Monitoring sanitation campaigns: Targets, reporting and realism

Published on 28 July 2021

The Sanitation Learning Hub’s latest Frontiers of Sanitation edition shares key lessons learnt from government sanitation campaigns around the world, including India, China, Nigeria, Vietnam and Zambia.

It is a vital learning resource for ongoing and future government campaigns aiming to end open defecation and improve access to safely managed sanitation. Matteus Van Der Velden – Water, Sanitation and Hygiene Specialist (co-author), said:

‘The potential for national campaigns to contribute to accelerated rates of access to sanitation has been widely acknowledged, however still relatively little is known on the factors that lead to success and (partial) failure of these campaigns – this issue of Frontiers explores this important topic’.

What is a national sanitation campaign?

National sanitation campaigns aim to educate, sensitise and encourage the target audiences across a country to change their behaviour to make using a toilet an automatic and positive behaviour as well as a social norm. Most campaigns focus on behaviours encouraging toilet use and/or handwashing with soap.

Many governments base their national campaigns on community-led total sanitation (CLTS) with the goal of changing mindsets towards ending open defecation.  Campaigns, combined with high levels of enforcement and the introduction of sanctions for not constructing and using toilets, have played a role in decreasing open defecation rates.

Campaigns long-term objectives are generally to either stop open defecation or upgrade toilets. The key objectives vary slightly between countries; many focus on health and cleanliness. They drawing on ideas of patriotism, with names designed to unify nationally such as ‘Keep Signapore Clean’ and ‘Make Zambia Clean and Healthy’.

4 carton characters hold up their fists ready to fight. Text reads "Goodbye dumi! Hello healthy!". Two logos are displayed, the department of health and UNICEF.
“Goodbye, Dumi! Hello, Healthy!” campaign supports the Zero Open Defecation (ZOD) Program of the Department of Health in the Philippines

Many governments in Asia and Africa have set ambitious target dates for their countries becoming open defecation free (ODF). Some have recently concluded national sanitation campaigns; a number of countries have campaigns underway; while others are in the conceptualising and planning process. Monitoring and reporting results is one of the key challenges associated with these campaigns.

What makes a campaign successful?

The Frontiers presents the case that campaign targets, monitoring, reporting, and verification arrangements, when used realistically and consistently, can increase the credibility of national declarations and strengthen campaigns to respond to challenges.

Global experience – including in Nepal and India – reveals that gaps and challenges in monitoring have emerged in assessing short- and longer-term impacts of national sanitation campaigns. The deadline for a campaign can often create incentives to cut corners or speed up the process. The resource presents key recommendations that can be useful across contexts to improve realism in monitoring sanitation campaigns.

  • Targets: Setting hard to reach targets can galvanise efforts to attain them but fear of failure can also lead to perverse incentives to inflate achievements. Targets for ODF status should be seen as progress milestones towards safely managed sanitation for all.
  • Monitoring allows for progress to be reported against targets. It is vital to use multiple sources of data to monitor and verify equitable progress towards and beyond ODF status, taking care to ensure consistency of the measuring scales.
  • Reporting systems should be designed to respond to multiple needs and the multiple ways the monitoring information can be shared. Combine upward reporting with information sharing between the different campaign stakeholders as well as creating opportunities for direct citizen engagement in reporting.
  • Realism: timelines and targets should be realistic in view of the baseline levels of coverage and the available resources. Agree on a clear process for making higher-level ODF declarations once all parts of country are certified and build strong local ownership of campaign through internal community monitoring.

Who is involved?

This Frontiers is based on a global scan of 13 national sanitation campaigns across 11 countries. It has been co-produced with six sanitation campaign experts from around the world (Adhikari, K, Adhikari, B. Cavill, S. Mehrotra, S. Rao Bejjanki, V. and Van Der Velden, M).

Currently countries including Ethiopia, Tanzania, Nigeria, Ghana, Kenya, South Africa, China, the Philippines, Indonesia, and Pakistan are running sanitation campaigns with targets to eliminate open defecation or achieve 100 per cent toilet coverage by 2030 or sooner. The successes and challenges of these campaigns are reflected upon throughout the Frontiers – drawn from existing resources.

The Frontiers edition also presents a summary of two newly published SLH case studies from India and Nepal, providing campaign-specific details from two countries recently declared to be ODF.

The India case study ‘Monitoring India’s National Sanitation Campaign (2014–2020)’ was written by Dr Santosh Mehrotra (Phd (Econ) Cambridge) who comments on his motivation to write the case study,

“India’s National Sanitation Campaign 2014-2019 has been claimed to be the most successful safe sanitation programme in India’s history, and even by international standards. This paper examines the reality behind the achievement.”

The case study identified lessons from India’s campaign that can be useful for other low and middle-income countries, including the importance of recognizing that increasing the number of toilets built will not overcome ODF without behaviour change, toilet design and safe water availability.

The Nepal case study, ‘Nepal Sanitation Movement Lessons Learnt on Targets and Monitoring’, written by Kamal Adhikari and Bharat Adhikari also shows factors behind the success of the national sanitation campaign and the national ODF declaration in 2019 plus key challenges along the journey and beyond.


Key contacts

Elaine Mercer

Communications and Networking Officer

+44 (0)1273 915816


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