Community-Led Total Sanitation (CLTS)

(Adapted from KAR and CHAMBERS 2008; WSP 2007)

Community-Led Total Sanitation (CLTS) is an approach which is based on the principle of triggering collective behaviour change. In this approach, rural communities are facilitated to take collective action to adopt safe and hygienic sanitation behaviour and guarantee that all households have access to safe sanitation facilities. CLTS focuses on instigating a change in sanitation behaviour rather than constructing sanitation infrastructure. This change in sanitation behaviours is accomplished through a process of social awakening that is stimulated by facilitators from within or outside the community (see also awareness raising). The CLTS approach concentrates on the whole community rather than on individual behaviours. Collective benefit from stopping open defecation can encourage a more cooperative approach. People decide together how they will generate a clean and hygienic environment that benefits everyone. It is essential that CLTS involves no individual household hardware subsidy and does not prescribe latrine models.

The CLTS approach concentrates on ending open defecation as a first significant step and entry point to changing behaviour. It starts by enabling people to do their own sanitation profile through appraisal, observation and analysis of their practices of open defecation and the effects these have.

In its fullest sense, total sanitation includes a range of behaviours such as: stopping all open defecation; ensuring that everyone uses a hygienic toilet; washing hands with soap before preparing food and eating, after using the toilet, and after contact with babies’ faeces, or birds and animals; handling food and water in a hygienic manner; and safe disposal of animal and domestic waste to create a clean and safe environment.

(Adapted from WSP 2007)

In Bangladesh (Rajshahi district) a unique community mobilisation approach was piloted in the year 2001 by the Village Education Resource Centre in Bangladesh, a local NGO and partner of WaterAid Bangladesh. The main goal was to achieve total sanitation coverage. The approach aimed to make the community realise how important it is to totally ban open defecation within the village, without any external subsidy, and based entirely on community mobilisation. The communities used their own resources, created action committees, developed innovative low-cost technologies, monitored progress, and ensured that all households adopted fixed-point safe and hygienic defecation practices. External agencies were only facilitating the process. The Rajshahi initiative demonstrated a paradigm-shift in promoting improved sanitation practices through a community-based strategy. However, the approach to scaling up was modest and only a village-by-village upscale was attempted.

The Rajshahi project had raised interest in India, leading to visits by policy makers facilitated by the Water and Sanitation Program-South Asia. Based on the visits to Bangladesh and dissemination of lessons in workshops, Maharashtra formulated a strategy to end open defecation in the state. The Bangladesh visits and Maharashtra initiative also assisted in revising the national sanitation guidelines in India and contributed in introducing the concept of the need to create open defecation-free villages. Within South Asia, there are efforts in Pakistan and Nepal to take up the approach, while CLTS has been introduced as a national program in Indonesia and Cambodia.

(Adapted from RCNN 2007)

In the beginning of the process, the community is approached to build rapport, clarify the objective of the programme and convince the community members why they should implement a no subsidy programme led on their own. Once the community understands the objectives, you have to make them realise and accept how open defecation creates problems and affects their lives. Then participatory rural appraisal (PRA) methods are adopted (see planning and process tools in general).

PRA methods are used to bring instant change in the understanding and behaviour of the people by igniting sparks of awareness in their minds. This process is adopted to motivate community members through their won involvement and initiative to build and use latrines as well as bring positive changes in their hygiene and sanitation behaviour. This method helps to change people’s perception allowing them to start thinking from a new dimension and perspective.

The following tools are used:

• Shameful walk: A shameful walk, an adapted version of a classic “transect walk”, is called the process of collectively visiting the places of open defecation by members of the community and representatives of the facilitating organisations.
• Faeces mapping: Faeces mapping is the process of preparing the community map indicating the places of defecation through community participation. 
• Faeces calculation: Once people realise that there is a lot of faeces lying around in the area, you should raise the questions such as: How much on an average does an individual defecate in a day?
• Faeces mobility mapping: In this exercise community members should realise how dangerous open defecation is by getting to know the five different faecal-oral contamination ways in order to avoid the transmission of diseases like diarrhoea and improve the health and hygiene situation. This is called the five-F-diagram. Faecal-oral contamination can happen through: 1. Food, 2. Fingers, 3. Flies (and all kind of insects), 4. Fields (agriculture field), 5. Fluids (e.g. water).

After having used these exploring methods and tools, the facilitator should ask the community who and by when the community will stop indirectly ingesting faeces or within how many days they will end open defecating practices. The names of the people will be listened down who commit that they will stop open defecation. Ask the person who commits to construct a toilet in the shortest span to step forward. Give a round applause to the individual and applause the rest one by one.

After the community members have expressed their commitment not to defecate in the open, it has to be decided by whom and how these commitments will be monitored. For this purpose it can be useful to form a committee (see also decision making section).

This committee should also decide the duration within which to declare the community an “open defecation free” area. Set the date for this and accordingly facilitate to develop an action plan.

(Adapted from KAR and CHAMBERS 2008; WSP 2007)

• Focusing on outcomes, not on hardware inputs.
• Collective action: Mobilising the community rather than establishing household contacts.
• Local choice: Providing a variety of technological options and getting people to access affordable technologies.
• Setting up proper institutional frameworks institutional framework: Giving local governments a central role in scaling up and sustainability.
• Incentives: Directing incentives to the community and rewarding outcomes, rather than subsidising household toilets.
• Market development: Promoting the availability of sanitary materials and allowing private suppliers to respond to the demand (see privatisation).
• Communities construct their own latrines or toilets with their own resources. Those people who are better off help those who are too weak or poor to help themselves.
• No standardised top-down designs: People decide for themselves.
• Facilitation, not teaching or preaching: Appraisal and analysis are facilitated. But after triggering information media campaigns and encouragement can be provided.
• Spontaneous emergence of Natural Leaders (NLs) as a community proceeds towards Open Defecation Free (ODF) status.
• Local innovations of low cost toilet models using locally available materials.
• Community-innovated systems of reward, penalty, spread and scaling-up.

(Adapted from CHAMBERS 2009)

CLTS entails with it the potential for further benefits beyond those of previous partial sanitation programmes:

• Speed. The speed of going total, meaning that the community is claiming to be Open Defecation Free (ODF), can be remarkable. In best-case scenarios communities declare themselves or are declared ODF in a matter of weeks.
• Totality. ODF conditions provide a public and not just a private good. CLTS has shown a spotlight on this aspect. A question is to what degree achieving total or degrees of total ODF status increases these benefits for the community. Claims of dramatic drops in diarrhoeas and other diseases following the achievement of ODF conditions are numerous. People in ODF communities do again and again report sharp drops in diarrhoea and medical expenses. Anecdotal evidence is so widespread, and seems such commonsense, that it is easy to believe.
• Social solidarity leading to other actions. The community solidarity and sense of achievement from a successful CLTS process can be an entry point for other initiatives. The Social Development Unit of CARE Bangladesh has pioneered here, and there have been examples of communities coming together to build embankments to prevent flooding and crop loss, following CLTS triggering and action. They have also tackled the annual hunger season in other ways, with the aim of achieving hunger-free communities.
• Local leadership, self-confidence and livelihood. Linked with social solidarity, the emergence and growing confidence of local leaders ― in a CLTS context usually described as Natural Leaders (NLs) ― is often reported. This provides opportunities for people with leadership potential and can also apply pressure on the existing leadership. The voluntary work and commitment of NLs can contribute to the sustainability of CLTS and other activities beyond the life of any external project.