CLTS is a time-tested process that has successfully transformed policy thinking and action from toilet construction to the process of collective hygiene behaviour change in more than 63 countries throughout Asia, Africa and Latin America, giving over 30 million people an opportunity to spontaneously stop open defecation (OD) and live in an open defecation free (ODF) environment. While I was at IDS, I also had the wonderful opportunity to address bright young students, leading practitioners and policy analysts from the WASH and related sectors at a STEPS seminar on the changing frontiers of CLTS over the past 15 years and to share my views and concerns on the challenges of CLTS such as those of sustainability and the politics of scaling up.
With the 2015 Millennium Development Goals (MDGs) deadline fast approaching, countries are scaling-up efforts to meet their national sanitation goals. The progress made by island nations like Madagascar and Kiribati, are especially noteworthy in this respect. For example, in just over a year in Kiribati, areas comprising 25 per cent of the country’s total population have officially been declared ODF. Similarly, Madagascar has achieved unprecedented success in CLTS implementation, achieving around 9000 ODF communities in just over the last three and a half years.
While these success stories reflect a systematically planned and implemented CLTS intervention process, they also highlight the need for innovative strategies for successful scale-up. The institutionalisation of ‘Natural Leaders’ and ‘Community Consultants’ into the local government system to mainstream nationwide scaling-up of CLTS has been a significant innovation. Shifting the focus from counting ODF villages to counting ODF districts or communes or regions instead and establishing multi-level partnerships among the community, institutions and private sector has been another innovative approach that has enhanced scaling-up of ODF communities.
The process of rapid scaling-up has however come with its own set of challenges. The poor quality of CLTS facilitation and gaps in ODF verification and certification is reflected in the lack of ODF sustainability. In the rush to achieve the numbers, many agencies have reduced CLTS to a bunch of triggering tools, compromising the very ethos upon which CLTS is conceptualised. In other words, CLTS is an outcome-focused approach, the success of which is reflected in the long-term sustained improvement in human health, triggered through a series of local actions by an empowered community. Effective implementation of CLTS therefore demands an in-depth understanding of the socio-political and behavioural processes involved in triggering and sustaining collective behaviour change which results in an improved health outcome for all, which I find often missing in CLTS implementation.
From this perspective, it is important that research studies in this area capture the overall outcome on individuals and the community as a whole as a result of collective behaviour change, instead of narrowly focusing only on tools and indicators. For example, one of Plan International’s recent reports, ‘ODF Sustainability Study’ records an ODF slippage rate of 92 per cent (combining a set of factors including hand-washing), but fails to provide any analysis if, as a result of this slippage, the ultimate health outcomes in the respective countries had returned to square one. As I’ve mentioned earlier, CLTS is an outcome-focused approach and merely measuring it on a few quantitative parameters could prove to be detrimental in achieving larger development objectives.
Lastly, escalating challenges of urban sanitation call for urgent strategic action. The CLTS experience in urban and peri-urban towns and municipalities in Asia and Africa, though limited, have taught us that it is important for elected people’s representatives managing the municipalities and city corporations to deeply understand the realities of poor migrants and slum dwellers, and to involve them in collective decision-making processes for improved basic facilities through pro-poor governance. This calls for strong political will and positive institutional attitudes towards people who are otherwise seen as illegal or unauthorised inhabitants of a city. Unlike in rural areas, there is also a need for strong partnerships together with local municipalities to deal with waste issues. Furthermore, issues of shrinking spaces and escalating land prices, coupled with providing subsidies, throw up related and important challenges that need to be addressed seriously for sustainable sanitation.
by Kamal Kar, Founder of the Community-Led Total Sanitation Foundation
Listen to an interview with Dr Kamal Kar, founder of the Community-Led Total Sanitation Foundation
Watch the STEPS Seminar ‘The Potential of Community-led Total Sanitation in achieving an Open Defecation Free World’
Read 'Shit Matters: The Potential of Community-Led Total Sanitation' by Lyla Mehta and Synne Movik
