Laboratoire Eau, Hydro-Systèmes et Agriculture (LEHSA), Institut International d'Ingénierie de l'Eau et de l'Environnement (2iE), 01 BP 594, Ouagadougou 01, Burkina Faso.
Laboratoire Eau, Hydro-Systèmes et Agriculture (LEHSA), Institut International d'Ingénierie de l'Eau et de l'Environnement (2iE), 01 BP 594, Ouagadougou 01, Burkina Faso.
Int J Hyg Environ Health. 2023 May;250:114160. doi: 10.1016/j.ijheh.2023.114160. Epub 2023 Mar 21.
Open-defecation (OD) is one of the most widespread sanitation practices in low-income countries. This practice often causes diarrheal diseases and 760,000 deaths per year. To eradicate OD, several approaches have been developed, including Community-Led-Total Sanitation (CLTS) which is a participatory and community approach. The specificity of CLTS is that it is managed by the community itself, as its name implies, and that no subsidies or financial contributions from outside the community are used in the construction of the facilities. Although, the CLTS is effective in the short-term for eradicating OD, the long-term results are not encouraging: Open-Defecation-Free (ODF) communities revert to OD or partially use latrines. The present research is based on literature review and authors investigation in Burkina Faso. It was conducted to provide a comprehensive understanding of the factors that affect the sustainability of ODF-status leading to slippage in communities. It was found that these factors can be grouped into five categories: behavioral and social, technological, organizational, and vulnerability factors. The last one, socio-political factors, is a contribution from the authors as it was not reported in the literature yet. The authors have proposed graphical synthesis of all the slippage factors and their associated categories in the ODF-communities. Finally, authors have suggested that to sustain ODF-status of communities: include all stages of the sanitation value chain (SVC) in the CLTS, the follow-up activities after achieving ODF-status must be planned well in advance, sanitation marketing should be developed and the sanctions against the practice of OD have to be reinforced. Governments and donors should pay particular attention to the following options: raising awareness and regular monitoring after ODF certification, encouraging research on sustainable and pro-poor sanitation technologies, and building the capacity of implementing actors including facilitators. While obtaining ODF status is materialized by a sign with the status on it, this paper drew the attention of CLTS implementers to the lack of materialization of slippage when it occurs, and the absence of studies on the evolution of the community sanitation scale after ODF-status.
露天排便（OD）是低收入国家最普遍的卫生实践之一。这种做法经常导致腹泻病和每年 76 万人死亡。为了消除 OD，已经开发了几种方法，包括社区主导的整体卫生（CLTS），这是一种参与式和社区方法。CLTS 的特殊性在于，顾名思义，它由社区自己管理，而且在设施建设中不使用社区以外的任何补贴或财政捐款。尽管 CLTS 在短期内消除 OD 非常有效，但长期效果并不令人鼓舞：无露天排便（ODF）社区会恢复 OD 或部分使用厕所。本研究基于文献综述和在布基纳法索的作者调查，旨在提供对影响 ODF 状态可持续性导致社区滑坡的因素的全面理解。研究发现，这些因素可以分为五类：行为和社会、技术、组织和脆弱性因素。最后一个，社会政治因素，是作者的贡献，因为它在文献中尚未报道。作者提出了所有滑坡因素及其在 ODF 社区中的相关类别综合图形的建议。最后，作者建议为了维持社区的 ODF 状态：将卫生价值链（SVC）的所有阶段都纳入 CLTS，在实现 ODF 状态后必须提前计划好后续活动，应该发展卫生营销，并加强对 OD 做法的制裁。政府和捐助者应特别注意以下选项：在 ODF 认证后提高认识和定期监测，鼓励对可持续和有利于穷人的卫生技术进行研究，并建立包括促进者在内的实施行为者的能力。虽然 ODF 状态的获得是通过带有状态的标志来实现的，但本文提请 CLTS 执行者注意在发生滑坡时缺乏实现，以及在获得 ODF 状态后社区卫生规模演变的研究不足。
