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www.wsp.org | www.worldbank.org/water | www.blogs.worldbank.org/water | @WorldBankWater Community-Led Total Sanitation (CLTS) Leo P. de Castro, MS Soc Project Coordinator Scaling Up Rural Sanitation Program Introduction to Sanitation Concepts and Approaches within an iWASH Framework

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  • www.wsp.org | www.worldbank.org/water | www.blogs.worldbank.org/water | @WorldBankWater

    Community-Led Total Sanitation (CLTS)

    Leo P. de Castro, MS Soc Project Coordinator Scaling Up Rural Sanitation Program

    Introduction to

    Sanitation Concepts and Approaches

    within an iWASH Framework

  • Module Content

    Understanding Community Led Total Sanitation (CLTS)

    Facilitating CLTS

    Triggering Process

    • Dealing with Difference Types of Responses

    • Action Planning for Zero Open Defecation (ZOD)

    2

  • UNDERSTANDING

    CLTS

  • Does TAE

    matter?

  • It does!!!

    Improper excreta disposal is the principal factor in the transmission and spread of

    gastrointestinal infections including intestinal parasitism.

    Excreta or tae contains: 10,000,000 viruses

    1,000,000 bacteria

    1,000 parasite cysts

    100 parasite eggs

    In short, tae makes people sick!

  • Open Defecation where there is

    Practice of passing feces outside a latrine

    or toilet, or in a natural environment (open

    field, body of water, etc.) and leaving the

    fecal matter exposed

    Contamination of water supply sources

    (positive for e-coli)

    Unpleasant conditions and foul odors

    which are nuisance to any community

  • What are the consequences?

    On the health of the people

    On the dignity of the people

    On human development

    On the environment

    On the progress of the economy

  • How do

    we

    eradicate

    OD?

  • How CLTS Started

    Developed by Dr. Kamal Kar sometime

    in 1999

    Based on an evaluation of the Water Aid Bangladesh

    traditional water and sanitation program

    Projects involved household latrine construction that is

    heavily subsidized with externally-supplied hardware

  • Kamal Kar’s Findings

    Open defecation practice continued despite the

    increase in the number of toilets in the villages

    Provision of external sanitation hardware subsidy

    was not the driver that led to the community’s

    decision to stop open defecation (OD) practices

    Decision to stop OD was a collective one made by

    the entire community

  • Principles of Rural CLTS

    No upfront household hardware subsidy on sanitation

    No blueprint design or top down prescription, only people’s

    designs at the beginning. All other support is demand driven

    and are not supply driven.

    People first: they can do it

    Don’t teach but facilitate

    Don’t lecture

    Facilitate more collective visual analysis by communities than

    only verbal discourse

  • Principles of Rural CLTS

    Don’t provide first, let the demand grow after triggering

    Watch out for the time when true demand for technology, market and many other issues emerge.

    Respond and act and involve Natural Leaders

    Don’t divide or segregate communities Involve all

    Source: Kamal Kar, CLTS Innovator

  • Stages of CLTS

    Implementation

    Stage 1. PRE-TRIGGERING – Selecting a community

    – Introduction and building rapport

    Stage 2. TRIGGERING – Participatory sanitation profile analysis

    – Ignition

    Stage 3. POST-TRIGGERING – ZOD action planning by community

    – Follow-up

    Stage 4. SCALING-UP and GOING

    BEYOND CLTS

  • PRE-TRIGGERING

    Preparing a local community for the CLTS triggering

    Selecting community (purok or sitio)

    - courtesy call to local purok officials

    - introducing the program and building rapport

    - identify ideal venue for triggering

    - inform members of the community

    - inform that no subsidy will be provided at the onset

    - doing a preliminary visit around the purok to be able to plan the transect walk

    Set date/schedule for triggering activity

  • Community Selection Criteria

    Number of people in the community who are practicing open

    defecation

    Morbidity/mortality cases (due to sanitation-related diseases)

    Preferably with no history of sanitation hardware subsidy

    Presence of strong community leaders

    Readiness to set up local organizations for follow-up activities

  • Data to be gathered during Community Assessment

    Number of households with toilets, without toilets, sharing toilets, public or

    communal toilets

    Gender disaggregated - Open defecation areas

    Defecation practices and after defecation cleansing practices

    Cultural beliefs on health and illness causation

    Secondary data on purok morbidity and mortality rates for STH and AGE

    Secondary data on water quality

    Other on-going sanitation programs in the purok

    Other salient characteristics of the community such as having congested or widely

    spaced houses, original settlers or recent migrants, housing tenure status, coastal

    or inland, IP or non-IP, Muslim or non-Muslim and other relevant data.

  • Community-Led Total Sanitation

    (CLTS)

    Integrated approach to

    achieving and sustaining zero

    open defecation (ZOD) status

    Utilizes participatory rural

    assessment (PRA) methods

    Analysis of own sanitation

    conditions

    Collectively internalize the

    terrible impact of OD on public

    health and on the entire

    community

  • Features of CLTS

    Focused on igniting a change in sanitationbehaviour

    rather than constructing toilets

    Involves a no hardware subsidy policy and does not

    prescribe latrine models

    Uses a hands-off approach by the facilitator through a

    process of social awakening that is stimulated by

    facilitators from within or outside the community

  • SHOCK,

    DISGUST

    AND

    SHAME

    The CLTS

    Triggering

    Process

    Urgent

    collective

    action toward

    Zero Open

    Defecation

    (ZOD)

    OPEN

    DEFECATION

    PRACTICES

  • Vital Elements of CLTS

    Social solidarity or “bayanihan”

    Spontaneous emergence of Natural Leaders (NLs)

    Local innovations of low cost toilet models using locally

    available materials

    Community-innovated systems of reward, penalty, spread and

    scaling-up

    “CLTS encourages the community

    to take responsibility and ACT”

  • Includes a range of behaviors such as

    – stopping all open defecation

    – ensuring that everyone use a hygienic toilet

    – washing hands with soap before preparing food and

    eating, after using the toilet, and after contact with

    babies’ feces or birds and animals

    – handling food and water in a hygienic manner

    – safe disposal of animal and domestic waste to

    create a clean and safe environment

    Total Sanitation

  • CLTS focuses on

    Ending open defecation (OD) as a first significant step and

    entry point to changing behavior

    Enabling people to do their own sanitation profile through

    appraisal, observation and analysis of their OD practices and

    its effects

    Kindling feelings of shock, shame and disgust, and a desire

    to stop OD and clean up their neighborhood

  • Is total – meaning that it affects all in the community and

    visitors as well

    Is based on collective community decision-making and action by

    all

    Is driven by sense of collective achievement and motivations

    that are internal to communities, not by external subsidies or

    pressures

    Leads to emergence of new Natural Leaders and/or highly

    encourages new commitment of existing leaders who do not

    need or follow a blue print but do things their own way

    When It occurs well, CLTS

  • Facilitating

    CLTS

  • As CLTS Facilitators

    Work directly with the communities member to

    trigger behavior change through CLTS

    Provide post-triggering follow-up aimed at

    guiding the community towards its goal of

    attaining ZOD status

    Therefore, attaining enduring behavioral

    change in hygiene and sanitation

  • DO DON’T

    Facilitate community’s own appraisal and

    analysis of their sanitation profile

    Do not educate, lecture or tell people what to do

    Let people realize for themselves through their

    own analysis

    Do not tell people what is good and bad

    Facilitate to trigger self-mobilization Do not push for or demand action

    Stand back, leave it to local leaders Do not be in charge

    Be cool and allow conversation between

    insiders – approaching the triggering moment

    Do not interrupt when charged up community

    members start shaming their own people for OD

    practices or other hygiene behavior

    Take a neutral stand and allow heated

    discussion for and against OD between

    them. Remember these are right

    indications and symptoms of approaching

    ignition moment

    Do not discourage members of the

    community from arguing amongst themselves or

    shaming each other, or quickly conclude that the

    “shaming” element between community

    members should be avoided as culturally

    insensitive

    Key Attitudes and Behavior as CLTS Facilitator

  • DO DON’T

    Appreciate those who take a lead and

    engage themselves

    Do not overlook emerging natural leaders (NLs)

    Always encourage women and the poorer

    sections of the community to participate

    Do not overlook women, children and others

    who often get left out

    Appreciate community members’ offers to

    help poorer members

    Do not overlook people who come forward

    to help

    Let people innovate simple latrines Do not promote particular latrine designs

    Trigger local action and encourage self-help Do not offer hardware subsidy

    Be bold yet cautious Do not be too humble or too polite

    Don’t try to convince too politely

    Listen attentively to everything Do not interrupt

    Key Attitudes and Behavior as Facilitator

  • CLTS Triggering Team

    Ideally 5 – 6 members for adult groups; 3 – 4 for children (a total of up

    to 10 members)

    Gender balance

    Speak the local language

    A mix of different backgrounds (Social/Community Dev’t Worker, Health

    and Sanitation Service Provider, Engineer, etc.)

    Includes front-line extension staff from government or non-government

    organizations that will take responsibility for follow-up with communities

    after triggering

  • Roles of CLTS Facilitating Team

    Lead facilitator. Leads the facilitation process and discussion by

    asking questions, initiating participatory exercises and steering the

    process through different collective activities.

    Fluent in the local language

    Possesses skills in communication

    Has a right attitude to learning from the local communities

    Experienced in participatory work

    Not a resident of the area

  • Roles of CLTS Facilitating Team

    Co-facilitator. Assists the lead facilitator in managing the entire process of facilitation by ”paraphrasing”, ”summarizing”, helping to manage large community groups, carrying out participatory analysis and helping in eliciting community responses.

    Content and process recorder. Documents what happens and monitors how the team is following the agreed strategy. Also helps the lead facilitator as and when required.

  • Roles of CLTS Facilitating Team

    Environment Setter. Ensures conducive environment,

    makes sure that children are separated at the right time

    in the beginning and are involved in their own

    participatory exercises, deals with difficult people, and

    monitors for the right timing of the adults’ and children’s

    groups for the children’s presentation to the adults.

  • AKTIBIDAD: TRIGGERING

    Ang Triggering ay isang gawain na naglalayong gabayan ang

    pamayanan upang

    masuri ang kalagayang pangsanitasyon at mamulat sa

    masamang epekto ng mga maling gawi sa sanitasyon at

    makabuo ng sama-samang kapasyahan na ihinto ito sa lalong

    medaling panahon.

  • Ihanda ang mga Kakailanganin

    Malaking flip chart na mga papel

    Colored cards o meta cards (150 bawat kulay - puti, asul, pula, berde, atbp.)

    Masking tape (4 reels)

    Colored markers (2 kahon bawat kulay – asul, pula, berde at itim)

    Gunting (5 o batay sa bilang ng team na mabubuo)

    Colored chalk (2 kahon)

    Saw dust o rice husk o ipa (kalahating sako)

    Baso at tubig (for demonstration)

    Paper plate at pagkain (for demonstration)

    Papel at panulat (for notes and computations)

    Megaphone o anumang uri ng public address system

  • Triggering Process

    1. Climate Setting

    2. Defecation Area Mapping

    3. Calculation of Tae and of Medical expenses

    4. Defecation Area Transect or Transect Walk

    5. Faecal-Oral Transmission Route

    6. Food and Tae Demonstration

    7. Glass of Water Demonstration

  • Triggering Process

    Climate Setting

    Defecation Area

    Mapping

    Calculation of Tae and

    Medical Expenses

    Transect Walk

    -Fecal Oral Transmission Route

    - Food

    - Water

    Ignition Moment

    ZOD Action Plan

  • Ignition Moment

    The point in the triggering process where the

    community collectively realizes the risk of open

    defecation and demonstrates disgust over the

    practice.

    This is established with a verbalization of one or more

    members that want to stop the practice of OD and

    they are committed to take the necessary action to

    become ZOD.

  • Activity

    Triggering

  • Sample ZOD Community Action Plan Name of LGU:

    Name of Barangay:

    Name of Purok:

    Target Date to become ZOD:

    Activity Objective Timeframe Responsible Person

    Resource Needed/

    Source Budget

    Call for a purok meeting Orient all HHs in the purok on the negative impact of OD and

    present the Action Plan including

    agreement on rewards and

    penalties for noncompliance

    3 days after the

    triggering session Purok

    Leader/Identified

    Natural Leader

    Drawing of the DAM,

    Action Plan prepared

    during the triggering

    session

    Prepare a list of identified

    HHs without toilet (or not

    using the toilet) and HHs

    with unsanitary toilets

    Identify no toilet HHs and assess

    what support would be needed by

    whom

    During the purok

    meeting

    Conduct house-to-house

    visits Discuss benefits of having own

    toilet and affordable options

    available to HHs

    After the purok

    meeting

    Set date for ZOD

    Declaration Part of the Action

    Plan (Anytime

    between 2 weeks to

    1 month)