Community-led total sanitation in rural areas : an approach that works

Conventional approaches in South Asia attempted to tackle the issue of poor sanitation by trying to improve coverage and access with financial support for constructing toilets. Sanitation programs incorporated the need to raise awareness and emphasize the benefits of toilet usage. The sanitation marketing strategy to create individual demand, often combined with subsidies linked to toilet construction by households, has not always resulted in significant progress ensuring the desired outcomes from sanitation programs. It is in this background that the significant results demonstrated by a recent approach adopted in South Asia have drawn attention. At the heart of this approach is a shift away from the provision of subsidy-led toilets for individual households and emphasizing not merely behavior change by individuals in general, but of an entire collective, to achieve 'defecation-free' villages. The objective is to reduce incidence of diseases related to poor sanitation and manage the public risk, posed by the failure to safely confine the excreta of some individuals, at the community level. This has been most effectively undertaken by empowered communities motivated to take collective action, with the government and other agencies performing at best a facilitating role. There is a growing recognition that this evolving approach, often referred to as Community-Led Total Sanitation (CLTS), offers tremendous potential, not only for achieving, but even for surpassing the relevant MDG targets set for 2015. Appropriate guidelines, demand responsive strategies, and inclusion of fiscal incentives, lay the foundation for overall sanitation goals in countries such as India and Bangladesh