Yes, I wanted to start a new conversation. I found the last thread unhelpful as it misconstrued the study and its findings. I am hoping we can have a more constructive discussion here rather than covering the same old ground.

Secretariat: I think this discussion needs to be linked with the discussion on Plan study:
CLTS doesn't lead to sustainable safe sanitation & hygiene - Study by Plan Australia

Thanks,

F H Mughal

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Answer by moderator (EvM): This was also my first thought that it should be linked with this other discussion: forum.susana.org/forum/categories/5-clts...dy-by-plan-australia

However, I asked Petra and she said she prefers a separate thread, rather than a continuation of the previous thread.

Paul, the only other in depth studies of sustainability we have come across are the following ones from Bangladesh and Indonesia. Off the the top off my head I can't remember if there is anything in them about the issues you raise, so must revisit these studies.

Long Term Sustainability of Improved Sanitation in Rural Bangladesh (WSP)
www.communityledtotalsanitation.org/reso...ion-rural-bangladesh

Factors Associated with Achieving and Sustaining Open Defecation Free Communities: Learning from East Java (WSP)
www.communityledtotalsanitation.org/reso...nities-learning-east

One of the main things the study highlighted for me was the issue of latrine quality and the link to longevity. There appears to be a complex link between the impetus to build a toilet from CLTS triggering, the willingness to prioritise a latrine in household expenditure, the quality of the latrine that is built and the likelihood that it will ever be upgraded. We were not able to delve into this issue beyond simply highlighting these as factors that household members expressed, and to identify those that might be linked.

I would be interested to know whether others have explored the issue of how to improve latrine quality without introducing subsidies - or whether clever or hidden subsidies, or credit/loans schemes have achieved this in CLTS programs without masking the true motivation to build a latrine that CLTS is premised on.

Congratulations to Plan for conducting and recently publishing the results of their ODF Sustainability study which was carried out in Ethiopia, Kenya, Sierra Leone and Uganda between March 2012 and October 2013. The study is available here (full report and a short summary of findings) here www.communityledtotalsanitation.org/reso...inability-study-plan if you have not yet seen it. It is great to see that Plan is investing in learning in this way and willing to share the results in a transparent way. The study presents an important milestone in that it will enable CLTS practitioners everywhere to learn more about what works, what doesn't and to consider adjustments and additions to CLTS programmes and projects that will help make efforts more sustainable.

The study should be taken as an important tool to improve CLTS implementation, practice and sustainability. It is timely and I am sure will be much welcomed by all of those seriously engaged in CLTS.

More than 60 countries are now implementing the approach, many countries having incorporated or even made it the core of their sanitation policies, and there have been many adaptations, for example urban CLTS (also in some contexts referred to as Citizen-led Total Sanitation), School-led Total Sanitation (SLTS), CLTSH (Community-led Total Sanitation and Hygiene), CATS (Community Approaches to Total Sanitation) in UNICEF, Pakistan Approach to Total Sanitation (PATS), Women-Led Total Sanitation, Leader-Led Total Sanitation etc. It has been almost 14 years since the approach was first innovated by Kamal Kar in Bangladesh, and in this time, CLTS has moved through many stages. In many countries, alongside continuing efforts to refine overall quality, we are now confronted with new and emerging challenges that this new landscape of CLTS at scale, and in many cases spearheaded by national governments, brings with it. Many questions remain unanswered and much needs to be found out and analysed, and many insights and innovations shared.

Among the many problems and opportunities that stand out most prominently include physical, social and institutional sustainability, second and third generation problems with ODF communities, long term follow up, monitoring and verification, equity and inclusion of those who are poorest and least able, integration of CLTS and Sanitation Marketing, triggering and adoption of handwashing, and adaptations and applications in urban, school and post-emergency contexts.

Most, if not all of these issues could be combined under the umbrella of sustainability. There is a long list of unknowns, challenges and opportunities. Anyone seriously engaged in CLTS is aware that it is not a one size fits all silver bullet but that it hinges on the quality of facilitation and on the commitment, ability and nimbleness of the people involved at all levels. In order for the approach, as well as practice and enabling policies to continue to evolve and grow, we need a constant learning feedback loop: learning from what happens on the ground, in communities needs to inform adjustments to programmes, projects and policies. As with anything, there is good practice and there is bad practice, there are things that work well and there are things that ask us all to reflect on, trial and share innovative ways of addressing the issues and questions.

With this study, Plan has given us a great opportunity to renew our efforts to understand better and work on

• the period between post-triggering and ODF
• definitions of ODF
• triggering and sustaining handwashing and hygiene behaviour change (timing and sequencing of messages about these)
• ongoing monitoring, verification and certification,
• post-ODF follow up

I hope that the study can be a starting point for discussions and much sharing and learning across countries and organisations of ideas, innovations and insights. It would be great to have a constructive discussion as to how to take forward the findings and how different actors plan to (or are already) addressing some of the issues raised by the study.

At the annual review meeting of the Plan Pan Africa programme (www.communityledtotalsanitation.org/country/pan-africa) in Lusaka last week (3-5 March) we spent considerable time discussing the study and its implications for practice and programming. All 7 countries present (Ethiopia, Kenya, Malawi, Niger, Sierra Leone, Uganda and Zambia) as well as staff from Plan Netherlands, Plan USA, IRC, UNC and the IDS –based CLTS Knowledge Hub came up with action plans detailing how they are going to address the findings. More on this will be posted on the Pan Africa project page (www.communityledtotalsanitation.org/country/pan-africa) in due course.