Community Led Total Sanitation in Kenya

Approximately 80% of the hospital attendance in Kenya is due to preventable diseases out of which 50% are water, sanitation and hygiene related. Poor disposal of human excreta is responsible for the spread of cholera typhoid, schistosomiasis, and other infections resulting in the hospitalization or death of thousands of Kenyans, with corresponding economic costs in health care and morbidity. In 1999 about 2,500 Kenyans died from diarrhoea and gastroenteritis diseases as compared to a reported mortality of 2,787 from HIV-AIDS related diseases. Diarrhoea and gastroenteritis diseases were the highest causes of infant hospitalization in 1999. Thousands of children suffer nutritional, educational and economic loss through diarrhoea and worm infections. Besides the burden of sickness and death, inadequate sanitation threatens to contaminate Kenya's water sources and undermine human dignity.  In the last 20 years, Ventilated Improved Pit (VIP) latrines have been introduced and promoted by the Government of Kenya's Ministry of Health with support from bilateral donors and Non Governmental Organisations. However, these have not been very successful due to cost and cultural factors. According to the Ministry of Health, only 46% of 34 million Kenyans have access to adequate sanitation, meaning that about 19 million still engage in open defecation.

In May 2007, after three water and sanitation facilitators had attended CLTS training in Tanzania and Ethiopia, Plan Kenya decided to pilot Community Led Total Sanitation in three Development Areas (DA). Previously, Plan Kenya had been using the Participatory Hygiene and Sanitation Transformation (PHAST) methodology which went hand in hand with the popularization of VIP latrines promoted by the Ministry of Health. Through the PHAST initiative, Plan Kenya used to finance construction of pit latrines with the community contribution amounting to between 5 – 20%. Although the investment by Plan was huge, the rate of latrine coverage in Plan supported areas was minimal only about 3%. An evaluation of the adoption and scaling-up of the VIP latrines by the communities using own resources revealed that this was negligible due to the high cost and resistance to change. Although PHAST techniques are still very good for engaging communities in sanitation education, scaling-up by communities using own resources is not significant.

The experiences and lessons emerging from the three Development Areas, where Plan Kenya has been piloting CLTS are quite encouraging. In many villages, people have stopped open defecation and latrine coverage has increased from 50% to 100% within very short periods of up to three months. Plan Kenya has now decided to go to scale in rolling out CLTS in all the 8 Development Areas where it operates