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Water, Sanitation & Hygiene

Plan International USA and UNC Water Institute Release Rigorous Research Findings

Gates Research Findings

An estimated 2.5 billion people worldwide do not have access to safe, hygienic toilets and as many as 1 billion people practice open defecation. This practice leads not only to sanitary issues within the immediate environment, but has repercussions on the health, safety, education, and economy for individuals and communities. For 15 years, community-led total sanitation (CLTS) has been a rapidly spreading, widely-accepted, gold standard sanitation intervention applied in the developing world to eliminate open defecation. CLTS uses community-wide behavior change approaches to “trigger” community members to take on ownership of the elimination of open defecation. Plan has been a pioneer of the approach worldwide.

As a recognized leader in CLTS, Plan was invited by the Bill & Melinda Gates Foundation to implement a rigorous evaluation of the approach in 10 countries, in partnership with the University of North Carolina’s Water Institute. The resulting four-year Testing CLTS Approaches for Scalability project analyzed the cost-effectiveness and scalability of the CLTS approach, while implementing three different interventions in Kenya, Ethiopia, and Ghana that focused on the role of local actors, such as teachers, local government staff, and natural leaders.

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