gradient. The analytical framework incorporated three explanatory lenses: power dynamics in sanitation governance, incentive structures shaping government and donor behavior, and ideological influences on program design and community engagement. Results revealed that political economy factors, specifically electoral incentive cycles discouraging long-term infrastructure investment, patronage networks influencing contractor selection, donor fragmentation reducing program coherence, and gender power dynamics suppressing women's sanitation rights, constituted the primary structural obstacles to sanitation progress. Technical and behavioral explanations were shown to be downstream consequences of upstream structural failures. The dissertation makes an original theoretical contribution by applying political economy analysis to environmental health service delivery in the Nigerian context and proposes a structural reform agenda. Keywords: sanitation coverage, political economy, North East Nigeria, structural determinants, open defecation.