Community-led total sanitation

Community-led total sanitation (CLTS) is an approach used mainly in developing countries to improve sanitation and hygiene practices in a community. It focuses on spontaneous and long-lasting behavior change of an entire community. The goal of CLTS is to end open defecation. The term 'triggering' is central to the CLTS process. It refers to ways of igniting community interest in ending open defecation, usually by building simple toilets, such as pit latrines. CLTS involves actions leading to increased self-respect and pride in one's community. It also involves shame and disgust about one's own open defecation behaviors. The concept was developed around the year 2000 by Kamal Kar for rural areas in Bangladesh. CLTS became an established approach around 2011. Non-governmental organizations were often in the lead when CLTS was first introduced in a country. Local governments may reward communities by certifying them with 'open defecation free' (ODF) status. The original concept of CLTS purposefully did not include subsidies for toilets as they might hinder the process. CLTS is practiced in at least 53 countries. CLTS has been adapted to the urban context. It has also been applied to post-emergency and fragile states settings. Challenges associated with CLTS include the risk of human rights infringements within communities, low standards for toilets, and concerns about usage rates in the long-term. CLTS is in principle compatible with a human rights based approach to sanitation but there are bad practice examples in the name of CLTS. More rigorous coaching of CLTS practitioners, government public health staff and local leaders on issues such as stigma, awareness of social norms and pre-existing inequalities are important. People who are disadvantaged should benefit from CLTS programmes as effectively as those who are not disadvantaged. Open defecation is the practice of defecating out in the open, rather than using a toilet. 'Open defecation free' (ODF) is a central term for community-led total sanitation (CLTS) programs. It primarily means the eradication of open defecation in the entire community. However, ODF can also include the additional criteria, such as: Even more stringent criteria which may be required before a community is awarded 'ODF status' might include: CLTS focuses on community-wide behavioural change, rather than merely toilet construction. The process raises the awareness that as long as even a minority continues to defecate in the open, everyone is at risk of disease. CLTS uses community-led methods, such as participatory mapping and analyzing pathways between feces and the mouth (fecal-oral transmission of disease), as a means of teaching the risks associated with OD.