TITLE:
Impact of Community-Led Total Sanitation (CLTS) on Hygiene and Sanitation Practices in Rural Ivorian Communities: Evidence from the Sub-Prefectures of Blapleu, Yorodoukou, Santa, and Sipilou (Western Côte d’Ivoire)
AUTHORS:
Balla Moussa Konate, Pétémanagnan Jean-Marie Ouattara, Franck Michaël Zahui, Amichalé Jean Cyrille Beda
KEYWORDS:
Côte d’Ivoire, Departments of Biankouma and Sipilou, Local Governance, Open Defecation Free, Sub-Prefectural Approach
JOURNAL NAME:
Health,
Vol.18 No.7,
June
30,
2026
ABSTRACT: Open defecation is a significant sanitation issue in sub-Saharan Africa, with Community-Led Total Sanitation (CLTS) showing efficacy yet facing challenges in maintaining Open Defecation Free (ODF) status post-certification. To tackle this, a sub-prefectural strategy was implemented in the Biankouma and Sipilou departments of western Côte d’Ivoire, engaging rural communities and local authorities. This study evaluated the impact of this approach on sanitation practices and reducing open defecation rates through a quasi-experimental before-and-after design. Data were collected from 81 localities via household surveys, field observations, and stakeholder interviews. The results indicated notable improvements in sanitation conditions: latrine coverage rose dramatically from 19% to 78%, and open defecation rates decreased significantly across various locales by 56, 65, 45, and 34 percentage points in Blapleu, Santa (Biankouma), Sipilou, and Yorodougou (Sipilou), respectively. ODF certification was achieved in all localities in Blapleu, 78% in Santa, 74% in Yorodougou, and 47% in Sipilou. Additionally, the initiative led to better wastewater management practices and the development of local monitoring, governance, and community solidarity mechanisms, which were crucial for sustaining sanitation improvements. The findings emphasize that the long-term effectiveness of CLTS relies on not only enhancing access to sanitation facilities but also bolstering local governance and fostering community engagement. Thus, the sub-prefectural method presents a viable strategy for increasing ODF achievements and maintaining rural sanitation advancements in sub-Saharan Africa.