To improve the evidence of the effectiveness of Community Led Total Sanitation Programs on health and behavioral outcomes.
The study provided evidence that a pure behavioral intervention with no monetary subsidies substantially increased access to sanitation facilities in rural Mali. Latrines were also cleaner and better stocked with handwashing supplies in treatment villages, indicating improved hygiene behavior. Our findings suggest CLTS improved child growth and reduced the prevalence of stunting among children.
The program did not have a significant impact on self-reported diarrheal illness, thus the program may have impacted child growth and mortality through pathways other than preventing diarrhea, such as reducing the subclinical condition of environmental enteropathy via decreased exposure to environmental fecal contamination.
Evaluation of the effectiveness of a community-led total sanitation (CLTS) program implemented by the government of Mali in small rural communities with poor sanitation coverage
Stanford University, USA; Aix-Marseille University, France; University of the Andes, Colombia; Université Laval, Canada. The CLTS intervention itself was implemented by the Malian government with the support of UNICEF.
Behaviour change Bill & Melinda Gates Foundation Community sanitation Enabling environment and institutional strengthening Health and hygiene Latin America & Carribian Rural Rural Sanitation systems and technology options (WG4) Specific to one or several countries Sub-Saharan Africa University, education or research institution WASH and nutrition
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