While implementing the Sanitation Support Fund (Fonds d'Appui pour l'Assainissessment (FAA)) program in Madagascar, MCD Global Health revolutionized community-led total sanitation (CLTS) approaches and tools by developing 'continuum CLTS' to sustainably eliminate open defection.
This holistic, systematic, and adaptive approach to CLTS aims beyond the simple generation of open defecation free (ODF) communities; it aims to prevent communities from slipping back to open defecation. Continuum CLTS encompasses the entire sanitation and hygiene service chain, from promotion and demand creation to creating a community-based movement to institutional strengthening to advocating for policy reforms.
Our FAA team developed and disseminated innovative approaches for improving sanitation and hygiene, including more than 65 new tools and resources. With MCD's guidance, this concept has been adopted, adapted, and scaled up by countries, such as Uganda, Nigeria, and Togo. The FAA program was funded by the Global Sanitation Fund, part of the Water Supply and Sanitation Collaborative Council.
To achieve this, our team trained, supervised, coached, and monitored 18 local non-governmental organizations who, in turn, worked to develop a strong network of more than 100,000 community leaders dedicated to eliminating open defecation and improving sanitation and hygiene.
The program was a driving force in developing a roadmap to reach an ODF Madagascar by 2025 and contributed directly to advancing the Ministry of Water's Basic Sanitation Strategy. The FAA also engaged and supported private sector actors in the development and marketing of innovative sanitation and hygiene products and services.
During 2020, the FAA program was selected as a 'front-runner' program to pilot the approach of the future Sanitation and Hygiene Fund, which expanded program activities into urban areas. It also rehabilitated or constructed sanitation and hygiene facilities in 496 schools and 283 health care facilities while promoting sanitation, hygiene, and menstrual health at those facilities. MCD was a leader in the collaborative effort to establish the first ODF region in the country.
Also in 2020, the program reoriented its goals and activities to reinforce Madagascar's response to the COVID-19 pandemic, intensively promoting behaviors that disrupted the spread of the virus and providing promotional materials, hand-washing stations, soap, and disinfectant.