Policy Diffusion in the Rural Sanitation Sector: Lessons from Community-Led Total Sanitation (CLTS)


Worldwide, 892 million people practice open defecation, most of whom live in rural areas of South Asia and Sub-Saharan Africa. Community-Led Total Sanitation (CLTS) is the most widely deployed approach to generate demand for, and use of sanitation facilities. CLTS relies on behavioral change and community self-enforcement to end open defecation.

Since its genesis in Bangladesh in 1999, CLTS has spread to approximately 60 countries, mostly in Asia and Africa, and is employed by the majority of development organizations operating in rural sanitation. This paper uses a qualitative approach to analyze the reasons and processes that drove the wide diffusion of CLTS, showing that CLTS was embraced because it was perceived as a fast and effective solution to the problem of open defecation.

This article was produced under the USAID’s Water, Sanitation and Hygiene Partnerships for Learning and Sustainability (WASHPaLS) project.

Publication Date
Produced By
World Development
Valentina Zuin 
Caroline Delaire 
Rachel Peletz
Alicea Cock-Esteb
Ranjiv Khush
Jeff Albert
14 pages
Implementing Partners
Population Focus
Related Countries