'Shit Matters': Addressing development's most compelling challenge

23 March 2011

Sanitation remains one of the biggest development challenges of our time. But despite growing attention and efforts by governments and donors many top-down approaches to rural sanitation are failing. Community-led Total Sanitation (CLTS) is a revolutionary approach to the problem that can have the makings of a development success story.

A new book co-edited by IDS Research Fellow, Lyla Mehta reveals how  CLTS is changing lives and gives a unique insight into the challenges facing its successful spread accross the globe.  The book was launched on 22 March to coincide with World Water Day.

Sanjay Wijesekera, Water and Sanitation Team Leader at the UK Department of International Development, says 'Community-led Total Sanitation is probably the biggest innovation of the last decade in helping us achieve what is the most off-track MDG target in Africa. This book is a 'must read‘ for anyone who believes that a world in which over one billion people defecate in the open is a world not fit to live in.'

Radically different approach

Globally, 2.6 billion people lack access to sanitation with about 1.1. billion still defecating in the open. Each year, 4,000 people, mainly children, die due to poor sanitation, hygiene and water. In many countries, especially in sub-Saharan Africa, the Millennium Development Goal for sanitation is seriously off track.

At the heart of CLTS lies the recognition that merely providing toilets does not guarantee their use and result in improved sanitation and hygiene. In CLTS, through intense facilitation and the upsurge of powerful emotions such as disgust and shame, communities are motivated to conduct their own appraisal of their sanitation situation and take their own action to create 'open defecation free' communities. During the process, the crudest local words for 'shit' and ‘shitting' are used in order to break conventional taboos. CLTS was pioneered by Kamal Kar and a local non-government organisation, Village Education Research Centre, in Mosmoil village in North West Bangladesh in 2000 and is currently being implemented in at least 40 countries.

Potential and challenges of CLTS

A new and important study from the Institute of Development Studies tells the fascinating story of the dramatic spread of CLTS around the world as well as the challenges that still remain regarding scaling up with quality, inclusion of the poorest, and sustainability. Drawing on research in Bangladesh, India and Indonesia, as well as experiences from Africa, Shit Matters: The potential of Community-led Total Sanitation, co-edited by IDS Research Fellow Lyla Mehta, provides important insights into the workings of CLTS on the ground.

The authors highlight several of its successes. They find:

  • In a span of 10 years, CLTS has spread to over 40 countries in Asia, Africa, the Middle East and Latin America. Between ten and twenty million people have benefited from CLTS worldwide. It is a powerful way to address the sanitation crisis, transcending geographical differences and cultural barriers.
  • Benefits can include better hygiene practices, diarrhoea reduction, an increase in household income due to better health outcomes and the ability to invest in poverty reduction and livelihood generation programmes.
  • There are clear benefits to women which include privacy, time saved, dignity and freedom from embarrassment and sexual violence as well as health gains which are often not articulated.
  • If its spread can be sustained with quality and rapidly, CLTS could both enhance human wellbeing and address a host of MDGs that go well beyond sanitation.

The book also highlights challenges in enabling and supporting the spread of CLTS. For example, the book finds:

  • Taking CLTS to scale requires institutionalization processes and high level support from government and key champions. The CLTS approach challenges donor and government mindsets about cash disbursements and top down development processes. Countries that have entrenched bureaucracies and subsidy regimes often resist the principles of CLTS.
  • In many cases, there has been exaggeration of success, an over-reliance on targets and flawed reward systems (for example, in India, where cash prizes for 'open defecation free' communities can both inflate the degree of success and be counterproductive for the quality of CLTS spread).
  • Behaviour change can be difficult to sustain. People can revert back to old habits if there has not been a profound change in attitudes. Inclusion of the poorest and the marginalised in the community remain key challenges for CLTS.
  • Questions remain regarding the overall sustainability of CLTS and its application in urban areas where overcrowding and poor tenure arrangements could make uptake difficult.

Co-editor, Lyla Mehta says, 'While CLTS is no magic bullet or one stop fix all, this study demonstrates that it is indeed a powerful way to tackle the sanitation crisis and several development challenges.'

Shit Matters: The potential of community-led total sanitation is edited by Lyla Mehta and Synne Movik, and was published on 22 March 2011 by Practical Action Publishing. Copies of the book are available from Practical Action.