Abstract
Community-led total sanitation (CLTS) is an approach to improving sanitation to combat open defecation (OD). OD is a health threat to children under five. CLTS promotes the construction of latrines with the goal of declaring communities open defecation free. However, which factors of the implementation process are most important for the success has yet to be ascertained. The analysed sample comprised of 94 communities in rural Ghana, where CLTS was implemented and factors describing the implementation process of CLTS were assessed. Additionally, monitoring data from the implementation process were used. Multiple regression analysis revealed that latrine coverage was significantly related to attendance at the CLTS meeting, the number of supportive community leaders, the expectation of participants of receiving an incentive, and the number of follow-up visits. Implementers of CLTS should direct their attention to the processes following the community meeting. The success of CLTS can be improved by investing in follow-up visits, the support of local leaders, and the careful application of incentives.
Highlights
In 2015, 2.3 billion people did not have access to safe sanitation facilities and were forced to defecate in the environment surrounding their communities.[1]
Every single follow-up visit to the community should increase latrine coverage by about 11.5%; every additional natural leader identified should increase latrine coverage by about 2.5%. This is the first time that several implementation factors describing the Community-led total sanitation (CLTS) process have been tested simultaneously for their influence on latrine coverage in communities
This was possible because of the large sample size of communities in this project. This allows firm suggestions to be made about improving the CLTS implementation process
Summary
In 2015, 2.3 billion people did not have access to safe sanitation facilities and were forced to defecate in the environment surrounding their communities.[1]. Community-Led Total Sanitation (CLTS) aims at stopping open defecation by motivating participants to construct household latrines and reach high latrine coverages in target communities. This set of community-based and participatory activities has been implemented in communities worldwide by local governmental and nongovernmental institutions.[9] The goal of CLTS is to trigger a movement of change towards an improved sanitation situation.[10] This change is achieved by the commitment of all community members. In the case of Ghana, where this study is located, a community is declared open defecation free, if every single person has access to a latrine and at least 80% of the community owns a household latrine.[11]
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