Resource Library

Audience-Specific Summaries


 

Peer-Reviewed Publications


Impact Evaluation of Training Natural Leaders during a Community-Led Total Sanitation Intervention: A Cluster-Randomized Field Trial in Ghana. Crocker, J., Abodoo, E., Asamani, D., Domapielle, W., Gyapong, B., & Bartram, J. (2016). Environmental Science & Technology, 50(16), 8867–8875. http://doi.org/10.1021/acs.est.6b01557

Teachers and Sanitation Promotion: An Assessment of Community-Led Total Sanitation in Ethiopia. Crocker, J., Geremew, A., Atalie, F., Yetie, M., & Bartram, J. (2016). Environmental Science & Technology, 50(12), 6517–6525. http://doi.org/10.1021/acs.est.6b01021

Building capacity for water, sanitation, and hygiene programming: Training evaluation theory applied to CLTS management training in Kenya. Crocker, J., Shields, K. F., Venkataramanan, V., Saywell, D., & Bartram, J. (2016). Social Science & Medicine, 166, 66–76. http://doi.org/10.1016/j.socscimed.2016.08.008

Project Publications


CLTS Learning Series: Lessons from CLTS Implementation in Seven Countries. Venkataramanan, Vidya. 2016. Chapel Hill, USA: The Water Institute at UNC.

CLTS Triggering in Lao PDR
Photo by Plan International

The Learning Series is a collection of seven case studies of rural sanitation. The aim of this report was to characterize variations in CLTS implementation through the perspectives of stakeholders, and to identify lessons pertaining to the potential for expanding the scale of activities. Plan International CLTS programs were studied in Cambodia, Lao PDR, Nepal, Indonesia, Uganda, Niger, and Haiti. This report presents findings from a comparative analysis of these seven cases, each of which are also documented as individual country reports. Findings in this report are categorized by CLTS implementation context and by seven themes that emerged across the seven case studies, with implications and recommendations for rural sanitation interventions.

> Download the Synthesis Report (PDF, 1MB, 57 pp.)


 

Community-led Total Sanitation and Teachers in Kenya: Implementation Narrative and Video. Plan International USA. 2015. Washington DC, USA: Plan International USA.

Woman Washes Hands after Using Bathroom
Photo/Video by Diana Mrazikova

The Testing CLTS Approaches for Scalability project was a four year, sanitation-focused, operational research project that aimed to advance rural sanitation efforts in Kenya, Ethiopia, Ghana and worldwide by improving the cost-effectiveness and scalability of the CLTS approach, with a particular focus on the role of local actors.  In Kenya, the project assessed the role that government officials could play in increasing the cost-effectiveness and scalability of CLTS.  The project was implemented in two Plan Program Units (PUs), Kilifi and Homa Bay, where CLTS activities were launched in 2007 and 2009, respectively. These two PUs were selected so that the project could build upon the ongoing CLTS activities and to provide a benchmark for comparison to assess the impact of the project.

> Download Narrative or Watch Video


 

Community-led Total Sanitation and Teachers in Ethiopia: Implementation Narrative and Video. Plan International USA. 2016. Washington DC, USA: Plan International USA.

Little Boy Washes Hands after Using Bathroom
Photo/Video by Diana Mrazikova

The Testing CLTS Approaches for Scalability grant is a four year, sanitation‐focused, operational research project that aims to advance rural sanitation efforts in Kenya, Ethiopia, Ghana and worldwide by improving the cost‐effectiveness and scalability of the CLTS approach, with a particular focus on the role of local actors. In Ethiopia, the project assesses teacher‐facilitated CLTS as an alternative to the conventional facilitation approach led by health extension workers (HEWs). This implementation narrative and video accordingly reflect this process and introduce project team analysis of factors that enabled and constrained implementation.

> Download Narrative or Watch Video


 

Community-led Total Sanitation and Natural Leaders in Ghana: Implementation Narrative and Video. Plan International USA. 2015. Washington DC, USA: Plan International USA.

Natural Leaders in Ghana
Photo/Video by Diana Mrazikova

The Testing CLTS Approaches for Scalability project is a four year, sanitation focused, operational research project that aims to advance rural sanitation efforts in Kenya, Ethiopia, Ghana, and worldwide by improving the cost-effectiveness and scalability of the CLTS approach, with a particular focus on the role of local actors. In Ghana, the project assesses the effectiveness of increasing the capacity of local actors (natural leaders), thereby enabling them to carry out post-triggering activities and reduce their dependency on local non-governmental organizations (LNGOs) for follow-up. This implementation narrative and video accordingly reflect this process and introduce project team analysis of factors that enabled and constrained implementation.

> Download Narrative or Watch Video


 

Community-led Total Sanitation and Local Actors in Ethiopia, Ghana and Kenya. Plan International USA. 2015. Washington DC, USA: Plan International USA.

CLTS Triggering in Ghana
Photo/Video by Diana Mrazikova

This short video offers a sneak preview at five lessons for policy-makers and practitioners on scaling up community-led total sanitation, based on findings from operational research conducted by Plan International and the Water Institute at UNC. These lessons relate to CLTS planning at the national and local level, its place in national sanitation systems, and the importance of involving local actors. Government officials, teachers, and natural leaders can play important roles in improving access to basic sanitation. As these actors tend to have long-term interests in community welfare, their involvement may improve sustainability.

> Watch the Video (09 min 31 secs.)


Community-led Total Sanitation in Cambodia: Findings from an Implementation Case Study. Venkataramanan, Vidya, Jennifer Bogle, and Ryan Rowe. 2015. Chapel Hill, USA: The Water Institute at UNC.

CLTS Triggering in a School, Photo by Jonny Crocker

CLTS Triggering in a School
Photo by Jonny Crocker

Plan International supports Community-led Total Sanitation (CLTS) implementation in a number of communities around Cambodia. This learning brief and underlying country report present the roles of local actors in Plan International’s program activities and highlight considerations for scalability, planning, implementation, and evaluation. Plan International and other sanitation practitioners can support the national government and local actors in developing a systematic approach to community selection, strengthening CLTS facilitation training, and standardizing monitoring & evaluation processes.

> Download the Learning Brief (PDF, 784KB, 4 pp.)
> Download the Country Report (PDF, 422KB, 33 pp.)


Community-led Total Sanitation in Lao PDR: Findings from an Implementation Case Study. Venkataramanan, Vidya, Jennifer Bogle, Alexandra Shannon, and Ryan Rowe. 2015. Chapel Hill, USA: The Water Institute at UNC.

Open Defecation Signage
Photo by Plan International/Alf Berg

Plan International supports Community-led Total Sanitation (CLTS) implementation in a number of districts in the Lao People’s Democratic Republic (PDR). In this learning brief and underlying country report, we review Plan International Laos’ CLTS activities. We found that they have formed a strong working relationship with the national government and directly involved district government and community leaders in CLTS implementation. Plan International Laos and other sanitation practitioners can support further progress by strengthening community selection for CLTS, expanding the cadre of CLTS trainers, and advocating for formal recognition and accountability of district government in the CLTS process.

> Download the Learning Brief (PDF, 760KB, 4 pp.)
> Download the Country Report (PDF, 599KB, 36 pp.)


Community-led Total Sanitation in Indonesia: Findings from an Implementation Case Study. Venkataramanan, Vidya, and Alexandra Shannon. 2015. Chapel Hill, USA: The Water Institute at UNC.

Sanitation Marketing in Grobogan District, Indonesia
Photo by Jonny Crocker

Plan International supports Community-led Total Sanitation (CLTS) implementation in a number of sub-districts in Indonesia. This learning brief and underlying country report present the roles of local actors in Plan International’s program activities and highlight considerations for scalability, planning, implementation, and evaluation. Plan International and other sanitation practitioners can support the national government and local actors by placing more responsibility on sub-district staff to lead triggering, enlisting the added support of village facilitators to lead post-triggering, and scaling up village-based financing mechanisms to sustain CLTS outcomes.

> Download the Learning Brief (PDF, 760KB, 4 pp.)
> Download the Country Report (PDF, 523KB, 29 pp.)


Community-led Total Sanitation in Nepal: Findings from an Implementation Case Study. Venkataramanan, Vidya, Alexandra Shannon, and Jennifer Bogle. 2015. Chapel Hill, USA: The Water Institute at UNC.

Pour Flush Toilet in Nepal
Photo by Vidya Venkataramanan

Plan International supports Community-led Total Sanitation (CLTS) implementation in a number of districts in Nepal. In this learning brief and underlying country report, we review Plan International Nepal’s CLTS activities. We found government targets and definitions to be ambitious while decentralized planning allowed a focus on community-led processes. Plan International and other sanitation practitioners can support sustained and equitable CLTS outcomes by providing post-triggering training and technical support to community volunteers, focusing on achieving gradual, yet sustained outcomes in program areas, and continuing to work with local governments to ensure that financing mechanisms for the poor are locally developed and equitable.

> Download the Learning Brief (PDF, 778KB, 4 pp.)
> Download the Country Report (PDF, 347KB, 32 pp.)


Community-led Total Sanitation in Uganda: Findings from an Implementation Case Study. Venkataramanan, Vidya and Alexandra Shannon. 2015. Chapel Hill, USA: The Water Institute at UNC.

Triggering Activities in Tororo District, Uganda
Photo by Plan International

In an effort to reduce open defecation worldwide, Plan International implements community-led total sanitation (CLTS), a behavior change intervention, in various sub-counties in Uganda. In this learning brief and underlying country report, we review Plan International’s CLTS activities in Uganda. We found a variety of contributions to national policies and guidelines and a model for engaging local health officials and entrepreneurs. Plan International Uganda can continue to support progress by providing capacity building activities for village level volunteers, advocating for a consistent definition and interpretation of a community’s sanitation status, and by expanding training of sanitation entrepreneurs to include more sanitation marketing activities.

> Download the Learning Brief (PDF, 1MB, 4 pp.)
> Download the Country Report (PDF, 412KB, 28 pp.)


Community-led Total Sanitation in Niger: Findings from an Implementation Case Study. Venkataramanan, Vidya and Alexandra Shannon. 2015. Chapel Hill, USA: The Water Institute at UNC.

Sign Declaring ODF Village in Dosso District, Niger
Photo by Vidya Venkataramanan

Plan International supports Community-led Total Sanitation (CLTS) implementation in two departments (districts) in Niger. In this learning brief and underlying country report, we review Plan International Niger’s activities. We found that Plan International Niger is gradually building capacity for CLTS at the district and local levels, which could help to realize greater progress in triggered communities. Plan International Niger and other sanitation practitioners can support further progress by formalizing the role of technical service committees, advocating for the standardization of benchmarks for achieving open defecation free status, and scaling-up village level financing and self-help initiatives to make high quality latrines more affordable.

Download the Learning Brief in English (PDF, 776kb, 4 pp.)
Download the Learning Brief in French (PDF, 762kb, 4pp.)
> Download the Country Report (PDF, 379KB, 32 pp.)


Community-led Total Sanitation in Haiti: Findings from an Implementation Case Study. Venkataramanan, Vidya and Alexandra Shannon. 2015. Chapel Hill, USA: The Water Institute at UNC.

Men Digging Pit Latrine in Haiti
Photo by Vidya Venkataramanan

Plan International supports Community-led Total Sanitation (CLTS) implementation in two departments in Haiti. In this learning brief and underlying country report, we present the roles of local actors in Plan International’s program activities and highlights considerations for scalability, planning, implementation, and evaluation. Plan International Haiti can lead the effort to determine the viability of CLTS in Haiti by targeting the approach to smaller, more cohesive communities, helping to build the supply chain for sanitation hardware, involving a variety of local actors in the post-triggering stage, and by providing training for multipurpose community health agents to carry out CLTS implementation.

Download the Learning Brief (PDF, 787kb, 4 pp.)
> Download the Country Report (PDF, 494KB, 30 pp.)


 

Community-led Total Sanitation in Kenya, Ghana, and Ethiopia: Findings from Situational Assessments. Crocker, Jonny, Jennifer Bogle, and Ryan Rowe. 2015. The Water Institute at UNC: Chapel Hill, USA.

Children practice good hygiene.

A situational assessment can inform program planning and evaluation. We assessed national policy, institutional arrangements, and monitoring systems for CLTS in Ethiopia, Ghana, and Kenya prior to evaluations of Plan International’s CLTS projects with local actors. In three short research summaries, we present the strong national government support for CLTS and the key role played by non-government actors in implementation. Improved monitoring is needed for countries to assess program efficiency and effectiveness. The insights provide a baseline reference for CLTS policy and practice.

> Download the Synthesis (PDF, 327KB)
> Download the Kenya Summary (PDF, 2.6MB)
> Download the Ghana Summary (PDF, 2.5MB)
> Download the Ethiopia Summary (PDF, 2.5MB)


Data Collection Checklists for Trainings and Community Visits. Crocker, Jonny. 2014. Chapel Hill, USA: The Water Institute at UNC.

Data Collection Checklists
These data collection checklists were developed for the Testing CLTS Approaches for Scalability project and are intended for those who coordinate and manage CLTS programmes – particularly those working in the the local offices of international or national NGOS or local government officials tasked with overseeing a CLTS programme. The checklists can be used to collect information on where and when CLTS activities take place, who is involved, and descriptions of activities carried out, all in a simple, consistent, and thorough manner.

> Download document (PDF, 291KB)


Research Summary: Systematic Literature Review of Grey Literature Publications on Community-Led Total Sanitation. Venkataramanan, Vidya and Ryan Rowe. 2014. Chapel Hill, USA: The Water Institute at UNC.

Photo by Vidya Venkataramanan

Photo by Vidya Venkataramanan

This research summary shares conclusions from a systematic review of grey literature on CLTS. Our research identified several areas for future work to advance CLTS research and practice: 1) develop a quality assessment methodology for grey literature publications; 2) strengthen practitioner capacity in monitoring, evaluation, and reporting; 3) standardize methods and indicators for monitoring and evaluation of CLTS; 4) perform theoretical and empirical research on CLTS and behavior change; 5) evaluate the role of local actors in CLTS outcomes.

> Download document (PDF, 4 pages, 1.5MB)


Testing CLTS Approaches for Scalability: Project Briefing. Crocker, Jonny, and Vidya Venkataramanan. 2014a. Hanoi, Vietnam, Submitted to 37th WEDC International Conference, September 15-19, 2014.

Briefing Presentation Title Slide
These two documents feature preliminary findings from the Testing CLTS Approaches for Scalability project, presented at the 37th WEDC International Conference in Hanoi, Vietnam in September 2014. They capture our current knowledge as to the different ways in which local government, natural leaders, and teachers engage in the CLTS process.

> Download the project briefing (PDF, 347KB)
> Download the briefing presentation (PDF, 1.3MB)


Managing CLTS: Facilitators’ Resource Pack. Fox, John, Stella Chepleting, and David Owuor. 2013. Plan International Kenya: Nairobi, Kenya.

Facilitator's Resource Pack
This resource pack was developed for the Testing CLTS Approaches for Scalability project and is intended for those who direct and manage CLTS programmes – particularly for officers at county or national levels in ministries concerned with public health and sanitation – and also NGOs active in the same sectors. The objective of the resource pack is to enable its readers to fully understand the nature of CLTS and equip them to select, train, monitor and support community-based and front-line workers.

This document is a draft and is subject to further revision. An updated and final document will be made available here in due course.

> Download document (PDF, 3.7MB)


Natural Leaders Training Guide – Community-led Total Sanitation. Plan International Ghana, 2013. Plan International Ghana: Accra, Ghana

Natural Leader

This resource pack was developed for the Testing CLTS Approaches for Scalability project and is intended for those who seek to enhance the capacity of Natural Leaders to play lead roles in attaining and sustaining Open Defecation Free status in their communities.

This document is a draft and is subject to further revision. An updated and final document will be made available here in due course.

> Download document (PDF, 1.9MB)


Systematic Literature Review (Grey Literature). Venkataramanan, Vidya. 2012. The Water Institute at UNC: Chapel Hill, USA.

Triggering
This study presents findings from a systematic literature review on the effectiveness and impact of CLTS programs. The 115 grey literature publications reviewed focused mainly on processes such as triggering and the role of key actors in implementation. While grey literature is often used by practitioners to cite the effectiveness and need for scale-up of CLTS, the publications reviewed lacked the rigor and/or consistency of methods to make definitive conclusions about the impact of CLTS on sanitation and hygiene outcomes.

> Download document (PDF, 384KB)


Trainers’ Guide on Community-Led Total Sanitation. Plan International Ethiopia. 2012. Plan International Ethiopia: Addis Ababa, Ethiopia.

Triggering
This training manual was developed for the Testing CLTS Approaches for Scalability project to guide trainers in training schoolteachers in facilitation of CLTS. The objective of the guide is to equip teachers with community facilitation skills, using the CLTS approach, so that school teachers promote community empowerment and change of behavior relating to sanitation and hygiene practices.

This document is a draft and is subject to further revision. An updated and final document will be made available here in due course.

> Download document (PDF, 2.0MB)


External Resources

The links below will guide you to key resources covering five important CLTS topics developed outside the context of the Testing CLTS Approaches for Scalability project. Please click the the black box with the ‘+’ sign to expand the selection and review the available resources.

If you have suggestions on resources or topics to include, please contact the project team.

The Role of Local Actors
Sanitation Marketing
Monitoring and Evaluation
Latrine Construction Technology
Sustainability