Sanitation in Bukwo, Uganda: An Assessment of Community Led Total Sanitation (CLTS) Open Access

Hoffman, Maria Sara (2015)

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In 2014, Emory University and Catholic Relief Services (CRS) collaborated in research aimed to assess the effectiveness of the Community Led Total Sanitation (CLTS) approach for hygiene and sanitation promotion under CRS's Integrated Water Resource Management (IWRM) project in Bukwo, Uganda. CLTS is a no-subsidy approach that encourages communities to self-assess their existing defecation and sanitation practices and harnesses local motivation and mobilization to eliminate unsafe practices and help communities become open defecation free (ODF). However, this approach can have unintended consequences as it generates collective feelings of shame, disgust and fear to motivate communities. In-depth interviews were conducted for 67 households in 28 villages across the Bukwo district to identify any consequences, as well as explore the motivators and barriers that caused households to use or abandon their latrine. The assessment found that communities received CLTS positively and the accompanying activities were executed in a culturally appropriate and sensitive manner. Health was the most common motivator for increasing sanitation and hygiene in a home, which influenced both sanitary and hygienic practices and latrine use. The barriers that caused people to abandon their latrine included structure and maintenance issues as well as availability of materials. Households that continued to practice open defecation cited lack of materials and funds and poor latrine conditions as barriers to safe defecation practices. Among households that practiced hygienic and sanitary behaviors, the expected outcomes of consistent latrine use motivated them to continue this practice. Programmatic recommendations included an emphasis on pre-implementation activities to familiarize the community with the objectives of the intervention as well as strategies for facilitators on how to operationalize the collective feelings of shame, fear and disgust with care. Emphasis should also be placed on the major motivators, which included health. To address maintenance and structure issues, future programming should focus on using sanitation marketing to disseminate best practices for latrine design and maintenance as well as increase the accessibility of materials while retaining CLTS's commitment to a no-subsidy approach. Communities should also be encouraged to assist one another and share not only sanitary and hygienic values, but also share responsibility.

Table of Contents

Executive Summary. 1

Introduction. 3

Sanitation in Uganda. 3

CLTS Background. 3

Advantages and Disadvantages of CLTS. 6

CRS's Implementation of CLTS in Uganda. 11

Research Aims. 13

Methodology. 14

Introduction to Sampling Strategy. 14

Research Setting. 15

Household Selection. 16

Data Collection. 17

Findings. 21

Was CLTS Culturally Sensitive and Respectful?. 21

Motivators and Barriers to Achieving ODF Status. 28

Sustaining ODF. 36

Discussion. 39

Limitations and Challenges. 51

Recommendations. 52

Conclusion. 54

References. 56

Appendix I. 58

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