Behavior Change in Water, Sanitation, and Hygiene: A 100-Year Perspective.

This article critically examines the historical evolution of water, sanitation, and hygiene (WaSH) policies and practices in rural sub-Saharan Africa (SSA) from 1918 to 2021, highlighting how colonial legacies and political-economic factors have shaped persistent inequities in access. It traces the shift from colonial-era urban-focused infrastructure and modernization-driven development to neoliberal-influenced promotion of low-cost appropriate technologies (AT) and, more recently, behavior change (WaSH Behavior Change, WBC) programs aimed at individual users. The analysis argues that WBC approaches often place undue responsibility on individuals without adequately addressing structural inequalities or technological inadequacies, thereby perpetuating colonial patterns of marginalization. The article recommends a paradigm shift toward utility-style, service-oriented WaSH models that relieve individuals of maintenance burdens and calls for broader political and economic reforms to support equitable, sustainable access in rural SSA.