Community-Led Total Sanitation Research Articles

Explore Indonesian Spatial Patterns: Poor House Sanitation and Critical Environmental Disease in East Kalimantan

Objective Community-Led Total Sanitation, along with its contained 5 pillars, impacts on the fundamentals of status environmental health. This study aims to determine the spatial distribution pattern with sanitation facilities. This research aimed to analyze the distribution of houses with low economic priority in terms of topografi and their occupants' health conditions, focusing on critical environmental-based diseases, particularly stunting. Methods In order to improve sanitation facilities in terms of the community-based total sanitation pillar, this program was utilized as the stimulant recipient in this study, which had a population of 45 homes with special attention categories. Total sampling was employed to establish the research sample. Average Nearest Neighbor (ANN) and one-way analysis of variance (ANOVA) were used to examine the gathered data. Results As a result, the distribution pattern of the houses by looking at the poor environmental health condition, is categorized as clustered. The topography is hilly, with poor access to clean water, and there is no difference in the physical condition of the houses. Conclusion The pattern of distribution of houses with low economy is obtained in groups in areas that do not have access to adequate clean water. Diseases that exist in these community groups include diarrhea, tuberculosis, ISPA, and stunting.

Socio-Demographic Factors Associated with the Uptake of Community Led Total Sanitation: An Empirical Study among the Residents of Isiolo County, Kenya

Despite Kenya aiming to achieve 100% ODF status by 2030 and adopting CLTS, about 5.6 million (14%) of the population practice OD. Thus, this study was guided by the research question: What is the level of uptake of community led total sanitation among residents of Isiolo County? The study used a descriptive cross-sectional methodology and conducted among residents of Isiolo Sub-County, Kenya. The study sampled 373 household heads from population of about 21,870 household heads for the study. Systematic random sampling was used to select the participants. An inclusion and exclusion criteria-based period lived in the county and consent to participate in the study were used. Data collection instruments entailed structured questionnaires for households’ heads, key informant interview (KII) guides for opinion leaders, and an observation checklist. The content validity of the tools was assessed by expert from the department of Environmental Health at Kenyatta University. The tools were piloted in Longopito Sub-location with 37 households. Reliability of the tools was assessed using the piloted data through the test-retest technique. The paired data sets were correlated, giving R=0.75. The study found an association between demographic factors and the uptake of CLTS in Isiolo county. The uptake of CLTS was found to be low with almost half of the sampled residents lacking latrines. The study concludes there were a number of demographic factors that were significantly associated with the utilization of CLTS including the highest level of education (χ2=66.866, p = 0.001), Occupation (χ2=12.690, p = 0.002), Average monthly family income (KShs) (χ2=43.373, p = 0.012) and number of household members (χ2=6.948, p = 0.044). The study also found that Isiolo County had a low uptake rate for community-led total sanitation. Only three out of ten households in the county uptake CLTS. The study recommends that the County Government of Isiolo should scale up health education programs on community led total sanitation

Rethinking community-led total sanitation for eradicating open defecation in rural Ebonyi state communities, Nigeria: practice considerations for social work practitioners and educators

Abstract Nigeria is ranked number two in the world with the highest prevalence of open defecation (OD) despite the adoption of community-led total sanitation (CLTS) since 2007. Using some CLTS-triggered communities in Ebonyi State, this study investigated the awareness of CLTS, OD status, and its drivers as well as social workers' involvement in environmental sustainability. Study data generated from primary surveys included the socio-demographic characteristics of the study population and measurable behavioral elements of the SaniFOAM framework. Results of the statistical analyses show that more than 79% of the respondents were aware of CLTS, yet OD prevalence was 84.8%. While being married (odds ratio (OR): 0.036), being a civil servant (OR: 0.109), and having at least secondary education (OR: 0.119) were associated with lower odds of OD, whereas dislike for trekking (OR: 4.322), absence of laws (OR: 5.380), sanctions (OR: 4.715), and other SaniFOAM variables were associated with increased odds of OD. The results suggest that behavioral change toward OD under CLTS, with its focus on community mobilization for self-awareness and self-assessment for eliminating OD, may be a mirage without stricter approaches, laws, and sanctions for behavioral change. The domiciliation of these within grassroot governments and social workers' involvement in sanitation promotion are suggested.

Sanitation in a changing world: the need for a paradigm shift in the mindset of development agencies

ABSTRACT National and international agencies have struggled to address sanitation challenges for over a century without groundbreaking evidence of success. The context of sanitation management has changed over the last two centuries. In this changing world, the viewpoint calls for development agencies to move from a fixed-growth mindset towards a ‘benefit mindset’. Such a perspective is about purposefulness, adaptability and flexibility by developing context-specific approaches. In this respect, improvised community-led total sanitation (CLTS) could offer a way forward.

OPEN DEFECATION AS A CHALLENGE TO PUBLIC HEALTH IN GIWA LOCAL GOVERNMENT AREA, KADUNA STATE, NIGERIA

Open defecation is a threat to public and environmental health, it affects the occurrence and spread of mainly communicable diseases. This study examines the compliance of people to Community Led Total Sanitation (CLTS) and challenges of the program to reduce the existence of open defecation in Giwa Local Government Area (LGA). The study employed the use of questionnaire and structured interview as a source of data. Descriptive statistics and thematic framework were used for the analysis while charts and themes were used to present the findings. Results revealed that majority (56%) of the respondents were satisfied with the level of how community complied with the program. The findings also revealed that majority (31.30%) of the respondent’s considered poverty as the greatest challenge to the success of the program. Some of the key informants were also of the view that CLTS is highly applicable towards reduction in the rate of open defecation in the area. Therefore, the study recommends the provision of incentive to the people that will reduce the rate of poverty for the successful implementation of the program

What works in sanitation promotion?

Promotion appears to be the least effective but is nevertheless often the only available, means to achieve increased access to sanitation services, especially at scale, in lower-income countries. A cursory examination of the history of past and present approaches to sanitation promotion, including sanitation marketing, community development, community-led total sanitation and public health, shows that they have a variety of features and characteristics which make them distinctive. Unfortunately, rigorous evaluation has not kept pace with this proliferation of approaches, so it is difficult to recommend any one approach over the others, based on empirical performance in a range of circumstances. However, I argue that a 'hybrid' approach which exhibits a number of salient features from all of the previous approaches is likely to be a good bet. I present a recent example of such a hybrid programme which proved to significantly increase the rate of improved sanitation coverage through promotion (without subsidy of any kind) at scale in Tanzania. I suggest other sanitation promotion programs may want to think about adopting similar practices in their own programming going forward.

Factors influencing community-led total sanitation (CLTS) implementation abandonment before achieving open defecation-free (ODF) status: case study of the Central-Western region of Burkina Faso.

Access to sanitation has become an important element for improving the health of populations in developing countries. In Burkina Faso, 12% of the population in rural areas has access to latrine and 65% practice open defecation (OD). In a bid to eliminate this unsanitary practice and enhance sanitation access in rural areas, the government embraced community-led total sanitation (CLTS) as a national strategy in 2014. However, more than 6years later, a notable observation is the high abandonment rate, with only a small fraction of rural communities successfully eradicating OD. Out of the 8892 villages in the country, 3546 underwent a CLTS triggering from 2014 to 2020. Nevertheless, in 787 of these villages, the implementation of the CLTS approach was abandoned, indicating a substantial abandonment rate of 22.19%. Until now, most studies on CLTS have focused on the post-ODF phase, emphasizing the question of the sustainability of the results generated by the approach, as if the process from triggering to obtaining ODF certification was not subject to any problems. However, cases of abandonment of the CLTS process after triggering do exist, although poorly documented in the literature, and there are no studies that clearly assign responsibilities to the actors when CLTS implementation comes to be abandoned. This research aims to bridge these gaps by identifying the root causes of these abandonment cases while delineating the distinct responsibilities associated with these instances. To achieve this, the study was conducted in the Central-Western region of Burkina Faso, where all stakeholders involved in CLTS implementation, including target communities, were identified, their different roles in the process defined, and data collected through household surveys, interviews, and focus groups. The content analysis method was used to analyze the data. The research findings indicate that the abandonment of the CLTS implementation process is due to four categories of factors: sociocultural and economic aspects (39.78%), physical conditions (17.52%), governance aspects (26.28%), and the quality of approach implementation (16.42%). Moreover, these factors highlight a shared accountability for abandonment involving the government, implementing organizations, and target communities. These findings have significant implications for the future design of sanitation programs using the CLTS approach. To mitigate abandonment rates in the CLTS implementation process across rural communities, it is imperative for policymakers to attentively consider these factors and integrate the recommendations delineated in this study.

Sustainability of facilities built under the Community-Led Total Sanitation (CLTS) implementation: Moving from basic to safe facilities on the sanitation ladder.

In the context of monitoring progress towards SDG target 6.2, a household is counted to have access to sanitation if it uses at least basic sanitation services. Several approaches have been employed to help rural communities to climb up the sanitation ladder such as Community-led Total Sanitation (CLTS), whose primary target is to end open defecation through behavior change. CLTS does not subsidize sanitation facilities, but let households build their own facilities. The types and sustainability of facilities when construction is entrusted to households without guidelines remain understudied. The contribution of CLTS in achieving SDG6.2 also have not been studied. This paper addresses these gaps. Conducted in the province of Sissili in Burkina Faso, our study involved interviewing CLTS implementers, government officials, and community stakeholders. Coupled with household surveys, the data was analyzed using SPSS and Excel software. Findings indicate that CLTS succeeded in motivating households to build latrines hence escalating latrine coverage from 29.51% in 2016 (pre-CLTS) to 90.44% in 2020 (post-CLTS) in the province. However, 97.53% of latrines built were unimproved pit latrines with superstructures and without/with wooden or clay slabs and no roof, of which 19.76% collapsed during the rainy season. During this period, sanitation access rate rose from 11.9% to 17.00%. The study has therefore revealed that CLTS significantly elevates latrine coverage, yet it does not guarantee a proportional rise in sanitation access. This discrepancy results from the type of technologies generated by CLTS, which are not considered in calculating the sanitation access rate due to their unimproved nature. Consequently, further exploration of social approaches is essential, amalgamating technical and engineering aspects. Beyond socio-economic considerations, the sustainability of CLTS and the achievement of access to adequate and safe sanitation also rely on the robustness and resilience of the implemented facilities.

Effects of Community-Led Total Sanitation (CLTS) Boosting and Household Factors on Latrine Ownership in Siaya County, Kenya.

Community-led total sanitation (CLTS) is a widely used approach for enhancing sanitation practices. However, the impact of boosted CLTS on household latrine ownership has not been adequately evaluated. This study aims to investigate the factors associated with latrine possession among households, with a specific focus on single and CLTS-boosting implementation. A community-based repeated cross-sectional study was conducted in Siaya County, Kenya, involving 512 households at the baseline and 423 households at the follow-up. Data were analyzed using the mixed-effects logistic regression model. At the baseline, latrine possession was significantly associated with CLTS implementation (adjusted OR [aOR]: 3.01; 95% confidence interval [CI]: 1.41-6.44), literacy among households (aOR: 1.83; 95% CI: 1.12-2.98) and higher socioeconomic status (SES) (second level: aOR: 2.48; 95% CI:1.41-4.36, third level: aOR: 3.11; 95% CI: 1.76-5.50, fourth level: aOR: 10.20; 95% CI: 5.07-20.54). At follow-up, CLTS boosting (aOR: 7.92; 95% CI: 1.77-35.45) and a higher SES were associated with increased latrine ownership (second level: aOR: 2.04; 95% CI: 0.97-4.26, third level: aOR: 7.73; 95% CI: 2.98-20.03, fourth level: aOR: 9.93; 95% CI: 3.14-28.35). These findings highlight the significant role played by both single and CLST boosting in promoting universal latrine ownership and empowering vulnerable households to understand the importance of sanitation and open defecation-free practices.

Towards more sustainable Water, Sanitation and Hygiene (WASH) projects in Magway Region, Myanmar

AbstractClean water and sanitation are essential for human development. Governments, international and national aid organizations have implemented water, sanitation, and hygiene (WASH) projects worldwide, notably in low- and middle-income countries. However, the majority of such projects experience failure. As a result, 2.4 billion people worldwide are deprived of improved WASH services. Research revealing how WASH projects can be sustained and which factors need to be considered is crucial. Despite the gap and its importance, existing studies on the sustainability assessment of WASH projects are limited. This study attempted to assess and compare the sustainability of WASH projects in Myanmar that used the Community Led Total Sanitation (CLTS) and Participatory Hygiene and Sanitation Transformation (PHAST) approaches with the “Sustainability Check” developed by The United Nations Children’s Fund (UNICEF). This research also evaluated the extent to which WASH projects contributed to the Myanmar National WASH Strategy. The study results show that both CLTS and PHAST project operations fully met the sustainability standards regarding accessibility and intra-village equity. Other sustainability indicators, such as water quality, use of sanitation facilities, and handwashing facilities, were at or above 85% and had already met the 2025 national targets. In contrast, handwashing practices have reached the 2030 national targets. The findings revealed that technical factors, institutional factors (at the community level), social, financial, and sanitation factors contributed to WASH project sustainability. The results also highlight the need for strengthening collaboration with local government to ensure that communities receive post-implementation support from local authorities, to encourage community participation and foster sense of ownership, to empower community-based bodies for O&M and monitoring of water and sanitation facilities, to integrate appropriate behavioral change activities, and to align with the National WASH Strategy. This study would be beneficial for WASH practitioners to ensure the inclusion of factors that support sustainability in the execution of future WASH projects. Graphical abstract

Acceptance Factors for the Social Norms Promoted by the Community-Led Total Sanitation (CLTS) Approach in the Rural Areas: Case Study of the Central-Western Region of Burkina Faso

Although access to sanitation has been recognized as a fundamental human right, 3.6 billion people do not enjoy this right globally. In this group, the practice of unhealthy sanitation behaviors, such as open defecation (OD), is very common. To alleviate this problem, several governments in low-income countries have adopted Community-led Total Sanitation (CLTS). This is a participatory approach focused on ending OD and promoting good hygiene behaviors in target communities. This approach is centered around and highly depends upon a given community’s willingness to adopt the practices it advocates. However, the determinant factors in a community’s acceptance or refusal of these practices during and after CLTS implementation remain unclear. The aim of this paper is to highlight and categorize these factors to increase the sustainability of the approach. To achieve this, a study was conducted in the central-western region of Burkina Faso, where CLTS has successfully been deployed. We began this study by drawing a list of possible determinants through a literature review and grouping them into six categories. This enabled us to set up an evaluation matrix with scores for each factor and data collection tools. Scoring was based on the number of positive respondents for that factor. Data were then collected at the institutional, regional, local, and household levels from CLTS stakeholders to identify context-specific factors that underpinned behavior change in the surveyed villages. The literature review revealed six categories of acceptance factors. In our study, the importance of these factors according to our respondents were ranked in descending order as follows: environmental (C1 = 592), social (C2 = 390), governance (C4 = 247), territorial (C6 = 189), economic (C3 = 15), and technological (C5 = 0). The most frequently discussed factors obtained included the understanding of the health and economic consequences of OD (C1, score = 550); the popularity and reputation of Open Defecation-Free (ODF)-certified villages (C6, score = 179); men’s desire to protect their wives’ privacy (C2, score = 138); and women’s understanding of the adverse effects of OD on their children’s health (C2, score = 119). Incorporating the acceptance factors found in this study into future CLTS interventions will improve the effectiveness of the approach and increase the sustainability of ODF status in similar contexts.

Latrine utilization and associated factors among districts implementing and not-implementing community-led total sanitation and hygiene in East Wollega, Western Ethiopia: A comparative cross-sectional study.

Discharge of excreta to the environment lead to surface and groundwater contamination and human exposure to disease-causing micro-organisms. There is limitation of evidences regarding the latrine utilization among community-led total sanitation and hygiene implemented and non-implemented districts of the East Wollega Zone. Hence, this study aimed to determine the magnitude and associated factors of latrine utilization among households in community-led total sanitation and hygiene implemented and non-implemented Districts in East Wollega Zone, Western Ethiopia. A cross-sectional study was conducted. A Multi-stage sampling technique was applied to select the 461 households. Data were collected using interviews and observations guided by a pre-structured questionnaire. Data were entered using Epi Data and exported to SPSS software version 25 for data recording, cleaning, and statistical analysis. Bivariable logistic regression was run to identify the candidate variables at p-value <0.25. Variables that had associations with latrine utilization in the bi-variable analysis were entered together into multivariable logistic regression. An Adjusted odds ratio with a 95% confidence interval was calculated and P-value< 0.05 was used to declare a statistically significant association. The overall prevalence of latrine utilization was found to be 52.7% (95%CI:48%, 57.3%). Religion (AOR = 0.149;95%CI:0.044,0.506), education (AOR = 3.861;95%CI:1.642,9.077), occupation, absence of children <5 years (AOR = 4.724;95%CI:2.313,9.648), toilet cleaning (AOR = 10.662;95%CI:5.571,20.403), frequency of latrine construction (AOR = 6.441;95%CI:2.203,18.826), maintenance need (AOR = 6.446; 95%CI:3.023,13.744), distance from health institution (AOR = 0.987; 95%CI:0.978, 0.996), distance from kebele office (AOR = 6.478; 95%CI:2.137,19.635), and latrine distance from dwelling (AOR = 11.656; 95%CI:2.108, 64.44) were the factors associated with latrine use. The latrine utilization in this study is low as compared to other studies. Religion, education, occupation, absence of children <5 years, toilet cleaning, frequency of latrine construction, maintenance need of the toilet, distance from health institution, distance from kebele, and latrine distance from dwelling are the associated factors of latrine utilization. Both households and health workers have to work together to improve latrine utilization and the safe disposal of children's feces.

How has community-led total sanitation (CLTS) affected open defecation in urban communities in the Tamale Metropolis?

How has community-led total sanitation (CLTS) affected open defecation in urban communities in the Tamale Metropolis?

Community-Led Total Sanitation: Method of prophylactic control of intestinal parasitic infections in rural areas, Côte d’Ivoire

Community-Led Total Sanitation: Method of prophylactic control of intestinal parasitic infections in rural areas, Côte d’Ivoire

Pemicuan Community Led Total Sanitation di Jorong Lubuk Koto, Nagari Sialang, Kecamatan Kapur IX, Kabupaten 50 Kota

The main factors related to open defecation behaviour in Jorong Lubuk Koto are the lack of basic sanitation facilities and the low level of public knowledge regarding health problems due to poor sanitation. Triggering Community Led Total Sanitation (CLTS) is needed to help the community understand the diseases caused by open defecation practices and encourage community behaviour change to stop open defecation. Based on data from the Regional Technical Implementation Unit of Sialang Public Health Center, the percentage of households with pit latrines is only 31.8%. CLTS had yet to be previously implemented in Jorong Lubuk Koto. Therefore, Jorong Lubuk Koto was chosen as the location for triggering CLTS. The CLTS activities included triggering, observations, and interviews through questionnaires. The pre-test and post-test questionnaires showed the increasing knowledge of participants regarding diseases caused by open defecation practices and the community's desire to build healthy family latrines.

Review of the slippage factors from open defecation-free (ODF) status towards open defecation (OD) after the Community-Led Total Sanitation (CLTS) approach implementation.

Open-defecation (OD) is one of the most widespread sanitation practices in low-income countries. This practice often causes diarrheal diseases and 760,000 deaths per year. To eradicate OD, several approaches have been developed, including Community-Led-Total Sanitation (CLTS) which is a participatory and community approach. The specificity of CLTS is that it is managed by the community itself, as its name implies, and that no subsidies or financial contributions from outside the community are used in the construction of the facilities. Although, the CLTS is effective in the short-term for eradicating OD, the long-term results are not encouraging: Open-Defecation-Free (ODF) communities revert to OD or partially use latrines. The present research is based on literature review and authors investigation in Burkina Faso. It was conducted to provide a comprehensive understanding of the factors that affect the sustainability of ODF-status leading to slippage in communities. It was found that these factors can be grouped into five categories: behavioral and social, technological, organizational, and vulnerability factors. The last one, socio-political factors, is a contribution from the authors as it was not reported in the literature yet. The authors have proposed graphical synthesis of all the slippage factors and their associated categories in the ODF-communities. Finally, authors have suggested that to sustain ODF-status of communities: include all stages of the sanitation value chain (SVC) in the CLTS, the follow-up activities after achieving ODF-status must be planned well in advance, sanitation marketing should be developed and the sanctions against the practice of OD have to be reinforced. Governments and donors should pay particular attention to the following options: raising awareness and regular monitoring after ODF certification, encouraging research on sustainable and pro-poor sanitation technologies, and building the capacity of implementing actors including facilitators. While obtaining ODF status is materialized by a sign with the status on it, this paper drew the attention of CLTS implementers to the lack of materialization of slippage when it occurs, and the absence of studies on the evolution of the community sanitation scale after ODF-status.

Sharing and Co-Generating Knowledges: Reflections on Experiences with PRA and CLTS

The evolution and spread of PRA (Participatory Rural Appraisal or Participatory Reflection and Action) and CLTS (Community‐Led Total Sanitation) have involved activities of sharing and co‐generating knowledge which can loosely be considered a form of Action Learning. Key activities for this have been sequences of participatory workshops which have evolved as creative collective experiences fed by and feeding into wider networking and dissemination. These workshops have been occasions for sharing practice and collating experiences, and going beyond these to generate ideas and evolve and agree principles and good practices. Critical reflections concern power, planning and process, theory of change and impact, lessons learnt, and an ongoing learning process.

Community-Led Total Sanitation: Conceptual Approach to Intestinal Parasites Control in Rural Areas, Cote d’Ivoire

Lack of appropriate sanitation, with poor hygiene and unsafe water, are sources of the spread of diseases. Ongoing efforts to control neglected tropical diseases, including helminth and intestinal protozoan infections, must be maintained and strengthened with new approaches. The aim of this study was to test the adherence of communities to the Community-Led Total Sanitation (CLTS) approach. The study was conducted in three (3) departments in south- central C&amp;ocirc;te d&amp;#39;Ivoire. In practice, the process of implementing CLTS involves 5 major steps: i) Mapping of defecation areas, ii) Calculating of human fecal matter quantity and medical costs, iii) Walk of shame, iv) Analysis of contamination pathways, v) Community decision making and latrine construction. Overall, latrine coverage and usage rates have increased considerably in the intervention localities. In particular, out of the 26 localities where the CLTS was applied, 11 reached a latrine coverage rate higher than 80%, 6 of which reached a 100% coverage rate. The results of this work should be used to raise awareness in rural communities about the importance of building and using latrines. Furthermore, CLTS implemented on a large scale can contribute to achieving Goal 3 and 6 of the Sustainable Development Goals (SDGs).

Stakeholder evaluation of sustainability in a community-led wastewater treatment facility in Jakarta, Indonesia

Indonesia’s severely flawed centralized wastewater treatment system has caused economic and socioeconomic losses for decades. An alternative system has been called for under a national-scale program called Sanimas or Community-Led Total Sanitation (CLTS), which would cater to 50–100 urban families in every intervention with urgent needs through the operation of a decentralized wastewater treatment system. Through household participation, this program features a co-production system wherein the national-level government initiates and provides initial funding until construction, after which a community-appointed social organization takes over. This study implemented a multicriteria approach to assess sustainability in Sanimas communities in Jakarta: 67 in Menteng (Central Jakarta) and At-Taubah in Koja (North Jakarta). Connected households and facility-operating committees were questioned separately for their opinions on six aspects that explained the survival of the establishment of a facility: technical, management, community participation, financial, institutional, and environmental. We found that although the facility’s excellence and overall satisfaction with the program were unanimous, Koja and Menteng showed substantial differences in management, institutional, and financial aspects, largely due to administrative policies, payment contributions, and committee commitments. Interviews revealed that periodic testing of the treated water was neglected, against the provided guidance. In conclusion, communities have come to focus more on the technical functionalities of the installation, regardless of the state of the management, which is indisputable not only in Menteng but also in Koja. Finally, we argue that although decentralized systems can substitute centralized systems, they still require stringent and adequate support in quality control and troubleshooting.

PEMBERDAYAAN MASYARAKAT DALAM KEPEMILIKAN JAMBAN KELUARGA DI DESA TALANG BOSENG WILAYAH PUSKESMAS SIDODADI KECAMATAN PONDOK KELAPA KABUPATEN BENGKULU TENGAH

Efforts to improve hygiene behavior and increase access to sanitation continue to be developed. One of the applications of the Community Led Total Sanitation (CLTS) concept, CLTS is a concept with a promotion approach by facilitating the community to apply good environmental sanitation with a focus on not defecating in the open. Based on the 2019 annual report Health Center, the incidence of diarrhea ranks second in environmental-based diseases with 111 cases. The high prevalence of diarrhea is partly due to the lack of access to clean water, as much as 27.4% of clean water facilities/dug wells do not meet the requirements. As many as 35% of households still defecate in the open. The process of implementing community service activities in the framework of open defecation-free villages in Talang Boseng Village Working Area of ​​the Sidodadi Health Center, Pondok Kelapa District, Central Bengkulu Regency, namely using a combination of triggering and providing stimulants for the construction of family latrines carried out by the Community Service Team from the Bengkulu Ministry of Health Polytechnic, Sidodadi Health Center, Sidodadi Village Officials, and the Sidodadi community who do not yet have or who have latrines that do not meet health requirements.