I quite agree with you, that we should give more attention to social and behavioural change. A school child whose knowledge is improve on the impact of open defecation will stand a better chance of influencing the family over time as the parent believes in the education. Even if the parents can not afford to construct one but his mindset is conditioned that it is not healthy and as soon as he start getting money to build he will add a toilet in his house.
I believe that behavioural change should be promoted in the CLTS approach.

How can these rates be optimized? and; what should be our response to communities that do not become defecation free?” –

This is an important question considering that CLTS as an approach is one that has received a more world wide acceptance by many sectors including national/central governments and private sector than many other approaches. The missed opportunity is that we are more focused on elimination of open defecation as a practice than the aspect of behaviour change which would be more long term. Context is key, I do not think that there exist an approach that applies to all types of communities even in a single country. the next step is for practitioners to embrace the challenge and device ways to focus the approach to its core principle of changing behaviours

bringing discussions such as these to practitioners is good way to deal with the issue. Another way is to encourage sharing of experiences.

for communities that do not stop open defecation, a solution would be to understand the motivation for the current practices. could it be the triggering process applied the drivers of ‘shame’ and ‘disgust’ in a negative way that made the communities recoil back instead of being a trigger for change? could the CLTS have been applied as ‘lets-build-toilets” than lets embrace different practices? I think there is much to be learned in this practice. For example in pastoralist communities in Kenya who are nomadic in nature the elimination of open defecation did not work out well because they are in constant motion. Some NGOs have tried introducing the mobile toilets by use of same temporary materials used to construct the houses. the success of this is still to be determined…..

Thanks all for your comments and questions. It's great to get your feedback and I hope Elisabeth's responses have addressed many of the queries.

For those with a particular interest in behavior change, I've just seen a post in the L inkedIn Community of Practice on Sanitation and Hygiene in Developing Countries from the KM team at World Vision International.

Post reads as follows:
***************
Interested in regular webinars on behaviour change for WASH?For those who are interested, GOAL and World Vision International gather for behaviour change-related webinars every two months or so. If you are interested in participating -- or even hosting a discussion -- please email us at This email address is being protected from spambots. You need JavaScript enabled to view it.. We can add you to our group.
***************

This looks like a great opportunities to continue the conversation on behaviour change.
Warmest regards,
Pippa

Marijn had asked for a summary of this webinar's sound and video recording. I don't have such a summary yet but Ryan Rowe, who is the Knowledge Manager at The WATER INSTITUTE at UNC, put it like this which I think sums it up quite nicely:

++++++++

Questions/issues at the webinar included:

1. ODF may be better suited for motivating communities than measuring success and is not a good metric for comparing communities due to its binary nature;
2. Low overall success rates suggest we are missing an opportunity to better target CLTS to specific communities and consider alternate sanitation strategies where CLTS is not appropriate;
3. We need better data and understanding of how to successfully change long-term social norms

+++++++

Regards,
Elisabeth

Dear all,

You can now refresh your memories regarding the CLTS webinar by listening to the audio files here:

1. Introduction - starts with the voice of Pippa Scott:
www.susana.org/images/audio/CLTSwebinar/..._Webinar_1_Intro.mp3

2. Chat Show (Part 1) - starts with the voice of Jane Bevan:
www.susana.org/images/audio/CLTSwebinar/...r_2_Chat%20Show1.mp3

3. Chat Show (Part 2) - starts with the voice of Jonny Crocket: www.susana.org/images/audio/CLTSwebinar/...nar_3_Chat_Show2.mp3

4. Chat Show (Part 3) - starts with the voice of Ada-Oko Williams:
www.susana.org/images/audio/CLTSwebinar/...nar_4_Chat_Show3.mp3

5. Chat Show (Part 4) - starts with the voice of Jane Bevan:
www.susana.org/images/audio/CLTSwebinar/...r_5_Chat%20Show4.mp3

6. Feedback from Breakout Rooms - starts with the voice of Pippa Scott: www.susana.org/images/audio/CLTSwebinar/...k_Breakout_Rooms.mp3

7. Closing Panel - starts with the voice of Jane Bevan: www.susana.org/images/audio/CLTSwebinar/..._7_Closing_Panel.mp3

The separate files should make it easier to listen/download the files also for those with a slow internet connection (they are about 10 MB large). Enjoy!

All the best,
Jona (on behalf of the the SuSanA Secretariat)

P.S. Please tell us if you any technical problems with accessing these audio files or if everything is fine?

We are still learning and experimenting with the best way to run webinars, so your feedback is really important. Also, as three times more people registered than actually attended, we are curious to find out reasons for non attendance (despite having registered). This is the first question in the survey – and the only one you need to answer if you registered but didn’t attend.

Whether you joined the actual webinar or not, we would also appreciate it if you could give us your feedback on the process of registering and attending the webinar, as well as on the content and facilitation of the session.

Please answer the questions in this very short feedback form . This way we can can evaluate the session and improve the delivery of future webinars.

Many thanks
Pier Andrea (for the webinar facilitation team)

Dear Marijn,

Thanks for your points.
I agree with you about the summary. I wonder if we can find any volunteers who would listen to the recording and do up a summary? Although you know, everyone's summary would differe because what one person finds important when listening, the other one may not...
But in any case, perhaps this would be a nice task for someone's intern?

Regarding lack of access to Youtube, yes, that's a real downside. Therefore, we have also created sound files (mp3) and they will be uploaded to this thread very shortly. The idea is that people can download the files (they are also 10 MB large though) and then listen to them on their mobile phone or i-pod or similar device.

About your third point:

Also, I am not sure the webinar really focused on how I had interpreted the title (what results do we need to see before we can say that a CLTS intervention is successful).

Point taken.
I invite the experts from the webinar to make a statement about that here? Ada, Jonny, Hansi, Darren or Ryan?

Regards,
Elisabeth

Dear Mughal,

We have discussed open defecation in India in several threads in the sub-category called "behaviour change and user psychology issues" (you contributed to many of them which is great):
forum.susana.org/forum/categories/71-beh...er-psychology-issues

For example here:
forum.susana.org/forum/categories/71-beh...t-want-pit-latrinesq

Sangita from r.i.c.e wrote there:

These latrines are going unused in India, even though available evidence suggests that using these latrines is better for child health than open defecation, and emptying these latrines poses minimal risk to the emptier because the feces is given time to decompose first. If latrines like these were given away in other developing countries, they would likely be used. But not in India.

This rejection of latrines with internationally recommended pit sizes is unique to India because of caste and untouchability. India's problem is unique, and so the solutions are also likely to be unique, and we need to be experimenting as much as possible with solutions that address people's real concerns.

So no matter how "good" CLTS might be, the issues are so complex in India that one approach alone (CLTS) will not be able to solve that, I guess.

Advocates of CLTS might also say that CLTS is not sufficiently wide-spread in India or not done in the right way (see also some explanations here about the former "total sanitation campaign" in India": en.wikipedia.org/wiki/Nirmal_Bharat_Abhiyan)

I actually don't know how wide spread CTLS is in India when looking at the total (rural) population.

Has anyone ever seen a world map (or table) showing the percentage of rural population triggered by CLTS? I would assume that in India it is perhaps 0.1% of the rural population whereas perhaps in some other countries it might be higher by now?

Regards,
Elisabeth

Dear Pippa and Ryan,

Please help me in understanding this point: CLTS, I think, is fairly population in India. There are success stories about Uttar Pradesh and Kalyani. Despite this, in India, a large population practices OD (open defecation).

The following information, from UNICEF website, is worth noting:

Globally, India has the largest number of people still defecating in the open: more than 595
Million, which is nearly half the population of India. One in two people uses a toilet.

Half of the population excretes more than 65,000 tonnes of poo outside every day.

An even lower proportion of India’s rural population uses toilets. About 65 per cent of people in
rural areas do not have access to toilets.

Of the more than 160 million people who have access to improved sanitation, the coverage is
highly inequitable. Open defecation is actually still increasing amongst the poorest segment of the population.

Only 11 per cent of Indian rural families dispose of child faeces safely. Eighty per cent of
children’s faeces are left in the open or thrown into the garbage.

With 44 per cent of mothers disposing of their children’s faeces in the open, there is a very high
risk of microbial contamination (bacteria, viruses, and amoeba) of water which causes diarrhoea in children.

India reports the highest number of deaths due to diarrhoea in children under five in the world.
Every year, diarrhoea kills 188,000 children in this age group.

Children weakened by frequent diarrhoea episodes are more vulnerable to malnutrition, stunting,
and opportunistic infections such as pneumonia. About 43 per cent of children in India suffer from some degree of malnutrition.

The faecal-oral route is an important polio transmission pathway. Open defecation increases
communities’ risk of polio infection.


I would like to know, why the OD percentage in India is so high, despite the popularity of CLTS there?

Research by Diane Coffey and Dean Spears of RICE Institute, Delhi, shows that even among households with a working latrine, more than 40 per cent reported that at least one family member preferred to defecate in the open. Those with a government-built toilet were especially likely to choose a bush instead.

In an unpublished parallel survey of Hindu-dominated villages in north India and Nepal, respondents lauded open defecation as wholesome, healthy and social. By contrast, latrines were seen as potentially impure, especially if near the home. Men often described them as for use only by women, the infirm and the elderly.

Regards,

F H Mughal

Dear Pippa ,
I think we always need to critically reflect on the statitics, capacity to monitoring, human resource capacity to follow up at local level before we making any conclusion of successful implementation of CLTS in Africa. At the last AfricaSan there was a great concern raised of the maintaining CLTS triggering and lasting impact from several Africa government representatives . Some reflection on statistics in Africa : www.afdb.org/en/blogs/afdb-championing-i...ics-a-tragedy-14229/

Dear Pippa and other colleagues involved.

Thanks for putting up the recordings. I think for future webinars it would be very helpful to also have a written summary. These are my reasons:

1.) The information density of the videos is somewhat low. It takes me an hour to watch, the webinar. I think I could have read a summary in 5 minutes.

2.) Not everyone on this forum can watch these videos (for political or internet speed reasons).

3.) I find it very hard to concentrate on the videos. When I attend a webinar, I am involved (even if I don't say anything) and it is easy to concentrate. Watching the videos I find it much harder to concentrate than on a well written summary.

Also, I am not sure the webinar really focused on how I had interpreted the title (what results do we need to see before we can say that a CLTS intervention is successful). Despite that, it was an interesting discussion. It was good to hear some directions in which people are thinking CLTS could grow, and how monitoring of CLTS interventions could be improved.

Kind regards

Marijn

Dear Pippa and Colleagues,

Thanks for sharing these video recordings of the webinar discussions and presentations.

On defining and measuring CLTS outcomes, the well-known issue of standardizing indicators came up during the webinar --

In 2012, as part of the joint Plan International USA / Water Institute at UNC study “Testing CLTS Approaches for Scalability”, one of our researchers collected and reviewed 115 ‘grey literature’ documents from various online sources. Download Report

Of the findings, we concluded that among the practitioner community, reporting and indicators are not standardized and this makes it very difficult to compare data across programs/regions. This is not new and not surprising to many in the sector of course...

We developed a categorized list of 23 indicators found in the literature which helps shed some light on the issues. Only 3 of the 23 indicators measured inputs or processes – important for assessing the consistency of program implementation. Only two indicators were used consistently - the number of triggered communities and number of communities declared ODF – but documents characterized them differently, in some cases as process indicators and other as output or outcome indicators. You can see the list and read our blog post on this topic which suggests actionable steps to be taken and offers resources to help move the conversation forward.

Other issues on M&E, regarding centralized systems and cost tracking for example, came out of our situational assessments of CLTS in Kenya, Ethiopia, and Ghana - available here .

Our findings on the weak status of M&E in the sector are further reinforced in our recent case study of CLTS in Cambodia , in which we found neither a national ODF definition nor verification criteria used by government actors as they implemented CLTS trainings and monitoring tasks. Thus, even for this key indicator, there is not a standardized approach to measurement.

There is a major need to standardize monitoring & evaluation practices for CLTS, especially at the national level, as we called for in a 2014 project research summary . This is an issue to be prioritized by government agencies and donors and placed high on the agenda at NGO stakeholder meetings.

Hopefully these resources will be helpful for our colleagues..

At the upcoming Stockholm World Water Week on Sunday August 23rd, we will be sharing additional findings from this grant. If you are not able to attend, you can also stay tuned to our project website .

Thanks

Best regards
Ryan Rowe

Knowledge Manager
The Water Institute at UNC
This email address is being protected from spambots. You need JavaScript enabled to view it.