ASSESSMENT OF COMMUNITY-LED TOTAL SANITATION TOWARDS OPEN DEFECATION FREE COMMUNITIES IN BAWKU WEST DISTRICT OF THE UPPER EAST REGION OF GHANA

Abstract

Open defecation is one of the primary causes of faecal contamination of water bodies and the transmission of faecal microorganisms. As part of efforts to end open defecation, this study assessed the contribution of Community Led-Total Sanitation towards Open Defecation Free communities in the Bawku West District. The study ascertained community-led total sanitation processes and triggering tools, explored community-led total sanitation challenges, evaluated Community-Led Total Sanitation outcome and examined ways of improving community-led total sanitation. A case study design and a qualitative approach to data collection were employed to gather data from 47 respondents including (25 Water and Sanitation Management Teams, 12 Natural Leaders, and 6 Focus Group Discussions across five selected Open Defecation Free communities and 4 institutional stakeholders. Key Informant Interview guide, In-depth Interview guide, and Focus Group Discussion guide were used in addition to participants’ observation to collect qualitative data. The study established that; pre triggering, triggering and post-triggering processes were used in programme implementation. The main triggering tools applied were; walk of shame, defecation map, glass of water, and medical calculation. The study revealed that, community level total sanitation major challenges included; over-reliance on community-level stakeholders, sustainability issues due to local materials used in latrine construction, nature of soil/ground challenges and ineffective post-open defecation free monitoring. The study again discovered that, effective facilitation/communication, provision of allowance to community stakeholders, strengthening post-open defecation free monitoring, enforcement of open defecation bye-laws, were critical in improving community led-total sanitation. The results indicated that, despite the challenges with the programme, the model has made some significant contributions towards open defecation free communities in the district. Hence, the study recommends that; facilitators should duly follow community led-total sanitation processes, while adopting/adapting community entry protocols based on the context. It is also suggested that, facilitators should have a better understanding of community setting (culture, norms, beliefs, etc.), to ensure effectively combined triggering tools and put measures that prioritize post-open defecation free monitoring and follow-ups to avoid a relapse.