A Mobile Platform Enables Unprecedented Sanitation Uptake in Zambia

Today, diarrhea remains the world’s second leading cause of death and is the leading cause of malnutrition and stunting in children under five. Many cases of diarrhea in developing countries can be prevented through access to sanitation and water. In fact, water, sanitation, and hygiene reduce diarrhea risk by an estimated 30%. When Kamal Kar published his first paper on Community-Led Total Sanitation (CLTS) in 2003, 43% of sub-Saharan Africa’s rural population was practicing open defecation. Initially taking flight in Asia, the CLTS approach was a novel shift in sanitation and hygiene improvement interventions from providing individual, household latrine subsidies to propelling subsidy-free, community-driven behavior change. Kar argues that CLTS is effective due to its focus on demand creation. By illustrating the communal costs of open defecation (e.g., that one person’s bad habits result in another person’s bad health), the CLTS program affects a communal resolve, i.e., “demand,” for change. Akros, in partnership with Zambia’s Ministry of Local Government and Housing (MLGH) and UNICEF, layered a unique mobile-to-web application over traditional CLTS delivery methods, resulting in an innovative service delivery and monitoring system dubbed “CLTS M2W.” CLTS M2W uses mobile phones, automated data feedback loops, and engagement of traditional leaders to provide communities with the ability to clearly see their progress towards sanitation goals. CLTS M2W paved the way for unprecedented CLTS uptake in Zambia, facilitating the creation of over 1,500,000 new users of sanitation in 18 months. In short, CLTS creates the demand, and CLTS M2W creates the critical transparency necessary to drive sustained behavior change.