The integration of CLTS into the CHSA in Kenya presents an opportunity to strengthen community leadership and governance in the health sector and give sanitation practitioners impetus to sustain gains made.
This is a book chapter taken from Sustainable Sanitation For All: Experiences, Challenges and Innovations.
Post-ODF follow-up is central to sustaining open defecation free (ODF) status, and needs to be integrated into Community-Led Total Sanitation (CLTS) programming from the outset. This chapter from Sustainable Sanitation for All: Innovations and Insights explores who is to carry out these activities, and how they might be motivated and financed. It argues for the importance of identifying existing administrative and social structures prior to implementation.
Looking at reasons for success in Nambale sub-county, which was declared ODF in 2012, the chapter discusses the role of Community Health Workers (CHWs), who, under the Kenyan Community Health Strategy Approach (CHSA) have an expanded remit that includes CLTS, in follow-up and in reaching the poorest and most marginalised within communities. The chapter highlights challenges which have arisen, such as incentives to motivate CHWs, as well as the risk that devolved government structures lead to inequity among districts and varying levels of funding for the same activities, thereby threatening ODF achievement and sustainability.
(Updated June 2023: the author has published a blog reflecting on this chapter and progress since 2016, ‘Has the status of Community Health Volunteers evolved in Kenya?‘ )