Community Led Approaches to Sanitation

2.5 billion people lack sanitation

Urban-Rural disparities

Disparities by Wealth Quintiles

Summary Of the 1.5 billion people in South Asia: 502 M already use improved sanitation 155 M currently use a shared source 756 M still practice open defecation as their only option Open defecation is declining as a percentage but remains almost constant in terms of numbers

Community Led Total Sanitation Based on PRA So similar in some ways to SARAR and PHAST

Community Analyze their sanitation conditions Collectively internalize the terrible impact Systematic triggering No hardware subsidy Hands off approach

Collective local action to trigger ODF status Shock, Disgust and Shame

Target community not household Sustainability still unproven Quality an issue

CATS Based less on a dogmatic approach More on applied principles

Principles Community (includes schools) centered No household subsidy Multiple triggers Shame Health Economics Pride Pressure Force

Hygiene

Improving sanitation coverage with equity Trends in reduction of open defecation by wealth quintiles Bangladesh 2000 - 2006 Poorest 2nd 3rd 4th Richest Open defecation Any sanitation facility Source: DHS 2000 and MICS 2006