Adaptation of the Community-led Total Sanitation (CLTS) Protocol during the COVID-19 Response

SLH Learning Briefs 15
June 2023

Before COVID-19, Mozambique’s Community-Led Total Sanitation (CLTS) protocol, introduced in 2008 and referenced in the Strategy of Rural Sanitation 2021-2030, broadly aligned with the original approach proposed by Kar and Chambers in the CLTS Handbook (2008).

It included participatory pre-triggering, triggering and post-triggering activities bringing whole communities together to promote collective behaviour change on sanitation and health in the community. During the pandemic, UNICEF Mozambique worked with the Government of Mozambique (GoM) and other partners to adapt the CLTS protocol in line with government restrictions to support continued implementation of the approach. With restrictions now reducing, clarity on a post-pandemic CLTS protocol is needed.

This rapid study explored how CLTS programming was adapted and implemented during the pandemic and the successes, failures, and lessons to inform recommendations moving forward. With only eight years to go to achieve the SDGs, it is timely for Mozambique to review and adapt the existing tools to ensure the required acceleration towards the elimination of open defecation is possible.

The study focused on how adaptations to the CLTS protocol were devised and implemented, what the changes involved, different stakeholders’ roles and responsibilities, and what the lessons and recommendations are.


1. Develop a revised CLTS protocol, led by DNAAS with contributions from all partners working in the sanitation sector, incorporating learning from before and during COVID-19.

2. Explore ways to retain and encourage the flexibility and adaptive capacity demonstrated during COVID-19, in line with wider sector thinking around the need for more adaptive programming. This may include enabling regular feedback from frontline staff to decision-makers, learning visits to the field, coordination meetings with diverse stakeholders, and advocacy to donors and decisionmakers to allow increased flexibility across the sector.

Additional details

PublisherInstitute of Development Studies
RegionSouthern Africa
ThemesBehaviour change, Challenging contexts, COVID-19, Health, Leave no one behind, Monitoring, evaluation and learning, Sustainability and safely managed sanitation
ApproachesCommunity-led approaches

Munguambe, C. and Coultas, M (2023) ‘Adaptation of the Community-led Total Sanitation (CLTS) Protocol during the COVID-19 Response’, SLH Learning Brief 15, The Sanitation Learning Hub, Brighton: Institute of Development Studies, DOI: 10.19088/SLH.2023.007


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