Community-led Total Sanitation Approach Research Articles

Latrine Utilization and Its Associated Factors Among Community Led Total Sanitation Implemented and Non-Implemented Kebeles of Tullo District, West Hararge, Eastern Ethiopia.

Background:Improper human waste management is a major health problem in most developing countries, including Ethiopia. In Ethiopia, the majority of the population used unimproved sanitation facilities and practiced open defecation. This problem is significantly higher in the rural parts of the country.Objective:The aim of this study was to assess latrine utilization and associated factors among Community Led Total Sanitation (CLTS) implemented and non-implemented kebeles in Tullo District, West Hararghe, and Eastern Ethiopia.Methods:A community-based comparative cross-sectional study design was conducted in 740 households in 3 kebeles Community Led Total Sanitation implemented and 3 kebeles non-Community Lead Total Sanitation implemented for comparison. Study units were selected using a multi-stage sampling technique. The data was cleaned and coded before being entered into Epi-data version 3.1 and analyzed with the Statistical Package for the Social Sciences version 20. Logistic regression analysis was used to assess the association between dependent and independent variables.Result:In this study, the overall prevalence of latrine utilization in the study area was 415 (56.1%) (95% CI = 52.6%, 59.9%). Of them, 243 (65.7%) (95% CI = 60.4%, 70.3%) and 172 (46.5%) (95% CI = 41.3%, 51.7%) of participants in the CLTS and non CLTS kebeles were utilized latrine, respectively. In CLTS implemented kebeles, literate (AOR = 3.66; 95% CI: 1.53, 8.73), households being visited by health extension worker (AOR = 11.72; 95% CI: 4.01, 34.31), households being graduated as model family(AOR = 7.56, 95% CI: 2.79, 20.44), ⩾2 years by years of latrine owning (AOR = 12.10, 95% CI: 3.21, 45.64), >6 meters distance of toilet to home (AOR = 27.43, 95%CI: 8.43, 89.29),Latrine with hand washing (AOR = 2.93, 95%CI: 1.19, 7.17), latrine with superstructure (AOR = 6.54, 95% CI: 2.04, 20.98) were significantly associated with latrine utilization, while in non CLTS implemented kebeles, literate (AOR = 25.78, 95% CI: 13.35, 49.78), medium wealth status(AOR = 4.87, 95% CI: 2.10, 11.29), poor wealth status(AOR = 2.51, 95% CI: 1.26, 5.01) were significantly associated with latrine utilization.Conclusion:The findings of this study revealed that more of the rural households had utilized latrines in CLTS implemented kebeles than non-CLTS implemented’ kebeles. So, it is recommended that the district health office increase the latrine utilization rate through the effective and sustainable implementation of the CLTS approach.

Open defecation near a world heritage site: causes and implication for sustainable tourism and heritage management

PurposeThe sixth of the global Sustainable Development Goals (SDGs) has access to improved sanitation as one of its targets. Sanitation is important not only for environmental quality and public health but also for the outstanding universal value (OUV) of heritage monument sites and tourism promotion. The study examined the causes of open defecation (OD) in the neighbourhood of a World Heritage (WH) site in Ghana and the implications of the practice for sustainable tourism and heritage management.Design/methodology/approachThe study used the qualitative approach. Data were gathered from purposively targeted respondents (an Environmental Health Officer, Heritage Managers, a Tourism Expert, Hoteliers, Zoomlion Staff, Open Defecators, Community Opinion Leaders and Ordinary Community Residents) and analysed using the thematic approach.FindingsIt became evident that the causes of OD were: the lack of toilet facilities in many houses in the community, filthy and foul-smelling public latrines, poor attitude and heritage culture, mental and income poverty, inadequate sensitisation and a poor law enforcement regime. OD threatened the sustainability of heritage tourism and its associated livelihoods, as well as public health. In addition, it impaired the authenticity and integrity of the heritage monument, culminating in a detraction from the OUV of the heritage property.Practical implicationsIn collaboration with the local, national and international stakeholders, the managers of the heritage monument should design and implement a comprehensive environmentally friendly plan. The plan should consider demarcating the boundaries of the heritage asset, monitoring the protected area, enforcing sanitation laws and mounting intensive sanitation education campaigns. It should also consider providing a decent toilet in the vicinity of the monument for the transit population, facilitate the provision of a toilet in every house through the community-led total sanitation approach, installing digital cameras at vantage points in the buffer zone of the castle to capture open defecators and punishing offenders severely to deter others from engaging in the ignoble practice of OD.Originality/valueThe authors argue that sanitation at heritage sites in developing countries merits further discussion within the WH network to promote sustainable heritage conservation management and tourism.

Zakat Funding Solution In Community-Led Total Sanitation (CLTS) Approach For Clean Water And Proper Sanitation In Banten, Indonesia

Providing clean water and sanitation for developing countries presents its problems mainly related to people‘s unhealthy behavior and funding that needed to build clean water facilities and infrastructure. Various attempts were made by both the government and the private sector to provide proper sanitation, particularly for the poor. It also aims to give one of the most significant service delivery challenges related to poverty alleviation and sustainable living. This article presents new sanitation developments focused on community-led total sanitation (CLTS) approach and zakat as a funding solution. The researchers used the Miles and Huberman (1992) research model consisting of data reduction, data display, and verification. The result is LAZ Harfa with the CLTS approach could increase the number of houses with latrines by 40.19 percent in Banten from 2006 to 2019, also coaching schools in building 25 latrines, the number of beneficiaries increased significantly to 47,174 from 14,461 individuals. The article closes by arguing that zakat as possible alternative funding by seeing the potential that can improve the sustainability of sanitation service interventions.

Reducing Open Defecation Through Community-Led Total Sanitation in Fort Dauphin, Madagascar: A Case Study

Globally, an estimated 4.5 billion people lack safe water and sanitation services. In Madagascar, open defecation is particularly commonplace, with nearly half of the population practicing it. Construction of latrines alone is ofen insufcient in reducing this number, as availability does not mean the latrines will be used by the community. Community-Led Total Sanitation (CLTS) is an approach which aims to reduce the prevalence of open defecation by catalyzing community action towards increasing use of latrines and other personal hygiene behaviors. Tis case study evaluates the hybridCLTS approach implemented by SEED Madagascar in Fort Dauphin, Madagascar, between 2014 and 2017. Specifcally, the intervention’s impact on sanitation and hygiene behavior outcomes, and health outcomes are investigated. Te report concludes that this intervention is a successful example of adapting a CLTS approach to an urban context where open defecation practices are driven by a complex set of traditional and cultural beliefs. However, signifcant challenges must be overcome to support such an approach, including ensuring adequate stakeholder engagement, sustainable fnancing, and broader Water Sanitation and Hygiene (WASH) strategies. Recommendations include fostering partnerships with other organizations, integrating participatory planning approaches, and promoting sustainable sanitation entrepreneurship.

Policy Diffusion in the Rural Sanitation Sector: Lessons from Community-Led Total Sanitation (CLTS)

Worldwide, 892 million people practice open defecation, most of whom live in rural areas of South Asia and Sub-Saharan Africa. Community-Led Total Sanitation (CLTS) is the most widely deployed approach to generate demand for, and use of sanitation facilities. CLTS relies on behavioral change and community self-enforcement to end open defecation. Since its genesis in Bangladesh in 1999, CLTS has spread to approximately 60 countries, mostly in Asia and Africa, and is employed by the majority of development organizations operating in rural sanitation. This paper uses a qualitative approach to analyze the reasons and processes that drove the wide diffusion of CLTS. We show that CLTS was embraced because it was perceived as a fast and effective solution to the problem of open defecation, one which was in line with the decentralization and community participation paradigms, at a time when donors and governments were looking for strategies to meet the MDG for sanitation. CLTS spread under the leadership of influential donors, NGOs, persuasive practitioners, and academics. Face-to-face interactions among members of this network and local governments at conferences and workshops played a central role in the diffusion of the approach. The use of experiential learning during study tours and workshop field visits has been crucial to persuade government actors at different levels, NGOs, and donors to use the CLTS approach. Notably, robust scientific evidence played little role in the diffusion of CLTS. We conclude by making suggestions to strengthen the evidence base for rural sanitation policies.

Sanitation: the neglected Siamese twin of water in achieving the millennium development goals (MDGs) in Ghana

While inadequate water and sanitation services have both been implicated in a number of mortality and morbidity situations all over the world, the improvement in sanitation provision lags far behind that of water. This paper therefore seeks to examine the spatial variation in sanitation provision in Ghana and assess the factors that have contributed to the low investment in sanitation infrastructure as well as how sanitation can be improved. It revealed that the low sanitation has its roots in somewhat complicated political, institutional, economic and socio-cultural factors, including inadequate political commitment, poor monitoring, higher negative externalities associated with sanitation compared with water, and low sanitation demand resulting from poor social marketing for sanitation. Sanitation should therefore be marketed as a concept that has public health benefits and not merely as a toilet facility. Proper social marketing for sanitation and scaling up the community-led total sanitation approach should be pursued to stimulate individual demand for private sanitation.

English

This study was carried out to determine the magnitude to which Community Led Total Sanitation (CLTS) approach leads to improved sanitation and its potential threats to groundwater quality and health of people. A comparative study was carried out between eight CLTS and non CLTS villages to measure the outcomes of CLTS approach. Water samples were collected to assess the level of contamination in groundwater sources near pits in villages where CLTS approach was adopted. Semi structured interviews, focused group discussions (FGDs) and transit walks were used for data collection. Results revealed the tendency of high level of groundwater contamination in CLTS as compared to non CLTS villages which might be because of pit latrines in the area. Water for hand washing is available, but the use of soap depends upon the economic status of the households. However, 5% increase in the hand washing practices was noticed during the field data collected in CLTS implemented village as compared to non CLTS villages. In addition, water borne disease prevalence was also noticed in CLTS villages, but some improvements were observed in terms of hygiene among the people in CLTS implemented villages. The findings showed that the drinking water quality is deteriorated in the study areas which could be linked to promotion of sanitation systems that do not break the pathogen cycle. Key words: Community Led Total Sanitation (CLTS) villages, groundwater contamination, Environmental sanitation, health, hygiene.

Urban community-led total sanitation: a potential way forward for co-producing sanitation services

Community-led total sanitation (CLTS) has been proved to be a successful strategy for tackling the challenge of open defecation in poor rural communities across Africa and Asia. This article explores whether a similar approach can be used in peri-urban and urban areas to help co-produce sanitation facilities and services with inputs from communities, duty bearers, and other sanitation stakeholders. It is argued that an urban CLTS approach does not mean a copy and paste of tools and methods which have proved successful in the rural environment but following a set of similar principles. Based on field experiences different steps are suggested that incorporate these principles and respond to the specific urban sanitation problem. This article helps to articulate and better define urban CLTS as well as giving practical guidance for those wanting to use this kind of approach.

Parasitological and nutritional status of school-age and preschool-age children in four villages in Southern Leyte, Philippines: Lessons for monitoring the outcome of Community-Led Total Sanitation

While preventive chemotherapy remains to be a major strategy for the prevention and control of soil-transmitted helminthiases (STH), improvements in water, sanitation, and hygiene (WASH) comprise the long-term strategy to achieve sustained control of STH. This study examined the parasitological and nutritional status of school-age and preschool-age children in four villages in Southern Leyte, Philippines where two of the villages attained Open-Defecation-Free (ODF) status after introduction of Community-Led Total Sanitation (CLTS).A total of 341 children (89.0% of the total eligible population) submitted stool samples which were examined using the Kato-Katz technique. Results showed that 27.9% of the total stool samples examined had at least one type of STH (cumulative prevalence), while 7.9% had moderate-heavy intensity infections. Between the two villages where CLTS was introduced, Buenavista had a significantly higher cumulative prevalence of STH at 67.4% (p<0.001) and prevalence of moderate-heavy intensity STH at 23.5% (p=0.000), while Caubang had a significantly lower cumulative prevalence at 4.9% and prevalence of moderate-heavy intensity at 1.8%. On the other hand, the non-CLTS villages of Bitoon and Saub had similar rates for cumulative prevalence (16.7% and 16.8%, respectively; p=0.984) and prevalence of moderate-heavy intensity STH (2.0% and 3.1%, respectively; p=1.000). The findings may be explained by factors that include possible reversion to open defecation, non-utilization of sanitary facilities, and mass drug administration (MDA) coverage, although further studies that can accurately assess the impact of CLTS are recommended. While this study was descriptive, the data indicate no clear pattern among the parasitological and nutritional parameters, as well as the presence of CLTS in the village, suggesting the need to monitor the ODF status of villages on a regular basis even after the end of CLTS activities to ensure the sustainability of the CLTS approach. In order to achieve effective control of STH, deeper collaboration between the WASH and STH sectors are recommended where partners can work together in the area of monitoring and evaluation that may include improved parasitological and nutritional status in high-risk groups, as well as sustainable behavior change as outcome indicators.

Technical Note: Is there a role for external technical support in the Community-Led Total Sanitation (CLTS) approach?

Community-Led Total Sanitation (CLTS) involves creating community health awareness, changing behaviours, generating a demand for sanitation, and finally the design and construction of sanitation solutions (e.g. latrines). The CLTS approach intentionally avoids any up-front external subsidies or technical support throughout the process. By excluding technical support, the CLTS philosophy argues that people innovate and develop a sense of ownership for the latrines that they build, which in turn leads to sustainable use of the latrines. This article questions this exclusion of technical support. Specifically, the article summarises the CLTS approach, identifies innovative designs that have been implemented by CLTS communities, discusses the technical weaknesses of some of these designs, and reports the responses from a survey of leading sanitation experts and practitioners regarding the potential need for technical support in CLTS. The study findings suggest that community innovations resulting from CLTS ar...

Community-based approaches for addressing the urban sanitation challenges

Urban sanitation presents one of the most significant service delivery challenges related to poverty alleviation and sustainable development in the developing world. The past decade has witnessed innovations in service delivery approaches for unserved rural and urban settlements with a clear policy shift to community-based approaches that attempt to overcome the supply-led, over-engineered sanitation solutions of the past decades. This article presents two examples of new developments: the urban-focussed household-centred environmental sanitation (HCES) and the rural-focussed community-led total sanitation (CLTS) approaches. The internationally renowned CLTS approach has achieved considerable success since its introduction, by harnessing community and small private sector capacity to solve sanitation problems locally. Experience with validation of the HCES approach in a variety of urban sites in Africa, Asia and Latin America is presented in the second part of the article highlighting some of the lessons learned. The article closes by arguing that a combination of HCES and CLTS, two field-tested methodologies, has the potential to improve the sustainability of sanitation service interventions.