Globally, CLTS has been widely embraced as a strategy to end open defecation, and dozens of countries have incorporated the approach as part of national policy for rural sanitation. Though the “total sanitation” focus of CLTS is laudable, there is reason to believe that the poor and more vulnerable segments of the community do not benefit equally, as they are more likely to construct lower-quality toilets and revert to open defecation.

On Wednesday, December 13, 2017, the USAID-funded Water, Sanitation and Hygiene Partnerships and Learning for Sustainability (WASHPaLS) Project held a webinar on the role of community-led total sanitation (CLTS) in helping to end open defecation. WASHPaLS presented key findings from a desk review assessing the knowledge base on CLTS program performance. The findings and identified evidence gaps will inform the WASHPaLS research agenda for subsequent years of the project. 

Under the African Urban Poor Improved Water Supply and Sanitation (AUP-IWS) program, USAID/Ghana implemented the Water Access, Sanitation and Hygiene for Urban Poor (WASH-UP) program from 2009 to 2012. WASH-UP started in October 2009 in slum communities of the two major cities of Accra and Takoradi, Ghana.

The findings in this first multi-country review of water, sanitation and hygiene (WASH) services in health care facilities (HCFs) are sobering. Drawing on data from 54 low- and middle-income countries, the report concludes that 38% lack access to even rudimentary levels of water, 19% lack sanitation and 35% do not have water and soap for handwashing. When a higher level of service is factored in, the situation deteriorates significantly.