Reducing Open Defecation Through Community-Led Total Sanitation in Fort Dauphin, Madagascar: A Case Study

Globally, an estimated 4.5 billion people lack safe water and sanitation services. In Madagascar, open defecation is particularly commonplace, with nearly half of the population practicing it. Construction of latrines alone is ofen insufcient in reducing this number, as availability does not mean the latrines will be used by the community. Community-Led Total Sanitation (CLTS) is an approach which aims to reduce the prevalence of open defecation by catalyzing community action towards increasing use of latrines and other personal hygiene behaviors. Tis case study evaluates the hybridCLTS approach implemented by SEED Madagascar in Fort Dauphin, Madagascar, between 2014 and 2017. Specifcally, the intervention’s impact on sanitation and hygiene behavior outcomes, and health outcomes are investigated. Te report concludes that this intervention is a successful example of adapting a CLTS approach to an urban context where open defecation practices are driven by a complex set of traditional and cultural beliefs. However, signifcant challenges must be overcome to support such an approach, including ensuring adequate stakeholder engagement, sustainable fnancing, and broader Water Sanitation and Hygiene (WASH) strategies. Recommendations include fostering partnerships with other organizations, integrating participatory planning approaches, and promoting sustainable sanitation entrepreneurship.