In rural communities, lack of hygiene and sanitation remains a large issue due to various reasons leading to serious illnesses and numerous fatalities. Observing rural areas in Ghana and India brings attention to the more complex social and structural factors that could be overlooked when focusing on a whole country. By focusing research on smaller, rural communities in two large countries allows for comparing and contrasting existing sanitation programs to see if issues overlap between countries worldwide and how specific interventions need to be within certain countries. Results show that the government implemented latrines either failed or did not exist within the rural areas of each country due to poor infrastructure and lack of funding. Due to incomplete, poor quality or lack of latrines most countries continued with open defecation. Though the government implementations failed or did not exist, both countries responded well to community-based interventions. These programs elected community leaders to run the project or attempted to shift community perspective, focusing on communities working together in the process of better sanitation and hygiene. Issues found are the sociocultural factors, sustainability, socioeconomic status, education and gender differences that impede latrine adoption differ between the countries. The results show rural communities in both countries responded similarly to the community-focused interventions relatively the same because they incorporated sociocultural norms in the community. The issue that persists within interventions and efforts to promote sanitation is the lack of consideration of the cultural and social differences within each rural community. Noticing the underlying factors contributing to decision-making within these rural communities is important because they show how each country has unique factors that must be considered when addressing a situation. It teaches us that in order for success we must understand social and cultural customs and that we must also work with communities and focus on community involvement in order to successfully reduce open defecation through building latrines.

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