Sierra Leone initiated Community led Total Sanitation (CLTS) in 2008, following the visit of Kamal Kar and training of 130 Government and NGO partners, including the Ministry of Health and Sanitation (MoHS), the Ministry of Education Science and Technology (MEST), the Ministry of Energy and Water Resources ( MoEWR), Concern Worldwide, GOAL, Plan Sierra Leone, Pikin to Pikin and Safer Future. As an approach which ignites communities to take active steps to change their sanitation practices, it has been embraced by the Government and is growing steadily. Scale up since inception has been rapid. By June 2010 out of over 3000 communities triggered, over 1000 had been declared Open Defecation Free. A key component of the WASH programme in Sierra Leone, the Government has factored CLTS into the Water and Sanitation Policy (2008). CLTS is being implemented in six districts with the target of achieving 100% ODF in one district and 50% in the other five districts by 2012.

In 2009 a WASH Consortium was established with key stakeholders that include the Ministry of Health and Sanitation, UNICEF, GOAL, Plan Sierra Leone, Oxfam, Pikin to Pikin, DIP, Safer Future, MUWODA, PACE and other international and national government partners. The National CLTS task force emerged from this to serve as a forum for advocacy, providing capacity development through information and encouraging partners to share experiences as well as contribute to quality implementation. District task forces have also been established to support scale up, ensuring local government commitment to CLTS. All CLTS communities have established village health committees which include a natural leader. Their key responsibilities include the spread of CLTS to other catchment communities and hygiene promotion.

A Natural Leaders training manual has also been developed and is currently (April 2011) being finalised. The manual will help to train natural leaders in operational areas ensuring harmonised approach to implementation.