Table 5.
Factors that facilitated or constrained implementation by stage of community-led total sanitation.
| Implementation and community-related factors ()a | No. of documents (%) | Stage of CLTSb | ||
|---|---|---|---|---|
| Pretriggering | Triggering | Posttriggering | ||
| Policy environment | ||||
| National government awareness and buy-in for CLTS | 41 (21%) | X | X | X |
| National sanitation policy vis-à-vis CLTS implementation | 37 (19%) | X | X | |
| Ambitious national ODF and/or sanitation targets | 26 (13%) | X | X | |
| History of latrine subsidy provision in the country | 21 (11%) | X | X | X |
| Ongoing latrine subsidy programs near triggered communities | 20 (10%) | X | ||
| Implementation quality | ||||
| Triggering quality | 80 (40%) | X | ||
| Frequency and effectiveness of follow-up activities in villages | 54 (27%) | X | ||
| Facilitator skill | 45 (23%) | X | X | |
| Provision of technical support on latrine construction | 44 (22%) | X | ||
| Community enforcement measures for noncompliance | 39 (20%) | X | ||
| Provision of incentives or rewards to villages for ODF status | 32 (16%) | X | ||
| Planning | 30 (15%) | X | X | X |
| Provision of latrine subsidies in triggered communities | 25 (13%) | X | ||
| Provision of incentives to community volunteers | 13 (7%) | X | X | |
| Presence of exchange visits between community leaders | 12 (6%) | X | ||
| Administrative context | ||||
| Local government ownership of CLTS | 84 (42%) | X | X | |
| Institutional capacity of implementers | 66 (33%) | X | X | X |
| Administrative and financial arrangements | 60 (30%) | X | X | X |
| Presence and functioning of M&E system | 42 (21%) | X | ||
| Coordination between implementing organizations | 37 (19%) | X | X | X |
| Presence/functioning of sanitation working groups | 14 (7%) | X | ||
| Community environment | ||||
| Climate conditions | 33 (17%) | X | X | |
| Soil or groundwater conditions | 28 (14%) | X | X | |
| Access to water in community | 23 (12%) | X | X | |
| Remoteness of community | 13 (7%) | X | X | |
| Community capacity | ||||
| Access to supply of latrine hardware | 62 (31%) | X | ||
| Availability of financial resources | 54 (27%) | X | ||
| Technical knowledge of latrine construction | 24 (12%) | X | ||
| Availability of land or land ownership | 18 (9%) | X | X | |
| Availability of time to construct latrines | 11 (6%) | X | ||
| Awareness of benefits of stopping open defecation | 10 (5%) | X | X | X |
| Community participation | ||||
| Community participation in CLTS | 82 (41%) | X | X | |
| Presence of village-level leadership | 50 (25%) | X | X | X |
| Initiative of “natural leaders” | 29 (15%) | X | ||
| Social cohesion | 27 (14%) | X | X | X |
| Sense of community responsibility | 25 (13%) | X | X | |
| Traditional beliefs about women and children's role in society | 9 (5%) | X | X | |
| Community behavior | ||||
| Expectation of subsidy for latrines | 29 (15%) | X | ||
| Preference for open defecation | 20 (10%) | X | X | |
| Traditional beliefs regarding open defecation | 19 (10%) | X | X | |
| Alternative priorities (other than sanitation) | 14 (7%) | X | X | X |
| Community's trust in implementers' motives | 11 (6%) | X | X | |
| Preference for a better latrine | 10 (5%) | X | ||
Abbreviations: CLTS, community-led total sanitation; M&E, monitoring and evaluation; ODF, open defecation–free.
The factors listed in this table emerged inductively from qualitative coding and analysis of all included literature. Percentages provided are out of all 200 documents, and are meant to illustrate how frequently the respective factor was mentioned in the CLTS literature that was reviewed.
The pretriggering stage comprises community selection, facilitator training, baseline information, and community entry; the triggering stage comprises a community-wide meeting with participatory exercises to trigger shame and disgust; and the posttriggering stage includes routine follow-up visits to verify and certify ODF status in communities.