David, P. A. D. (2017). Community led total sanitation towards the achievement of a zero open defecation environment among the Aeta Ambala of Barangay Tubo-tubo, Dinalupihan, Bataan (Unpublished master's thesis). Graduate School of Public and Development Management, Development Academy of the Philippines.

Graduate School of Public and Development Management Health Systems and Development Batch 7 Thesis (MPM-HSD)--Development Academy of the Philippines.

Acute Gastroenteritis remains as the 2nd leading cause of morbidity in the municipality of Dinalupihan and a cause of an under five child death last 2016 among the Aeta Ambala tribe of Barangay Tubo-tubo, Twenty-five (25) out of 39 Aeta households in the barangay have no access to sanitary toilets and are practicing open defecation which comprises 21.19% of all households in the barangay. The study aimed to identify current water, sanitation and hygiene services/programs implemented in the Aeta Ambala community of Barangay Tubo-tubo, understand the principal drivers/barriers that influence the Aeta Ambala of Barangay Tubo-tubo from achieving zero open defecation status and implement strategies to achieve zero open defecation by improving sanitation practices. The study employed both a quantitative and qualitative design with data collection methods such as household survey, key informant interviews, focus group discussions and documents analysis. The SaniFOAM framework of the WSP was used to analyze the results. Deep well with water pump is the main source of drinking water of the Aeta Ambala which is owned by the barangay. A third of the respondents reported that they are located 500 meters away from the nearest water source. Household water treatment such as boiling is not practiced by majority of households. Majority of Aeta households practice non-sanitary modes of fecal disposal such as open pit (14/19) or open defecation (11/39). Seventeen (17) respondents reported their sanitation facility was less than 25 meters from their house while 13 respondents have facilities are more than 25 meters. Majority of households (58.97%) also report that the sanitation facilities are more than 25 meters from the nearest source of water which make it inconvenient to use. Aeta Ambala household reported frequent handwashing behavior (21/39, 53.85%, >7 times/day, 17, 43.59%, <7 times and use both soap and water (76.32%). The study respondents reported that they often get information/education materials on hygiene from the TV (28.21%), parents (20.51%) NGOs (17.95%), school (12.82%) and from the LGU/health workers (2.56%). Almost a fifth of the respondents (17.95%) reported not receiving any information on hygiene. Behavioral determinants to open defecation were categorized into opportunity, ability and motivation. Opportunity determinants include low access/availability to toilets, product attributes, cultural norms of open defecation from ancestors (social norms), and no regulations among the community to stop the behavior (sanctions/enforcement). Ability determinants include the low hygiene education, lack of skill or financing to construct a sanitation facility despite knowledge on the oro-fecal transmission of disease due to open defecation (knowledge, skill and affordability). Motivation determinants include existing attributes and beliefs that open defecation cannot be stopped despite toilet provisions, feelings of self-esteem, disgust and shame and the need to fit in with non-Aeta households in the barangay (emotional, social and physical drivers). Aeta households also would rather spend their available money on basic necessities (competing priorities) but have showed willingness to start constructing a septic tank (intention) and to borrow money (willingness to pay). Community Led Total Sanitation was conducted in order ti increase awareness on the dangers of open defecation and elicit demand for better access to water and sanitation facilities. A post-CLTS triggering activity is recommended to assess progress made by the community. The establishment of Barangay WATSAN council is recommended for all barangays of Dinalupihan.