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National Sanitation Coverage

The Federal Government of Ethiopia (FDRE) Constitution has given due emphasis to the Environmental Right of the Ethiopian people i.e. All persons have the right to live in a clean and & healthy environment. In addition, the National Health Policy (1993) emphasizes the development of the preventive, promotive, rehabilitative, and curative components of the health care system which includes safe disposal of human waste, household, agricultural, industrial, prevention of environmental pollution & hazardous waste.

To implement the above and to achieve the health MDGs by 2015 the Ministry of Health (MoH) has prepared a Health Sector Development Plan that is being implemented by regional health bureaus and aims to scale up delivery of primary care services through the health extension Programme and health clinics at district level. Over 38,000 health extension workers (HEWs) have been trained and deployed to health posts at kebele level in both rural and urban areas. HEWs work with communities and households through members of the Health Development Army (HDA) to promote behavior change, including use of improved sanitation facilities, hygiene promotion and eradicating open defecation.

History of CLTSH in Ethiopia

The CLTS approach was first introduced in Ethiopia in October 2006’s in Arba Minch area by an Irish NGO called VITA. Later, in February 2007, Plan International Ethiopia and Plan Regional Office for Eastern and Southern Africa (RESA) invited Dr. Kamal Kar to conducted training for selected WASH and Health staff members from Government, NGOs and Plan RESA countries. After the training Plan International Ethiopia piloted the approach in cooperation with Kebele administration and district/Wereda Health Office with direct technical support from Plan International Ethiopia. The piloting was successful and resulted in sanitation and hygiene behavior changes, communities designing and constructing their own latrines, and establishing follow up and monitoring mechanisms.

After the first kebele Fura became ODF on September 2, 2007 many partners including UNICEF Ethiopia, Water and Sanitation Program of the World Bank (WSP/Africa), Ministry of Health (FMoH), Regional Bureaus of Health and others visited Plan Ethiopia’s implementation areas and Fura.

The first major step taken to scale up CLTS was when UNICEF in cooperation with the FMoH invited Dr. Kamal Kar to give training to the Regional Health Bureaus in 2009. During his visit he conducted advocacy with Ministry of Health officials and subsequently a training for Regional Health Bureaus at Adama was organized in June 2009. After the training, Hygiene and Sanitation Task Forces (HSTF) at national and regional levels were established by the Federal Ministry of Health to scale up CLTS in the country. This marked the official acceptance of the CLTS approach in Ethiopia. Following this, with UNICEF support, CLTS hands-on training was given to environmental health professionals in the Regional Health Bureaus. To mainstream and coordinate CLTS activities in the country, the Ministry of Health prepared CLTS Implementation Guidelines, a Training Guide and a Verification Protocol, adding ‘H’ to CLTS to emphasize Hygiene. 

Current status

Currently the CLTSH approach is the national approach which all regions and sector actors are using. The number of kebeles/communities which have achieved and declared ODF are 4,912, with a total population of 24, 560,000 (Source FMoH)

To further strengthen the implementation of hygiene and sanitation activities, the FMoH has prepared a number of additional manuals, eg a Sanitation Marketing Guideline, a Menstrual Hygiene Management Guideline, a Hygiene and Environmental Health Communication Guideline, an Urban Sanitation Strategy, a Hygiene and Environmental Health Strategy etc. The government has also prepared a One WASH Program to coordinate donors financing and implementation of WASH. In addition, the Ministries of Finance and Economic Development, Water, Health and Education have signed a WASH Protocol to coordinate WASH activities.

(September 2015)