Ghana

History and Background
Community Led Total Sanitation (CLTS) has been identified as the approach that has demonstrated the potential to propel Ghana back on track to reach its MDG target on sanitation. This approach came on the heels of a sanitation promotion approach implemented by the Afram Plains Development Organisation (APDO) and funded by WaterAid in Ghana (WAG) called ‘Total Sanitation’ under which total sanitation of communities was encouraged.

Between 2006 and 2007, CLTS was piloted in 4 Regions through the collaborative efforts of government and private sector actors. These included the Community Water and Sanitation Agency (CWSA), Consultants and NGOs. To facilitate a better understanding of the approach, UNICEF sponsored learning trips to Bangladesh and Ethiopia in 2007. Following this, a number of trainings were then organized for sector actors for effective CLTS facilitation including an international one organized and attended by sector players in Nigeria.

The National Technical Working Group on Sanitation
To facilitate coordination and harmonization of efforts at CLTS, the Environmental Health and Sanitation Directorate (EHSD) which is the government institution responsible for providing policy direction and guidance for sanitation delivery in the country, formed the National Technical Working Group on Sanitation (NTWGS) in 2008 comprising of key stakeholders and organizations. In 2009, UNICEF supported an evaluation of CLTS implementation in Ghana which sought to bring to the fore challenges with its implementation and make proposals for addressing the challenges. The NTGWS has since its formation supported the development of a number of documents to guide CLTS implementation including a protocol for the declaration of ODF for communities.

National ToTs with Kamal Kar
In February 2011, the EHSD, UNICEF and the NTWGS invited Dr. Kamal Kar, the originator of “CLTS” to Ghana to help scale up CLTS. Dr. Kar, supported by Bisi Agberemi, WASH Specialist from UNICEF Nigeria and the NTWGS conducted two national level Training of Trainers (TOT) and undertook visits to three regions, namely the Eastern, Northern and Central where he held extensive consultations with relevant stakeholders. The training workshops were sponsored by UNICEF, Plan Ghana and WAG. The trainees were mainly Environmental Health Staff of the Community Water and Sanitation Agency, District Water and Sanitation Team members from the District Assemblies and NGO field workers.

Scaling Up Plans
Following the visits, Ghana has committed to scaling up CLTS in all the 170 districts in its ten regions and has committed to building a critical mass of natural leaders and community engineers and consultants for scaling up and documenting experiences.

Achievements

• 123 persons trained to facilitate CLTS in Ghana
• 40 National Master Trainers Identified
• 10 National back up support team selected
• 24 Communities in 3 Districts from 2 Regions entered and triggered
• Advocacy for Political Commitment and support for CLTS in Ghana. (e.g. the Hon. Regional Minister of Northern Region made a declaration of delivering NR as an ODF Region by December, 2012)
• A road map for ODF Northern region was drawn after one day stakeholders’ workshop in Tamale.
• Video Coverage and still pictures of the entire visit for knowledge management and sharing purposes
• Inputs into National CLTS Scaling up Plans and Road Map
• Regional and Agency/Institution CLTS Scale-up plans
• Increased Institutional Collaboration and commitment to scale up CLTS
• Key stakeholders sensitized to support the CLTS approach

Highlights of Plans for Scaling Up CLTS

• Widely publicise CLTS through knowledge management interventions that would ensure a widespread and complete understanding of the approach as well as stakeholder buy-in.
• The use of Natural Leaders to emerge and replicate themselves in a manner that appreciates their efforts and recognises them and establishment of a network of Natural Leaders.
• Establish a national ODF league showing the status of districts and the setting up of awards for high performing districts and regions every year.
• Identify and develop the role of children as pressure groups in getting their parents to stop open defecation and their communities to become ODF. A strategy will be developed to harness the power of children to promote ODF declaration in their communities in the Ghanaian context.
• Create the need for access to markets, creative financing and skills for climbing up the sanitation ladder. Creating this access should be done in a manner that does not compromise the core principles of CLTS.
• Incorporate CLTS indicators into the assessment criteria of the Functional Organizational Assessment Tool (FOAT). Progress towards open defecation free districts will therefore be one of the key criteria underlying the allocation of the District Development Fund (DDF) for Metropolitan, Municipal, and District Assemblies (MMDAs).
• The EHSD of the MLGRD should issue a directive demanding compliance with the national policy and strategy on sanitation with respect to CLTS. The directive should highlight the fact that individual household hardware subsidies undermine CLTS. The EHSD should in collaboration with all key stakeholders institute measures to identify and ensure compliance by all organisations and projects.
• Establishment of interagency coordinating committees on sanitation to enhance collaboration among stakeholders at the district and regional levels.
• Development of national, regional and district plans for scaling up CLTS in Ghana in line with the National Environmental Sanitation Policy (NESP) and National Environmental Sanitation Strategic Plan (NESSAP) and as integral components of District Environmental Sanitation Strategy and Action Plans (DESSAPs).
• Build Capacity with a special focus on environmental health staff, District Water and Sanitation Team, and community natural leaders and volunteers.
• Appoint a full time staff to be in charge of CLTS at the national, regional and district levels.
• EHSD to adopt measures to incorporate ODF performance indicators into the performance assessment criteria of Environmental Health Staff

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