Gender and CLTS: Evidence from Madagascar


Gender equality, serving the most vulnerable, and addressing the particular needs of women and girls are among the core principles of the Global Sanitation Fund (GSF). In order to better understand the link between gender dynamics and the impact of its Community-Led Total Sanitation (CLTS) work, the GSF supported a study in a small number of communities in Madagascar covered by ‘Fonds d’Appui pour l’Assainissement’ (FAA).

Download the 'GSF in focus' case study summarizing and reflecting on the study, or read the feature article below.

Madagascar: Access to improved latrines, by region (% population)Madagascar: Access to improved latrines, by region (% population)

Gender, development and sanitation

Addressing gender inequality is crucial to achieving sustainable development and has far-reaching impacts on human wellbeing. Human rights principles, such as gender equality and non-discrimination, are important instruments for delivering better education and health. Abiding by these principles also ensures more peaceful societies and long-term, transformative social change. WSSCC strives to integrate a gender focus in all of its work, including through the GSF. However, significant challenges remain in effectively doing so, such as matching theoretical perspectives to practical approaches.

The GSF focuses its resources on supporting collective behaviour change approaches. One of the most notable of these approaches is CLTS, a proven and internationally-recognized approach to achieving and sustaining open defecation free (ODF) communities – a first step towards universal improved sanitation. Proponents argue that CLTS is highly effective because it is widely participatory, class-neutral, values human dignity, and engages both men and women in community action. In addition to positive sanitation outcomes for the whole community, the CLTS process has led to some positive gender outcomes such as increased respect for women for their contribution and new roles, improved community interactions, and reductions in domestic violence.  However, CLTS critics argue that the approach fails to recognize and respond to gender roles and relationships at the community level, thereby missing the opportunity to empower women and men.

The study helps address the need for more research into gender and CLTS. Specifically, its research question was: What role does gender play in shaping the experience and outcomes of the FAA’s CLTS interventions? To answer the question, three lines of enquiry and relationships were examined:

  • Gender and engagement in CLTS activities
  • Gender and sanitation outcomes
  • Gender and empowerment

Gender-focused research methodology

The study explored gender dynamics – common issues and patterns – in four villages covered by the FAA in the Itasy region of Madagascar, using qualitative research methods. Empirical data was collected through semi-structured interviews with 30 community members, six FAA staff and partners, and three sanitation and gender experts.

Given the breadth of the FAA programme – the FAA works in all 22 regions of Madagascar, with diverse sociocultural contexts – the study was limited in geographic and representative scope. However, it aimed to provide valuable insights for the FAA and other GSF-supported initiatives, to better understand the interaction between CLTS and gender dynamics. The study aimed to suggest some practical actions for the FAA to consider in its ongoing programming. In addition, the analysis allowed for a bottom-up approach involving the community members themselves in the research, which is in alignment with FAA and CLTS methods.

Findings and recommendations

The findings and analysis of the study demonstrate that there are positive outcomes for both sanitation and the empowerment of women where the CLTS process has been applied. However, the data suggests that gender roles and relationships may limit voice and equal participation for women generally, thus changing women and men’s experience of CLTS and impacting on outcomes.

Gender and engagement in the CLTS process

“Sincerely, I don’t have that skills [to take part in the discussion] but when it is agreed by everybody, I always follow... I live like that... I dare not say anything.” (Female community member, Amparafaravato village)

“It is not that you are women and we have no consideration of you... never... men and women have the same rights now... but the thing is that women in the countryside have a low intellectual level... they cannot understand lots of things.” (Male community member, Ampiakarana village)

The study found that both women and men felt that women have less ability and opportunity to actively participate in overall village meetings, the primary governance and decision-making forum for the village. The data also confirmed that women were not as actively engaged in contributing or decision-making in CLTS-specific meetings, such as triggering and post-triggering sessions. This suggested that at the time of the study, women’s suggestions and needs may not have been adequately considered when devising community solutions to sanitation problems.

Gender and sanitation outcomes

"We have already made a vow of cleanliness that... we will not let down this cleanliness anymore no matter what... with the presence of a facilitator or not, whether he would come or not... we always keep it... we will not go back to [open defecation] anymore." (Female community member, Mahazoarivo village)

“I can say that it is true because when we did not have a toilet we felt like we were not clean. Now we have one and we are like the other people.” (Female community member, Tsaramasoandro village)

In the ODF villages, the study found positive sanitation outcomes for both genders in improved health, convenience, safety, privacy and a sense of dignity and wellbeing. These findings contrasted with the findings in non-ODF villages, particularly in terms of latrine quality and consistency of latrine usage.

Gender and empowerment

The evidence shows that there is significant progress in CLTS communities for both women and men. In ODF villages in comparison to non-ODF villages, both women and men showed higher levels of openness, confidence and enthusiasm in talking about sanitation with their interviewers. This provided an indication of increased voice for women in CLTS and ODF settings, despite limited participation in village and CLTS meetings. The study also provided evidence that CLTS interventions helped facilitate new, respected roles for women and helped to improved relationships in the village.


The FAA welcomes the findings of the study, which provide valuable insights and evidence to better understand the interaction between CLTS and gender dynamics. In various FAA-supported communities, the programme has observed the positive empowerment outcomes highlighted in the findings, as well as the challenges in ensuring that women’s needs are fully incorporated. Moreover, the programme has observed how CLTS mobilizes communities to collectively find solutions to social problems beyond sanitation, while encouraging collaboration and self-help amongst women.

Both the GSF Secretariat and FAA note the finding related to women’s limited participation in CLTS-specific meetings. Given the range of activities that occur during the CLTS process – including pre-triggering, triggering, post-triggering, and post-ODF follow-up – it would be worthwhile to gain more insight into women’s participation levels during these activities. For example, how are women engaged in post-triggering activities such as Follow-up MANDONA and Local Community Governance, during which more Natural Leaders emerge? Is there more engagement in smaller group meetings, where there is more room for women to speak up?

Furthermore, it would be beneficial to engage a larger sample size, to test the findings from this study further. Similar studies could be carried out in other FAA-supported fokontanys, districts and regions, to gain a more in-depth and broader understanding of the gender dynamics in CLTS and sanitation improvement initiatives.