In India, CLTS is not literally possible. TSC, NBA and presently SBA (G)programs are all practically subsidy / supply driven. TSC program was initiated in 1999 with the objective of demand driven approach, but for all practical purposes it became supply driven as it was totally subsidized and amount of subsidy was revised upwardly regularly by the Government of India. Many households did not get toilets constructed as they expected for higher subsidy in coming days- may be near General Election time. Non usage of toilets made them dysfunctional in many cases.

A CLTS program was funded by GSF to Jharkhand State (India) in 5 districts, with initial technical support provided by Mr Kamal Kar. I was assigned to evaluate the program in 2013, while working with the Ministry of Drinking water and sanitation. Most of the villages were declared ODF within a few weeks of CLTS program.

Constructed toilets were all small boreholes- with pour flush but without pan and trap or brick lining, and superstructure with old plastic sheets or used cloths. My visit was just after rainy season. Superstructures were blown away, boreholes were filled/ collapsed.There was not a single toilet in operation constructed under the program. In fact households informed that they constructed toilets and also used for some days as they were informed that Government would provide subsidy for pucca toilets (two pit toilets with brick, cement super structure). Villages visited were almost 100% OD and ODF.

There are very good examples of Women SHGs in some states. They are doing well for motivating/ triggering people in construction and use of toilets. Hard subsidy is the major barrier to achieve the goal.

CLTS or SHGs will be effective only when hard subsidy is scraped (that's not possible) or supply chain of subsidy or materials is properly maintained and made available to whole community in a village or cluster during or just after triggering. Selection of suitable technology for the area should be the responsibility of the local government. A Community can't decide the technology.

Pawan

This is a recent peer-reviewed article looking at some of the sustainability questions about CLTS: onlinelibrary.wiley.com/doi/10.1002/wat2.1055/full

In poor rural areas, where people earn less than dollar a day, with a large family (typically, 7 members, in rural areas) to feed, and eat one meal a day, comprising of raw onions and a bread (roti, as it is called here), subsidies would do a lot whole good for constructing simple latrines, to prevent OD.

Could anyone kindly guide me to high-quality, authoritative publications, or peer-reviewed papers, on long-term monitoring and evaluation of CLTS, which show that the achievements, both short- and long-term, are sustainable.

F H Mughal

Dear Joe,

Good questions, my take on some of them. Some of my answers may be a little out of date, as I only ready some of the original texts by Kamal Kar. So Petra and others, correct me if you feel that I misrepresent CLTS as you see it.

Why is it so important that CLTS is required to be in an environment free of subsidies? What is there about the triggering which means it is only effective if communities are unable to call upon subsidies to build latrines etc?

As far as I understand CLTS should happen in an environment that is free from subsidies that will stop communities from taking charge in solving the OD problem. The classic example is hardware subsidies, which could stop people from taking action because they would wait for a toilet program to happen. Also, if triggering would be accompanied by (hardware) subsidies, the subsidies would give the organization that supplies them too much "weight" in the process thus undermining community ownership. This community ownership of the process after triggering (in my understanding) was very much at the core of the process that Kamal Kar described.

Are those NGOs who are using CLTS but also supplying some kind of subsidy (or even technical support on the issue of groundwater, as discussed previously on these boards) undermining the idea of CLTS? How and/or why?

As I recall, in the early versions of CLTS, anything that took part of decisions made during the construction of toilets away from the community was seen as undermining the process.

I think what happened was that some organizations (if not many) felt that in the area where they were active there was no way for the people they worked with to keep improving their sanitation solution (climbing the ladder) after the initial toilets were constructed. Or at least, not without significant outside advice and/or subsidies.
For example in a project I worked with it was considered irresponsible to have people construct all sort of make shift toilets first, only to tell them later that we were now going to help them do a better job. Once the community asked for toilets, it was decided that all houses should have a sanitary toilet at the end of the project.

However, it was also realized that many hardware driven programs fail. So some of the CLTS tools were used during and after the toilet construction project. For about 2 years, follow-up (on an almost daily basis) was done by project staff and community members motivated by the CLTS based activities. This was semi-jokingly know as "toilet police" in the community. After this period of follow-up using the toilets had become such an ingrained behavior that the "policing" could stop.



Regards

Marijn

Elisabeth - from this PLOS Medicine paper:

Beginning in 2006, the WSP India office supported the TSC program under the TSSM project in ten districts in Madhya Pradesh. The WSP worked with local authorities to create an enabling environment for the TSC activities, to develop local implementation capacities at the district level, and to support the use of monitoring systems to assess progress towards the TSC goals. WSP promoted and provided capacity building support to implement community-led total sanitation (CLTS) based behavior change methods [21]. The CLTS methodology involves a series of community “triggering” exercises, led by an external facilitator after building rapport with the community in the pre-triggering phase, which highlight the magnitude of the practice of open defecation, elicit shame and disgust, and mobilize community action to end open defecation [21]. These triggering activities are followed by community follow-up actions that are supported by facilitators. Although the intervention used CLTS based tools for behavior change, it cannot be considered as a classical CLTS intervention. CLTS principles require that no hardware subsidies be provided to individual households and specific latrine models not be prescribed [21], whereas the intervention provided hardware subsidies to individual households to build offset pit latrine designs approved under the Nirmal Vatika program. Provision of hardware subsidy as a post-construction incentive was advocated by the WSP, but the mechanisms of the convergence of Nirmal Vatika and the TSC essentially meant that the subsidies were released before and during but rarely after IHL construction.

from here: journals.plos.org/plosmedicine/article?i...09#pmed-1001709-g001

(by the way, this one of the papers mentioned in the letter)

This interesting paper talks about 'purists' who say that CLTS can only be done without subsidies and the way that it is actually being practiced on the ground - where NGOs use a hybrid approach:

The CLTS component largely boils down to triggering, which development organizations may combine with some training about building toilets, the provision of slabs or some subsidies. As these hybrids exist in most countries where CLTS is being implemented, the impact of emerging hybrid approaches requires further research

from here: onlinelibrary.wiley.com/doi/10.1002/wat2.1055/full

I think the wording used by CLTS people is that "no hardware subsidies" should be granted, implying that "software subsidies" (like you pointed out, Kris) would be OK?
However, perhaps the line between hardware subsidies and software subsidies might also be not as clear as one thinks. E.g. is a micro-credit scheme to help buy toilets a hardware or a software subsidy?

And I do have the feeling that "CLTS" is a kind of "protected" term, i.e. others are not meant to use is for "similar" approaches unless the core elements are the same.

For example, the "Total sanitation campaign" (TSC) of the Indian government cannot be regarded as an example of CLTS as it omitted the triggering and gave hardware subsidies instead, as far as I know (??).

Actually I don't know that much about it, so I turn to Wikipedia and if you put "Total Sanitation Campaign" in the search field you get re-directed to here:
en.wikipedia.org/wiki/Nirmal_Bharat_Abhiyan

Is this statement from Wikipedia correct? :

Nirmal Bharat Abhiyan (NBA) previously called Total Sanitation campaign (TSC) is a program following the principles of community-led total sanitation (CLTS) and was initiated by Government of India in 1999. It is a demand-driven and people-centered sanitation program. It evolved from the limited achievements of the first structured programme for rural sanitation in India, the Central Rural Sanitation Programme, which had minimal community participation and was not following the principles of CLTS. The main goal of Total Sanitation Campaign is to eradicate the practice of open defecation by 2017. Community-led total sanitation is not focused on building infrastructure, but on changing cultural norms to prevent open defecation.

It also depends on your definition of subsidy. Clearly CLTS advocates are not against indirect subsidies that enable the CLTS process to be facilitated through community outreach workers that are paid by an external source.
I think most of the indirect or market enabling subsidies are perfectly fine in combination with CLTS and simply do not fall into the narrow definition most CLTS advocates seem to have.

JKMakowka wrote: My impression was always that the CLTS advocates are simply the most vocal about the idea that no subsidies are better that badly designed ones, which are sadly the ones you will usually find.

The letter above seems to suggest it is all subsidies which are incompatible with CLTS, not just bad ones.

And, interesting point: is it possible that CTLS would work in co-ordination with imperfect subsidies, which are the norm? Are people generally pointing to problems with the CTLS concept, the subsidies or both?

My impression was always that the CLTS advocates are simply the most vocal about the idea that no subsidies are better that badly designed ones, which are sadly the ones you will usually find.

I tried to start a discussion about good design principles for sanitation subsidy schemes a while ago and would still like to hear further feedback on it.
forum.susana.org/forum/categories/164-fi...on-subsidies#page-14

In the recent letter/response (described here ) to the World Bank's World Development Report 2015, Robert Chambers, Petra Bongartz and the other authors say:

CLTS is a sustained process, much more than just a triggering exercise, dramatic and critical though triggering can be. For CLTS to go to any scale, it requires an environment which is free of hardware subsidies

They also conclude that

In privileging Randomised Control Trials over the mass of evidence and recorded experience concerning CLTS that is in the public domain, in failing to distinguish between the TSC and the radically different CLTS, and in neglecting to check out the text and conclusions in the Report before going to press, the WDR fell short of the levels of professional behaviour and rigour we expect from the World Bank. Not only has CLTS been misrepresented, but the credibility of the WDR as a cutting edge, thorough and evidence-based publication has been undermined. Given the focus on mind-sets and behaviour, it is ironic that the report does not critically reflect on the mindsets and behaviours that underpin the report itself. In this case they have led to an erroneous and damaging conclusion.

So, some questions:

Who owns the 'ideas' behind CLTS? Can the Indian government (or anyone else) 'borrow' the ideas of CLTS to trigger demand for their subsidised sanitation - and still call it CLTS (because, perhaps, it is literally true that the demand for total sanitation in the affected areas is community-led)? Or does this make a mockery of the ideas that Kamal Kar and others have been advocating in some way?

Why is it so important that CLTS is required to be in an environment free of subsidies? What is there about the triggering which means it is only effective if communities are unable to call upon subsidies to build latrines etc?

Are those NGOs who are using CLTS but also supplying some kind of subsidy (or even technical support on the issue of groundwater, as discussed previously on these boards) undermining the idea of CLTS? How and/or why?

Any thoughts would be interesting to hear and if referenced might end up on the wikipedia page.