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Lessons from Pakistan

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The Pakistan Approach to Total Sanitation (PATS) endorses a number of different total sanitation models of which Community-Led Total Sanitation (CLTS) is one. Last week I attended the 2nd Pakistan Conference on Sanitation (PACOSAN II) in Islamabad. The conference was organised by the Ministry of Climate Change, with the support of WaterAid, UNICEF, Water and Sanitation Program – South Asia (WSP-SA), Plan Pakistan and other sector partners. Through different presentations, conversations and meetings I was able to develop an understanding of how Community-Led Total Sanitation (CLTS) is being used. More excitingly, I was able to learn about a number of ways CLTS is being morphed and redesigned to fit in with the local context. Here are some examples:

The process

UNICEF have developed a longer two-day process in order to create a more holistic development approach. Pre-triggering social analysis is used on the first day to identify community problems with no mention of sanitation. It is only on the second day when triggering tools are used. They have also turned the transect walk into a walk of pride however I have struggled to find out in what ways it is different. 

Smart, Targeted Support:

Certain projects have been using smart, targeted support for the poorest in communities. I use the word ‘smart’ because these systems have been designed to help the most vulnerable without directly subsidising the construction of individual household toilets. Therefore, a sense of ownership can still be maintained and toilets are more like to be used.
UNICEF have been identifying the poorest in communities using participatory methods, for example by asking who owns expensive items such as tractors in community discussions. Those identified as the most vulnerable segments of the community are given vouchers that can then be exchanged for building materials and components at local markets.
Furthermore, some organisations have been donating demo-latrines, set up in villages as an example of an appropriate technology, to the most vulnerable households. These households are identified by Village Development Committees, two groups, one of men and one of women elected by the community. They also identify families through household surveys.
ACTED as part of ‘Pakistan Emergency Food Security Alliance’ have provide latrines for 900 out of 4360 households. Materials are provided after triggering however households are required to undertake the construction work. The criteria to identify the poorest include widows, children or women led households, those with family members suffering Severe Acute Malnutrition or Moderate Acute Malnutrition and pregnant and lactating mothers.

Post-ODF Engagement:

In the Punjab the provincial government have been engaging with post-Open Defecation Free (ODF) activities in order to sustain behaviour change in communities. The government have been rewarding   communities who are declared ODF and sustain ODF status with rewards such as elevated hand pumps, elevated latrine blocks, solar based wastewater treatment or solar based drinking water systems. These rewards vary in different contexts based on the needs of the community. Once a village is reported ODF a committee of three people, including representatives from local and national government, are used for certification. The community is then eligible for other development projects. 

Sanitation Marketing:

Sanitation Marketing is being used in different ways. For example, UNICEF have been developing local markets, making sure local entrepreneurs are able to supply the parts needed in the local market. These entrepreneurs accept vouchers given to the worst off which can then be exchanged for cash. 
ACTED have conducted market assessments and give communities information about where different components can be purchased.

Monitoring and Verification:

The approach UNICEF takes is to monitor the quality of the process as well as the outcome. They use consultancy companies to monitor and verify. Those hired must be familiar not just with WASH issues but also with Participatory Rural Appraisal. Therefore, the triggering is monitored and reported on as well as the sanitation status of communities. This can help make sure that triggering and other community based analysis and mobilisation tools are conducted correctly. This approach could benefit other parts of the world where the scaling-up process has led to bad facilitation.


There are a number of difficulties to using the CLTS approach in Pakistan.

  • Due to areas being prone to flooding pit latrines contaminate groundwater. Appropriate technologies that are high enough up the sanitation ladder are unaffordable for many.
  • In some instances CLTS is taught as a set of steps that must be adhered to rather than a range of techniques that practitioners can use depending on the circumstances.
  • Problems of accessibility due to political instability and violence makes it extremely difficult for CLTS and post-ODF engagement to be carried out in certain parts of the country.

Pakistan is an excellent example of adaptations being made to the traditional CLTS process due to local conditions, something I would very much encourage. It is due to conducting CLTS in areas recovering from the 2010 floods that some of these adaptations have been made. Many I met in Pakistan said that they were not using CLTS – a contributing factor to this view may be that people are taught that CLTS is a strict set of steps that facilitators must conduct. However, the way I see it, CLTS’s most important values are its commitment for the process to be community-led and its ambition for collective behaviour change. This new form of CLTS in Pakistan still adheres to these values. There is still much I do not understand and much more to learn but I do think there are important lessons here, especially for those working with CLTS in post-emergency settings and those wanting to start on the middle rung of the sanitation ladder.

Jamie Myers is Research Assistant at the CLTS Knowledge Hub.


Date: 27 February 2015