A nationwide Community-Led Total Sanitation (CLTS) initiative is achieving remarkable success in eliminating open defecation across rural Kenya, with over 1,200 villages now certified as open defecation free. The program, implemented by the Ministry of Health in partnership with local governments and NGOs, uses participatory approaches rather than infrastructure subsidies to trigger collective behavior change. Through facilitated community meetings where residents map out their own defecation patterns and calculate the quantity of feces being openly deposited in their environment, the program creates powerful disgust and shame that motivates entire communities to build and use basic latrines without external financial incentives.
The health and economic impacts of this sanitation transformation are substantial. Communities that have achieved open defecation free status report dramatic reductions in diarrheal diseases, particularly among children under five, leading to lower healthcare costs and fewer school absences. The approach has proven particularly effective because it creates local ownership—villagers themselves monitor progress through certification committees and develop their own sanctions for non-compliance. Women and girls have benefited significantly from improved safety and dignity, no longer having to wait for darkness to relieve themselves in the open, which often exposed them to harassment and snake bites. The program has also stimulated local economies as demand for pit latrine construction has created new livelihoods for local artisans.
The long-term sustainability of these gains depends on maintaining community vigilance and addressing the challenge of upgrading from basic to improved sanitation facilities. The Kenyan government is now building on this success with a second phase that promotes total sanitation, including handwashing with soap and safe management of household water. As climate change brings more frequent flooding that can contaminate water sources, these community-level sanitation behaviors become even more critical for public health. The CLTS model demonstrates that the most effective development solutions often come not from expensive infrastructure projects but from empowering communities to solve their own problems through collective action, creating lasting change that continues long after external facilitators have departed.