Role of Implementation Factors for the Success of Community-Led Total Sanitation on Latrine Coverage. A Case Study from Rural Ghana

[Image: see text] Community-led total sanitation (CLTS) is an approach to improving sanitation to combat open defecation (OD). OD is a health threat to children under five. CLTS promotes the construction of latrines with the goal of declaring communities open defecation free. However, which factors of the implementation process are most important for the success has yet to be ascertained. The analysed sample comprised of 94 communities in rural Ghana, where CLTS was implemented and factors describing the implementation process of CLTS were assessed. Additionally, monitoring data from the implementation process were used. Multiple regression analysis revealed that latrine coverage was significantly related to attendance at the CLTS meeting, the number of supportive community leaders, the expectation of participants of receiving an incentive, and the number of follow-up visits. Implementers of CLTS should direct their attention to the processes following the community meeting. The success of CLTS can be improved by investing in follow-up visits, the support of local leaders, and the careful application of incentives.