Factors that influence the effectiveness of sanitation programs

Marilu Fernandez-Haddad, Maia Ingram

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Local governments in both Mexico and the U.S. spend considerable money on public services, which do not always bring the expected results. For instance, a large part of the public budget is destined to solve social and health problems, such as public sanitation. Government has attacked the problem by providing public sanitation infrastructure (such as garbage and recycling receptacles) and by using social ad campaigns. However, these efforts do not always affect the habits of residents and bring the desired changes in city sanitation. This article presents a case study that used a participatory method to address an innovative city sanitation effort: The Clean City Program in Puebla, Mexico. This program adopted social marketing techniques, a discipline born in the 70s when the principles and practices developed to sell products and services started to be applied to sell ideas, attitudes, or behaviors. Social marketing programs have been adopted by governments to change attitudes and behavior in areas such as public services. The article first describes the context and strategies of the program, which included the use of the promotora model to engage community members. The researchers then make use of qualitative data gathered throughout program planning and implementation to evaluate the impact of the social marketing programs and its effectiveness. The article analyzes social, educational, economic, demographic, and cultural factors that influence the effectiveness of sanitation programs and presents recommendations for strategies to engage community members in community sanitation programs.

Original languageEnglish (US)
Article number201
JournalFrontiers in Public Health
Issue numberSEP
StatePublished - Sep 1 2015


  • Cleanliness of cities
  • New habits
  • Promotion
  • Public health
  • Social marketing

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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