GHANA- Situational Analysis:
CLTS/SLTS/ULTS
1
GHANA- Situational Analysis on CLTS/SLTS/ULTS
Contents
1. Ghana Fact overview .......................................................................................................... 3
2.
Sanitation overview ............................................................................................................ 3
3.
Pan Africa CLTS programme in Ghana ................................................................................ 4
4.Institutional mapping .............................................................................................................. 5
5.
Already existing platforms (networks, LAs) ........................................................................ 5
6.
Background information- Ghana ........................................................................................ 8
Annex 1: Reference review ..................................................................................................... 18
Annex 2: Case studies .............................................................................................................. 19
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1. Ghana Fact overview
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Population : 24,000,000 pop in 2010 (Gov of Ghana). 46% urban; 54% rural
GDP/capita PPP : 1,600$US in 2010 (IMF)
Main economic activities : Agriculture (37% of total economic activity), Oil, Cocoa,
Timber, Electricity, Diamond, Bauxite and Manganese
Major cultural groups : Ashanti, Fante, Akyem, Kwahu, Ga, Ewe, Mamprusi and
Dagomba, among others
Religions : Christian, animist
Political regime : Presidential republic
Geographical context : Tropical climate, 4 geographical regions (Low plains, Ashanti
Uplands, Volta Bassin, High plains)
2. Sanitation overview
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Figures
o Rural sanitation (broad definition) 13%
o Urban sanitation 27%
Ghana aims at achieving 85% coverage for water supply and sanitation by 2015, which
would exceed the Millennium Development Goals' target of 78%
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Responsible authority for sanitation
o Urban areas: Ghana Water Company Ltd and other private agencies
o Rural areas: The Ministry of Local Government and Rural Development shares
responsibility for setting sanitation policies and coordinating funding for the
subsector with MWRWH.
The Community Water and Sanitation Agency (CWSA) is an independent agency
coordinating efforts with district authorities
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Policies/strategies in place
National Water Policy (NWP) in 2008, which focuses on the three strategic areas: (i) water
resources management; (ii) urban water supply; and (iii) community water and sanitation.
National Community Water and Sanitation Programme (NCWSP) in rural areas, which is
carried out directly by the communities and their District Assemblies. The NCWSP focuses
on three main objectives in order to achieve health improvements: safe water supply,
hygiene education, and improved sanitation.
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Challenges in country
In communities with fewer than 50,000 inhabitants, water supply systems are owned and
managed by the respective community on a demand-driven basis. According to the NCWSP,
these systems do not receive any cross-subsidies and 5% of the cost of providing the facility
is paid by the operating community. Therefore, the rural communities and small towns form
gender-balanced voluntary groups which are represented by elected water and sanitation
boards, including one or two village-based caretakers who received special training in repair
and maintenance. Communities and the CWSA are enabled to contract external actors, such
as private sector consultants or NGOs, to provide technical assistance, goods, or services.
Local artisans are used to provide household latrines.
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History of CLTS in Ghana
The Community Water and Sanitation Agency (CWSA), Plan, UNICEF and WaterAid have
been piloting CLTS since 2007 in approximately 237 communities in Ghana in an attempt to
scale up hygiene and sanitation improvements. The pilot activities were in the Northern,
Upper West, Eastern, Central and Greater Accra Regions. In addition, a case study of
Oboyambo community in Central region of Ghana on children’s involvement in communityled total sanitation was conducted by Daniel Sarpong, Plan Ghana
3. Pan Africa CLTS programme in Ghana
 Target population
20, 000 people from 50 communities and 25 schools; in the Upper West Region, Central
Region, Volta Region and Eastern Region (Districts of Sissala West, Wa municipal, Agona
East, Abura Assebu Kwamankese, and South Tongu Upper Manya Krobo)
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Specific objectives/country:
Overall objective:
Within five years, the overall objective of the project is to reduce sanitation related
illnesses, improve knowledge and skills and enhance sanitation services for 50 rural
communities in Ghana
Specific objectives:
1. Terminate indiscriminate defecation in 50 project communities in 5 districts in
Ghana by facilitating the implementation of CLTS
2. Promote proper waste management through facilitating community led sanitation
action and management systems for 50 rural communities
3. Promote proper hygiene in project communities through education, sensitization
and awareness district workshops for the beneficiary communities
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4. Improve the health, living standards and long-term viability of the beneficiary rural
communities by providing reliable, convenient access to clean water
5. Build capacity and networks in strengthening CLTS/SLTS in the six program areas.
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Progress (in 2010-2011):
1. 45 communities and 20 schools have been triggered successfully include one (1) periurban community in the Northern sector
2. Networks and collaboration with various national and international organisations.
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Challenges (in 2010-2011):
1. Plan Ghana old approach was based on subsidy
2. Taboo days in some communities coinciding with market days in the area- this
affects mobilization
3. Competing for community time and interest
4. Promotion of subside by some NGOs in some of the project communities and
neighbouring communities
4. Institutional mapping
 Government agencies
Environmental Health and Sanitation Directorate under the Ministry of Local Government
and Rural Development
Water Directorate of the Ministry of Water Resources, Works and Housing
Community Water and Sanitation Agency (CWSA)
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Major donors
 Majors INGOs
WaterAid Ghana,
Plan Ghana,
 Major local NGOs
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Other relevant actor
District Water and Sanitation Teams (DWST) at the district level, consisting of an engineer, a
hygiene expert, and a community mobilizer.
5. Already existing platforms (networks, LAs)
RCN Ghana
Level: national
Frequency of meeting, location (if constant)
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Actors involved, leaders: TREND, WaterAid Ghana, KUNST, Water Research Institute.
Supported by IRC
Contact organisation/person: http://www.ghana.watsan.net
List of ongoing topics
WASH learning alliance –This is the same as RCN. It is an office that coordinated the
activities of the WASH Learning alliance
Level: national
Frequency of meeting, location (if constant): Monthly
Actors involved, leaders: UNICEF, WATERAID,PLAN, WORLD VISION, CHF, CWSA, GWCL,
WASHCOST, TREND, EHSD, KNUST
Contact organisation/person
List of ongoing topics/issues discussed
National CLTS task force:
Level: National
Frequency of meeting, location (if constant)
Actors involved, leaders: PLAN, UNICEF, CWSA, APDO, TREND, EHSD, PRONET,
WATERAID, CHF, CoC
Contact organisation/person:EHSD, Kweku Quansah
List of ongoing topics/issues:
CONIWAS:
The Ghana Coalition of NGOs in Water and Sanitation (CONIWAS), created in 2001, "works
in partnership with sector players to influence policies, remove barriers and promote access
to potable water, sanitation and improved hygiene for the poor and vulnerable." According
to the coalition, giving NGOs one voice for advocacy and lobbying has been one of its major
benefits.
Level: National
Frequency of meeting, location (if constant): Yearly
Actors involved, leaders
Contact organisation/person
List of ongoing topics/issues
Water Directorate: This is not a platform. It is department under the Ministry of Water
Resources, Works and Housing
Level: National
Frequency of meeting, location (if constant)
Actors involved, leaders
Contact organisation/person
List of ongoing topics/issues
WASH journalist: This is a network of Journalist who have great interest and reports on
WASH issues
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Level: Various
Frequency of meeting, location (if constant)
Actors involved, leaders
Contact organisation/person
List of ongoing topics/issues
Local District water and Sanitation team: This is a department which support WASH
programs in the District Assembl
Level: District
Frequency of meeting, location (if constant)
Actors involved, leaders
Contact organisation/person
List of ongoing topics/issues
District SHEP: This is a department that support Sanitation, Health, Education programs in
the district Assemblies
Level: District
Frequency of meeting, location (if constant)
Actors involved, leaders
Contact organisation/person
List of ongoing topics/issues
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6. Background information- Ghana
1. Introduction
The Republic of Ghana is a country located in West Africa. It is bordered by Côte d'Ivoire
(formally called Ivory Coast) to the west, Burkina Faso to the north, Togo to the east, and
the Gulf of Guinea to the south. The word Ghana means "Warrior King" and is derived from
the ancient Ghana Empire.
Ghana was inhabited in pre-colonial times by a number of ancient predominantly Akan
Kingdoms, including the Akwamu on the eastern coast, the inland Ashanti Empire and
various Fante and non-Akan states, like the Ga and Ewe, along the coast and inland. Trade
with European states flourished after contact with the Portuguese in the 15th century, and
the British established the Gold Coast Crown colony in 1874.
The Gold Coast achieved independence from the United Kingdom in 1957, becoming the
first sub-Saharan African nation to do so[7][8][9] and the name Ghana was chosen for the new
nation to reflect the ancient Empire of Ghana, which once extended throughout much of
west Africa. Ghana is a member of the South Atlantic Peace and Cooperation Zone, the
Commonwealth of Nations, the Economic Community of West African States, the African
Union, and an associate Member of La Francophonie. Ghana is the second largest producer
of cocoa in the world and is also home to Lake Volta, the largest artificial lake in the world
by surface area.
2. Water and sanitation sector
The water supply and sanitation sector in Ghana faces severe problems, partly due to a
neglect of the sector until the 1990s. Tariffs were kept at a low level which was far from
reflecting the real cost of the service. Economic efficiency still remains below the regional
average, resulting in a lack of financial resources to maintain and extend the infrastructure.
Since 1994, the sector has been gradually modernized through the creation of an
autonomous regulatory agency, introduction of private sector participation, and
decentralization of the rural supply to 138 districts, where user participation is encouraged.
The reforms aim at increasing cost recovery and a modernization of the urban utility Ghana
Water Company Ltd. (GWCL), as well as of rural water supply systems.
Another problem which partly arose from the recent reforms is the existence of a multitude
of institutions with overlapping responsibilities. The National Water Policy (NWP), launched
at the beginning of 2008, seeks to introduce a comprehensive sector policy.
The water supply and sanitation infrastructure is insufficient, especially in rural areas and
concerning sanitation. There are substantial discrepancies between access data from
various sources, partially because of different definitions being used by different institutions
that are providing access data. According to the Joint Monitoring Program for Water Supply
and Sanitation of UNICEF and WHO access is as follows:
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Urban
Rural
Total
(46% of the population) (54% of the population)
Water
Sanitation[1]
Broad definition
88%
64%
75%
House connections 37%
4%
19%
Broad definition
27%
11%
18%
Sewerage
13%
2%
7%
However, according to the multi-donor Africa MDG assessment access to an improved water
sources is much lower (56%) and access to improved sanitation is higher (13%).
The share of non-functional supply systems in Ghana is estimated at almost one third, with
many others operating substantially below designed capacity. Moreover, domestic water
supply competes with a rising demand for water by the expanding industry and agriculture
sectors.http://en.wikipedia.org/wiki/Water_supply_and_sanitation_in_Ghana - cite_noteoecd_294-12 Ghana aims at achieving 85% coverage for water supply and sanitation by
2015, which would exceed the Millennium Development Goals' target of 78%.
3. History on water and sanitation
In 1928, the first piped water supply system was constructed at Cape Coast. The Water
Supply Division of the Public Works Department was responsible for the service provision in
rural and urban areas of Ghana. After Ghana's independence in 1957, the division was
separated from the Public Works Department and placed under the Ministry of Works and
Housing. In 1965, it was transformed into the Ghana Water and Sewerage Corporation
(GWSC), a legal public utility responsible for the provision of urban and rural water supply
for public, domestic, and industrial purposes as well as the establishment, operation, and
control of sewerage systems.
Since 1993, various reforms have been introduced to address the problems of the sector.
The key objectives of the reforms were to separate rural and urban service, to introduce
independent regulatory agencies, and to promote private sector participation.
In order to pay more attention to water supply and sanitation in rural areas, the Community
Water and Sanitation Division was founded as a semi-autonomous division of GWSC in 1994.
Four years later, it changed its name to the Community Water and Sanitation Agency
(CWSA) and became fully independent. In 1999, the GWSC was replaced by the publicly
owned GWCL. At the same time, the responsibility for rural water supply and sanitation was
decentralized to the District Assemblies. In addition, sanitation was separated from water
supply and became a responsibility of the District Assemblies in urban and rural areas.
As a result, the GWCL remained responsible only for urban water supply, whereas more
than 110 small towns' water systems were transferred to District Assemblies, which receive
support from the CWSA. In terms of sanitation, District Assemblies are responsible in urban
and rural areas. In the latter case, a demand-driven and community-managed approach was
introduced.
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The regulation of water supply has been shifted from the government to independent
agencies. Two commissions were created in 1997 to regulate the sector: The Public Utilities
Regulatory Commission (PURC) has been developed to formulate and approve appropriate
pricing mechanisms aimed at full cost recovery, since the government began to phase out
the subsidization of water services in 2003. The PURC has no authority over communitymanaged water systems and only regulates GWCL services. Besides the provision of tariff
guidelines and the examination and approval of tariffs, it protects the interests of
consumers and providers, promotes fair competition, and initiates, conducts, and monitors
standards concerning the provided service.
Whereas the PURC takes responsibility for economic regulation of urban water supply and
sanitation, the Water Resources Commission (WRC) regulates water resources: it is in
charge of licensing water abstraction and wastewater discharges.
3.1.21st century
To carry out the private sector participation of GWCL, originally a 10-year lease contract was
envisaged . In 2000, a lease contract between GWCL and the US company Azurix failed due
to public opposition and accusations of corruption which led to the formation of the
Coalition against Water Privatization.
In October 2006, under the framework of the Urban Water Project (see below) a five-year
management contract was signed between the GWCL and AVRL. The main objectives of this
private sector participation are:
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Extending reliable water supply especially to low-income areas
Making potable water affordable for low-income consumers
Increasing cost recovery
Ensuring investments based on low-cost and concession financing
Supporting further involvement of the private sector
Reducing non-revenue water
Increasing water treatment
The project is financed by the World Bank, the Nordic Development Fund and the Republic
of Ghana (see below).
In March 2008, severe water shortages in Accra were reported, leading Boniface Abubakar
Saddique, the Minister for Water Resources, Works and Housing, to review whether AVRL is
working in compliance with the management contract. However, he explained that the
reason for the shortages was unforeseen power outages at two water treatment plants in
Weija and Kpong. Saddique stated that the overall situation will improve notably by the end
of 2008 due to several new boreholes and a more stable power supply.
3.2.National Water Policy
To overcome the lack of coordination between the numerous institutions which were
created since 1993, Saddique launched a National Water Policy (NWP) at the end of
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February 2008, which focuses on the three strategic areas: (i) water resources management;
(ii) urban water supply; and (iii) community water and sanitation.
Although the sector has made substantial progress, a lack of coherence in policy formulation
resulted in a multitude of implementation strategies which led to new problems. The NWP
thus aims to formulate a comprehensive sector policy which includes all relevant actors in
the sector. According to the minister, the NWP could make it easier for development
partners to provide the necessary support to the sector.
The NWP has been prepared by the Ghanaian Water Resources Commission (WRC) since
2002 and is based on the Ghanaian Constitution of 1992, the Ghana Poverty Reduction
Strategy (GPRS), international agreements and conventions, and other national programs.
4. Responsibility for water supply and sanitation
According to a multi-donor review of Ghana's water supply sector, it is "quite well
structured", with the government in charge of policy and regulation, while the private sector
and communities play important roles in service delivery. The institutional framework for
sanitation is far less clear, with responsibilities not being clearly defined.
4.1 Policy and regulation
At the moment, a number of institutions exist to supervise and regulate water supply and
sanitation. The entire policy framework is based on the Ghana Poverty Reduction Strategy
(GPRS), the Millennium Development Goals targets, and the Government's coordination
with donor assistance.
General water sector policies for both rural and urban areas are set by the Water
Directorate within the Ministry of Water Resources, Works and Housing (MWRWH).
Furthermore, the ministry solicits funding from external support agencies, monitors the
sector, and advises the Cabinet. The Water Sector Restructuring Secretariat, created in 1997
in the Ministry of Water Resources, Works and Housing, oversees the process of private
sector participation in the sector.
The Ministry of Local Government and Rural Development shares responsibility for setting
sanitation policies and coordinating funding for the subsector with MWRWH. The
government promotes decentralization so that sanitation policies are expected to be carried
out by Metropolitan, Municipal, and District Assemblies. To enforce environmental quality
laws, the Environmental Protection Agency (EPA) under the Ministry of Environment and
Science is expected to examine the impact of sanitation development activities on the
environment.
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4.2. Service provision
4.2.1. Urban areas
The Ghana Water Company Ltd. (GWCL) is responsible for providing, distributing, and
conserving water for domestic, public, and industrial purposes in 82 urban systems in
localities with more than 5,000 inhabitants. Moreover, the company is mandated to
establish, operate, and control sewerage systems in Ghana.
Local private companies are in charge of meter installation, customer billing, and revenue
collection. In the framework of the urban water project, since October 2006 the private
operator AVRL supports GWCL under a five-year management contract to improve its
performance and rehabilitate and extend the infrastructure. Urban sanitation is a
responsibility of local governments.
4.2.2. Rural areas
The Community Water and Sanitation Agency (CWSA) is in charge of coordinating and
facilitating the implementation of the National Community Water and Sanitation
Programme (NCWSP) in rural areas, which is carried out directly by the communities and
their District Assemblies. The NCWSP focuses on three main objectives in order to achieve
health improvements: safe water supply, hygiene education, and improved sanitation.
The CWSA was created in 1994 under the framework of the Ghana decentralization policy
and became autonomous in 1998. The institution does not directly construct, operate, and
maintain utilities for water supply and sanitation. Instead, its role is to coordinate the work
of a number of actors which carry out the services in rural areas, including public sector
organizations, local beneficiary communities, private sector organizations, and NGOs. The
CWSA is also expected to ensure that financial support from development partners is
effectively used and to provide rural areas and small towns with hygiene education. To carry
out its tasks, the agency operates ten regional offices besides its head office in Accra.
In communities with fewer than 50,000 inhabitants, water supply systems are owned and
managed by the respective community on a demand-driven basis. According to the NCWSP,
these systems do not receive any cross-subsidies and 5% of the cost of providing the facility
is paid by the operating community. Therefore, the rural communities and small towns form
gender-balanced voluntary groups which are represented by elected water and sanitation
boards, including one or two village-based caretakers who received special training in repair
and maintenance. Communities and the CWSA are enabled to contract external actors, such
as private sector consultants or NGOs, to provide technical assistance, goods, or services.
Local companies are regularly encouraged in the provision of boreholes and hand-dug wells,
and local artisans are used to provide household latrines. Although the communities' water
and sanitation boards are expected to independently operate and maintain their water
supply systems, they do receive technical assistance by District Water and Sanitation Teams
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(DWST) at the district level, consisting of an engineer, a hygiene expert, and a community
mobilizer.
4.3 Other stakeholders
The Ghana Coalition of NGOs in Water and Sanitation (CONIWAS), created in 2001, "works
in partnership with sector players to influence policies, remove barriers and promote access
to potable water, sanitation and improved hygiene for the poor and vulnerable." According
to the coalition, giving NGOs one voice for advocacy and lobbying has been one of its major
benefits.
5. Role of CLTS
Within the Ghanaian government structure, the Environmental Health and Sanitation
Directorate (EHSD) is the body responsible for the implementation of a National
Environmental Sanitation Policy, within which, the concept of Community-Led Total
Sanitation (CLTS) has been acknowledged as the preferred approach to scale-up rural
sanitation and hygiene in Ghana.
Since 2007, a number of different agencies working in the Sanitation and Hygiene Sector
have been piloting CLTS strategies. Activities have been taking place in Northern, Eastern,
Central and Greater Accra Regions. The organisations spear heading these exercises have
set-up and implemented the pilots independently of each other and have adopted slightly
different strategic approaches and institutional arrangements.
Given the relative newness of the concept and the movement to adopt CLTS as the way
forward, the EHSD, in collaboration with UNICEF, decided to conduct an in-depth
assessment of the different CLTS approaches and their achievements. An evaluation has
been completed and the findings presented to the Ministry for the further elaboration and
formation of the national policy and strategy in terms of sanitation.
The following section presents and discusses the findings from the evaluation and the
recommendations to effectively roll-out CLTS in Ghana on a wider scale1. As CLTS is an
approach being introduced across the West Africa Region, discussion on this evaluation in
such a forum will not only serve to inform country level partners within Ghana, but will also
be an opportunity for neighboring countries to learn from the Ghanaian experience.
5.1 Background of the evaluation
In June 2009, the Environmental Health and Sanitation Directorate (EHSD) of the Ministry of
Local Government and Rural Development in partnership with UNICEF and others
1
The following section is based on a paper submitted for the West Africa regional sanitation and hygiene
symposium, Accra, Ghana (3-5 November 2009), written by N.L. Demedeme and P. Nutsugah.
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commissioned an evaluation on CLTS projects being implemented in Ghana. The evaluation
covered projects by the United Nations Children’s Fund (UNICEF), the Community Water and
Sanitation Agency (CWSA), Plan Ghana and WaterAid.
The objective of this paper is to present the finding of the Evaluation Team on CLTS
implementation in Ghana and shear lessons learnt with participants
5.2 Objectives of the evaluation
The objective of the evaluation was to assess the suitability of Community Led Total Sanitation
as the preferred approach for rural sanitation and to make recommendations for adapting the
approach as a national strategy. The EHSD had earlier on indicated that, the CLTS approach
was the preferred approach for rural sanitation in the revised environmental sanitation policy.
Stakeholders had also reported various levels of success with the implementation of the CLTS
pilots.
The evaluation was conducted in July and August 2009 and revealed the strengths and
weaknesses of the CLTS projects as implemented in Ghana. This paper will present the
background of CLTS implementation in Ghana; methodology used for the evaluation; the
major findings and conclusions; as well as provide recommendations for taking the process
forward in the country
5.3 Background
The Community Water and Sanitation Agency (CWSA), Plan, UNICEF and WaterAid have
been piloting CLTS since 2007 in approximately 237 communities in Ghana in an attempt to
scale up hygiene and sanitation improvements. The pilot activities were in the Northern,
Upper West, Eastern, Central and Greater Accra Regions. The four organizations set up the
pilot exercises independently of each other and adopted slightly different institutional
arrangements, drawing facilitators from different local government departments and NGOs.
Prior to the implementation of these pilot projects UNICEF had facilitated two learning visits
by key stakeholders led by the Environmental Health and Sanitation Directorate with
support from UNICEF to Bangladesh and Ethiopia in 2007 to understudy the CLTS projects in
these countries. The search for a new approach to sanitation improvements was necessary
as previous approaches seemed to have failed. The JMP, 2008 indicated that out of 51
African countries, Ghana placed 48th with a sanitation coverage of 10%. This coverage rate
represents achievements made using subsidy based approaches to sanitation improvement
under the national community water and sanitation program which has been in operation
for more than a decade. Open defecation practices were common in the country and the
three northern regions had 79-81% of their population involved in this practice.
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5.4 Evaluation Methodology
Thirty seven (37) communities with an average population of One Hundred and fifty made
up women and children covering all 14 pilot districts in the Northern Region (NR), Upper
West, Central Region (CR), Eastern Region (ER) and Greater Accra (GAR) regions were
selected as sample communities for the evaluation. The communities represented
approximately 15% of the total communities where CLTS was being piloted. Key
characteristics of the sample included; communities where CLTS was well established,
communities where CLTS was at initial stage of implementation, presence of credit schemes
for sanitation and communities where SaniMarts or subsidies were provided.
An evaluation team comprising an international consultant, a local consultant and 4
nationals drawn from the Environmental Health and Sanitation Directorate, the Community
Water and Sanitation Agency, WaterAid and Trend was formed to ensure participation of
stakeholders in the assignment.
Interview guides were prepared for key informants at the national and regional levels and
semi-structured interviews and focus group discussions held with district and community
level informants. The evaluation team also undertook observations using a checklist at the
community level. Key informants/respondents included staff of the funding and
implementing agencies, local government authorities, environmental health officers, chiefs,
queen mothers, community opinion leaders, children, community based hygiene volunteers,
water and sanitation committee members, latrine artisans who are members of the
communities with Masonary background and Sanimart operators.
After analyzing the data from the field, findings were presented to stakeholders at a
validation workshop.it was interesting to hear some of the finding prominent among them
was the Okyeamikissi in the Kwahu North District of the Eastern Region of Ghana where the
members of the community decided to put up child friendly sanitation facility in addition to
that of adults The entire assignment was guided by the national working group on
sanitation.
5.5 Key Findings of the Evaluation
The Evaluation revealed that the projects had led to significant sanitation improvements in
more than 200 communities in Ghana which was part of the . 60% of the communities
visited had access to latrines; clean environments, well maintained refuse pits/ and some
had hand washing facilities with soap in use next to the latrines. A total of 1857 household
latrines were constructed over a period of two years which is very significant and if they are
facilitated well with other PLA tools like the Sanitation Ladder they can move up and
encourage others to construct their own household latrines and at least 5 communities had
100% coverage of improved sanitation facilities. 69 communities have been declared open
defecation free.
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Awareness of faeco- oral transmission routes was very high and safe behavioural practices
were very encouraging among the communities where CLTS had been promoted.
Community members in ODF communities indicated a reduction in diarrhoeal diseases
although there was no empirical evidence to support this assertion. CLTS has empowered
many extension workers in the use of the Participatory Learning Assessment Tools to move
from didactic hygiene education to empowering community members to take charge of
their sanitation situation through participatory assessment, community action plans and
sustenance of positive behavioural practices.
There were however challenges with facilitating CLTS by the Environmental Health
Assistants due to limited knowledge in the use of the Participatory Learning Assessment
Tools and their orientation as Public Health Law Enforcers who are use to arresting and
prosecuting Sanitary offenders and in most cases lack means of transport to the
communities for follow-up visit during the post-triggering stage, a situation that affected
success in those areas. The local NGO staff on the other hand excelled in facilitating CLTS as
they already had experience with facilitating participatory approaches. The EHAs need
greater capacity building to make them more effective at CLTS facilitation.
The evaluation revealed that community members once triggered were eager to stop open
defecation and construct their own household latrines. Major setbacks faced included the
lack of credit for latrine construction, low-cost measures for dealing with latrine
construction in flood prone areas, unstable soils and shallow ground water areas as well as
the fear of having smelly toilets next to their bedrooms and kitchens.
Although several studies point to children as effective change agents, most of the CLTS
projects had sidelined children ,this was attributed to the days chosen for the triggering
which are usually weekdays when the children were in school This could result in outcomes
that are not sustainable as children like adults engage in open defecation. It is the view of
many community members that children are the worst culprits of open defecation practice.
Some Local Government (District Assembly) Authorities were found to be promoting latrine
construction projects which were at variance with the CLTS approach. This indicated the
need for harmonized national strategy and advocacy. Ghana’s previous experience with
subsidies has also been a major challenge in implementing CLTS. In the Abura Asebu
Kwamankese in the Central Region for example the European Union (EU) is still promoting
the construction of Public Toilets in communities.
Some communities had attained ODF status but because they had not been certified and
celebrated, their achievement had diminished in significance and the opportunity to use the
celebration as an advocacy tool was lost. Two communities that were celebrated and
honoured nationally by Community Water and Sanitation Agency and their respective
District Assemblies have sustained ODF status for a year whilst two others that were not
celebrated have resorted to open defecation practices.
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Finally it was realized that there was little documentation of the baseline situation,
processes and outcome of CLTS. This resulted in difficulties in assessing information on
budget line and the cost involved in attaining Open Defaecation Free (ODF) by the
Evaluation team. The absence of proper documentation also has implications for advocacy
and knowledge management.
5.6 Conclusions and Recommendations
Based on the assessment of achievements, constraints and potentials the Evaluation Team
concluded that CLTS could become a cost effective, commercially viable in the sense that if
the process is well facilitated from the inception and effort made by committed facilitators
who are provided with the requisite logistics to follow up on the post triggering activities
,sustainable solution to the sanitation challenges in the rural areas of Ghana will be
achieved if a national CLTS strategy and action plan is developed and a complementary
capacity building and advocacy plan executed to ensure proper implementation and
national level support.
The CLTS strategy should include children to ensure faster and longer lasting behavioral
change. Greater attention should also be paid to ODF certification and celebration as a
means of encouraging and sustaining positive behaviour change. To ensure that community
members have easy access to technological knowledge to enable them move up the
sanitation ladder, the CLTS strategy should include measures to build the capacity of latrine
artisans for hygienic and safe latrine construction particularly in difficult environmental
conditions such as shallow water table areas, unstable soils and flood prone areas.
Sanitation financing should also be considered as an important aspect of the strategy.
The CLTS action plan should make provision for the documentation of processes, lessons
learnt, best practices and outcomes in a SMART monitoring and management information
system as a matter of strategic importance.
Finally it is recommended that a thorough evaluation of impact of CLTS be done after two
years after this evaluation.
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Annex 1: Reference review
http://www.communityledtotalsanitation.org/country/ghana
Demedeme, N. L . Nutsugah, P. (2009). Evaluation of Community Led Total Sanitation
(CLTS) In Ghana. Paper presented at West Africa regional sanitation and hygiene
symposium, Accra, Ghana, 3-5 November 2009. Available at:
http://www.irc.nl/page/50830 + PPT
Magala, J.M. and Roberts, L. (2009). Evaluation of strategy for scaling up community led
total sanitation in Ghana : final report. New York, NY, USA, UNICEF. Available at:
http://www.communityledtotalsanitation.org/resource/evaluation-strategy-scaling-cltsghana
WaterAid Ghana (2009). Monthly update from Ghana : Gozakope constructs its first latrines
in over 100 years. Accra Ghana, WaterAid. Available at:
http://www.communityledtotalsanitation.org/resource/gozakope-constructs-its-firstlatrines-over-100-years
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Annex 2: Case studies
Children’s involvement in community-led total sanitation (CLTS): A case study of
Oboyambo community in Central region of Ghana
By Daniel Sarpong
Introduction
The Oboyambo community is in the Agona East District of the Central Region of Ghana and
has a population of 512 including children. The community is made up three different ethnic
groups mainly; Fantes, Ewes and Northerners. The community has 67 households and out of
this 3 had latrines prior to CLTS activities in 2008.
CLTS implementation in the community has partly contributed to the construction of a
school building which started with 30 pupils. Now the school population stands at 150.
Pre-School Project
The self help spirit encouraged by CLTS has helped the people of Oboyambo to embark on a
school building project for their preschoolers. The community had earlier on put up a
structure with bamboo and straw as a classroom for the pre-scholars. The facility however
collapsed after a short while. After some months, they mobilized resources to build a mud
and wattle structure for the school children and employed teachers to teach the children.
The community contributed in terms of labour, sand, stones and water. The Masons and
carpenters were drawn from the community to put up the two class room built with bricks.
The most interesting part of the project was the involvement of children and women during
the construction of the school building. They were tasked to fetch water from the stream to
the building site.
Children active involvement in CLTS
Generally, children participated actively during the baseline data collection, particularly on
the community mapping, refuse sites, recreational centers and water points. During the
time of tracing the route of transmission of diseases, children realized that their excreta
were washed directly into the stream. They therefore resolved to stop swimming and
drinking from the stream. The children also educated their parents and that helped to settle
the dispute over the borehole. The children supported the women and men to weed, and
sweep the surroundings and wash the borehole platform.
Prior to CLTS activities, the community members used to fetch water from the stream and
had abandoned a borehole in the community. Weeds had taken control of the borehole site
and it was virtually impossible to access the facility. When the community was triggered and
members went through the walk of shame and glass of water, the community realized that
they were indirectly ingesting their faeces through their continuous use of the water from
the stream. The children who were mostly seen swimming in the stream realized the risk of
open defecation; they had a change of mind and attitude.
Formation of a children’s Club in the school
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Through the CLTS process, a club was formed by the children to carry hygiene messages
across the community. The children used drama, role play and quiz competitions in the
awareness creation process.
The children are responsible for sweeping the classrooms, compound, and toilet and urinal.
From time to time, the community members visit the school to weed the surroundings and
remove cobwebs. These were done in collaboration with the Parent Teachers Association
(PTA), school management and opinion leaders. The club periodically cleans the communal
latrine and sweep streets. They also promote hand washing with soap campaign in school
and at home. In short, the children are the hygiene ambassadors in the community. The
teachers have also been helpful in developing action plans for the school and community to
attain an open defecation- free status.
Obayambo receives support from Japan
In the year 2006, Plan Ghana received grant support from Plan Japan to construct a
4-class room block with modern pre-school facilities for the community. The support came
as a result of the community self help spirit and good leadership qualities exhibited by the
chief and elders.
Lessons from the CLTS implementation
Children’s active involvement in the CLTS helped to settle the dispute among community
members over improper financial accountability of borehole water sales.
Children participation in the CLTS process facilitated the need to provide the school with
child friendly toilet facilities, hand washing facilities, drinking water facilities, urinals and
canteens
Formation of school young club led to the training of food vendors on good nutritional
practices and food handling.
Children and teachers effective collaboration with parents and opinion leaders attracted
support from Plan Ghana to search for grant to build modern classroom for the community.
The formation of School Clubs helped to carry the hygiene message across the community.
Children were involved in ODF declaration and celebration.
Key Success factors and best practices
One of the key factors that led to the successful project implementation was the fact that
there were regular follow-ups and high commitment on the part of the natural leaders.
People who were caught defecating openly were fined an amount of five Ghana Cedis
($3.50 equivalent) and a bottle of schnapps. The community watch- dog committee was
very vibrant.
Good leadership and community self help spirit
Good facilitation by Partner Organizations and follow ups by Plan staff.
The neighboring community has learnt from the Oboyambo community and has adopted
the CLTS approach.
Conclusion
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In conclusion, the involvement and active participation of children in CLTS or SLTS is
paramount. Children are capable of transforming a community and therefore they should be
involved in community developmental project.
Acknowledgement
The author would like to extend sincere appreciation to Plan International, the donors and
all those who contributed in diverse ways during the preparation of this paper.
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Reference
1. Report on improving sanitation and hygiene situation at Oboyambo using CLTS, 2008
2. End of phase one report for Plan Ghana’s water and sanitation program in the Mankessim
Program Area, July 2006
3. Interview with Plan Program Area Manager, Bawjiase, (21th July, 2010).
4. Interview with Plan community facilitator, Bawjiase, (21th July, 2010.)
Keywords
School Led Total Sanitation, School Young Club, Northerners, Preschoolers
Contact details
Daniel Sarpong
Water and Sanitation Advisor
Plan Ghana
Tel: +233 244 48 84 40
E-mail: Daniel.Sarpong@plan-international.org; dsarpong@yahoo.com
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Girls as natural leaders in CLTS in school
By: Daniel Sarpong
One would have thought or argued that boys have the courage and selfless spirit to work as
natural leaders in communities. It turns out that girls equally have all that it takes to become
natural leaders in support of either community or school project. A very good example
began during the SLTS triggering activities at Kanchau basic school in the Sissala West
District of the Upper West Region in Ghana. There was a drinking water competition which
involved boys and girls during the triggering activities. In all, three students volunteered
including two young girls of age 12 and 13. The girls decided to participate in the
competition to prove to their male counterpart that what men can do, women can equally
do it even better. They were given an equal amount of clean water to drink. At the end of
the first round, it was not clear who won the competition because they all finished drinking
the water virtually at the same time. A second round trip drinking competition was
proposed and the facilitator requested a little amount of shit to be added to the water. It
was expected that the school children would drink since it was a competition but
surprisingly, none of the competitors was ready to take the glass of water to the month, let
alone, to drink the water being served. It was then that the 12years old girls made a
declaration to the whole students and teachers that she was not going to drink the water
because it was polluted with shit. She further explained that their water sources were
polluted with shit because most people practice open defecation in the community. Her
statement received a big applause from her colleagues. Another girl of age 13 stood in front
of the teachers and other students and exclaimed; “We will stop shitting behind the
classrooms and near wells”. Others joined her to declare that they will report anybody who
would be caught defecating openly to the elders of the community.
Some boys explained in their native language to their friends about the linkage between
polluted water and diarrhoea. What broke the camel’s back was the boldness and courage
the school girls had to say that “we will not continue to defecate in the bush and around
wells or ponds” and that they will go every length to ensure that their parents construct
latrines for them.
The student composed songs and chanted in the streets of the community. They developed
a clear action plan which was to be monitored by the student leaders and teachers.
Lesson learnt
 Girls have courage and selfless working spirits to support community/school achieve
ODF.
 Song composed was initiated by girls and it received great backings from their male
counterparts.
 Girls can influence the peers to take up advocacy issues up to higher levels.
 Girls can equally match up with boys in decision-making and persuade their parents
to construct latrines and their effort should be acknowledged.
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