"Key Takeaway 11 is ""behavior shifts are highly reactive and are reset by a resource constrained environment."" Temporary stimuli such as disease force users to consider a holistic shift in sanitation practice only for the duration of the illness. Essentially, the sanitation and hygiene habits of households are an equilibrium caused by opposing forces. Behavior changes can be instigated, but not are sustained until seen as an absolute necessity. To illustrate, in slums, toilets are used under special circumstances in absence of which people revert to open defecation. People who are accustomed to open defecating may use the toilet only during rainy seasons when access to open fields becomes an issue. Many realize that continued use of a pit toilet will cause it to fill up more quickly which will be impossible/expensive to excavate. This knowledge and the realization that there are other alternatives to toilets makes it difficult to encourage individuals to use facilities even when they are available to them."
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