June 2018: The power of institutional triggering for open defecation-free communities

June 2018: The power of institutional triggering for open defecation-free communities

In this edition …

Toilet Agenda shares positive results from various institutional triggering exercises organized in Ghana between 2012 and 2017. The article explores three positive examples to prove the power and efficacy of regular institutional triggering exercises as a necessary component of a successful open defecation eradication agenda.

Dr Kamal Kar (extreme right) facilitating an institutional triggering exercize in Ho in May 2015


The term ‘triggering’ used within the Community-Led Total Sanitation (CLTS) approach means a demonstration of full understanding of the need to stop open defecation and a determination to take immediate actions to stop. In CLTS, triggering has generally been targeted at whole communities, where the demonstration of commitment is seen as a collective decision taken after a facilitation process.

Community decisions are usually influenced by a few personalities such as the Chief and Elders, opinion leaders, local political representatives such as the Assembly Member, Teachers, Religious Leaders, Health workers among others. It is therefore very necessary to identify such personalities and trigger them first so that they may in turn apply their influence to support the professional facilitation process. It is believed that when these influencers are adequately triggered, it will be easier to trigger their respective communities or constituents.

At various times within the implementation of Ghana’s CLTS programme, there has been a few institutional triggering exercises at three different levels – national, regional and district. Some of these exercises have indeed yielded positive responses that need to be studied for replication. Toilet Agenda reviews three positive cases where institutional triggering has made impacts.

National level

After various pre-2010 pilot CLTS projects, it took a national level institutional triggering exercise facilitated by the originator of the approach in 2012 to get several partners convinced to buy into the idea. The facilitation skills of the originator, coupled with practical field demonstration of the approach with their instant results were enough to convince stakeholders to come out with a national consensus to make CLTS the rural sanitation approach. The Ministry of Local Government and Rural Development also took an immediate decision (in 2012) to launch a national scale-up programme through which several organizations are now playing an active part in CLTS implementation. By 2018, all the ten regions in Ghana are implementing the approach though at varying level. Some districts have even been able to stop open defecation in more than 50% of their communities. Currently, UNICEF, iDA, World Vision International, WaterAid, Global Communities, SNV, are among the major partners supporting the implementation of CLTS in Ghana.

The Dafiama Bussie Issa District

Hon Fidelis Zumakpie, for DCE of DBI: Triggered during and institutional triggering exercise in Wa.

Dafiama Bussie Issa (DBI) is a relatively new district carved out of the Nadowli District in 2012. CLTS implementation was initially not a priority in DBI even though the parent district – Nadowli – was still implementing until an institutional triggering encounter in 2015. As at 2015, the district could still not boast of a single open defecation-free (ODF) community. At an institutional triggering forum that was held for Metropolitan, Municipal and District Chief Executives (DCEs) in Wa, with the originator of the CLTS approach, Dr Kamal Kar leading the facilitation, the then DCE from DBI was reborn. He is said to have felt very bad after learning about what his other colleagues had been able to achieve through CLTS and the fact that someone had to travel from outside his country to educate Ghanaians about the need to stop open defecation. Back to his office, he made some necessary re-organisation in his district CLTS team, decided to be personally interested in the programme and provided the necessary logistical and moral support. By the end of 2016, DBI had recorded 16 ODF communities.

After the 2016 general elections, the DCE had to be succeeded by the current member of the new government. He also received a lot of initial briefing from his CLTS team and participated in a regional level institutional triggering exercise shortly after his appointment. He was convinced and therefore decided to continue with the good work of his immediate predecessor. As at March 2018, DBI had been able to convert 57 communities out of the total of 105 to ODF status. With this rate of progress, the district has set a 100% target of December 2019, a review of the original December 2020 deadline set in 2015.

Kpota Electoral Area – Akatsi South District

The Akatsi District piloted CLTS as late as 2014 when some other districts in the Volta Region had already started yielding a number of ODF communities. In November 2017, the district organized an institutional triggering session for opinion leaders including Assembly Members. The Assembly Member for the Kpota Electoral Area, Hon. Daniel Agozi, attended the forum. He says the forum reminded him of a project in 1999 that similarly sensitized the people to stop open defecation and use toilets. He says even though with that project, some households were supported to build their latrines, he developed much interest in the CLTS concept which rather challenged households to finance their own latrines. He says he was convinced that households in his communities were capable of building their own latrines.

When the Assemblyman went back home, and starting from his hometown (Kpota Kpodokope), he discussed the idea with some elders of the community. He then lobbied for a community meeting where a decision was immediately taken to ban open defecation. They also instituted a weekly communal labour system where the youth collectively dug at least two household latrines until the entire community was covered. Upon seeing what was happening in that community, all the seven other communities in the Electoral Area expressed interest in the programme. With facilitation by the Assemblyman, six of them had started the programme out of which two had already been verified as open defecation-free as at May 2018.


There have been no in-depth scientific studies into the impacts of institutional triggering exercises in Ghana. However, these three positive examples give an impression that it is a necessary practise in the national efforts at stopping open defecation in Ghana.


It is necessary that every institution with a potential to influence a change in defecation behaviours be triggered at all necessary levels. Notable among these institutions are political leadership such as the Head of State, Regional Ministers, DCEs, and Assembly Members. They also include all management staff of RCCs and MMDAs, Heads of educational and healthcare institutions, Traditional and Religious Leaders, Parliament and the Judiciary.

Institutions may be stable for ages but leadership in institutions changes very frequently. An institution may be triggered today, but within a short period several of the influential individuals may have moved. Triggering should therefore be on-going and regular, especially when there are changes in leadership in various target institutions especially after elections.

Commitments made at various institutional triggering exercises must be publicised and monitored so that the authorities may not relent in their efforts at fulfilling them. In spite of the positive impacts that institutional triggering has had in some parts of Ghana, there are several promises of interventions and deadlines for targets that have not been fulfilled, and that have attracted virtually no external follow up pressures from the public.

Article by Emmanuel Addai