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Sanitation related diseases have become endemic in southern Africa resulting in increased sanitation and hygiene morbidity and mortality. The region has experienced 318 400 cases of cholera and diarrhoea outbreaks between 2006 and 2012. There is insufficient financing for sanitation and hygiene activities, as people lack basic sanitation services, they engage in open defecation, the primary cause of faecal oral disease transmission. This study investigated Community Led Total Sanitation (CLTS), subsidy free, community based disaster risk reduction approach, for open defecation reduction, in four constituencies in Swaziland. Data collected from households, through a knowledge, attitudes and practices (KAP) survey illustrated that with appropriate training, involvement of traditional and community leaders, CLTS minimises open defecation. There is need of participatory rural appraisal through regular community monitoring and feedback meetings, as the disgust generated especially for women and youth, through the meetings, as well as group dynamics, steer the sustained construction and use of sanitation facilities. Lack of coordination between Non-Governmental Organisations (NGOs) leads to slow improvement of sanitation coverage, wherein the same communities are promoting CLTS and others are promoting Subsidy Based Sanitation Intervention (SBSI) which involves subsidies. It is recommended that there be coordination between partners for harmonisation of messages and an integration of the CLTS and SBSI approaches.

Community led total sanitation for community based disaster risk reduction: A case for non-input humanitarian relief