Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

CLTS Experience In Kilifi

111 views

Published on

Published in: Education
  • Be the first to comment

  • Be the first to like this

CLTS Experience In Kilifi

  1. 1. Local District Experience in Scaling up Community Led Total Sanitation in Kilifi. “ Usafi wa mudzini” Dr.B.K.Tsofa District Medical Officer of Health KILIFI
  2. 2. <ul><li>Outline of presentation </li></ul><ul><li>Background information </li></ul><ul><li>CLTS experience in Kilifi </li></ul><ul><li>- Initiation </li></ul><ul><li>- District scale up </li></ul><ul><li>- Achievements so far </li></ul><ul><li>- Stregnths and Challanges </li></ul><ul><li>- Lessons learnt </li></ul><ul><li>- Critical issues for consideration </li></ul>
  3. 3. <ul><li>Introduction </li></ul><ul><li>Kilifi District is one of the thirteen districts in coast province. </li></ul><ul><li>It covers an area of 3870.2km 2 </li></ul><ul><li>It has 6 administrative divisions </li></ul><ul><li>It has a population of approximately 450,000 people living in aprox 500 villages. </li></ul>
  4. 4. District Map
  5. 5. <ul><li>Background Information </li></ul><ul><li>Kenya's Latrine coverage is very low; with a National coverage of about 46%; and Coast provincial coverage of 51% </li></ul><ul><li>Pit latrine coverage in Kilifi is low standing at 33%; with a 46% access. (HMIS 2007) </li></ul><ul><li>75% of water sampled in 2007 from different sources in the district had E-coli contamination </li></ul><ul><li>There is a high prevalence of sanitation related diseases in the district </li></ul>
  6. 6. Top 10 OPD under 5 yrs morbidity 2008
  7. 7. <ul><li>Why CLTS in Kilifi Now? </li></ul><ul><li>Several other strategies, including use of Public Health Act Cap 242, Chiefs Act Cap 210,PHAST, PHC demonstration ; have been used before with little success at community level in many parts of the district. </li></ul><ul><li>Though poverty levels are high, every family builds a house, kitchen, store and shade for animals, WHY NOT A LATRINE?? </li></ul><ul><li>If your neighbors don’t have latrines/proper sanitation, does your house hold get affected….!!?? </li></ul>
  8. 8. <ul><li>CLTS in Kilifi District . </li></ul><ul><li>CLTS was started/piloted in Jaribuni village, Ganze Division in July 2007,as a collaborative effort between MoH ,Plan Kilifi and the community. </li></ul><ul><li>At triggering time, the village had 45 homesteads with only 3 pit latrine; and most of the villagers practiced open defecation. </li></ul><ul><li>After the triggering session, Jaribuni village finally celebrated open defecation free status in 19 th Nov 2007, and by then 42 pit latrine had been constructed and were in use. </li></ul><ul><li>The Latrine were constructed by the community members without any subsidies. </li></ul><ul><li>Lessons learnt provided a platform for a district scale up. </li></ul>
  9. 9. Sample latrines in Jaribuni....,,,,,
  10. 10. More latrine designs in Jaribuni….
  11. 11. <ul><li>CLTS Scale up </li></ul><ul><li>In May 2008, the DHMT, all PHOs & PHTs and some Plan Kilifi staff were trained on the CLTS concept with support and facilitation from Plan international Kilifi DA and Plan Kenya. </li></ul><ul><li>Mass triggering sessions were carried out in different villages all across the district, with different outcomes. </li></ul>
  12. 12. <ul><li>Spill over effect in neighboring villages started being experienced. </li></ul><ul><li>In July 2008, Kilifi hosted a Plan RESA training for CLTS, which was facilitated by Prof. Kamal Kar among others </li></ul><ul><li>Interacting with different CLTS champions provided us with an opportunity for exchange of ideas on the approach. </li></ul>
  13. 13. Prof Kamal Kar facilitating in the RESA training
  14. 14. Achievements so far DIVISION NO OF VILLAGES NO TRIGGERED EXIXTING PIT LATRINE NEW PIT CONSTRUCTED & IN USE UNDER CONSTRUCTION PIT LEVEL SLAB LEVEL SPS VITENGENI 80 11 63 720 30 6 3 KIKAMBALA 74 6 34 882 133 49 43 BAMBA 85 14 60 1026 147 130 32 GANZE 73 3 10 178 50 32 5 BAHARI 104 8 81 516 114 61 8 CHONYI 61 4 138 268 10 12 6 DISTRICT 477 46 386 3590 484 290 97
  15. 15. Achievements in the District
  16. 16. Achievement so far per division
  17. 17. Latrines under construction - District
  18. 18. <ul><li>Achievements Cont… </li></ul><ul><li>Two other villages ( Ngamani and Katsemerini ) have conducted an ODF status graduation celebration. </li></ul><ul><li>Five villages are btw 95% - 100% implementation level. </li></ul><ul><li>Majority of the triggered villages are over 50% implementation levels. </li></ul><ul><li>Spill over effect in neighboring villages is on the rise with good outcomes. </li></ul>
  19. 19. <ul><li>Ngamani Village Vitengeni Division </li></ul><ul><li>Was the venue for last years world toilet day celebration. </li></ul><ul><li>Triggered through spill over effect from neighboring Kahingoni village </li></ul><ul><li>Has 35 homesteads, and at triggering, (July 2008), only 6 homesteads had pit latrines. </li></ul><ul><li>29 Pit latrines were constructed and in use by end of October 2008. </li></ul><ul><li>Whole process was championed by two Community Health Workers in the village . </li></ul>
  20. 20. <ul><li>Katsemerini Village ODF Celebration </li></ul><ul><li>Was conducted last week. </li></ul><ul><li>Was entirely organized by the villagers themselves </li></ul><ul><li>Integrated sanitation issues with other community primary health issues </li></ul>
  21. 21. DMOH and DPHO led by Ngamani Village Sanitation Committee on an inspection tour of latrines in the village.
  22. 22. DMOH & DPHO inspecting latrines in Ngamani Village Vitenegeni Division....
  23. 23. World Toilet Day Celebrations in Ngamani in November 2008
  24. 24. <ul><li>Strengths </li></ul><ul><li>Stewardship from top DHMT management </li></ul><ul><li>Trained Public health staff took up the CLTS approach with a lot of enthusiasm. </li></ul><ul><li>Good reception and co-operation from local leaders and administrators </li></ul><ul><li>Good cooperation and partnership with local stakeholders </li></ul><ul><li>. Receptive community with active participation </li></ul>
  25. 25. Stewardship from core DHMT.....; DMOH,DPHO,DPHN KILIFI
  26. 26. <ul><li>Challenges </li></ul><ul><li>Hard rock in parts of the coastal line Bahari and Kikambala Division </li></ul><ul><li>High water table in Kikambala division. </li></ul><ul><li>Loose soils in several parts of the district </li></ul><ul><li>Shortage of PH staff and competing tasks has led to minimal post triggering support and supervision </li></ul><ul><li>??? Urban communities – Kilifi & MtwapaTowns; and institutions!!! </li></ul>
  27. 27. <ul><li>Challenges cont… </li></ul><ul><li>Rapid spread of spill over effects posing major challenges in tracking and monitoring progress </li></ul><ul><li>The recent drought and hunger in the district is now posing as one of the greatest challenges to most programmes, CLTS included. </li></ul><ul><li>??? Disease impact assessment </li></ul>
  28. 28. Rocky soils!!
  29. 29. <ul><li>Lessons Learnt </li></ul><ul><li>The approach works!; and communities should always take the lead role. </li></ul><ul><li>Start small, for easy tracking and monitoring </li></ul><ul><li>No blueprint design (only people’s designs, not engineers’) </li></ul><ul><li>Facilitate, don’t provide (zero subsidies) </li></ul>
  30. 30. <ul><li>Critical Emerging Issues </li></ul><ul><li>Neighboring districts through their DHMTs have shown interest but lack the support for training </li></ul><ul><li>There is need for “buying in” of the CLTS approach at higher level in the ministry, and explore possibility of entrenching it in the existing government community health strategy. </li></ul>
  31. 31. Conclusion We are quite determined to be declared the first ODF district in Kenya and probably in this region!!
  32. 32. I belive, …..” Yes We Can” ……!!! With determination, we can move from Kogelo to The Oval Office……!!
  33. 33. <ul><li>Acknowledgements </li></ul><ul><li>The Kilifi community for “doing it” </li></ul><ul><li>All Public health staff who have been overseeing the process in the district </li></ul><ul><li>Amos Ndenge the CLTS coordinator in the district </li></ul><ul><li>The DHMT Kilifi for the leadership and stewardship </li></ul><ul><li>Plan Kilifi for facilitation, support and true partnership </li></ul>
  34. 34. Namuvera zhomu Ero kamano Nimwega muno Asantenei sana Thank you very much!!

×