Ending open defecation: Prospects and challenges in the implementation of community led total sanitation in Sawla Tuna Kalba District in Northern Region

No Thumbnail Available
Journal Title
Journal ISSN
Volume Title
Background: In Ghana, poor access to improved sanitation and open defecation had delayed progress with sanitation-related indicators. Community-led total sanitation (CLTS) is a participatory approach to mobilizing communities for sustained behavior change aimed at eliminating open defecation. Its outcome is for communities to attain an open defecation free (ODF) status. In Ghana, the prospects of CLTS in ending open defecation (OD), the challenges in getting communities to attain ODF status and the outcomes in terms of sanitation and hygiene behavior, and latrine ownership have not been documented. Aim: To examine the prospects and challenges of the implementation of community-led total sanitation (CLTS) by the District and partner NGOs in participating communities in Sawla Tuna Kalba District (STKD). Methods: A household (HH) census was conducted in 12 communities in which CLTS had been implemented either solely or with partner NGOs from January to December, 2016. Selection of the communities was done by multi-stage sampling among ODF and non-ODF communities. Three hundred households were enrolled from the 12 communities and visited at follow up. A pre-tested questionnaire was administered to household heads, and ten departmental staff responded to a separate questionnaire. Six focus group discussions were also held with latrine owners to complement data collected from the survey. Results: Access to private latrines was higher among households in ODF (51.3%) and non-ODF (19.1%) communities. Self-reported cases of OD dropped in the non-ODF communities as a result of increased number of latrines and sanctions on OD. The program also increased perceived privacy and safety during defecation among women. The ODF communities were sustained over five months and the non-ODF communities had done self-assessment, verified by the District Inter-Agency Coordination Committee On Sanitation (DICCS) and were awaiting Regional Inter-agency Coordination Committee on sanitation (RICCS) verification. Conclusion: CLTS shows some potential of ending OD, if fully supported with collaboration from the District Assembly and communities.
A thesis submitted to the School of Public Health, College of Health Sciences, in partial fulfillment of the requirements for the Award of a Master’s Degree (Msc) in Environment and Public Health.
Ending open Defecation, Prospects, Challenges, Implementation of community, Sawla Tuna Kalba District, Northern Region