Although CLTSH has had tremendous success since its initial start, only 24% of the population currently has an improved toilet. Traditional unimproved pit latrines made from locally available and affordable materials are low cost and easy to construct, but are not considered hygienic or sustainable as people stop using dirty and smelly toilets or go back to open defecation after their latrines collapse. There is a need and increasing aspiration for an improved latrine based on the recognized benefits: improved toilets are safer (i.e.

This UNICEF review is aimed as a timely contribution to overall knowledge on the provision of equitable and sustainable sanitation and hygiene for all – highlighting what has worked, and issues that still need attention, especially in the area of Community Led Total Sanitation (CLTS).

WASH services in small towns are frequently neglected by all branches of government due to lack of capacity, unclear mandates, low budgets and lack of feasible options to provide services. Typical high-tech infrastructure solutions are neither feasible nor affordable for these contexts. Progress towards MDG- and sanitation-specific targets in sub-Saharan Africa is much higher in urban areas. However such achievements often mask a disparity between the rich and poor in urban contexts and between major urban cities and small towns or rural centres.