Community-Led Total Sanitation

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Screenshot from the movie Ten steps to total sanitation, produced by WaterAid.
Community members from a small village in Nepal receive an award for achieving the “open defecation free status” after a successful CLTS Campaign.
Photo: SSWM

Community-Led Total Sanitation is a way to mobilize a community, with the goal to completely eliminate open defecation in a community area. The community is facilitated to make their own analysis of open defecation and the faecal-oral contamination that it leads to. The aim is to generate a sense of 'shame' and 'disgust' among the members of the community, which mobilizes the community to take their own action to end open defecation, for example through the construction of latrines and changes of sanitation behaviour. Subsidies for hardware are not used.

'Total Sanitation' refers to 100% sanitation coverage in a target area, usually through a combination of awareness raising and affordable sanitation options.


There are two important realizations which are at the center of the Community-Led Total Sanitation approach. The first is that merely providing toilets does not guarantee their use, and does not automatically result in improved sanitation behaviour. Projects that started with prescribed high sanitation standards and subsidies have often led do uneven adoption, problems with sustainability, and partial use. Using subsidies as an incentive also can lead to a culture of dependence on subsidies.

The second realization is that as long as even a minority of people continues to practice open defecation, everyone in the community is at risk of disease. Individual hygiene can affect the health of a whole community.

Community-Led Total Sanitation, if successful, triggers the community's desire to change and stimulates them to act. This leads to better ownership of the solutions, and greater sustainablity.

Description of the Approach

A movie of the process by WaterAid describes the process in the following steps1:

  • Step 1: The community discuss the impacts of open defecation with an external facilitator.
  • Step 2: Together, they visit sites of open defecation.
  • Step 3: The community maps out the areas of open defecation, by drawing a map.
  • Step 4: The community works out how much human waste they produce in total. On average, one house generates over one metric tonne of faeces per year. Without latrines, this waste is spread everywhere, which makes people ill.
  • Step 5: The community draws up an action plan to tackle the situation.
  • Step 6: Health and Hygiene education sessions are carried out.
  • Step 7: The facilitator and community work out an action plan.
  • Step 8: Construction of latrines begins. Members of the community who are not abiding by the new rules are somehow discouraged from this behaviour, for example by putting flags in outdoor faeces, or by issuing a fine.
  • Step 9: Latrines are now available to everyone and hygiene education continues.
  • Step 10: The community is awarded defecation free status and a sign is erected at the beginning of the village.


Community-Led Total Sanitation can be very effective in achieving better sanitation and hygiene behaviour. However, the uptake of the approach can be difficult, for example because the shift away from subsidies sometimes requires a different mindset. Good management and support are needed for organizations that support the communities. The approach has both been used by small NGO programmes and by large scale governmental programmes. In some cases, problems with monitoring, mediation and the supply chain exist, and it is unclear which mix of approaches is most effective.

Community-Led Total Sanitation can be a very good starting point for other community action activities, as it mobilizes the community towards common action. As sanitation interventions have immediate health benefits, this demonstrates the power of collective action, which builds confidence in the community to undertake other developmental projects as well.

Field experiences

Community-Led Total Sanitation was first pioneered in Bangladesh in 1999 by Kamal Kar (see external links for a list of his articles on the subject), and since then has been widely adopted in that country in in others, particularly in South and Southeast Asia. The approach is also being used in Africa, notably in Uganda and Zambia.2

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RSR Project 768
Coastal area Water, Sanitation and Hygiene
RSR Project 533
Support on WASH: Miyo woreda
RSR Project 351
Cost effective means of financing WASH
RSR Project 387
Upscaling sanitation with community credit
RSR Project 459
Upscaling CLTS for Healthy Communities
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Akvorsr logo lite.png
RSR Project 456
Partnership in WASH services delivery
RSR Project 462
Northern Region WASH Programme
RSR Project 386
Scaling-up using CLTS in Kenya
RSR Project 789
RSR Project 600
Community-led WASH and Safe Motherhood
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RSR Project 361
Improving Communal Health Through WASH
RSR Project 810
Improved Water Sanitation and Hygiene
RSR Project 488
Community-based WASH Project in Nepal
RSR Project 922
WaterAid Rural
WASH Project
RSR Project 933
Accelerating Sanitation and Water for All 1

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  1. Ten steps to total sanitation, animation produced by WaterAid.
  2. Kar, Kamal and Pasteur, Katherine (2005). Subsidy of Self-Respect? Community-Led Total Sanitation. An Update on Recent Developments. IDS Working Paper, 68 pages.