Working Paper

Taking Community-Led Total Sanitation to Scale: Movement, Spread and Adaptation

Published on 1 February 2008

When a practice becomes widespread enough, then it has ‘gone to scale’. But increasing the intensity and spread of a particular practice is not a linear or obvious endeavour. The paper proposes that going to scale is multi-dimensional and complex.

It focuses on Community-led Total Sanitation (CLTS): an innovation in participatory methodology, as well as a unique approach to sanitation. While CLTS has followed both vertical and horizontal trajectories, with quantitative, political, functional and organisational scaling-up, its general movements are best described as ‘spread and adaptation’. The paper describes how CLTS offers important lessons to understand spread which is critical for scaling up in an effective way.

CLTS shows how increased scale entails both wide-scale coverage, with pertinent adaptations to local contexts. The main argument is that spread and adaptation are important aspects of scaling up, which is often neglected in the literature. After a brief overview of CLTS, the paper reviews the literature on scaling-up and extracts the useful points relevant to CLTS, and highlights the gaps in the literature around self-spreading movements.

A number of case studies of innovative methods or approaches that have been successfully scaled-up are then considered: PRA, Reflect, Community Integrated Pest Management and System of Rice Intensification. The author then maps out CLTS experience, outlining the various ways in which CLTS has spread. After considering the various forms of spread, the ‘spatial strategy’ employed by CARE Bangladesh is given specific attention.

The paper then discusses how CLTS and other participatory approaches challenge dominant thinking around community developing by critically examining the World Bank’s discourse around Community-based/driven development. The final section offers concluding remarks regarding how to better understand scaling-up and spread.

Publication details

published by
Deak, A.
IDS Working Paper, issue 298
978 1 85864 677 4


About this publication

Programmes and centres
The Sanitation Learning Hub

Related content


Key Considerations: Effective Vaccine Rollout and Uptake in Sierra Leone

SSHAP Briefing

Abu Conteh & 3 others

15 May 2024