Community-led total sanitation
Community-led total sanitation (CLTS) is an innovative methodology for mobilising communities to completely eliminate open defecation (OD). Communities are facilitated to conduct their own appraisal and analysis of open defecation (OD) and take their own action to become open defecation free (ODF).
At the heart of CLTS lies the recognition that merely providing toilets does not guarantee their use, nor result in improved sanitation and hygiene. Earlier approaches to sanitation prescribed high initial standards and offered subsidies as an incentive. But this often led to uneven adoption, problems with long-term sustainability and only partial use. It also created a culture of dependence on subsidies. Open defecation and the cycle of fecal–oral contamination continued to spread disease.
In contrast, CLTS focuses on the behavioural change needed to ensure real and sustainable improvements – investing in community mobilisation instead of hardware, and shifting the focus from toilet construction for individual households to the creation of “open defecation-free” villages. By raising awareness that as long as even a minority continues to defecate in the open everyone is at risk of disease, CLTS triggers the community’s desire for change, propels them into action and encourages innovation, mutual support and appropriate local solutions, thus leading to greater ownership and sustainability.
CLTS was pioneered by Kamal Kar (a development consultant from India) together with VERC (Village Education Resource Centre), partner of WaterAid Bangladesh, in 2000 in Mosmoil, a village in the Rajshahi district of Bangladesh, whilst evaluating a traditionally subsidised sanitation programme. Kar, who had years of experience in participatory approaches in a range of development projects, succeeded in persuading the local non-governmental organization (NGO) to stop top-down toilet construction through subsidy. He advocated change in institutional attitude and the need to draw on intense local mobilisation and facilitation to enable villagers to analyse their sanitation and waste situation and bring about collective decision-making to stop open defecation.
CLTS spread fast within Bangladesh, where informal institutions and NGOs are key. Both Bangladeshi and international NGOs adopted the approach. The Water and Sanitation Programme (WSP) of the World Bank played an important role in enabling spread to neighboring India and then subsequently to Indonesia and parts of Africa. Plan International, WaterAid and UNICEF have become important disseminators and champions of CLTS. Today there is CLTS, in more than 40 countries of the world, especially in Asia, Africa, Latin America and the Middle East.
CLTS has a great potential for contributing towards meeting the United Nations Development Programme goals, both directly on water and sanitation (goal 7) and indirectly through the knock-on impacts of improved sanitation on combating major diseases, particularly diarrhoea (goal 6), improving maternal health (goal 5) and reducing child mortality (goal 4).
In addition to creating a culture of good sanitation, CLTS can also be an effective point for other livelihoods activities. It mobilizes community members towards collective action and empowers them to take further action in the future. CLTS outcomes illustrate what communities can achieve by undertaking further initiatives for their own development.
More recently, it has also been adapted to the urban context. At the moment, the most exciting developments are taking place in Mathare 10, Nairobi where Plan together with CCS are doing an Urban Community-led Total Sanitation pilot.
CLTS’s behavioral changes process is based on the use of shame, this is meant to promote collective consciousness-raising of the severe impacts of open defecation and trigger shock when participants realize the implications of their actions. There is quite a deal of evidence now that the triggering process has seen practices utilized, which infringe the human rights of recipients. There have been cases of fines (monetary and non-monetary), withholding of entitlements, public taunting, posting of humiliating pictures and even violence. It should be noted that the victims of these infringements are in most cases already the poorest and most vulnerable in their communities.
CLTS does not specify technical standards for toilets. This is a benefit in terms of keeping the costs of constructing toilets very low. However, it can produce two problems: first in flood plains or areas near water tables poorly constructed latrines are likely to contaminate the water table and thus represent little improvement. Second, long-term use of sanitation facilities is related to the pleasantness of the facilities, dirty overflowing pits are unlikely to be utilised in the longer term. A related issue here is that CLTS does note address the issue of latrine emptying services or where they exist, how they dispose of waste.
- Susan Engel and Anggun Susilo, "Shaming and Sanitation in Indonesia: A Return to Colonial Public Health Practices?" Development & Change 45(1) 2012: 157–178; Jamie Bartram, Katrina Charles, Barbara Evans, Lucinda O’Hanlon and Steve Pedley, “Commentary on community-led total sanitation and human rights: should the right to community-wide health be won at the cost of individual rights?” Journal of Water and Hygiene 10(4) 2012: 499-502; and Liz Chatterjee, “Time to Acknowledge the Dirty Truth Behind Community-led Sanitation” GuardianNews and Media, London
- Black, M. and B. Fawcett (2008) The Last Taboo: Opening the Door on the Global Sanitation Crisis. London: Earthscan
- Kamal Kar with Robert Chambers (2008) Handbook on Community-led Total Sanitation. IDS and Plan International also available in French, Spanish, Portuguese, Hindi, Bengali, Khmer and Arabic
- Kamal Kar (2010) Facilitating “Hands-on” Training Workshops for CLTS: A Trainer's Training Guide
- Petra Bongartz and Robert Chambers (2009) Beyond Subsidies- Triggering a Revolution in Rural Sanitation (In Focus Policy Briefing)
- Robert Chambers (2009)Going to Scale with Community-led Total Sanitation: Reflections on Experience, Issues and Ways Forward
- Bongartz, Petra, Musyoki, Samuel Musembi, Milligan, Angela and Ashley, Holly (2010) Tales of Shit: Community-Led Total Sanitation in Africa, Participatory Learning and Action 61, London: International Institute for Environment and Development
- Kamal Kar and Petra Bongartz (2006) Latest Update to Subsidy or Self Respect. Update to IDS Working Paper 257
- Kamal Kar and Katherine Pasteur(2005) Subsidy or Self-Respect? Community Led Total Sanitation. An Update on Recent Developments . IDS Working Paper 257
- Kamal Kar (2005) Practical Guide to Triggering Community-Led Total Sanitation. IDS. Also available in Chinese, Arabic, Spanish, French and Lao
- Kamal Kar (2003) Subsidy or Self-Respect? Participatory Total Community Sanitation in Bangladesh . IDS Working Paper 184
- Video of Kamal Kar talking about community-led total sanitation in the Water Cube at the 2010 Stockholm Water Week
- Community-led total sanitation at Appropedia.org - includes a summary of Kar & Pasteur's writing.
- Communityledtotalsanitation.org information about the approach.