Mobility up the sanitation ladder following community-led total sanitation in rural Zambia

Author:

Russpatrick Scott1,Tiwari Amy1,Markle Laurie1,Musonda Engervell2,Mutunda Anne1,Osbert Nicolas3,Pinfold John3,Winters Anna14,Winters Benjamin14,Larsen David A.15

Affiliation:

1. Akros, Lusaka, Zambia

2. Ministry of Local Government and Housing, Lusaka, Zambia

3. UNICEF Zambia Water and Sanitation Unit, Lusaka, Zambia

4. University of Montana School of Public and Community Health, Missoula, MT, USA

5. Syracuse University Department of Public Health, Food Studies and Nutrition, Syracuse, NY, USA

Abstract

Scaling the sanitation ladder decreases exposure to various illnesses including diarrheal disease, soil-transmitted helminths and trachoma. In rural Zambia, community-led total sanitation (CLTS) has been deployed to help Zambians scale the sanitation ladder. Analysis of monthly routine surveillance data of village-level sanitation coverage of 13,688 villages shows that villages moved up the sanitation ladder following CLTS intervention with more than one third of villages achieving 100% coverage of adequate sanitation. Villages also moved down the sanitation ladder – approximately half of those achieving 100% coverage of adequate sanitation also dropped from that coverage at some point during monitoring. Larger villages were less likely to achieve 100% coverage, and more likely to drop if they did achieve 100% coverage. Drops were more likely to occur during the wet season. Of those villages dropping from 100% coverage, more than half rebounded to 100% coverage. The adequate latrine components most likely to drop off from 100% coverage were handwashing stations and lids to cover holes, both key components in preventing disease transmission. These results have implications for water, sanitation and hygiene (WASH) programming – sustained support may be required to ensure villages move up the sanitation ladder and stay there.

Publisher

IWA Publishing

Subject

Public Health, Environmental and Occupational Health,Pollution,Waste Management and Disposal,Water Science and Technology,Development

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