Community-led total sanitation

Community-led total sanitation (CLTS) is a participatory approach used mainly in developing countries to improve sanitation and hygiene practices within a community. CLTS aims to achieve behavior change with a 'trigger' meant to lead to spontaneous and long-term abandonment of open defecation practices, thereby improving community sanitation and overall health. The term "triggering" is central to the CLTS process. It refers to ways of igniting community interest in ending open defecation, usually by building simple toilets, such as pit latrines. The effect of CLTS is two-fold: it involves some actions leading to increased self-respect and pride in one's community and promotes shame and disgust about one's open defecation behaviors. CLTS takes an approach to rural sanitation that works without hardware subsidies and facilitates communities to acknowledge the problem of open defecation and take collective action to become "open defecation free" and clean up.

The concept was developed around 2000 by Kamal Kar for rural areas in Bangladesh. CLTS became an established approach around 2011. Local governments may reward communities by certifying them with "open defecation free" (ODF) status. The original concept of CLTS purposefully did not include subsidies for toilet installations, as they might hinder the process.

CLTS is practiced in at least 53 countries and has been adapted to the urban context. Along with this, it has also been applied to post-emergency and fragile states settings.

Challenges associated with CLTS include the risk of human rights infringements within communities, low standards for toilets, and concerns about usage rates in the long term. CLTS is, in principle, compatible with a human rights-based approach to sanitation, but there are examples of bad practices in the name of CLTS. More rigorous coaching of CLTS practitioners, government public health staff, and local leaders on issues such as stigma, awareness of social norms, and pre-existing inequalities are important. Disadvantaged people should benefit from CLTS programs as effectively as those who are not disadvantaged.