The scale of investment required to deliver sanitation goods and services to those who lack access is beyond the capacity of public finance alone. The private sector has already proven itself a key player in the financing, construction, and operation of municipal water supply and wastewater systems in both developed and developing world settings, and has a significant role to play in the provision of onsite sanitation.

This is the final report of a project in which CLTS was analysed using the RANAS (Risks, Attitudes, Norms, Abilities, and Self‐regulation) approach. In this project, funded by the Bill and Melinda Gates Foundation, two cross sectional studies in Cambodia and Mozambique and one big field experiment with 3120 households in northern Ghana were conducted. The following research questions were addressed in this study:

Globally, preterm birth (PTB) and low infant birth weight (LBW) are leading causes of maternal and child morbidity and mortality. Inadequate water and sanitation access (WASH) are risk factors for PTB and LBW in low-income countries. Physical stress from carrying water and psychosocial stress from addressing sanitation needs in the open may be mechanisms underlying these associations. If so, then living in a community with strong social capital should be able to buffer the adverse effects of WASH on birth outcomes.

In order to address some of the challenges faced in implementation of Indian government's flagship programme Swachh Bharat Mission (Gramin), the Madhya Pradesh state government introduced the direct benefit transfer of incentives to beneficiary households in 2016. This system uses an android application and web portal for digitising the processes, resulting in direct transfer of toilet construction incentives into beneficiaries' bank accounts.

Around 2.3 billion people in developing countries still lack access to improved sanitation facilities and almost one billion practice open defecation (OD). Community-Led Total Sanitation (CLTS) has recently become a particularly popular approach used in more than 60 countries. It is a behaviour change approach that aims to ignite community action and make OD socially unacceptable without providing any external financial or material support to individual households. Also sometimes perceived as a revolutionary approach that has proven to be highly cost-effective in abolishing OD.