An Evaluation of the CLTS Implementation Process from the Beneficiary Perspective: A Cross-sectional Study from the Bole District of the Savannah Region, Ghana

Abstract

CLTS is by far the most widely implemented rural-based sanitation intervention across lower middle-income countries worldwide. Today, within the National Environmental Sanitation policy (NESP), CLTS has been acknowledged as the preferred approach to scale-up rural sanitation and hygiene in Ghana. The approach focuses on igniting a change in sanitation behaviour rather than constructing toilets. This research was intended to evaluate the CLTS implementation process from the beneficiary perspective in Bole District. The cross-sectional study employed the mixed method approach using questionnaires, focus group discussions and in-depth interviews in collecting data from a sample of <i>137</i> households from <i>20</i> communities. In addition, <i>2</i> Environmental Health Officers, <i>10</i> Natural Leaders and <i>1 </i>management team member of Bole District Assembly were also interviewed. The qualitative data were manually analyzed using thematic content analysis and the quantitative data were analyzed using the SPSS version 22.0. The findings of the study revealed high level of knowledge about the CLTS concept among the participants (66.3%). The study further revealed that the entire CLTS implementation process within the district was largely in line with established CLTS implementation processes and procedures. However, specific activities such as enactment of community regulations, children and local authority involvements in the implementation process was either not carried out or was poorly done. In terms of the general impression of the participants about the CLTS implementation process, majority of the respondents rated the process as below standard. The study recommends the development and enforcement of a comprehensive CLTS implementation framework by the government.