In a blog post in Impatient Optimists, Deputy Director of WASH Louis Boorstin explains how the Gates Foundation is supporting efforts to help communities end the practice of open defecation.
The Foundation believes that community engagement is essential to ensure sustainable access to improved sanitation and that community led total sanitation, or CLTS is the most effective approach to realise this (Boorstin refers to a 2011 WSP report supporting this).
One of the efforts that the Gates Foundation has funded is a Water and Sanitation Program (WSP) project (2007-2011) with aims to achieve 100% “open-defecation-free status” for 4.5 million people in India, Indonesia and Tanzania. The projects the CLTS approach with two other components:
Training local entrepreneurs to offer an affordable range sanitation products and services (increasing supply to meet increased demand) and
Engaging local governments to improve their sanitation policies and train local officials in implementing them (necessary to scale up work and sustain the adoption of safer sanitation over time).
However, recent studies by the Arghyam Foundation and WSP show that CLTS is not without problems, Boorstin admits:
Sometimes several villages successfully adopt CLTS … but the approach can’t be scaled up due to the absence of active government support or the high cost per household of achieving that outcome.
In other cases, thousands of households have been convinced to install latrines … but the quality is so poor that the latrines fail within a year. And sometimes only half or three-quarters of the community is motivated to install latrines, meaning there is still substantial open defecation and the attendant health risks.
Read the full blog post: Louis Boorstin, Tackling the Rural Sanitation Challenge, Impatient Optimists, 15 Sep 2011
Sanitation Updates 
open defecation is not as bad as perceived. if we unpack the alternatives being practised after defecation at home. for instance dry latrines in many homes where the excreta stays for 24 hours before being manually carried out and thrown at the street end may be causing lot of contamination, though not open dedicating.
it is important to unpack the alternative disposal of excreta from home and safe disposal of sewerage water. rather than flushing down stream untreated domestic sewage.
we need to have viable treatment methods .
There is no comparison between open defecation and unsafe sanitation practice for defecation at home. Use of dry latrines, manual carrying for eventual throwing at the street end etc. and also the open defecation should not at all be practised.