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Improving Uptake and Sustainability of Sanitation Interventions in Timor-Leste: A Case Study

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  • Naomi E Clarke

    (Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia
    Research School of Population Health, College of Health & Medicine, The Australian National University, Canberra, ACT 2601, Australia
    Joint first authors.)

  • Clare E F Dyer

    (Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia
    Joint first authors.)

  • Salvador Amaral

    (Research School of Population Health, College of Health & Medicine, The Australian National University, Canberra, ACT 2601, Australia
    Menzies School of Health Research, Charles Darwin University, John Mathews Building, Royal Darwin Hospital Campus, Tiwi, NT 0810, Australia)

  • Garyn Tan

    (Research School of Population Health, College of Health & Medicine, The Australian National University, Canberra, ACT 2601, Australia)

  • Susana Vaz Nery

    (Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia
    Research School of Population Health, College of Health & Medicine, The Australian National University, Canberra, ACT 2601, Australia)

Abstract

Open defecation (OD) is still a significant public health challenge worldwide. In Timor-Leste, where an estimated 20% of the population practiced OD in 2017, increasing access and use of improved sanitation facilities is a government priority. Community-led total sanitation (CLTS) has become a popular strategy to end OD since its inception in 2000, but evidence on the uptake of CLTS and related interventions and the long-term sustainability of OD-free (ODF) communities is limited. This study utilized a mixed-methods approach, encompassing quantitative monitoring and evaluation data from water, sanitation, and hygiene (WASH) agencies, and semi-structured interviews with staff working for these organizations and the government Department of Environmental Health, to examine sanitation interventions in Timor-Leste. Recommendations from WASH practitioners on how sanitation strategies can be optimized to ensure ODF sustainability are presented. Whilst uptake of interventions is generally good in Timor-Leste, lack of consistent monitoring and evaluation following intervention delivery may contribute to the observed slippage back to OD practices. Stakeholder views suggest that long-term support and monitoring after ODF certification are needed to sustain ODF communities.

Suggested Citation

  • Naomi E Clarke & Clare E F Dyer & Salvador Amaral & Garyn Tan & Susana Vaz Nery, 2021. "Improving Uptake and Sustainability of Sanitation Interventions in Timor-Leste: A Case Study," IJERPH, MDPI, vol. 18(3), pages 1-13, January.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:3:p:1013-:d:486010
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    References listed on IDEAS

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    1. United Nations UN, 2015. "The Millennium Development Goals Report 2015," Working Papers id:7097, eSocialSciences.
    2. United Nations UN, 2015. "The Millennium Development Goals Report 2015," Working Papers id:7222, eSocialSciences.
    3. Joseph Kihika Kamara & Moses Galukande & Florence Maeda & Sam Luboga & Andre M. N. Renzaho, 2017. "Understanding the Challenges of Improving Sanitation and Hygiene Outcomes in a Community Based Intervention: A Cross-Sectional Study in Rural Tanzania," IJERPH, MDPI, vol. 14(6), pages 1-16, June.
    4. Briceno, Bertha & Coville, Aidan & Martinez , Sebastian, 2015. "Promoting handwashing and sanitation : evidence from a large-scale randomized trial in rural Tanzania," Policy Research Working Paper Series 7164, The World Bank.
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