Very good question Craig. ...

Very good question Craig. From my experience with sanitation programs in India, approaching the crisis through a purely infrastructural lens (the "if you build it, they will come" approach, if you will) is wildly ineffective. Behavior change and capacity building activities with beneficiaries/end-users is certainly vital, and there is an ever-more increasing focus on this with associated media coverage, but the real missing link in the chain lies within the implementation agencies and government bodies tasked with providing, and more crucially maintaining, sanitation infrastructure. Above and beyond capacity-bulding, though, is the need to build in a sense of accountability and transparency into the equation. I was well and truly shocked at how often government officials simply didn't care enough to do their jobs, nor fear any sort of reproach for their lack of action. Infusing a sense of empathy is a controversial topic, but I am firmly on the side calling for it. Failing to engage implementers on an emotional level, what is needed is some sense of incentivization to drive positive behavior (and punish negative behavior) by those who are supposed to build and maintain infrastructure. The latter is of particular concern as, far too often, facilities that are mere months old are no longer useable due to no maintenance or provisioning of utilities such as water and electricity. There needs to be educational outreach to infuse an understanding of the importance of hygienic sanitation habits, but that must be done in concert with a fundamental shift in how those building the infrastructure view and approach their work.