Successes and challenges in monitoring CLTS at scale: Views from an international workshop in Malawi

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While Team GB was doing surprising well at securing medals in a number of “sitting down” sports at the London Olympics – such as equestrian events, sailing and rowing – I was in Malawi thinking about how to measure the performance of an altogether different kind of “sitting down” event.

In August 2012, I represented SHARE at an IDS international workshop to share learning on effective monitoring of Community-Led Total Sanitation (CLTS) at scale. Participants were drawn from governments, International NGOs, bilateral agencies, and research institutions. Experiences were shared from Malawi, Ghana, Nepal, Zambia, Kenya, Uganda, Nigeria, India, Angola, Eritrea, Ethiopia, Nepal, Indonesia, Bangladesh, South Sudan, and Tanzania.

The CLTS approach focuses on behaviour change at a community level as a means of ending open defecation in a community, and it is going to scale; it is now being implemented in more than 50 countries with at least 15 having CLTS integrated in their national policy. There are also campaigns for entire rural areas to become ODF (open defecation free) in the near future in Northern Ghana by 2012; Kenya 2013; Indonesia 2014; Ethiopia, Mauritania and Zambia 2015; Malawi 2016; Nepal 2017; Madagascar 2018.

Up to now much attention has been focused on the triggering process itself, but “post-triggering” verification, certification and re-verification are critical for assuring the achievement and sustainability of ODF villages. This isn’t easy: counting toilets or handwashing stations is easier than monitoring the long-term behaviour changes that result in permanently ODF communities. But increasingly, governments and other stakeholders are being asked to demonstrate the impact of funding invested in the CLTS approach.

This workshop brought a diverse group together to discuss the importance of monitoring CLTS at scale, and the challenges associated with it.This was a participatory workshop; we all shared information, contributed to teaching, and learnt from one another. All the while Robert Chambers and Petra Bongartz worked hard as the facilitator to keep us on our toes – often quite literally – with a number of energisers from ‘killer bee attacks’ to ‘cat and dogs chases’.

There were several key themes of discussion that emerged in the course of the workshop.

How can sustainable progress post-ODF be supported and monitored?

Many participants reported on the systems in use in their countries that are already working at scale for “post-triggering” follow-up, verification, and post-ODF sustainability; whilst others described the pilot projects they had been running. I presented WaterAid’s work on the SHARE-funded Sanitation Mapper, which harnesses the potential of new technology to monitor the shift away from open defecation to using an improved latrine.

Some participants described their challenging task of tracking voluminous amounts of data from village to the district and national levels and crunching it into meaningful reports. It was reported that an increasing number of governments and organisations are using technologies for more sophisticated monitoring of CLTS, including the option of using graphic wizardry to visually articulate trends in ODF status. A number of these advances were presented in the Workshop such as:

• the Sanitation Mapper (SHARE/WaterAid) and the new CLTS Mapper (People in Need) both of which link GPS data, Microsoft Excel and Google Earth to generate slum or village level maps;

• community-led digital mapping of sanitation and hygiene in Kenya (Spatial Collective Ltd.);

• Google Fusion tables and Google Earth for hosting CLTS data online (Government of Madhya Pradesh and UNICEF);

• Android phones for sanitation data collection in New Delhi and SMS-based sanitation monitoring systems in East Java (WSP).

As a group, we also recognised the many barriers to the use of ICTs; the levels of hardware and software skills required, the fact that technologies can quickly become redundant, and the degree of backstopping that is often necessary. The workshop group agreed that government leadership in the process of monitoring is crucial; CLTS monitoring should be mainstreamed into existing government monitoring and evaluation systems. If government aren’t involved from the beginning in designing monitoring systems, handing over the system over when it is finished is simply not going to work.

The power of mapping at the other end of the technology spectrum was also illustrated with an example from Rwanda. Here, there has been much experience of drawing social maps of villages on a bed sheet . The maps include households’ poverty profiles and can be used to track whether households are moving out of extreme poverty. NGO and government performance can then be held to account against this data.

How can monitoring by communities and by local level staff provide realistic and comparable data for monitoring and aggregating higher up the system?

However governments can’t do it alone: I heard impressive examples of how health extension workers can spark sanitation and hygiene related behaviour change in the communities where they live. In Ethiopia a “Women’s Development Army” – community-level volunteers – make regular rounds to check on neighbours and encourage practices like latrine building. In Uganda, we heard that Home Improvement Campaigns have sought to promote good hygiene and sanitation practices at the household level including building: refuse pits, soak pits, ventilated improved pit latrines, separate, private bathing area, animal pens, wire lines to hang washing and drying racks.

I was also inspired by accounts from our host country Malawi, where access to basic sanitation in rural areas has grown significantly in recent years, and where the Government of Malawi formulated a national sanitation policy that recognises CLTS as an approach for sanitation promotion. In Malawi, the triggering and pre/post triggering process are facilitated by Health Surveillance Assistants who work with communities to shift social norms away from open defecation to using a latrine and have an on-going role in reinforcing latrine use and hygiene promotion.

The workshop also included the opportunity to get out of the ‘classroom’ and go to the Phokoto village in the district of Salima to have a look for ourselves. The village has 18 households, a total of 109 people, and CLTS was triggered in 2010. We saw latrines build with local materials and painted with hygiene messages, community members that assisted older people or those with disabilities to construct pit latrine together with the use of innovative handwashing facilities which protected soap from livestock. We also heard about the challenges faced by communities when trying to improve sanitation and cease open defecation. Many households told us about their latrine pits collapsing, we heard about the time it takes to become ODF post triggering, and how in some communities there is a need to pay closer attention to hygiene promotion, particularly for children.

How can target-driven campaigns and reward systems avoid generating inflated data? The examples we heard from the communities we visited demonstrated that, for validity and credibility, the processes of certification and verification of ODF status should preferably be carried out by independent third parties and not by implementers or those with an interest in positive findings. ODF celebrations have been used by some organisations to provide an incentive to communities for building latrines, including in some parts of Malawi. However, care must be taken to ensure that data is not inflated when there are rewards to communities or leaders for becoming ODF.

Following on from this, participants in the workshop highlighted that for effective verification and certification of ODF, adequate funding, human resources and training are vital. Participants reported that in most countries that have set themselves targets, there are often serious resource gaps for monitoring – however we heard of one notable exception: Zambia has dedicated staff for CLTS triggering and training.

Participants acknowledged the need to build evidence and documentation for more learning on what is working for monitoring CLTS. A good example from Malawi is the SHITS newsletter produced by Engineers Without Borders and WES (Water Environmental Sanitation) network. This is also something we have been trying to address through SHARE Research Consortium. In fact, SHARE recently funded WaterAid and RWSN to run a writing course for WASH professionals called Improving documentation in the WASH sector for policy, programmes and publication: a writing course for WASH professionals.

While the Olympics is about people achieving their personal best, safe sanitation for all helps create the conditions in which people can realize their social potential. I went to the workshop expecting to hear familiar laments about the need for monitoring post-triggering follow up, verification, and progress. I was really heartened to hear the variety of options for verification and certification that are already underway and producing realistic and comparable data for monitoring. I left convinced of the critical need for more attention to the importance of indicators for monitoring the uptake and post ODF sustainability of those targeting for sanitation promotion. I hope that all our varied efforts will be infinitely more successful, and achieve greater impact, as a result of the collaboration and creativity of participating in this workshop.

This blog post was originally written for and published by SHARE

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Date: 16 October 2012