World Toilet Day: The Role of Local Government, Natural Leaders, and Teachers in CLTS

Triggering in Nepal

November 19, 2014

This post features preliminary findings from the Testing CLTS Approaches for Scalability project, presented by Jonny Crocker, PhD student at UNC Chapel Hill, at the 37th WEDC International Conference in Hanoi, Vietnam in September 2014. Download the 4-page project briefing and accompanying presentation.

Each year on World Toilet Day the international community recognizes that 2.5 billion people still lack access to adequate sanitation. The 2014 slogan is We Can’t Wait. The message is clear: there is little time to waste in resolving the sanitation crisis and eliminating open defecation. We must therefore design interventions and target investments to achieve the greatest impact.

Community-led total sanitation (CLTS) is an approach to creating demand for sanitation that has spread globally over the past 15 years. CLTS seeks to eliminate open defecation and encourage the construction and use of sanitation facilities by ‘triggering’ a community-wide commitment to becoming open-defecation free. Plan International USA and The Water Institute at UNC are implementing the Testing CLTS Approaches for Scalability (TCAS) project to study the results of CLTS when facilitated by different ‘local actors’: local government staff, natural leaders, or teachers. Learn more.

To begin, we reviewed 115 publications on CLTS to better understand local actor involvement (Venkataramanan, 2012). The review revealed that there are few rigorous studies that demonstrate whether CLTS improves health or is cost-effective and sustainable as compared to other sanitation interventions. The literature suggests local actors are important, but there is little corresponding evidence to show their influence on sanitation and hygiene outcomes (Venkataramanan, 2012).

The TCAS project addresses this gap. Since 2011, we have collected data on CLTS programs via seven case studies and three project evaluations in Kenya, Ghana, and Ethiopia, along with corresponding assessments of the national context and stakeholders in these three locations. Through this process, we have identified considerable variation in the way local actors engage in CLTS (Crocker & Venkataramanan, 2014a; Crocker & Venkataramanan, 2014b). We broadly summarized this information as follows:


Local Government

As CLTS programs mature, local government staff become more involved, which has the potential to broaden the reach of CLTS and generate a rapid increase in latrine coverage. However, government-led facilitation tends to be more instructional. This is at odds with the community-led participatory process of behavior change that guides the CLTS philosophy. Local government authorities also have limited resources, which is a primary barrier to large-scale implementation in Kenya, Ghana, and Ethiopia despite national government support for CLTS. Furthermore, institutional arrangements and CLTS programs involve training local government in facilitation, yet CLTS remains largely in the hands of non-governmental organizations without a clear allocation of responsibilities.


Natural Leaders

Natural leaders did not play an important role in implementation activities carried out by Plan International in the four Southeast Asian countries reviewed as part of the seven global case studies. CLTS guidelines suggest natural leaders should emerge naturally from the triggering process and do not need to be established community leaders (Kar & Chambers, 2008). However, they are often pre-selected to assist facilitators and monitor community progress, suggesting that it may be useful to engage local leaders before triggering. The role of natural leaders in Ghana is currently under study and will be presented once the evaluation has concluded.



Teachers did not play a lead role in CLTS facilitation in any of the seven case study countries. We are currently evaluating the role of teachers in CLTS in Ethiopia, the results of which will inform a discussion on the potential roles for teachers in CLTS.

Next Steps

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As our project enters its final year, these findings will be characterized further and shared in a series of country-focused case studies. In addition, individual project evaluations will reveal how the involvement of natural leaders, local government staff, and teachers influences CLTS outcomes and costs. This should help us all make better decisions on sanitation planning and move toward an open defecation-free world. We Can’t Wait.

Please do not hesitate to contact us if you have questions or comments on this work.

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