In Mali, Communities Take Health and Well-Being into their Own Hands. Global Waters, July 18, 2017.
In the center of Simaye village in Mali’s Mopti Region, men, women, and children gather under a large tree to listen. Two USAID-trained facilitators discuss the health challenges facing the village.
Tackling open defecation in communities is a starting point for improved health. Ensuring the drinking water sources are clean is another. USAID works with local artisans in communities like Anga to repair or rehabilitate artesian drilling, such as this one, as an incentive to become ODF-certified. Photo Credit: CARE Mali
Only three latrines serve many families, so more than half of the people are practicing open defecation; the water point no longer functions, so most families are pulling dirty water from the river; many of the infants and young children are not benefitting from exclusive breastfeeding or a diversified diet, so they are malnourished.
Holding a glass of clear water and pointing to feces on the ground, the facilitators paint a clear picture of the health risks associated with leaving feces in the open — contaminated drinking sources, diarrheal disease, and poor outcomes for children and their families.
Their objective: to trigger a sense of disgust, a determination in the community to control their own health and well-being, and to set in motion plans and solutions to create open defecation free (ODF) communities through a process known as community-led total sanitation (CLTS).
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Plan International USA and The Water Institute at UNC have conducted the first study to present comprehensive, accurate, disaggregated costs of a WaSH behaviour-change programme. The study calculated programme costs, and local investments for four community-led total sanitation (CLTS) interventions in Ghana and Ethiopia.
Jonny Crocker, Darren Saywell, Katherine F. Shields, Pete Kolsky, Jamie Bartram, The true costs of participatory sanitation : evidence from community-led total sanitation studies in Ghana and Ethiopia. Science of The Total Environment, vol. 601–602, 1 Dec 2017, pp: 1075-1083. DOI: 10.1016/j.scitotenv.2017.05.279 [Open access]
Evidence on sanitation and hygiene program costs is used for many purposes. The few studies that report costs use top-down costing methods that are inaccurate and inappropriate. Community-led total sanitation (CLTS) is a participatory behaviour-change approach that presents difficulties for cost analysis. We used implementation tracking and bottom-up, activity-based costing to assess the process, program costs, and local investments for four CLTS interventions in Ghana and Ethiopia. Data collection included implementation checklists, surveys, and financial records review. Financial costs and value-of-time spent on CLTS by different actors were assessed. Results are disaggregated by intervention, cost category, actor, geographic area, and project month. The average household size was 4.0 people in Ghana, and 5.8 people in Ethiopia. The program cost of CLTS was $30.34–$81.56 per household targeted in Ghana, and $14.15–$19.21 in Ethiopia. Most program costs were from training for three of four interventions. Local investments ranged from $7.93–$22.36 per household targeted in Ghana, and $2.35–$3.41 in Ethiopia. This is the first study to present comprehensive, disaggregated costs of a sanitation and hygiene behaviour-change intervention. The findings can be used to inform policy and finance decisions, plan program scale-up, perform cost-effectiveness and benefit studies, and compare different interventions. The costing method is applicable to other public health behaviour-change programs.
Posted in Africa, Publications, Research, Sanitary Facilities
Tagged Community-Led Total Sanitation, direct support costs, Ethiopia, Ghana, local investment, Plan International, programme costs, UNC Water Institute
GHANA WASH PROJECT: Lessons Learned: Hybrid CLTS Approach to Improving Sanitation, 2014.
USAID’s Ghana Water, Sanitation and Hygiene (GWASH) Project aimed to improve rural sanitation access through the provision of household latrines to households in targeted communities. In the beginning of the project, GWASH used a “high-subsidy” approach for household latrine provision, providing households with a 60 percent subsidy per latrine.
It was in this vein that GWASH aimed to meet its project target of constructing 4,680 household latrines over the course of a four-year period. During the second year of the project, the Government of Ghana (GOG) implemented a new sanitation policy that promoted a pure Community-Led Total Sanitation (CLTS) approach.
The strategy is a no-subsidy approach that emphasizes community-level demand creation for sanitation improvements aimed at stopping open defecation and supporting household and community efforts to independently construct improved household latrines.
CLTS Monitoring and Evaluation Toolkit and Manual, 2016. USAID SAREP (South Africa Region Environmental Programme)
This toolkit and manual contains all forms and materials that are need for a CLTS monitoring team to be established in communities.
It is aimed at CLTS facilitators and Natural Leaders who wish to take the next step in ensuring their community becomes Open Defecation Free (ODF).
It also contains a training agenda and training materials so that M&E team members in communities are able to train other people to become part of the team.
Focus on Community-Led Total Sanitation – Water Currents, April 18, 2017
Welcome to the inaugural external issue of Water Currents, a biweekly publication from USAID’s Water Team.
Water Currents aims to replace the WASHplus Weekly, which ceased publication in 2016 when the WASHplus Project ended.
Each issue of Water Currents will have a special focus on a featured topic, as well as an update on recent water sector news.
This issue highlights community-led total sanitation (CLTS), including selected 2017 reports and articles on the subject, as well as coverage on open defecation and behavior change and recent CLTS videos. Our “In the News” section features recent articles on household water treatment, WASH training materials and other water matters.
Articles and Reports
Keeping Track: CLTS Monitoring, Certification and Verification. IDS, January 2017. These critical elements of the CLTS process ensure the sustainability of open defecation free achievements and support the behavior change education necessary to improve CLTS implementation.
Local Governance and Sanitation: Eight Lessons from Uganda. Global Sanitation Fund (GSF), April 2017. This case study presents eight lessons learned from the GSF-supported Uganda Sanitation Fund on coordinating, planning, and implementing CLTS at scale through a decentralized government system.
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Discovering sanitation realities through rural immersions. by Jamie Myers, CLTS, March 2017.
At the end of last year the CLTS Knowledge Hub heard that the Indian Institute of Management (IIM), Indore, in collaboration with UNICEF and the Government of Madhya Pradesh, were sending 630 of their first year management students to spend a week living in 157 open defecation free (ODF) villages.
The villages cut across 13 districts in the central Indian State of Madhya Pradesh. Students were asked to verify ODF status of villages through a household survey and early morning and evening inspections of open defecation sites. They were also tasked with collecting data on school and Anganwadi (child and mother care) centres sanitation and handwashing facilities.
The sheer number of people involved was impressive in itself as was the level of detail that could be collected in the length of time they were able to spend there. Furthermore, the fact that they would be staying overnight meant that they would be in the villages at the times when open defecation was most common, early in the morning and later in the evening. Needless to say we were excited to hear not only about their findings but also the process and methodology.
Read the complete article.