Can open-defecation free (ODF) communities be sustained? A cross-sectional study in rural Ghana

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Title: Can open-defecation free (ODF) communities be sustained? A cross-sectional study in rural Ghana

Community-led total sanitation (CLTS) is a widely used approach to reduce open defecation in rural areas of low-income countries. Following CLTS programs, communities are designated as open defecation free (ODF) when household-level toilet coverage reaches the threshold specified by national guidelines (e.g., 80% in Ghana). However, because sanitation conditions are rarely monitored after communities are declared ODF, the ability of CLTS to generate lasting reductions in open defecation is poorly understood. This study examined the extent to which levels of toilet ownership and use were sustained in 109 communities in rural Northern Ghana up to two and a half years after they had obtained ODF status. The study findings found that the majority of communities (75%) did not meet Ghana’s ODF requirements.

Considering results, authors suggest that interventions that address toilet collapse and the difficulty of rebuilding, particularly among the poorest and most vulnerable households, will improve the longevity of CLTS-driven sanitation improvements in rural Ghana.

Category: Access to sanitation household toilets in rural areas