I. Practicum Project Problem Statement

  1. Introduction

    Cheha Community is located in Cheha district, in Southern Nationals and Nationalities regional state in Ethiopia. It has a total population of 133,233 (51%Female and 49%Male)( Cheha District Administration Office, 2014). The dominant culture is Gurage ethnic culture and the cultural system is so powerful and influencing the characteristics and behavior of the community in their day –to-day life. The cultural symbol is reflected in the communities traditional food preparation, clothing, music, communication and also punishing the undesirable behaviors. The Cheha community is also endowed with various types of natural resources like air, favorable climate for agricultural production, excellent soil which grows different types of food and cash crops. It has a mixed weather, meteorological, conditions in which the mid-land weather condition is more prevalent while in some of the few villages high-land and low-land weather conditions are a normal characteristics of the community.

With different agro ecology, Cheha dsirict has a total area of 44,072 hectares of land and out of which 66% is suitable for cultivation. Agriculture is the dominant means of livelihood and it is practiced by almost 85% the members of the communities (Cheha District Administration Office, 2014). The settlement patterns of the communities’ predominantly rural village structures divided by administrative structures like district …Kebele…villages (the lowest administrative structure).

  The landing feature in Cheha Community is plains with small proportion of deserts and mountains. There is little number of rivers in Cheha district and the volume of water in the river is also seasonally variable with increasing the volume in rainy season. Deep well, shallow well and ponds are constructed by government and NGOs to address the pressing problem of water scarcity particularly in the dry seasons. Data from Cheha district Water and Mining and Energy Office indicated that the water coverage is standing at 55% in 2014.

The situation of infrastructures like roads, electricity, telecommunication, schools, health institutions and others are still in their infancy and their coverage is too poor and negatively affecting the socioeconomic progress of the community. Hygiene and sanitation is among the major problem in Cheha community due to poor latrine coverage and utilization and this where my practicum work focus. In the following picture, Cheha Community is represented by Rose color..


                 Picture 1:  Map of Cheha District in Gurage Zone, SNNPR Regional State         

  1. Practicum Central Problem

Poor hygiene and sanitation causing the major health problems in Cheha district community and posing a serious threat to the community by hindering the community effort to break the deeply rooted-chain poverty. From the community Health center in 2014 revealed that hygiene and sanitation related diseases are the main prevailing communicable diseases dominating the ten top lists in Cheha community. In order to address the problem of poor hygiene and sanitation, various approaches and strategies were tried by both government and None-governmental organizations supported by various popular international donors. But neither of the approaches tried previously succeeded in bringing the desired behavior change by the community in order to control open defecation and consistently utilize latrines.

While many of the approaches and strategies tried previously failed to achieve the desired behavior change by the community, but Community Led Total Sanitation (CLTS) is achieving promising results in increasing the construction and utilization of latrines and bringing sustainable behavior changes in the targeted communities. CLTS is purely a bottom-up approach and led-by the community as well all the resources are generated by the community according to the principles of the CLTS approach which strongly criticizes the provision of subsidy for the construction of latrines. While many of the CLTS tools are still dynamic in activating community empowerment and generating resources and momentum for the construction and utilization of household latrines, but ensuring sustainable behavior change by the targeted communities continues to be a challenge and which is not properly addressed yet.

Therefore, for the CLTS to achieve its final objective of creating open defecation free environment and ensuring sustainable behavior change by the targeted community , strengthening three-way partnership between the community, local government and external agent is not strong enough to bring lasting behavior change . What is require is placing the three-way partnership at the center of the communities’ dominant cultural norms, rules and regulations which guide the day-to-day life and interaction of the communities by rewarding and recognizing acceptable norms and behaviors as well as punishing some odd behaviors which is not acceptable by the culture and norms of the communities.

“When three-way partnership is strengthened and guided by the communities’ valuable and culturally accepted norms and regulations, a more synergistic and culturally sensitive tool can be created which facilitate to adopt and sustain behavior change which ensures the sustainability of open defecation free environment achieved by CLTS.” This is the central issues of my practicum and I am currently working and implementing CLTS projects in 14 villages and I had learned that in some villages the pace of CLTS implementation is moving at higher speed due to the proper integration and utilization of three-way partnership strengthened by existing traditional norms and regulations. However, in other villages the pace of CLTS implementation is not moving forward as planned and expected mainly due to lack of balance between the existing traditional norms and regulations and the three-way partnership which inclines and reflects the relevance of modern government rules and regulations to achieve behavior change by the targeted communities. But experiences elsewhere in developing countries, particularly in traditional society indicated that cultural norms and regulations are more powerful tool to facilitate the adoption and sustainable maintenance of new behaviors. This is exactly what is happening in Communities I am currently coordinating the implementation of CLTS in 14 villages.

  1. Underlying Theory of Change

       3.1 Problems or Opportunities

Open defecation is key problem in Cheha district community and creating conducive environment for the transmission of communicable diseases including diarrhea which is the main reason for the higher incidence and prevalence of under-five morbidity and mortality. Since 2000, CLTS is the approach used by the government and None-governmental organization to increase the construction and utilization of latrines. While the CLTS approach is against the previously subsidy oriented top-down approach and rely on locally existing resources and capacities and use participatory tools to activate community empowerment and create momentum for mobilizing locally existing resources and energies to construct and utilize toilets leading to open defecation free environment. However, sustainable behavior change is still a challenge in many communities which require searching more context specific and culturally suitable solution which enable to address behavior change on a sustainable basis.

There are various opportunities which can be used to search context specific and culturally suitable solutions to address behavior change on a sustainable basis. The existing government health policies, particularly related to hygiene and sanitation is supporting bottom-up, participatory approaches and strengthening partnership with government structures and other external agents working in the area. Secondly, in Cheha community, traditional norms, rules and regulations are deeply rooted in the lives of the communities and still playing a key role in searching solutions to many problems that happens in the day-to-day life of the community. For example, in times of conflicts and accidents, medical illness which need much cost that is beyond the capacities of the individual, theft, un acceptable odd behavior, wedding, death, supporting the elders, disabled, etc., in all cases the community uses its traditional norms and rules to search participatory solutions. Similarly, the communities have and use cultural norms and rules which punish odd and un acceptable behaviors as well as to recognize and acknowledge model behaviors and works. If these existing communities valuable assets is strengthened by three-way partnership, it becomes possible to create conducive environment which enable to ensure sustainable behavior change.

Therefore, if CLTS approach is adapted and implemented to fit in to these existing community norms, rules and regulations and also further mentored by three-way partnership, it becomes possible to monitor and control odd behaviors (in this case open defecation)and ensure sustainable utilization of toilets by every member of the community.


     3.2 Approach

 - My first entry point would be communicating to Cheha district Health and explaining the purpose of my practicum project, the targeted communities, what problem my practicum intended to address, how the communities would be participated and the types of partnership proposed with the Health office and other relevant line structure offices to achieve the objectives of the project . The key intention here is to build consensus and get official permission to work with the targeted communities.

    -Go to the targeted communities and have discussion with influential community leaders, Extension workers and Kebele(the lowest government administration) leaders . The focus of the discussion would be the status of hygiene and sanitation in their village and the possible solutions to address the problems using local resources and energies…

   -Agreeing with community leaders and partners on the purpose of the project, the process to be followed to address the problem, how the community to be participated as well as how the community will benefit from the results of the practicum project

    -With the active participation of the community leaders and partners, selecting community volunteers who will be trained on CLTS approaches and tools. The selected volunteers will be assigned to lead community mobilization and leading the process of pre-and post-triggering at the targeted villages.

   - Establishing community CLTS implementing/steering committees which would be responsible to ensure the quality and standards of implementation as well as manage conflicts when it happens.

   -The CLTS Committee establishment will be purposely guided to include influential people both, M and W members. Then capacity building trainings will be facilitated for the CLTS committees which enable them to ensure the quality and standards of CLTS implementation

  • Selecting and training community volunteers to lead the implementation of CLTS
  • Joint Monitoring and supervision of implantation process to identify gaps and address it timely
  • Joint review meeting to evaluate the progress of implantation and identify and address gaps
  • Coordinating and integrating the community effort in to the broader local government and None-governmental structures to ensure sustainability
  1. Short term outcomes
  • Raising community awareness about the negative impact of open defecation in their community;
  • Strengthening community committees and building their capacities which enable them to lead implementation of community led total sanitation in their villages;
  • Selecting and training community volunteers with the active participation of the community;
  • Creating a conducive working environment by strengthening three-way partnership and integrating it with the existing communities’ culturally sensitive norms, rules and regulations in order to create synergies which enable to adopt and sustain behavior change to maintain open defecation free environment on a sustainable basis.
  • Achieving 100% coverage of improved latrine construction and utilization by the targeted communities;
  • Announcing open defecation free environment (ODF) by the targeted villages
  1. Long term outcomes
  • Creating conducive living and working environment which is free from fecal contamination and build the confidence and dignity of the communities particularly women who were suffering more due to lack of improved latrines;
  • Achieving behavior change by the targeted communities which enable to maintain open defecation free environment on a sustainable basis.

 Strategic Components

  1. Where I am now

Conducting participatory community analysis by using CLTS tools (transect walk, community mapping, shit calculation, Glass of water exercise) to be done in order to understand the current status of the targeted communities related to open defecation and latrine utilization;

  1. Where I hope to be at the end of the practicum

I am hoping to see the targeted community living in an open defecation free environment by achieve 100% latrine construction and utilization at the end of my practicum project.

  1. How I propose to get from where I am to where I want to be.

     8.1 Implementation strategy

  • Building consensuses with local government health structures and getting permission to implement my practicum project;
  • Building rapport and partnership with local government structures and community Based Organizations and cultural institutions and leaders;
  • Conducting participatory community situation analysis with the active involvement of targeted communities, partners and culturally influential leaders by using CLTS tools( transect walk, community mapping, shit calculation, Glass of water exercise) in order to understand the current status of the targeted communities related to open defecation and latrine utilization;
  • Preparing meeting with the whole community members and partners in order to discuss on the results of communities’ current situation analysis and building consensus on the type of actions to be taken in order to achieve open defecation free(ODF) environment at the end;
  • Conducting capacity building activities for community committees, volunteers and partners which enable them to lead the momentum forward to achieve ODF;
  • Preparing detailed implementation plan with the active participation of all relevant partners; Community committees, volunteers with clear roles and responsibilities;
  • Facilitating the preparation of culturally acceptable and inclusive bye-lows which can be used to guide the behavior of the targeted communities for creating and maintaining open defecation free environment on a sustainable basis;
  • Facilitating joint supervision with all relevant partners to identify and address implementation related challenges on the spot; as well as to motivate and recognize the achievements of household heads related to latrine construction as well as to facilitate mechanism to support the poor and disabled who lack the capacity to construct latrine;
  • Conducting review meeting with all the relevant partners to evaluate the progress of implementation and address challenges which may hinder implementation;
  • Establishing simple understandable and participatory Monitoring, supervision, reporting mechanisms to facilitate the progress of implementation ;
  • Empowering the community to achieve 100% latrine coverage according to the CLTS principle;
  • Declaring Open Defecation free environment ;
  • Coordinating and integrating the communities’ achievement in to the broader local government and None-governmental structures to ensure future sustainability.


Prepared and submitted by: Assefa Mulatu

Date : May 24/2016