Studies have shown that while health is a major driver for sanitation projects for governments and NGOs, it is often not a motivator at the individual/household level. Significant non-health benefits of improved sanitation include environmental cleanliness, convenience and dignity. Capturing the real demand for sanitation in a community is vital to program success, but is often neglected. The EcoHealth approach is presented as a framework that enables inclusion of a variety of factors and stakeholders in a project. Using this approach, the many interrelated issues that influence the water and sanitation situation in a community can be identified and addressed. The authors present justification for targeting 100% sanitation coverage in a community. While 100% coverage has not been proven as required for improving public health, it would ensure the benefits of improved sanitation are equally accessible to the poor, who may well be unable to build toilets without intervention.
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