Celebrations in North Bank Region

Community led Total Sanitation is a concept introduced for communities to control their own sanitation and hygiene with no cost or subsidy from the government and other NGOs. This was facilitated and motivated extension workers on the approach by guiding the communities on the benefits of sanitation and hygiene and the ramifications of open defecation to the environment. The concept was introduced and piloted in The Gambia in 20 communities in URR in 2009. An initial assessment of the pilot in URR necessitated the scaling up of the approach to all other health regions. Since the adoption of CLTS in The Gambia, the country has witnessed a decline in open defecation rates nationally. The MICs survey in 2012 shows an open defecation rate of 2.8% as opposed to 4.4% in 2005. We need to focus on sanitation improvements through CLTS, because they have been found to significantly reduce diarrhea morbidity by 36%. As diarrhea is one of the top killers of children under 5 in the Gambia, improvements in sanitation can significantly reduce child mortality. There is also evidence that improved sanitation and hygiene impacts on many other areas of child survival and development such as improving nutritional status, school attendance, and overall quality of life.

In the Upper River Region May 2012, 75 communities were assessed and those practicing open defection were triggered in May 2012. At the later part of December 2012, a follow up was conducted in the triggered communities and it was found out that 44 communities representing 59% have now attained ODF status.

In the Central River Region, the CLTS concept was introduced in this region in 2010 and was piloted in 5 communities. This was scaled up to 20 communities in 2011. Significant progress was made in terms of coverage, as 100 communities were triggered in that year alone. In all a total of 125 communities were triggered and only 12 attained ODF status. More effort is needed to get more communities triggered for the attainment of ODF. It is worth to mention that open defecation rates have been found to be high in some LGAs such as Kuntaur (13.6%), Janjangbureh (9%) in The Central River Region. There is therefore the need to focus on these LGAs.

In the North Bank Region East, The CLTS approach was introduced in 2010 and piloted in 6 communities. This was later increased to 20 communities in 2012 and 44 communities were triggered in that year alone. A total of 70 communities were triggered and 20 (28.5%) were able to attain ODF status.

A total of 70 communities were assessed and triggered from 2010 to 2012 based on their OD status. A Significant progress was made in 2012 in terms of coverage, as 44 communities were triggered in that year alone. A total of 20 communities attain open defecation free status (28.5%) of the total number of villages triggered.

CHALLENGES / CONSTRAINTS

•The timing of the triggering was not appropriate as it coincided with farming activities as most community members were out on the farms.

•The past consecutive three years CLTS triggering is always done in May when farmers are busy clearing their farms.

•The celebration and presentation of certificates to OD free villages was done in Soma which should have been in their various villagers as stated by Kamal.This is to trigger other villagers to emulate.

•There is no logistic support provided during triggering such as flip charts and markers.

•No proper linkage between central and regional level.

•There is no continuous monitoring of CLTS in these villages.

A cross section of community representatives awaiting certification of their communities in Central River Region

The Governor Central River Region presenting an ODF certification to a village head.