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Ghana has adopted the Community Led Total Sanitation (CLTS) as the rural basic sanitation promotion approach. This approach thus, replaces the subsidy approach which failed to bring an end to open defecation (OD) after several years of implementation. Since 2010, the country has been making efforts to scale up CLTS to all districts.
The Government-led implementation has concentrated its efforts in five regions. The regions are the Upper East and West, Northern, Volta and Central regions.  While there are reports of successes in some districts where the approach has been implemented, there remain some challenges that need to be addressed.
The number of organisations now implementing the approach has increased from few to many. Such organisations include, Plan Ghana, Global communities, SNV, Ring, Spring, WaterAid and its local partners and the Catholic Relief Services. The others include, World Vision Ghana and Care international Ghana. Quasi Government institutions such as the Community Water and Sanitation Agency are also implementing CLTS in 90 Districts. Implementation has moved from 300 communities in 3 regions in 2010 to over 5,000   communities in 9 regions in 2015.

The following are key achievements attained as of July, 2015. Achievements fall into, a) enabling environment to ensure quality at scale and b) actual implementation.

Enabling environment

  • Development of a Rural Sanitation Model and Strategy (RSMS) for CLTS implementation
  • Development of Basic Sanitation Information System (BaSIS) software for effective monitoring and evaluation and decision making. BaSIS has two versions namely the online version (for all partners) and the desktop version for actually data capture at the implementation level. 200 Officers from 38 MMDAs have been trained in BaSIS during three zonal trainings.
  • Development of a software called District CLTS Toll Our Plan (DROPS). DROPS is a planning tool to aid Districts develop costed plans for achieving District wide open defecation free status. 117 Officers in 38 districts have been trained on DROPS in three zonal trainings. A DROPs software has also been developed
  • A national level platform for CLTS knowledge and dissemination called the CLTS Stock Taking Forum (CLTS-STF) has been established and has been running for four years now. STF is for learning, sharing and stock taking of CLTS implementation activities in the Country for all partners in CLTS
  • Training of 78 Officers on documentation and report writing on CLTS activities 
  • An assessment of the suitability of using business solutions and micro-financing for basic sanitation has been carried out. This was followed by presentation and validation of initial sanitation marketing assessment workshops by districts. A national validation of sanitation marketing assessment was also carried out. Sanitation marketing implementation workshop for districts leading to piloting of sanitation marketing interventions in 10 districts. TOT on entrepreneurship for sanitation marketing carried out for 10 Districts. Development of a set of operational strategies and guidelines on using business solutions and micro-financing for basic sanitation.
  • Successful implementation of two years of Result Based Financing (RBF) for NGOs using CLTS. This piloting was done to help test the option of implementing CLTS through NGOs.
  • An ODF verification protocol has been developed to take concerns of all partners. The distinct feature of the verification and cetification protocol is that it categories communities into four levels of ODF status, bringing competition among communities.
  • Three institutional triggering workshops were held in Volta, Upper West and Northern Regions in May 2015 in partnership with the CLTS Foundation. These involved two elements of intervention: firstly a pre institutional triggering meeting with high levels officials of the region including the Deputy Regional Minister, and, in the case of Volta Region, the Regional Minister herself. These meetings were an opportunity to invite the leadership figures to attend the institutional triggering, as well as to ‘trigger’ them if they were not already fully committed to scaling up CLTS in the region. The leadership figure was also invited to think about a target date for achieving ODF in their region
  • The first phase Technology Assessment has been conducted and completed. The main purpose of the Technology Assessment is to undertake a technological assessment of household latrines delivery and make recommendations for improvement within the basic principles of the CLTS Approach. The assessment is necessary for the purposes of documenting the successes and challenges of acquiring and using improved household latrines in the rural areas in Ghana. The recommendations will inform the WASH sector’s decisions on guidelines for basic household sanitation (toilets) and mechanisms for providing technical support for the construction of latrines within CLTS programmes. In addition, the assessment will also provide input for the design of business solutions for improved sanitation uptake.
  • Coordination structure has been established at the Regional and Districts levels. Regions have the Regional Interagency Coordinating Committee on Sanitation (RICCS). Districts have the District Interagency Coordinating Committee on Sanitation. RICCS and DICCS as coordination structures are to ensure the avoidance of duplication among partners, see to knowledge management and information dissemination among others. Membership of RICCS and DICCS is drawn from all sectors in CLTS implementation


Over 1700 communities now live in ODF environments. Many communities are awaiting verification and certification. Scaling up CLTS in Ghana has not been without challenges. These challenges can be divided into three categories:

Challenges pertaining to DPs and international NGOs

  • Failure on the part of big International and Governmental organisations following and using developed tools for implementation.
  • Application of untested methodologies in CLTS implementation by some sector players  
  • Failure on the part of INGOs to report gains in CLTS appropriately

Challenges at the MMDA level

  • The private sector has not yet developed the business potential in responding to the increasing latrine demand in rural communities.
  • Low priority given to basic sanitation by MMDAs
  • Weak reporting by MMDAs
  • Weak coordination at the Regional and District levels.

Challenges from the Sector agency; MLGRD

Ongoing activities include

  • The development of an urban sanitation strategy
  • The launching of a Social Norms Campaign against OD
  • A three year sanitation marketing project in 50 districts

((November 2015)