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Sustainability and WASH: reflections from the UNC Water and Health Conference 2018

The University of North Carolina (UNC), Water and Health Conference 2018 in Chapel Hill, United States, provided researchers, implementers and donors the opportunity to reflect and discuss how the Water, Sanitation and Hygiene (WASH) sector is achieving sustainability, the biggest challenges to progress and possible ways forward to make sanitation outcomes equitable, accessible and affordable to everyone at all times. (The UNC Water and Health Conference is held at Chapel Hill since 2011)

Achieving sustainability in WASH research and programming

Rethinking Rural Sanitation Approaches

A man shows his handwashing station in Nambale

Current rural sanitation practitioners and decision makers are faced with insufficient information on the relative performance of different programming approaches. These approaches are frequently defined either too tightly, or too loosely, which stifles innovation, learning and opportunities to combine and tailor approaches to the changing contexts in which they operate. The cost of facilitating and delivering these approaches is often not well understood or monitored.

Date: 21 February 2018

Community-Led Total Sanitation: A Mixed-Methods Systematic Review of Evidence and Its Quality

Community-led total sanitation (CLTS) is a widely applied rural behavior change approach for ending open defecation. However, evidence of its impact is unclear. UNC (Vidya Venkataramanan, Jonny Crocker, Andrew Karon, and Jamie Bartram) conducted a systematic review of journal-published and gray literature to assess evidence quality, summarize CLTS impacts, and identify factors affecting implementation and effectiveness which was published in Environmental Health Perspectives DOI:10.1289/EHP1965

Date: 19 February 2018

On context, data and decisions: reflections from the UNC Conference 2017

Monday morning and the UNC Water and Health conference begins…there’s plenty of coffee to overcome the jetlag and joy in reconnecting with friends, colleagues and associates from around the world. Conferences in the WASH sector tend to be an incredible mix of academics, government officials, global decision-makers, donors and this one is no different. Some of us come with detailed knowledge of a specific context – a village, district or region. Others bring global and nationally representative data and show trends over decades.

The true costs of participatory sanitation: Evidence from community-led total sanitation studies in Ghana and Ethiopia

Evidence on sanitation and hygiene program costs is used for many purposes. The few studies that report costs use top-down costing methods that are inaccurate and inappropriate. Community-led total sanitation (CLTS) is a participatory behavior-change approach that presents difficulties for cost analysis. We used implementation tracking and bottom-up, activity-based costing to assess the process, program costs, and local investments for four CLTS interventions in Ghana and Ethiopia. Data collection included implementation checklists, surveys, and financial records review.

Date: 13 July 2017
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Building capacity for water, sanitation, and hygiene programming: Training evaluation theory applied to CLTS management training in Kenya

Training and capacity building are long established critical components of global water, sanitation, and hygiene (WaSH) policies, strategies, and programs. Expanding capacity building support for WaSH in developing countries is one of the targets of the Sustainable Development Goals. There are many training evaluation methods and tools available. However, training evaluations in WaSH have been infrequent, have often not utilized these methods and tools, and have lacked rigor.

Date: 18 August 2016
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Teachers and Sanitation Promotion: An Assessment of Community-Led Total Sanitation in Ethiopia

Community-led total sanitation (CLTS) is a participatory approach to addressing open defecation that has demonstrated success in previous studies, yet there is no research on how implementation arrangements and context change effectiveness. UNC used a quasi-experimental study design to compare two interventions in Ethiopia: conventional CLTS in which health workers and local leaders provided facilitation and an alternative approach in which teachers provided facilitation.

Date: 3 August 2016
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Impact Evaluation of Training Natural Leaders during a CLTS Intervention: A Cluster-Randomized Field Trial in Ghana

UNC used a cluster-randomized field trial to evaluate training natural leaders (NLs) as an addition to a community-led total sanitation (CLTS) intervention in Ghana. NLs are motivated community members who influence their peers’ behaviours during CLTS. The outcomes were latrine use and quality, which were assessed from surveys and direct observation. From October 2012, Plan International Ghana (Plan) implemented CLTS in 60 villages in three regions in Ghana.

Date: 3 August 2016
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From Haiti to Indonesia: What’s Different; What’s the Same in CLTS Implementation

This learning brief shares key findings that emerged from a cross-country synthesis of CLTS projects implemented by Plan International Country Offices (COs) in Cambodia, Nepal, Indonesia, Lao PDR, Uganda, Niger, and Haiti. Specifically, this research aimed to characterize variations in CLTS implementation through the perspectives of stakeholders, and to identify the roles of local actors in implementing CLTS.

Date: 23 February 2016

Testing CLTS Approaches for Scalability: Uganda Learning Brief

Plan International supports Community-led Total Sanitation (CLTS) implementation in a number of sub-counties in Uganda. This learning brief reviews Plan International’s CLTS activities in Uganda. It was found that Plan Uganda contributed to national policies and guidelines and a model for engaging local health officials and entrepreneurs.

Date: 10 December 2015
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