Understanding the adoption of urine-diverting dry toilets (UDDTs) in low- and lower-middle-income countries using the Diffusion of Innovation framework

Understanding barriers and facilitators to the adoption of sanitation technologies is crucial to the diffusion of these innovations. Urine-diverting dry toilets (UDDTs) have been implemented throughout regions that are lacking improved sanitation. This review applied the Diffusion of Innovation theory to 18 research articles that collected end-user/potential end-user feedback on UDDT pilot projects in low- and lower-middle-income countries to better understand barriers and facilitators to adoption. Results show the main barriers to adoption were beliefs incompatible with UDDT by-product reuse, a lack of supporting infrastructure, high capital costs, and ineffective promotional communication strategies. The benefits promoted by the diffusion agency were often misaligned with the desires and interests of the potential adopters. Ensuring supporting infrastructure was in place and tailoring the promotional communications to the adopters' perspectives facilitated UDDT adoption. The main facilitator was the perceived relative advantages of the UDDT over existing sanitation options, including fertilizer production. This indicates that safe treatment and reuse processes need to be implemented. Urine diversion was rarely mentioned as a barrier. These findings can help communities and organizations working to increase sanitation technology adoption in low-income, rural areas by better understanding common barriers and facilitators to adoption.