A INFORMAL UPDATE PAPER ON THE STATUS OF COMMUNITY LED TOTAL

SANITATION (CLTS) IN NEPAL

By Chrissie Wellington, 2005

Introduction and background

Safe drinking water and adequate sanitation are the basic right of every citizen and are
vital for improving health and alleviating poverty. In adopting the Millennium
Development Goals (MDGs) countries pledged to reduce by half the proportion of
people without access to safe drinking water and basic sanitation by 2015. Although
Nepal has shown some progress in improving access to drinking water, the country
remains plagued by extremely low levels of sanitation. The population with adequate
access to sanitation was only 27% in 2002 (WHO/UNICEF, 2004). Inadequate access
to safe water combined with poor sanitation and personal hygiene practices have
detrimentally impacted upon the health and quality of life of millions of Nepalis,
especially the poorest and most vulnerable.

In the Tenth Plan, His Majesty’s Government of Nepal (HMGN) declared its intention to
provide sanitation facilities to 7.421 million people (5.613 million from rural and 1.808
million from urban areas) by 2007. It is recognised that the “[d]evelopment of this sector
will…produce healthy manpower, additional income generation and less health
expenditure on treatment of diseases” (National Planning Commission, 2002). Despite
the best efforts of many agencies working in Nepal, new approaches to expanding
sanitation provision are still needed if the government is to meet its targets and the
needs of its people.

Community Led Total Sanitation (CLTS) is an innovative approach that empowers local
communities to stop open defecation and to build and use latrines without external
hardware subsidies. Participatory Rural Appraisal (PRA) tools are used to help the
community understand the poor sanitation situation and the associated impacts.
Motivated by a sense of disgust and shame communities themselves commit to
improving the situation by whatever means are available. The role of the NGO is to
facilitate this process. The pioneer and leading advocate of CLTS is Dr Kamal Kar who
initiated the first pilot of CLTS in 2000 in a small community in Bangladesh, while
working as a participatory development consultant for WaterAid Bangladesh in
collaboration with the Village Education Resource Centre (VERC). Kamal Kar has since
facilitated the spread of CLTS to other areas of Bangladesh, India, Cambodia,
Indonesia, China, Mongolia, Nepal and Uganda. The key principles, processes and
experiences in Bangladesh were documented in the seminal IDS Working Paper by Dr
Kar entitled ‘Subsidy or self-respect? Participatory total community sanitation
in Bangladesh’ (Kar, 2003). Subsequent publications, including a draft
update of Working Paper 184, are detailed in the reference list at the end of
this paper.

CLTS in Nepal

In July 2004, following a visit to Nepal by Kamal Kar, a small number of INGOs/NGOs -
namely WaterAid Nepal, Plan Nepal and Nepal Water for Health (Newah) 1 – took the
1
Note that Newah are the local implementing partner for WaterAid’s projects, and two of those
implemented by Plan Nepal.
lead in piloting the scheme in rural Nepal, with varying degrees of success. These
organisations have also used a ‘non-CLTS approach’ in other villages (that is, still using
targeted/graded subsidies). The full list of project sites is at Annex A.

Nepal’s experience has shown the School Sanitation and Hygiene Education (SSHE)
program to be a successful model in improving health and sanitation. Recognising this,
HMGN’s Department of Water Supply and Sewerage (DWSS) in the Ministry of
Physical Planning and Works, together with UNICEF, developed a proposal to link
CLTS with SSHE - through a school-community partnership. They have named the
integrated approach School Led Total Sanitation (SLTS). Consultation and discussion
the draft proposal/SLTS guidelines took place in spring 2005, led by the DWSS National
Sanitation Steering Committee. Comments were sought from other sector organisations
before finalisation of the proposal/guidelines 2. The decision was made to pilot the
scheme in Chitwan. Two district level meetings were held and participating
organisations agreed to implement the scheme in different VDCs in Chitwan. According
to NEWAH, which is implementing SLTS in two VDCs, the initial survey and planning
work is currently being undertaken with selected schools. The approach will be rolled
out to other districts in 2006. A list of the proposed districts is at Annex B.

The following stakeholders are involved in CLTS (and SLTS) in Nepal. A full list of key
contacts, in Nepal and internationally, is attached at Annex C.

Community: local people/direct beneficiaries

Government: Central HMGN ministries; National Sanitation Steering
Committee (NSSC). Local and district level government agencies
including District Development Committees, District Health Office
(DHO) and Drinking Water Supply and Sanitation Office (DWSS)
I/NGOs and NGOs: Plan Nepal, WaterAid, RRN and NEWAH - as well as other
members of the Sanitation Alliance (outlined below)
Multilateral agencies: UNICEF

CLTS in other organisations

NEWAH (and WaterAid)

Newah has successfully completed three pilot projects in Karkidhanda in Dhading
district, Dumre Ekta Chowk in Morang district and Bhorle in Gorhka district. These sites
have now been declared open defecation free. Other projects have since been
undertaken, as detailed in Annex A, and more are planned. Newah has also completed
an internal documentation and research project into their experiences so far in
implementing CLTS. Myself, Cecial Adhikari and Dr Neeraj Joshi met with NEWAH on 7
October to discuss their findings, and share experiences. A hard copy of the draft
research report and copy of their presentation is available.

Buoyed by the positive experiences of WaterAid Bangladesh, WaterAid Nepal have

played a key role in driving forward the CLTS process here - although they do not
implement CLTS projects directly. WaterAid staff completed an internal field trip to
Bangladesh in spring 2005, where they had been able to compare the process and
impacts of the Government’s non-CLTS approach with the CLTS pilots. WaterAid have
also developed a monitoring toolkit.

2
Final version of the SLTS guidelines has been saved in the RRN common drive/ruth/CLTS
Plan Nepal
Plan attended the CLTS orientation session delivered by Kamal Kar in Kathmandu in
July 2004. The participants of the workshop immediately carried out ignition PRA for
CLTS in three villages - Nitanpur, Gamar Gawan and Naya Behara of Chhata Pipra
VDC in Bara district. Since then Plan, together with Newah, have implemented CLTS in
Dumre Ekta Chowk and Dumre Prakriti Chowk in Ulabari VDC, Morang district. Thus
far, Plan has not conducted a formal piece of research and documentation of their
experiences (although the two Morang sites were covered by Newah’s internal research
project).

Despite the initial success of CLTS in Dumre Ekta Chowk, Dumre Prakriti Chowk, and
Gamar Gawan - which have been declared open defecation free – Plan staff have
some reservations about the long term sustainability. A decrease has been noted in the
community engagement with the CLTS process, and the enthusiasm of the user groups
for continuous community level monitoring and evaluation has declined. Some of the
less permanent structures have been damaged/destroyed by heavy rainfall, land
erosion and wear and tear - and low income households do not have the financial
resources to build new structures. This demonstrates the need for continuous follow
up, long after the NGO has withdrawn – to ensure that the activities started under the
project are continued. Plan are thinking about how they might promote the
establishment of appropriate financial mechanisms, in order that the community
themselves can mobilise funds for longer term operation and maintenance. At a my
meeting with Nabin Pradhan on 13 September he also stated Plan’s desire for a
researcher (external?) to undertake a 1-2 month price of research into Plan’s
experiences with CLTS, to document the process of implementation and develop
recommendations for ensuring long term sustainability – including possible financial
mechanisms.

Unfortunately Nabin Pradhan and Sudeep Gautam, who were leading on CLTS work for
Plan Nepal, have now left the organisation. It is not yet clear how Plan Nepal will be
taking the work forward.

Sanitation Alliance
In 2004, a loose alliance was formed of 8 organisations working on water and sanitation
in Nepal, coordinated by Water Aid and Plan. A few meetings were held, however
enthusiasm has since waned and they have not convened a meeting since 10
September 2004. Newah have expressed a desire for the alliance to be reactivated and
RRN has expressed its wish to participate. The alliance currently comprises the
following: WaterAid Nepal, Plan Nepal, Newah, LUMANTI, the Nepal Red Cross,
Environment and Public Health Organisation (ENPHO), Helvatas and the Gorkha
Welfare Scheme.

DFID Nepal
DFID Nepal supports the implementation of CLTS through their funding of WaterAid,
and has visited one of Newah’s project sites.

Kamal Kar
Kamal Kar is a social and participatory development consultant based in Kolkata, India.
Kamal Kar initiated the first pilot of CLTS in 2000 in a small community in Bangladesh,
while working as a consultant for WaterAid Bangladesh in collaboration with the Village
Education Resource Centre (VERC). Here, Kamal Kar worked closely with Timothy
Clayton, who then worked for WaterAid Bangladesh, and is now Country
Representative for Oxfam GB Nepal. Kamal Kar has since facilitated the spread of
CLTS to other areas of Bangladesh, India, Cambodia, Indonesia, China, Mongolia,
Nepal and Uganda. Kamal Kar gave a presentation on CLTS at the March 2005 DFID
Asia Regional Advisors Retreat in Delhi.

Institute of Development Studies (IDS) Sussex

Kamal Kar has collaborated with members of the Participation Group, at the Institute of
Development Studies (IDS) in Sussex and in April 2002 received funding from IDS to
document his experiences with CLTS in Bangladesh. Kamal Kar presented his findings
at an IDS seminar in May 2002, and subsequently produced the Working Paper 184
with input from the notable academic and expert on participatory development,
Professor Robert Chambers, among others. Robert Chambers undertook a field visit to
India and Bangladesh in January 2005 in order to undertake some informal research on
the processes and impact of CLTS. A note of this visit is saved in the common drive.
IDS is currently engaged in discussions with DFID in London regarding funding for
further research on CLTS in South Asia, a proposal was submitted and they are
awaiting a response. Lyla Mehta is leading on this proposal for IDS.

RRN and CLTS

Since joining RRN in September 2004, I have undertaken the following activities
specifically related to CLTS:

 Presentation at RRN’s AGM in October 2004 (saved in common drive).

 Established and forged working relationships with staff at WaterAid, Plan Nepal and
Newah, as well as maintaining email contact with Kamal Kar, Robert Chambers
and Kath Pasteur (IDS Sussex)
 Organised and attended meetings with these organisations. A note of one of these
meetings (9 June) is saved in the common drive.
 Drafted research proposal on ‘CLTS in Nepal’ (saved in common drive)
 Encouraged RRN to pilot CLTS in two sites covered by RRN’s CWASH project (see
CWASH documentation for more information on the activities undertaken)
 Inputted comments (via WaterAid) on the draft SLTS proposal/guidelines (received no
feedback and no further correspondence has taken place on this)

Future research into CLTS in Nepal

According to Dr Kamal Kar, follow-up research and documentation are an integral part
of the approach. In his view, “[m]onitoring and continuing learning about the CLTS
approach will help to ensure that scaling up and transfer to other countries and
contexts has more likelihood of success. Participatory research should be encouraged
in order to provide feedback to policy and practice”. He goes on to say that “[i]t is
important to know more about where CLTS works best and where it is unlikely to work
well. Lessons from different socio-cultural, physical and political contexts need to be
explored, compared and documented” (Kar and Pasteur, 2004). Although follow-up
assessments of CLTS projects have been undertaken in Bangladesh and India so far
no comprehensive research has been conducted into the implementation process and
outcomes of the CLTS projects in Nepal.
WaterAid, Newah and Plan have all acknowledged the need for a detailed analysis into
the implementation and effectiveness of the approach in order to inform the
development of future project activities, and broader understanding of CLTS. In light of
this, and my own personal interest in CLTS (coupled with the need to obtain a research
visa), I developed a research proposal/concept note in April 2005. The goal of the
proposed research was to assess and systematically document the implementation of
CLTS in Nepal, as undertaken by WaterAid, Newah, Plan and RRN. The specific
objectives, activities, budget and timeline are detailed in the concept note saved in the
common drive.

The concept note was finalised with the agreement of WaterAid, Newah and Plan Nepal
in May/June 2005. The intention was to undertake this research between June and
November 2005, however disappointingly the pressure of other work commitments at
RRN meant that it could not be undertaken. In addition, NEWAH were also conducting
their internal research into CLTS at that time and saw less value in a collaborative study
until this had been completed.

Despite the inability to complete the collaborative research as intended, WaterAid,

Newah and Plan have expressed interest in this piece of research being conducted in
future. Professor Robert Chambers and Kamal Kar have also expressed considerable
enthusiasm for this research to be undertaken, and are keen to be kept involved if, and
when, the research takes place. IDS could be approached as a possible funding
source if necessary. Timothy Clayton, who now works as the Country Representative
for Oxfam Nepal, but was engaged in CLTS with WaterAid Bangladesh, should also be
contacted for his valuable insights and advice.

Recommendations for future action by RRN

1. Maintain frequent contact with the other organisations/people included in the

contacts list, including by arranging meetings to keep updated and share
experiences on CLTS implementation.
2. If necessary, follow up my email to WaterAid of 10 November 2005 regarding the
Sanitation Network, reiterate RRN’s desire to participate and request information
about when it might reconvene.
3. Actively participate in the Sanitation Network if this reconvenes in order to share
learning on CLTS, but also other water and sanitation issues. Water and sanitation
feature heavily in RRN’s projects across Nepal and this Network would provide a
good opportunity to inform other organisations of our activities and share
experiences.
4. Find out more information about the implementation of SLTS, through
DWSS/UNICEF, and explore the possibility of RRN’s involvement. [I emailed
Namaste Lal Shrestha at UNICEF on 10 November, but have not yet received a
response]. SLTS combines health, sanitation, education and community
empowerment, all of which are key tents of RRN’s work. In addition we have an
office in Chitwan which makes us well placed to undertake activities in this district.
5. Ensure the continuous follow up of CLTS project work undertaken by RRN (initially
that undertaken as part of the CWASH project), of both the project activities on the
ground and also through systematic documentation of processes and impacts,
including development of learning publications and articles as necessary. RRN’s
new Monitoring and Evaluation Unit has a key role to play in this process.
6. Encourage the mainstreaming of CLTS in other RRN projects, based on learning
from the CWASH project and the experiences of other I/NGOs.
7. Undertake exposure visits to the CLTS project sites of other organisations for
sharing and learning and, if appropriate, invite beneficiaries, government officials,
media and I/NGOs – and RRN staff - to visit RRN CLTS sites.
8. Share RRN’s findings and experiences of CLTS with other organisations, including
donors
9. Engage media, such as newspaper and radio journalists, in order disseminate
information about RRNs activities on CLTS
10. Collaborate with other agencies on the larger piece of research on ‘CLTS in
Nepal’, as detailed above. If necessary RRN may need to initiate this piece of
research.
11. Maintain email contact with Robert Chambers and Kamal Kar to find out more
about CLTS in other countries and update them on activities in Nepal.
List of key references on CLTS

Central Bureau of Statistics (CBS) [Nepal]. 2001b. Statistical year book of Nepal 2001.
Kathmandu, Nepal: Central Bureau of Statistics.

Kar, K (2004) ’Practical Guide to Triggering Community led Total Sanitation’. Draft.
Institute of Development Studies, Sussex, unpublished

Kar, K (2003) ‘Subsidy or Self Respect? Participatory Total Community Sanitation in

Bangladesh’. IDS Working Paper 194, Institute of Development Studies, Sussex

Kar, K and Pasteur, K (2004) ‘Subsidy or Self-Respect? Participatory Total Community

Sanitation: An Update on Recent Developments’. Draft. Institute of Development
Studies, Sussex, unpublished

National Planning Commission (2002) ‘Tenth Plan’ His Majesty’s Government of Nepal.

Noor, T. R. and Ashrafee, S. (2004) ‘An end to Open Defecation: Process, Cost,
Motivation and Sustainability’. A paper presented at the 30th WEDC International
Conference, Vientiane, Lao PDR, 2004

VERC (2004) ‘Process documentation of CLTS’. Final draft

WHO/UNICEF Joint Monitoring Programme on Water Supply and Sanitation (JMP)

(2004) ‘Meeting the Drinking Water Target: a mid-term assessment of progress’. At
http://www.unicef.org/wes/mdgreport/

World Sanitation Programme – South Asia (WSP-SA) (2001-2) ‘Igniting Change for
100% sanitation’. Jalvaani. Vol 4, No 3 (Nov 20012-Feb 2002)
List of Acronyms

CBS Central Bureau of Statistics

CIR Centre for International Relations
CLTS Community Led Total Sanitation
HMGN His Majesty’s Government of Nepal
INGO International Non Governmental Organisation
IDS Institute of Development Studies
NEWAH Nepal Water for Health (Nepalese NGO)
NGO Non Governmental Organisation
MDG Millennium Development Goal
PRA Participatory Rural Appraisal
VERC Village Education Resource Centre
 ANNEX A - LIST OF CLTS PROJECTS AND SUBSIDY PROVIDED PROJECTS

CLTS approach

Central Region:

Name of village No. of District VDC Status Implementing

households NGOs
Karkidanda 65 Dhading Bhumisthan declared Wateraid/Newah
Deurali 38 Dhading Bhumisthan declared Wateraid/Newah
Shulikhola Bahuntole 63 Dhading Bhumisthan declared Wateraid/Newah
Gamargawan village 120 Bara Chhtapipra declared Plan Nepal
Devisthan 133 Dhading Devisthan ongoing Wateraid/Newah
Shulikhola 65 Dhading Bhumisthan ongoing Wateraid/Newah
Tamangtole
Simle 51 Dhading Bhumisthan ongoing WaterAid/Newah
Naya Behara 140 Bara Chhtapipra ongoing Plan
Nitanpur 127 Bara Chhtapipra ongoing Plan

Eastern Region

Name of village No. of District VDC Status Implementing

households NGOs
Dumre Ekta Chowk 70 Morang Urlabari -7 declared Plan/Newah
Dumre Prakriti 35 Morang Urlabari –7 declared Plan/Newah
Chowk

Western Region

Name of village No. of District VDC Status Implementing

households NGOs
Borle 23 Dhuwakot Gorkha declared WaterAid/Newah

Sim Kholi 39 Salyan Sejawaltakura ongoing RRN

Gogan Kholi 62 Salyan Dangagaon ongoing RRN

Non- CLTS approach (subsidy)

Central Region

Name of projects No. of District VDC Status Implementing

Households NGOs
Bhadaure 215 (99 latrine) Dhading Bhadaure complete Newah
Tamegahate 57 (57 latrine) Dhading Tasarpu complete Newah
Belbhanjayang 85 (66 latrine) Dhading Gajuri complete Newah

Eastern Region

Name of projects No. of District VDC Status Implementing

Households NGOs
Itaharwa 219 Siraha Itaharwa complete Newah
Beli 108 Siraha Sisawani ongoing Newah
 ANNEX B: DISTRICTS IN WHICH SLTS WILL BE PILOTED IN 2006

Eastern Region
1. Panchthar
2. Udayapur
3. Sunsari
4. Saptari

Central Region
1. Chitwan
2. Parsa
3. Kavre

Western Region
1. Kaski
2. Tanahun
3. Nawalparasi
4. Kapilvastu

Mid and Far Western Regions

1. Dang
2. Dadeldhura
3. Achham
4. Humla
 ANNEX C: LIST OF CONTACTS

Organisation Name Email address Telephone

number
NEWAH Laxmi laxmipaudyal@newah.org.np 4377107
Ratan ratan@newah.org.np 4377108
Anamika Singh asingh@newah.org.np
WaterAid Dinesh Bajracharya DineshBajracharya@wateraidnepal.org.np 552764
Urmila Simkhada urmilasimkhada@wateraidnepal.org.np 5552765
Barun Kanta Adhikari barunkantaadhikari@wateraidnepal.org.np
James Wicken jameswicken@wateraidnepal.org.np
Rabin Lal Shrestha (SLTS) rabinlalshrestha@wateraidnepal.org.np
DFID Nepal Chandra Shrestha c-shrestha@dfid.gov.uk
Plan Nepal Nabin Pradhan nabin.pradhan@plan-international.org3 5535580
IDS Sussex Professor Robert Chambers R.Chambers@ids.ac.uk
Kath Pasteur K.Pasteur@ids.ac.uk
Lyla Mehta L.Mehta@ids.ac.uk
Consultant Dr Kamal Kar kamalkar@yahoo.com
kamal.kar@vsnl.com
UNICEF Namaste Lal Shrestha nshrestha@unicef.org
VERC Yakub Hossain verc@bangla.net
Oxfam (Nepal) Timothy (Timo) Clayton Timo@oxfam.org.uk 553-6075
552-7685

3
Note: Nabin has now left Plan Nepal, and his successor has not yet been appointed.