Dimby and Doda Built a Latrine | USAID ACCESS Health Program


The USAID ACCESS program introduced the community-led total sanitation (CLTS) approach to engage communities in recognizing and addressing their sanitation and hygiene needs.

In this small community of the Toamasina II district, Dimby and Doda, a couple with visual impairment, managed to build their own latrines to improve their living conditions. In fact, USAID ACCESS used the CLTS approach to trigger behavior change in a community and lead people to stop practicing open defecation. Amidst the widespread construction activities, Dimby and Doda led the change and rolled up their sleeves to build their own latrine despite their disability. It inspired the entire community and elevated prosperity in the village.

The Accessible Continuum of Care and Essential Services Sustained (ACCESS, 2018-2025) is an integrated health project funded by USAID and led by Management Sciences for Health (MSH). The goal of the program is to accelerate sustainable health impacts for the Malagasy population through three primary objectives:

  1. Quality health services are sustainably available and accessible to all Malagasy communities in the program’s target regions
  2. Health systems function effectively to support quality service delivery
  3. The Malagasy people sustainably adopt health behaviors and social norms

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