Progress towards the Millennium Development Goal (MDG) sanitation target has generally been slow-paced in Ghana. This is particularly the case in rural areas where access to improved sanitation has increased by just 4% within two decades. This paper examines defecation practices as well as constraints and existing opportunities at both household and institutional levels in promoting in-house toilet construction. The study was conducted in three rural communities in the Tain district and drew on key informant interviews, focus group discussions, field observations and face-to-face interviews of 400 residents selected from 249 houses. The results showed the scarcity of in-house toilets, which means consequently open defecation and use of communal toilets are common practices. The need for in-house toilet facilities is high among property owners without them, mainly driven by the desire for comfort and safety. Barriers at the household level constraining latrine installation include ignorance of low-cost technologies, the perceived high cost of latrines and the low priority given to their ownership. Analysis of expenditure patterns at the local assembly shows low priority afforded to sanitation promotion, which is constrained by low donor support, lack of requisite logistics and poor human resource capacity. Existing opportunities for accelerating sanitation coverage in these study communities are examined both at the household and institutional levels, and best practices discussed.

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