Variations frequently occur between the intended and actual outcomes of rural water, sanitation and hygiene promotion projects, even projects that exhibit best practice. As a result, the intended impact of poverty reduction through sustained health improvements is diminished. This thesis establishes that inadequate consideration of culture in interactions between and within project stakeholders is a major reason for these unintended project outcomes. Aspects of individual and group behaviour that are influenced by culture are examined, and an initial conceptual framework of established cultural dimensions developed. This framework is then applied to a broad variety of stakeholder groups: seven end user groups and two implementing agencies in Ethiopia and Uganda; national Governments and international donor organisations. As a result, two new cultural dimensions are proposed. Firstly, concern for public selfimage, defined as ‘the degree to which an individual expresses interest in how others perceive him/herself, and the manner in which the individual seeks to influence that perception’. Secondly, spirituality, defined as ‘the nature and degree of people’s beliefs and practices concerning the existence, nature, and worship of, and connectedness to God, a god, gods, or a greater spiritual whole, and involvement of the divine or greater spirit in the universe and human life’. Aspects of these dimensions that need to be measured are identified. Hierarchies of cultural dimensions are identified where a certain combination of individual or group orientations causes the suppression or even reversal of behaviour in a dimension. Modifications to established cultural dimensions are recommended, especially long-term orientation which the author proposes renaming to ‘resistance to change’. A multidisciplinary approach that reflects the complexities of group behaviour and converges research findings is recommended, including utilising software that simulates complex systems. Recommendations are made for development practitioners, especially to enhance participation, promote femininity and achieve lasting change through training
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