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How does Community-Led Total Sanitation (CLTS) promote latrine construction, and can it be improved? A cluster-randomized controlled trial in Ghana

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  • Harter, Miriam
  • Inauen, Jennifer
  • Mosler, Hans-Joachim

Abstract

Open defecation is connected to poor health and child mortality, but billions of people still do not have access to safe sanitation facilities. Community-Led Total Sanitation (CLTS) promotes latrine construction to eradicate open defecation. However, the mechanisms by which CLTS works and how they can be improved remain unknown. The present study is the first to investigate the psychosocial determinants of CLTS in a longitudinal design. Furthermore, we tested whether CLTS can be made more effective by theory- and evidence-based interventions using the risks, attitudes, norms, abilities, and selfregulation (RANAS) model.

Suggested Citation

  • Harter, Miriam & Inauen, Jennifer & Mosler, Hans-Joachim, 2020. "How does Community-Led Total Sanitation (CLTS) promote latrine construction, and can it be improved? A cluster-randomized controlled trial in Ghana," Social Science & Medicine, Elsevier, vol. 245(C).
    • Handle: RePEc:eee:socmed:v:245:y:2020:i:c:s0277953619307002
    DOI: 10.1016/j.socscimed.2019.112705
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    References listed on IDEAS

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    1. Ajzen, Icek, 1991. "The theory of planned behavior," Organizational Behavior and Human Decision Processes, Elsevier, vol. 50(2), pages 179-211, December.
    2. Contzen, Nadja & Meili, Iara Helena & Mosler, Hans-Joachim, 2015. "Changing handwashing behaviour in southern Ethiopia: A longitudinal study on infrastructural and commitment interventions," Social Science & Medicine, Elsevier, vol. 124(C), pages 103-114.
    3. Amy J. Pickering & Habiba Djebbari & Carolina Lopez & Massa Coulibaly & Maria Laura Alzua, 2015. "Effect of a community-led sanitation intervention on child diarrhoea and child growth in rural Mali: a cluster-randomised controlled trial," Post-Print hal-01456117, HAL.
    4. Friedrich, Max N.D. & Kappler, Andreas & Mosler, Hans-Joachim, 2018. "Enhancing handwashing frequency and technique of primary caregivers in Harare, Zimbabwe: A cluster-randomized controlled trial using behavioral and microbial outcomes," Social Science & Medicine, Elsevier, vol. 196(C), pages 66-76.
    5. Tumwebaze, Innocent K. & Mosler, Hans-Joachim, 2015. "Effectiveness of group discussions and commitment in improving cleaning behaviour of shared sanitation users in Kampala, Uganda slums," Social Science & Medicine, Elsevier, vol. 147(C), pages 72-79.
    6. Sophia Rabe-Hesketh & Anders Skrondal & Andrew Pickles, 2004. "Generalized multilevel structural equation modeling," Psychometrika, Springer;The Psychometric Society, vol. 69(2), pages 167-190, June.
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    Cited by:

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