| dc.description.abstract | Community-Led Total Sanitation (CLTS) is a behaviour change approach designed to promote sustainable and equitable access to sanitation and hygiene. Despite more than a decade of CLTS implementation in Kenya, open defecation persists, particularly in low-income and pastoralist communities. This study investigated the influence of social, cultural, and household ability factors on the implementation of CLTS in Laisamis Sub-County, Marsabit County, Kenya. A descriptive study design employing a mixed-methods approach was used. The sample comprised 393 randomly selected household heads across five wards in the sub-county, treated as strata. Quantitative data were analyzed using descriptive and inferential statistics, while qualitative data from focus group discussions were thematically analyzed and presented narratively. Findingsrevealed that natural leaders played a critical role in mobilizing communities to construct latrines following CLTS interventions (Unadjusted OR = 1.576; 95%CI: 1.245–3.476; p= 0.042). Although 63.3% of participants reported increased awareness of the health risks associated with open defecation, the practice remained prevalent. This was largely attributed to pastoralist livelihoods, where herders spent extended periods in graze lands lacking toilet facilities (Unadjusted OR = 4.094; 95% CI: 0.145–2.856; p =0.000). Cultural taboos surrounding toilet sharing between adults and children also hindered utilization (OR = 0.67; 95% CI: 0.345–4.567; p = 0.002). While CLTS encouraged latrine construction, many of the facilities were poorly constructed from weak, locally available materials. Household income levels significantly influenced latrine quality, with lower-income households being 63.4% less likely to construct durable facilities. Additionally, over 90% of participants perceived human fecal matter as no more harmful than animal waste, undermining sanitation behaviour change. Gender roles further complicated implementation, with women bearing responsibility for toilet construction while men, often in the field, showed limited engagement with sanitation improvements. The study concludes that although CLTS has contributed to increased awareness and some behavioural change, its effectiveness is constrained by socio-cultural norms, economic limitations, and gendered responsibilities. To enhance outcomes, CLTS programs should be tailored to the local context and include both men and women in triggering events and behaviour change communication strategies aimed at eliminating open defecation across all environments. | en_US |
