Scaling the sanitation ladder decreases exposure to various illnesses including diarrheal disease, soil-transmitted helminths and trachoma. In rural Zambia, community-led total sanitation (CLTS) has been deployed to help Zambians scale the sanitation ladder. Analysis of monthly routine surveillance data of village-level sanitation coverage of 13,688 villages shows that villages moved up the sanitation ladder following CLTS intervention with more than one third of villages achieving 100% coverage of adequate sanitation. Villages also moved down the sanitation ladder – approximately half of those achieving 100% coverage of adequate sanitation also dropped from that coverage at some point during monitoring. Larger villages were less likely to achieve 100% coverage, and more likely to drop if they did achieve 100% coverage. Drops were more likely to occur during the wet season. Of those villages dropping from 100% coverage, more than half rebounded to 100% coverage. The adequate latrine components most likely to drop off from 100% coverage were handwashing stations and lids to cover holes, both key components in preventing disease transmission. These results have implications for water, sanitation and hygiene (WASH) programming – sustained support may be required to ensure villages move up the sanitation ladder and stay there.
Mobility up the sanitation ladder following community-led total sanitation in rural Zambia
Scott Russpatrick, Amy Tiwari, Laurie Markle, Engervell Musonda, Anne Mutunda, Nicolas Osbert, John Pinfold, Anna Winters, Benjamin Winters, David A. Larsen; Mobility up the sanitation ladder following community-led total sanitation in rural Zambia. Journal of Water, Sanitation and Hygiene for Development 1 September 2017; 7 (3): 436–444. doi: https://doi.org/10.2166/washdev.2017.111
Download citation file: