Handbook on Community-Led Total Sanitation

This handbook guides communities, non-governmental organisations (NGOs), governments, donors, and other practitioners in the use of Community-Led Total Sanitation (CLTS), an approach to rural sanitation developed by lead author Kamal Kar, an independent development consultant from India. It is based on his experience with providing hands-on training in Bangladesh and in many other countries throughout the world (in India, Cambodia, Indonesia, Mongolia, Nepal, China, and Pakistan in Asia; in Uganda, Zambia, Ethiopia, Tanzania, Kenya, and Sierra Leone in Africa; in Bolivia in South America; and in Yemen in the Middle East).

As detailed in the handbook, CLTS focuses on igniting a change in sanitation behaviour rather than constructing toilets. It does this through a process of social awakening that is stimulated by facilitators from within or outside the community. CLTS entails the facilitation of a community's analysis of their sanitation profile, as well as their practices of defecation. Participatory rural appraisal (PRA) methods are used to enable local communities to collectively internalise the impact of open defecation (OD) on public health and on the entire neighbourhood environment - hopefully leading to collective action to become OD-free (ODF). That is, approaches in which outsiders "teach" community members are not CLTS in the senses of this handbook.

CLTS intentionally uses local crude words for faeces, and avoids the polite phrases that often obscure the subject; this strategy is designed to generate strong emotions that help to move the process forward. As part of the process, local communities visit the dirtiest and filthiest areas in the neighbourhood. The community's appraisal and analysis of the practice of open defecation and its consequences usually trigger shock, disgust, and shame when people realise that they are literally eating each other's faeces. Kar describes this style as "provocative and fun, and is hands-off in leaving decisions and action to the community." The key is that it concentrates on the whole community rather than on individual behaviours. People decide together how they will create a clean and hygienic environment that benefits everyone. Social solidarity, help, and cooperation among the households in the community are common and vital elements in CLTS. Other important characteristics are the spontaneous emergence of natural leaders (NLs) as a community proceeds towards ODF status, local innovations of low-cost toilet models using locally available materials, and community-innovated systems of reward, penalty, spread, and scaling-up. CLTS encourages the community to take responsibility and to take its own action, rather than relying on external help and handouts. According to Kar, when triggered systematically and combined with a 'no-hardware subsidy' policy and a hands-off approach by the facilitator, CLTS could provoke urgent collective local action to become totally ODF.

This handbook has been compiled as a source of ideas and experiences that can be used for CLTS orientation workshops, advocacy to stakeholders, training facilitators and NLs, and implementing CLTS activities. Narrative is complemented by photographs, charts and tables, case studies and examples from different countries and organisations, as well as a number of appendices. Users of the manual are encouraged to use their own judgment at all times and to innovate locally appropriate approaches and tools to achieve and enhance community participation and empowerment leading to total sanitation and beyond.