Prior to 2003, all sanitation promotion approaches in Nepal relied on significant hardware subsidies and in some programmes the use of a revolving loan to finance sanitation. Hygiene promotion had been recognised by the sector in Nepal as critical for increasing demand for sanitation for some time and as a result was being implemented in different programmes to varying degrees.

In June 2003, WaterAid Nepal (WAN), Plan Nepal, Nepal Water for Health (NEWAH) and other government and civil society stakeholders travel to Bangladesh to visit the work of Village Education Resource Centre (VERC) in relation to sanitation promotion. The team were given some initial orientation on the Community Led Total Sanitation (CLTS) approach and shown the impact on the ground.

Stimulated by what was seen in Bangladesh, the knowledge gained was translated into action by the design and implementation of the first pilot CLTS projects in Karki Danda, Dhading District, Nepal, in October 2003. In the preceding two years, WAN and Plan supported a number of local NGOs, including NEWAH, to implement WaSH project using the CLTS approach on a pilot basis. During this time a sector coordination committee on CLTS was established to support dissemination of experiences and the sharing of the approach with a wider set of actors in the sector. The coordination committee organised further training to other interested agencies on the CLTS approach, with the support of Plan International.

UNICEF took a keen interest in the approach and decided to pilot a modified CLTS approach, called School Led Total Sanitation (SLTS). This approach took the school as the lead institution in stimulating and promoting changes in sanitation, and worked to cover the whole school catchment area. WAN also supported NEWAH to pilot this approach in one of their working districts. UNICEF has scaled up SLTS in their WaSH programme across Nepal.

The use of CLTS and SLTS approaches for promoting sanitation were incorporated into a Government-led programme to achieve total sanitation coverage in the District of Chitwan. The Government encouraged all actors in the district to use CLTS and SLTS approaches, with no hardware subsidy being provided. Despite good progress to achieve total coverage in the district some agencies have continued to give hardware subsidies.

In 2006, both WAN & NEWAH and Plan Nepal conducted separate evaluations of their CLTS activities supported to date. The evaluations used external stakeholders, including some members of the original trainers from Bangladesh. The evaluations showed some positive results in terms of getting people to change sanitation behaviours and stop open defecation. However the evaluations also raised some concerns over the hygienic nature and sustainability of some latrines that had been constructed.

Following the WAN & NEWAH evaluation, a number of modifications were made to the CLTS approach to fit with the Nepal context. Although the core principles of CLTS were kept unchanged, including the ignition tools and the principle of not giving hardware subsidies up front, the provision of a Community Sanitation Fund was put in place. The Community Sanitation Fund is provided to the community after the achievement of Open Defecation Free (ODF) status, and is to enable poorest households upgrade their latrines to sustainable structures. The modified approach has now been mainstream across NEWAH and WAN’s programmes.

The use of the CLTS approach have been implemented in WaSH projects by at least 10 local NGOs in over 30 of the 75 districts in Nepal, with support of 6 International NGOs. However community-led approaches in Nepal are still not mainstreamed and although some agencies, including WAN, NEWAH, UNICEF and Plan, have made moves in recent years to implement these approaches across their programmes, most agencies have not. Significantly, the two largest rural water supply and sanitation programmes in Nepal supported by the World Bank and ADB have not adopted Community-led Total Sanitation approaches.

To support the harmonization of sanitation approach, a number of sector stakeholders have supported the Government of Nepal to develop an “Implementation Guidelines of Total Sanitation in Nepal”. Many stakeholders have contributed to the development of the document and as of November 2009 it is in its final stage of preparation. It is hoped that this guideline will support the “National Hygiene and Sanitation Master Plan”, which the Government of Nepal are also currently in the process of finalising. The Master Plan will set out a National Sanitation Programme, with key approaches and target areas of intervention for all sector actors to follow.