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Sanitation (CLTS)
Lillian Mbeki
Introduction
The CLTS approach relies on generating action and behavior change by enabling
communities to assess their own current practices and getting triggered to stop
open defecation and build and use latrines. It is built on the basic foundation of
communities finding local solutions to their problem and is non-reliant on funding or
external subsidy. CLTS does not prescribe technologies but rather encourages
households to identify local technological options for their own needs.
Background of CLTS in Kenya
The Government of Kenya and partners have previously used the Participatory
Hygiene
and
Sanitation
Transformation
(PHAST)
approach
for
sanitation
Common knowledge
Creation of a social norm within a community requires that a critical number of
people be exposed to information on the desired behaviour( which happens during
triggering), it requires the use of nodes as change agents/influencers ( in CLTS this
are the natural leaders ), the community should themselves come up with sanctions
for offenders ( villagers decide what punishment to administer to those caught
defecating in public) and a process of creating common knowledge on the social
norm( this happens when community commits publicly to end open defecation, it is
done at frequent community meetings and when a community is declared ODF
there is erection of a bill board declaring the village ODF)
The findings from this study, in villages that were ODf and where latrine use was a
social norm, show that about all the respondents sampled among those that own or
share a toilet at home (99.1%), believed with utmost certainty that they ought to
be using a latrine for defecation.
& the community members, whereas non-material sanctions of disapproval, i.e. the
shame! are given by any community member.
When respondents were asked- what would you do if you found someone defecating
in the open, they said I will force him to carry his faeces; I will take him to the
chief; Advise him on how to use a latrine; I will tell him he is doing wrong by
spreading diseases; I will tell that defecating in the open is bad; I will ask him if he
has a latrine at home; Will advise him to construct a toilet; Will report him to the
health worker; He/she should be a child and should be caned; Should be warned
against such behaviours;
Majority of respondents also reported that they would offer advice to the norm
breakers; a significant proportion reported that they would sanction compliance
directly or indirectly through other actors at the community level. Some of the
reported sanctions include: reporting to the chief or government
official; giving ultimatum or last warning; reporting to the elders; reporting to the
CHW or natural leader; confronting, beating or chasing away; inducing shame e.g.
by forcing to carry the shit around the village; segregation where community
members avoid visiting them to avoid contracting diseases; expulsion from the
village / community; and thorough caning if the offenders are minors.
The study outcomes indicate that the enforcement of social by-laws (sanctions) is
wide spread across the sampled villages with 38 of the 42 villages that reported
existence of by-laws reporting that there is enforcement as well.
Misperceptions
The term misperception is used to describe the gap between actual attitudes or
behaviour, and what people think is true about others attitudes or behaviours.
For example, the majority who engage in healthy sanitation behaviour may
incorrectly believe they are in the minority (pluralistic ignorance.) This occurs when
a majority of individuals falsely assume that most of their peers behave or think
differently from them when in fact their attitudes and/or behaviour are similar.
Pluralistic ignorance encourages individuals to suppress healthy attitudes and
behaviours that are falsely thought to be non-conforming and to provide
The findings show that about all the participants sampled from ODF certified
villages (98.8%), they belief with utmost certainty that they ought to be using a
latrine for defecation.
Majority of the respondents believe that others think that they should be frequent
users of a latrine 96.3% of ODF villages participants.
What these means is that in villages that latrine use is a social norm,
misperceptions have been cleared and there is common knowledge of beliefs and
practice.
Social Networks
Numerous studies have documented the role that the social networks of individuals
play in initiating and reinforcing both positive and negative behaviours. (Dorsey,
Seeman, & Sayles, 1985). In order for individuals to be influenced by their social
networks, they must either feel some degree of affinity, or desire connectedness
with a reference group (Ajzen, I., &Fishbein, M. 1980). Social norms interventions
focus on peer influences, which have a greater impact on individual behaviour than
biological, personality, familial, religious, cultural and other influences. ( Perkins,
H.W. and A. D. Berkowitz., 1986)
Misperceptions increase as social distance increases. But social groups that are
closer are more influential in shaping behaviour. This was also the conclusion of
Borsari and Carey (2003) in a meta-analysis of social norms studies, in which they
found that misperceptions were greater as social distance increased while the
influence on behaviour of closer or more salient social groups was stronger.
Results in ODF villages further show that among the respondents who have access
to a toilet at home (own or shared), a majority of them (95.4%) expect that
members of their social networks use a latrine every time;
Another curious outcome from this study is that, villages that have dense household
distribution are more cohesive and hence social norms deeply rooted as compared
In a network, not all individuals play an equal role. Some individuals are more
central. Central individuals have less distance from others. If someone knows
everybody in a district, that person is very central. Someone can also be central if
she knows very few people but if these people know a lot of people.
Some individuals have a high degree of connectedness. This simply means that
they have ties with many people. Research therefore suggests that programs
targeting behaviour change at a community level would do well to use such
information in selecting change agents.
The results show that among the respondents from ODF certified villages, a
majority of them (96.9%) expect that members of their reference networks use a
latrine every time.
The findings indicate that as many as 96.3% of the respondents from ODF certified
villages believed (and expect) that members of their reference network consider
them to be every time users of a latrine. Less than 6% believed there would be
deviations in expectations. These results validate similar results in the study where
respondents said we use a latrine every time because we believe that enough of
others in our reference networks expect us to use a latrine every time
Pre-triggering
It is important the individual/s planning a triggering event:
Identify the key influencers in the community. Identify both formal and
informal leaders and ensure that they participate in the triggering event
The results show that the community health workers (CHWs) and the natural
leaders played the lead roles in CLTS mobilization.
Engage the local leadership and work with the community in selecting the
Take time to study the existing networks and referent groups within the
village
community activities to help decide on the best season, time and day for triggering.
During the planting and weeding seasons in rural and mainly agricultural areas, it is
much harder to get adult household members before 2PM for a triggering meeting.
These and other local issues should alswys be borne in mind
Triggering
If pre-triggering and community mobilization is done well there should be a critical
mass of people at the triggering event, as well as the presence of key opinion
leader and influencers. During triggering it is important to look out for the
following:
out for them during triggering. These are the individuals that show
enthusiasm for the new desired behavior and are willing to lead, initiate and
persuade others to change. They also have the predisposition to influence
others around them
to support each other within the village and ensure the community was ODF
in a specified period of time.
children
during
triggering
and
possibly
involvement
of
schools
in
The results show that 28 of the 42 villages (66.7%) received follow-up to ensure
that toilet use was sustained. In a majority of these villages (82%), the results
indicate that the government agents and CHWs provided the lead role. Their efforts
were complemented by NGOs (21.4%), the villagers (10.7%) and the village based
organizations (7.1%).
In order to accelerate progress to ODF and in the development of a social norm,
some of the actions that were found to work in the parts of rural Kenya where the
study took place are outlined below:
weekly household visits and addressing village meetings where they bust
misperceptions and communicate on the normative expectations with the aim of
creating common knowledge is useful
Enforcing sanctions- When it was found that some households were resisting
The role of local government and other key opinion leaders-The District
Focus on behavior change- Over the years public health teams relied on
imposing the chiefs act where households that did not comply and build latrines
had the household heads arrested and fined. The evidence shows that this did not
have much impact in increasing latrine coverage. In areas where triggering involved
enabling the villagers understand the harmful effects of open defecation and then
decide
to
change
behavior, latrines
that
were
willingly
built
were
used.
Subsequently the new behaviour was strengthened when individuals realized that
other villagers approved the new practice and were also adopting latrine use.
billboards. In some villages declared ODF there were large billboards erected that
read This village is ODF- Anyone caught defecating in the open will be punished
Conclusions
Triggering relies on energizing to end open defecation by instilling fear, shame and
disgust toward defecating in the open then helping the community itself to tackle
sanitation issues with no government or NGO funding or support. (Kamal Kar &
Robert Chambers, Hand book on Community Led Total Sanitation).
Normative change at both the collective and perceived levels is largely driven
by natural leaders who often are within a close network group and are a trusted
source of information within the community social networks
stimulating change and sustaining the social norm for safe sanitation behaviours
community where social networks are tight and households are in close proximity.
Communities that are more sparsely populated and are more heterogeneous
require a multi-pronged approach and more intense follow-up in developing and
strengthening the desired norm
None of the villages where Post ODF following was done had severe OD
reversal