Effects of Community Led Total Sanitation in Scaling up Sanitation Ladder and Disease Prevention in Developing Countries: A Review Focusing on Kenyan Situation

Abstract

Many people in many countries, especially in developing ones, face numerous challenges in accessing basic sanitation and hygiene. Reports indicate that around the world significant proportion of population do not have access to basic sanitation and hygiene. Although there have been valiant efforts, methodologies and approaches in scaling up sanitation, in recent years there has been escalation of CLTS implementation presumed to be effective in improving community sanitation. Thus the purpose of this review was to examine the effects of improving sanitation and hygiene through community led total sanitation (CLTS) adopted in many developing countries. Systematic reviews were conducted by searching existing literature resulting in retrieval and review of several published papers and reports. To achieve this, Preferred Reporting Items for Systematic Reviews and meta-analysis (PRISMA) method was followed in which 1108 were retrieved through Boolean internet search method. And after four stages of screening, 30 published papers were considered relevant as they met the criteria for reporting effectiveness of community led total sanitation as well as the relationship of sanitation and disease prevention. Most articles reviewed reported sanitation as a major problem in many developing countries and that CLTS is effective in up scaling sanitation and preventing sanitation related diseases. Moreover many people in developing countries who have adopted CLTS stopped open defecation and increased latrine usage. Although Kenya adopted CLTS over 10 years ago, it’s still lagging behind in realizing its goal of achieving ODF status in the entire country. This review has shown that sanitation is a major problem in many developing countries and that community led total sanitation approach (CLTS) is effective compared to other methodologies and models. After CLTS adoption and attainment of ODF status in villages, upgrading unimproved latrines into improved latrines, that’s moving step up in sanitation ladder, is crucial for safe human wastes disposal. However, sustainability is crucial for their continued usage and maintenance. Importantly, use of various conservancy technology options is vital in promoting their adoption in communities. Kenya as well as many countries needs to step up efforts in CLTS implementation so as to achieve goal of ODF status in entire country.