Wednesday, May 15, 2013

Feature: Triggering A Sensitive Stage In Community Led Total Sanitation Concept

A CLTS facilitor using approved technics
Source: Ato Quansah
Extension Services Specialist

With less that 1000 days for Ghana to meet the Millennium Development Goal (MDG) sanitation targets of 54%, the country has 14% sanitation coverage which implies that only 14 out of every 100 Ghanaian have improved sanitation (UNICEF & WHO, 2012).

Again, 19% of Ghanaians (about 4.6 million people) do not have a ‘fixed defecation address’ and therefore defecate in the open every day (MLGRD, EHD, 2012). These disturbing conditions have compelled the country to adopt the CLTS approach to help address the sanitation challenges that confront her.


Community-Led Total Sanitation (CLTS) is a concept developed by Kamal Kar which involves facilitating a process to inspire and empower communities to stop open defecation. The CLTS approach ignites a sense of disgust and shame among the community and ultimately inspires community members to take action on their own to stop open defecation.

Through the approach, community members analyze their own sanitation situation including the extent of open defecation (OD) and the spread of faecal-oral contamination that detrimentally affects them. Since the approach does not prescribe latrine models, community members often build their own latrines with their own designs and local material without external subsidies. However, one important aspect of CLTS which facilitators must attach importance to is the triggering stage.

What is Triggering

Triggering is simply facilitating a process of community self-analysis of their sanitation profile through which community members comes across the crude fact that they are "ingesting each other faeces or shit". A good triggering exercise must persuade community members to come out with their own measures to deal with the open defecation situation in their community. The central role of a facilitator is to help community members to realize that open defecation has disgusting consequences and creates an unhealthy and unpleasant environment. 

Aim for triggering

Triggering ensures that community members feel disgust and embarrassed due to poor sanitation conditions in their communities. However, the exercise is to make community members conscious of the fact that they eat each others faeces through faeco-oral transmissions.

These often impel people to end OD and practice hygienic fixed-point defecation. However, achieving the aim of CLTS largely depends on how the triggering exercise is done. Hence, a good triggering exercise must have an impact of self-realization among community members.

This must lead to change in behaviour and attitude of community members to put an end to the practice of OD. The community must have an Open Defecation Free (ODF) status which means that there must be no practice of open defecation in the entire community.  The success of triggering however largely depends on the skills of the facilitator.

Key issues in Triggering for facilitators

It is incumbent for the facilitator to introduce him or herself and the team to the community members and explain the purpose of the visit as for an assessment of community profile. To enable the community members to open up for discussion, other issues such as the history, economic activities and the demographic characteristics of the community must be elicited first before issues of sanitation are tackled.

Using the defecation area mapping, transact walk, calculation of shit, faecal - oral transmission routes or calculation of medical expenses as triggering tool, the facilitator must help the community members to analyze for themselves that they are eating each others faeces. The facilitator must thus listen and observe the reactions, gestures, comments and signs of the community members during the triggering exercise.

When the community is triggered or members confess that they are eating their own faeces, application of triggering tools need to be stopped and the facilitator must deliberately ask permission to leave to see the reaction of the community members. At that point, the triggering exercise has ended, given room for post triggering activities.

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