The article was first published here: http://wawash.fiu.edu/drupal-cms/news/2017/02/15/dr-kamal-kar-clts-founder-meets-usaid-wa-wash-staff 

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The CLTS Foundation Global team in partnership with UNICEF Eastern and Southern Africa Regional Office ( ESARO) has been invited by the Government of Eritrea to conduct a refresher training, ODF protocol development and also to implement a diagnostic tool called CLTS Rapid Appraisal Protocol (CRAP) from 13 Feb to 17 Feb 2017 in Eritrea to review the status and quality of CLTS.

CRAP will provide a quick assessment of the health of the CLTS programme delivered at large scale in the country. The quality of implementation of CLTS on the ground varies immensely from country to country in the region. CRAP involves a series of participatory exercises involving stakeholders at the national, regional and district levels to analyze and reflect on their country’s sanitation program. The tool is designed to identify the strengths and gaps existing in the current implementation process and made the necessary rectifications to improve the programme.

Community-Led Total Sanitation (CLTS) was adopted by the Government of Eritrea in its national policy in late 2007. Prior to the introduction of the community led approach, the focus of sanitation interventions carried out in the country focused on producing “high end” toilets with a subsidy that included five bags of cement, iron bars for reinforcement, vent pipes and re-useable moulds for the floor slab. As funds were limited and families were waiting for subsidies, very few toilets were built and the usage of the constructed latrines was very less.

The adoption of the CLTS approach created a shift in hygiene and sanitation promotion. Consequently, a considerable amount of capacity building through training was done for all stakeholders at various levels. Regional advocacy workshops on CLTS were carried out in six regions between July 2008 and February 2009. These were attended by more than 400 participants (including regional governors, sub-regional administrators, higher government officials, religious leaders, regional assembly members and implementers of sanitation programmes). In early 2009, the Ministry of Health, through their Environmental Health Unit, was ready to scale up CLTS and launched a nationwide sanitation programme with the assistance of UNICEF in 46 villages.

Kamal Kar, the Chairman of CLTS Foundation Global visited Eritrea in June 2009 during which he carried out a review of the programme as well as advocacy to strengthen CLTS in the country. During his mission, a week-long national “hands-on” CLTS ToT training for 46 participants (Public Health Technicians, Sanitarians, community Integrated Management of Child Illnesses (IMCI) focal persons and nurses) from all over the country was conducted. As of May 2014, 869 villages out of 2,644 have been triggered in the six regions of the country with 489 villages (18 % of the rural villages) already declared Open Defecation Free. Since 2007 when the CLTS approach was introduced in Eritrea, 146,700 households (or an estimated 733,000 people, 31 % of the rural population) have stopped open defecation in all the six regions of the country. The National Rural Sanitation Policy and Strategy Direction was launched in October 2009 and this policy fully supports the CLTS approach.

It is hoped that the refresher training, ODF Protocol and the administration of the CRAP tool by the sanitation teams in Eritrea will pave the way forward to enhance implementation and scale up the programme towards national ODF status.

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Group Photograph of CLTS Practitioners and Policy Makers in Thies, Senegal

It was a major advocacy and training workshop organised in Bamako in Mali later, in which leaders from 23 countries in the region participated, that provided the necessary impetus for mainstreaming CLTS in the region. Following this, CLTS pilot projects were introduced in most of the countries in the region and was subsequently adopted as the core strategy for enhancing sanitation progress during the Millennium Development Goals (MDG) period. This is the second follow up intervention of CLTS Foundation Global for this region after Bamako 2009 CLTS workshop. In between intensive efforts were given in many Francophone and Anglophone countries by Community Led Total Sanitation Foundation. A recent regional workshop organised in Dakar with participation from 18 countries can be seen as a similar milestone to boost sanitation efforts during the Sustainable Development Goals (SDG) period.

Experience of CLTS in Western and Central Africa Region (WCAR):

Simulation exercise by Dr. Kamal Kar in progress at Thies, Senegal.

In the last decade, majority of countries in WCAR decided to adopt CLTS as the recommended methodology for rural sanitation programming. The early adopters of the approach were Sierra Leone, Mali, Ghana and Nigeria. Subsequently, other countries such as Benin, Cote d’ ivoire, Cameroon, Chad, Congo Brazzaville, Gambia, Guinea, Guinea Bissau, Liberia, Mauritania, Niger, Nigeria, Senegal and Togo followed suit. At the end of 2010, it was estimated that more than one million people were living in open defecation free environments as a result of the CLTS interventions. As the momentum to achieve results picked up towards the end of the MDG period, it is certain that the ODF achievement in these countries would have increased at the end of the year 2015.

However, huge challenges persist for the región during the SDGs. While individual countries might have made progress, the rate of open defecation (OD) has increased on the whole.  At the end of the MDG period, the rural OD rate in WCAR stands at 38%. Countries like Burkina Faso and Democratic Republic of Congo are yet to do away with a subsidy policy entirely and lag far behind its counterparts in the region. More than half of the population in Benin, Burkina Faso, Chad, Niger, Sao Tome and Principe and Togo defecate in the open. The rate of OD in Cote d’Ivoire, Mauritania and Nigeria is equally high between 25% and 50%. Nigeria is ranked 4th in the world for number of people practicing open defecation, which is as much as 45 million people.

While the rolling out of CLTS in the countries in the region produced impressive results during the last decade, scaling up of these interventions nation-wide has remained a challenge. This has been primarily due to the lack of an enabling environment and persistence of institutional bottlenecks that have prevented capacity building and change in mindsets at different levels, mobilisation of the necessary government and external funds, and mechanisms for actor coordination; all of which are critical in achieving CLTS outcomes. Going forward, what is required in the SDG period are context specific strategies to scale up CLTS in each of the target countries in the WCAR. While some countries require immediate capacity strengthening and process support at different levels, some others need advocacy support to influence their national policy to create an enabling environment for CLTS implementation and scale up. In most cases, for effective CLTS implementation, it is critical to establish functional linkages among key actors, develop an engagement strategy among different levels of government functioning and capture outcome and impact through locally evolved monitoring and verification mechanisms.

A community member presenting in the workshop

Towards achieving this objective, CLTS Foundation Global will support the Western and Central Africa Region to accelerate and improve sanitation and hygiene behaviour practice through elimination of open defecation, in partnership with UNICEF WCAR Office. Following the landmark regional workshop in Mali in the year 2007, this will the second stage of CLTS Foundation Global’s institutional support to the region, which will involve policy advocacy to build an enabling environment for CLTS, enhancing capacity to implement and scale up CLTS; assessing the status of CLTS programming in countries already implementing CLTS through an innovative methodology; and improve regional learning and exchange via capacity building, documentation and learning events.

Regional Workshop with CLTS Practitioners and Policy Makers in progress at Thies, Senegal

To kickstart this initiative, a regional workshop bringing together participants from 18 countries in the region, was organised recently in Dakar in Senegal. The objective of the workshop was to enhance capacities for scaling up through appropriate policy and coordination mechanisms that bring all formal and informal actors ( like Natural leaders and local actors) into the fold. As part of the regional planning to meet the sanitation milestones set out in the SDGs, the aim of the workshop was to establish a pool of trained individuals and organisations within WCAR who would not only contribute to capacity building nationally at various levels but would also support the organisation of trainings in other countries in the region.

This 7 days’ regional training workshop took place in Dakar and Thies in Senegal from August 22nd to 28th, 2016 and involved participants from the following countries: Senegal, Benin, Cameroun, Liberia, Sierra Leone, Cote d’ivoire, Mali, Mauritania, Burkina Faso, Congo, Chad, Djibouti, Guinea-Bissau, Guinea Conakry, Madagascar, Ghana and Burundi.  The participants were directors and senior officers from different ministries (mainly Ministry of Health, Ministry of Water and Sanitation, Ministry of Environment), deputy heads of NGOs and UNICEF WASH teams from different countries in the region. The workshop included discussions and deliberations in Dakar on key topics related to CLTS scaling up, followed by a hands-on field training experience. Eight communities were triggered in the villages of Thies, as part of this workshop. The last two days of the workshop focused exclusively on essential elements of post triggering follow up and post ODF activities addressing the elements of sustainability, effective monitoring mechanisms and scaling up with quality to produce ODF districts/ regions etc. Each country team met in small groups to brainstorm on and develop action plans focusing on streamlining the national sanitation policy to ensure an enabling environment for CLTS, developing an appropriate scaling up strategy involving all conventional and non-conventional actors such as Natural leaders and Community Consultants, and building national capacity and mechanisms for sharing and disseminating experiences and best practices.

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Download the full book ‘Digging in, Spreading out and Growing up- Introducing CLTS in Africa

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A project in Ethiopia launched by Vita shows the positive impact of community led total sanitation approach by increasing livelihood options for the local community.

Since Kamal Kar and Vita launched community led total sanitation in 2006, the approach has now reached over 40% of the two million people living in Gamo Gofa.

Livelihood generation

The triggering of CLTS has culminated in a series of community led livelihood initiatives which has changed the dynamics in communities previously trapped in poverty and dependency. Four weaving cooperatives employing 240 members have been established by community collective action with limited support from Vita and Irish Aid. A highly marginalised group of women came together to form a pottery cooperative. Savings and credit, income generation and other groups have also been established by communities without external support.

An Irish Aid monitoring team comprising Peter McEvoy, Susan Frazer and Oonagh O’Connor observed the remarkable impact of CLTS and community led development in their visit to Gamo Gofa in April 2015. The executive summary states: “Community Led Total Sanitation is considered by the monitoring team to be of particular value, and not merely as an ‘entry point strategy’. There is much evidence at the field level to point towards Community Led Total Sanitation encouraging communities to be active participants in their own development and acting as a mechanism for forging community cohesion and inclusion. The community-wide benefits associated with Open Defecation Free status are of universal value to all and Community Led Total Sanitation is, therefore, a powerful development approach.”

Potato cultivation

The most significant community led initiative relates to potato development and a community led approach to tackling bacterial wilt, which is the biggest scourge of African potato farmers. Communities have come together to impose bans on import of non-certified seed, established Ethiopia’s first two community-protected seed sites which have led to Chencha having Ethiopia’s first mobile plant clinic and zonal potato board. CIP has now identified community led approaches as being vital in potato development and will work with Vita under the Potato Coalition to bring these approaches to wider communities.

CLTS has led to significant new resource mobilisation in Gamo Gofa. The community led approach is driving a new green impact fund developed by Vita which will raise EUR 1.5 million in loans for community led household energy and water provision. The community led provision of basic services such as water, sanitation, cooking energy and lighting energy will be championed under the fund for a more affordable and inclusive model that can reach the poorest households.

Vita Final Monitoring Report

The author of this article is John Weakliam, Chief Executive Officer, Vita, Ireland.

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