Sustainability of community-led total sanitation outcomes: Evidence from Ethiopia and Ghana

International Journal of Hygiene and Environmental Health
Jonny CrockerJamie Bartram

Abstract

We conducted a study to evaluate the sustainability of community-led total sanitation (CLTS) outcomes in Ethiopia and Ghana. Plan International, with local actors, implemented four CLTS interventions from 2012 to 2014: health extension worker-facilitated CLTS and teacher-facilitated CLTS in Ethiopia, and NGO-facilitated CLTS with and without training for natural leaders in Ghana. We previously evaluated these interventions using survey data collected immediately after implementation ended, and concluded that in Ethiopia health extension workers were more effective facilitators than teachers, and that in Ghana training natural leaders improved CLTS outcomes. For this study, we resurveyed 3831 households one year after implementation ended, and analyzed latrine use and quality to assess post-intervention changes in sanitation outcomes, to determine if our original conclusions were robust. In one of four interventions evaluated (health extension worker-facilitated CLTS in Ethiopia), there was an 8 percentage point increase in open defecation in the year after implementation ended, challenging our prior conclusion on their effectiveness. For the other three interventions, the initial decreases in open defecation of 8-24 percentage ...Continue Reading

Citations

Dec 15, 2017·International Journal of Environmental Research and Public Health·Mitsunori OdagiriYameha T Asamou
Aug 3, 2018·International Journal of Environmental Health Research·Temilade SesanCharlotte Ray
Oct 12, 2018·Tropical Medicine & International Health : TM & IH·Frederick G B GoddardMatthew C Freeman
Feb 23, 2019·The American Journal of Tropical Medicine and Hygiene·Kojo Yeboah-AntwiDavidson H Hamer
Mar 4, 2020·The American Journal of Tropical Medicine and Hygiene·Anna EllisMatthew C Freeman
Jul 18, 2020·International Journal of Environmental Research and Public Health·Seungman ChaIan Ross
Sep 22, 2018·Health Promotion International·František Ficek, Josef Novotný
Jul 17, 2019·International nursing review·B C Mbakaya, R L T Lee
Oct 28, 2019·International Journal of Environmental Research and Public Health·Karen SettyJamie Bartram
Jun 26, 2020·International Journal of Environmental Research and Public Health·Renee De ShayBethany A Caruso
Mar 14, 2020·International Journal of Environmental Research and Public Health·Paschal A ApangaMatthew C Freeman
Mar 17, 2019·International Journal of Environmental Research and Public Health·Abraham Marshall NunboguHans-Joachim Mosler
Feb 27, 2020·International Journal of Environmental Research and Public Health·Anoop JainIsha Ray
Jan 5, 2021·Environmental Science and Pollution Research International·Muhammad Irfan MalikMuhammad Nadeem
Dec 29, 2020·International Journal of Hygiene and Environmental Health·Jonny CrockerJamie Bartram
Apr 8, 2021·Environmental Science & Technology·Hugo LeggeWilliam E Oswald
Jun 17, 2021·Environmental Health Perspectives·Sabrina S Haque, Matthew C Freeman
Dec 21, 2021·Pathogens and Global Health·Zhe WangSandi K Lam

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