Sanitation for all

Today, 2.3 billion people still live without access to safe sanitation services 

The safety, privacy, comfort and dignity of an accessible toilet should be an everyday reality for all. Through our sanitation projects - as part of an integrated approach to water, sanitation and hygiene called WASH - Tearfund seeks to achieve this. 

Getting the community actively involved and ’owning’ the project increases the level of sanitation coverage, so wherever possible this is how we work.

This short video from WaterAid features the process of getting the community actively involved in a sanitation project – at Tearfund, we take a similar approach.

Demand-led approaches

The demand for WASH services can come from individuals, households or communities themselves, taking the lead in designing and running sanitation services. Through our demand-led approaches we provide support and encouragement along the way, as well as advocacy to ensure that an enabling environment is created and sustained. This might include influencing national policies, regulating private sector involvement, supporting local supply and providing technical assistance. 

However, levels of demand can vary for each component of WASH (i.e. for water, sanitation and hygiene) and at different stages in the transition from relief to development. Usually the demand for safe and accessible water already exists, but the demand for sanitation and hygiene facilities may need to be stimulated. 

Getting the local community actively involved is a key part of demand-led approaches. This can create a ‘light-bulb’ moment, where the need for change is realised.

Getting the local community actively involved is a key part of demand-led approaches. Using methods that encourage participation, individuals and their communities work together to analyse their own situation. This can create a ‘light-bulb’ moment, where the need for change is realised. Evidence suggests that when there is a high level of ownership and involvement, supported by capacity building, long term change is more likely. 

Demand-led approaches also help to broaden out the choice of technologies that are available to communities. Using their local knowledge and skills, they can identify the best low cost and sustainable options. 

Tearfund employs a combination of demand-led and supply-driven approaches to WASH at different stages of response, when evidence and context suggest they are the most appropriate. Although demand-led approaches are preferred, emergency response often requires the construction of communal latrines and the distribution of temporary water supply to collection points to meet the needs and rights of communities affected by disaster. 

Encouraging a higher level of latrine usage among communities

Tearfund uses several approaches that try to encourage a higher level of latrine use in communities. Details of these can be found below.

PHAST (Participatory Hygiene and Sanitation Transformation)

PHAST is a facilitated approach that typically involves seven steps to enable communities to analyse their WASH situation and develop their own plans for action. Facilitators and community health workers explore and engage with the different practices within the community and expand upon their understandings in ways that inform, question or challenge.

Community Health Clubs

A Community Health Club is a community-based group facilitated by community workers to raise awareness of hygiene issues and support participants to apply their understanding of good hygiene practices in their decision making at home and within the community.

Community Led Total Sanitation (CLTS) and other Rapid Rural Appraisal techniques

This is an innovative methodology that gets communities working together to eliminate open defecation. Facilitation provides communities with the opportunity to conduct their own investigation and analysis of open defecation and discuss the impacts. Communities are then encouraged to find their own solutions and to organise themselves to become Open Defecation Free (ODF).

Both the reflective learning process described above and understanding what triggers can change people's behaviour, are essential to initiating a process of sustained behaviour change.

Experience has shown that this process of mobilisation can be empowering, as it opens a space for marginalised groups to gain a voice within their communities, and to articulate and analyse issues relating to WASH and beyond.

Guidance on CLTS 

Adoption of CLTS: Guidance for programming in Tearfund supported projects 

CLTS in Post-Emergency and Fragile States Settings - available in English (PDF 5.4 MB), French (PDF 5.2 MB) and Portuguese (PDF 5.4 MB).

For general information and resources on CLTS, visit

Other key sanitation learning documents used in Tearfund:

Keeping Communities Clean (PDF 477 KB) – the role of the church and faith-based groups generally, in helping communities achieve safe sanitation and hygiene practices

The role of the church in improving access to sanitation (PDF 241 KB) - contains a shorter version of the 5 church-based roles

The Church’s role in sanitation and hygiene: Guidelines and tools (PDF 935 KB) - an internal follow-up report on how various churches and church-based organisations journey through the 5 roles

Sanitation marketing. 

Sanitation marketing uses social and commercial marketing to scale up the demand and supply for improved sanitation and water supply, particularly amongst those living in poverty. 

It assumes that many people, including those living in poverty, are willing to pay for water and sanitation facilities that will meet their needs, if the technology is packaged and marketed appropriately, and the supply mechanism is easily accessible. 

The approach links very well with demand-led, livelihood approaches, such as Community Led Total Sanitation (CLTS) and Behaviour Change Communication which prompt communities to consider their open defecation habits and encourage particular sanitation practices before using social marketing to help households move up the Sanitation Ladder. The sanitation ladder is a tool being used to support and monitor steps towards improved sanitation practices. 

Read more about Sanitation Marketing (PDF 1.1 MB) 

Footsteps issues on Sanitation

Footsteps is an online and print magazine for grassroots health and development workers.
Footsteps edition 9 - Sanitation
Footsteps edition 73 - Sanitation