Scaling up community sanitation programmes in Bangladesh

Increasing the intensity and spread, or ‘scaling up’, of a particular practice is not straightforward. Governments and donors often emphasise the expansion of programmes and institutions. The Community-led Total Sanitation (CLTS) programme, pioneered in Bangladesh, indicates that processes of spread and adaptation within communities may be more relevant. 

Apaper from the Institute of Development Studies, in the UK, examines differentcommunity development programmes to illustrate how scaling up takes place,focusing on the innovative CLTS initiative. The author hopes to provideinsights on the principles and strategies for scaling up participatory andpeople-centred approaches to development.

Sinceit was piloted in Bangladesh in 1999, CLTS has been considered a ‘spreadingrevolution’. Currently, over 2 million Bangladeshis – and many more across the developing world – are covered by CLTS. Facilitatorsmotivate communities to build their own sanitation infrastructure. The mainobjective is to make community members aware of the link between defecating inthe open and the negative impacts on their health.

Tounderstand how CLTS has spread, the author comparesit with other community development programmes. Scaling upcan happen in many ways. All the case studies demonstrate elements of‘self-spread’, often promoted by individuals or institutions, but each isunique. CLTS, too, has spread and adapted in different ways in different contexts.Factors promoting its spread include:

• organisations committed to CLTS andindividuals able to resist institutional pressures
• international support for the principal innovator, including visits betweencountries
• transfers of individual key CLTS individuals (champions) betweenorganisations
• international meetings and hands-on training workshops
• dissemination through publications, websites and networking.

Manychallenges exist. People have different views of how sanitation programmesshould be run, and the use of the incentives (if any) to participate.Bureaucracies operate in a top-down manner and face various operational andbudgetary pressures. Programmes may not be popular, or popularity may affectquality.

CAREBangladesh’s CLTS programme was designed for scalingup. It relied on spreading the programme across villages through ‘naturalleaders’ who were the most engaged. But spreading CLTS politically posed moreproblems. Key lessons include:

• Scaling up of CLTS can also be done byincorporating other community development activities, as in CARE Bangladesh’sadaptation.
• If rapid scaling up is done by large organisations (such as the WorldBank), CLTS risks being compromised and weakened.
• Similarly, spreading CLTS vertically is politically difficult becausethe programme has to interact with the state and other institutions, and risksbeing diluted.
• Champions play a central role in spreading CLTS; in India and Indonesia,state and district bodies took on this role to spread CLTS widely.
• Processes of self-spread have their own momentum; if they remain open,accessible and adaptable, spread is sustained and eventually scale is achieved.