Integrating Social Norms in Community Led Total

Sanitation (CLTS)

Lillian Mbeki

Introduction
The CLTS approach relies on generating action and behavior change by enabling
communities to assess their own current practices and getting triggered to stop
open defecation and build and use latrines. It is built on the basic foundation of
communities finding local solutions to their problem and is non-reliant on funding or
external subsidy. CLTS does not prescribe technologies but rather encourages
households to identify local technological options for their own needs.
Background of CLTS in Kenya
The Government of Kenya and partners have previously used the Participatory
Hygiene

and

Sanitation

Transformation

(PHAST)

approach

for

sanitation

improvement. While PHAST is a very rigorous approach, its implementation, which

included an element of subsidy failed to promote sanitation and hygiene at a scale
and with sustainability.
Community-Led Total Sanitation (CLTS) was introduced in Kenya and piloted in
parts of western Kenya at a time when the Ministry of Health (MOH) and partners in
the sanitation sector were searching for innovative approaches that could accelerate
the progress of improving sanitation in order to declare Kenya Open Defecation
Free. The approach was started in August 2010.
CLTS in Kenya entails the facilitation of the communitys own analysis of their
sanitation profile, their practices of defecation and the consequences, leading to
collective action to become ODF. By 2014 DEC more than 9000 villages in rural
Kenya have been triggered with approximately 4000 villages claiming to be open
defecation free.

Social Norms, and Sanitation Behaviours

Communication
Norms are social phenomena which are propagated among group members through
communication. Communication plays a part not only in formulating perceptions
about norms, but also in acting as a conduit of influence (Lapinski M.K., Rajiv N.
Rimal. & R.N. 2005) One of the factors people use in making behavioural decisions
pertains to their assessment as to whether others also engage in the behaviour. In
the CLTS approach the key communication strategy that has been used is that
everyone must change their behaviours or else no one in the community will benefit
from the sanitation improvement.
Individuals often misperceive the prevalence of descriptive norms (Clapp and
McDonnell, 2000; Perkins and Wechsler, 1996) and the magnitude of this perception
is positively related to interpersonal discussion about the topic (Real &Rimal, 2002).
Thus, both interpersonal and mediated messages may influence perceptions of the
prevalence of a particular behaviour. This is where the social persuasion driven by
natural leaders that follows triggering plays an important role in CLTS.
The extent to which behaviour is enacted in a public or private setting is likely to
moderate normative influences (Bagozzi et al., 2000: Cialdini et al. 1990). Open
defecation is enacted in the public domain and this attribute of defecation behaviour
determines why it is amenable to normative change, hence the decision to use this
approach in targeting behaviour changes for safe sanitation.
Responses from both the ODF and non-ODF households indicate the existence of
empirical expectation 86.7% of the ODF households expect that everyone ought to
be using a latrine to avert diseases and the existence of normative expectations,
people who continue to embrace the OD behavior are frowned upon because of (a)
of factual beliefs that non-latrine users would get sick and consequently make the
entire community sick; and (b) of normative expectations that they would make
everyone in the community sick,

Common knowledge
Creation of a social norm within a community requires that a critical number of
people be exposed to information on the desired behaviour( which happens during
triggering), it requires the use of nodes as change agents/influencers ( in CLTS this
are the natural leaders ), the community should themselves come up with sanctions
for offenders ( villagers decide what punishment to administer to those caught
defecating in public) and a process of creating common knowledge on the social
norm( this happens when community commits publicly to end open defecation, it is
done at frequent community meetings and when a community is declared ODF
there is erection of a bill board declaring the village ODF)
The findings from this study, in villages that were ODf and where latrine use was a
social norm, show that about all the respondents sampled among those that own or
share a toilet at home (99.1%), believed with utmost certainty that they ought to
be using a latrine for defecation.

Sanctions and norm enforcement

Social norms are rules and standards that are understood by members of a group,
and that guide and/or constrain social behaviour without the force of laws (Cialdini
et al. 1990, p. 152). These rules and standards include the expectations of valued
others and standards that develop from observations of others behaviour. Social
norms are thus informal, socially shared, and relatively stable guides of behaviour
or attitude. Their informal, no obligatory, character implies the presence of social
reinforcements, such as approval or disapproval, and distinguishes social norms
from laws. Social norms are shared within a group, which differentiates them from
personal norms based on a consumers own internalized values or expectations for
behaviour, and ensures that they are generally stable over time (Jones, 2006).
From the study in ODF villages, we established that violation of the normative
expectation results in punishment [you will be punished by the community as well
as the chief: this response reveals the existence of sanctions going along
normative expectations and indicates that physical sanctions are given by the chief

& the community members, whereas non-material sanctions of disapproval, i.e. the
shame! are given by any community member.
When respondents were asked- what would you do if you found someone defecating
in the open, they said I will force him to carry his faeces; I will take him to the
chief; Advise him on how to use a latrine; I will tell him he is doing wrong by
spreading diseases; I will tell that defecating in the open is bad; I will ask him if he
has a latrine at home; Will advise him to construct a toilet; Will report him to the
health worker; He/she should be a child and should be caned; Should be warned
against such behaviours;
Majority of respondents also reported that they would offer advice to the norm
breakers; a significant proportion reported that they would sanction compliance
directly or indirectly through other actors at the community level. Some of the
reported sanctions include: reporting to the chief or government
official; giving ultimatum or last warning; reporting to the elders; reporting to the
CHW or natural leader; confronting, beating or chasing away; inducing shame e.g.
by forcing to carry the shit around the village; segregation where community
members avoid visiting them to avoid contracting diseases; expulsion from the
village / community; and thorough caning if the offenders are minors.
The study outcomes indicate that the enforcement of social by-laws (sanctions) is
wide spread across the sampled villages with 38 of the 42 villages that reported
existence of by-laws reporting that there is enforcement as well.
Misperceptions
The term misperception is used to describe the gap between actual attitudes or
behaviour, and what people think is true about others attitudes or behaviours.
For example, the majority who engage in healthy sanitation behaviour may
incorrectly believe they are in the minority (pluralistic ignorance.) This occurs when
a majority of individuals falsely assume that most of their peers behave or think
differently from them when in fact their attitudes and/or behaviour are similar.
Pluralistic ignorance encourages individuals to suppress healthy attitudes and
behaviours that are falsely thought to be non-conforming and to provide

encouragement to engage in the unhealthy behaviours that are seen incorrectly as

normative. Social norms interventions in CLTS correct pluralistic ignorance by
natural leaders informing the majority that their behaviour is actually more
normative and healthy than they think.
In contrast, the minority of people with unhealthy attitudes and/or behaviours may
incorrectly think that they are in the majority (false consensus). The false
consensus misperception functions to maintain an individuals denial that his or her
attitudes or behaviour are problematic or unusual. Finally, an individual may enjoy
thinking that her or his behaviour is more unique than it really is (false
uniqueness).
Each of these misperceptions operates in a different way and may affect behaviour
differently.
The combination of false consensus and pluralistic ignorance allows open defecators
to have an influence that is greatly disproportionate to their numbers by
strengthening their voice and suppressing the voice of the silent majority who
may favour policy initiatives and interventions to curb negative behaviour. This
creates a spiral of silence in which individuals who perceive their position to be
unsupported will fall silent, thereby creating the appearance of even less support
for the position (Prentice & Miller, 1996, pg 116)
For a new sanitation behaviour to be supported and developed into a social norm, it
is important for sanitation promoters in this case the natural leaders to confront
misconceptions and misperceptions and instead create common knowledge of what
the prevailing behaviour and perception is.
Communication influences the extent to which people perceive a discrepancy
between their own and others attitudes or behaviours. Individuals are generally
more persuaded by detailed and specific descriptions of expected behaviour than by
more abstract descriptions, possibly because they can more easily process the
information and imagine themselves performing the behaviour. Prior research has
thus argued that social norms that clearly specify the expected behaviour and the
situation in which this behaviour is appropriate should have a stronger influence
than norms that do not specify this.

The findings show that about all the participants sampled from ODF certified
villages (98.8%), they belief with utmost certainty that they ought to be using a
latrine for defecation.
Majority of the respondents believe that others think that they should be frequent
users of a latrine 96.3% of ODF villages participants.
What these means is that in villages that latrine use is a social norm,
misperceptions have been cleared and there is common knowledge of beliefs and
practice.
Social Networks
Numerous studies have documented the role that the social networks of individuals
play in initiating and reinforcing both positive and negative behaviours. (Dorsey,
Seeman, & Sayles, 1985). In order for individuals to be influenced by their social
networks, they must either feel some degree of affinity, or desire connectedness
with a reference group (Ajzen, I., &Fishbein, M. 1980). Social norms interventions
focus on peer influences, which have a greater impact on individual behaviour than
biological, personality, familial, religious, cultural and other influences. ( Perkins,
H.W. and A. D. Berkowitz., 1986)
Misperceptions increase as social distance increases. But social groups that are
closer are more influential in shaping behaviour. This was also the conclusion of
Borsari and Carey (2003) in a meta-analysis of social norms studies, in which they
found that misperceptions were greater as social distance increased while the
influence on behaviour of closer or more salient social groups was stronger.
Results in ODF villages further show that among the respondents who have access
to a toilet at home (own or shared), a majority of them (95.4%) expect that
members of their social networks use a latrine every time;
Another curious outcome from this study is that, villages that have dense household
distribution are more cohesive and hence social norms deeply rooted as compared

to villages with sparse settlements patterns. These is a key consideration in

identifying triggering clusters.
A significant majority of the respondents believed that they would face severe social
sanctioning if they are found to be breaking the latrine use norms. The respondents
reported that they believe other people: will report them to CHW/PHO/natural
leader; will report them to the chief; will report them to the elders; will engage in
bad gossip (perceived to be unclean, crazy or mad hence disgust and shame); will
be thoroughly beaten, arrested or punished; will be shamed/ disgust and may be
forced to carry their shit; will be reported at community barazas; or will receive
stern warning against repeating the vice. Social pressure and expectations of
consequences from within the social circles is therefore a key determinant in
reinforcing the new behavior and strengthening the social norm.
Referent group member/key influencer/central node
Literature also indicates that the magnitude of the misperception and the influence
of norms on behaviours will be determined by, among other things, the source of
the information (referent group member, stranger, typical other ;( Borsari & Carey,
2003). For example, research framed in the TRA and other norms-based
interventions has indicated not only that normative information from referent others
can influence behaviours, but also that the social distance between the actor and
the referent is negatively associated with the accuracy of normative perceptions.
When individuals internalize normative information, the presence of the reference
group is not required for sustained normative effects (Sherif, 1935). If, however,
individuals enact behaviour in the absence of internalizationa process termed as
compliance then the presence of the reference group is required for normative
influence to occur.
Norms are, first and foremost, social phenomena. Who communicates a norm (the
source) can determine the extent of its influence as well as how likely others are to
notice adherence to the norm. Norms may be more relevant, and hence more
influential, when coming from persons with whom the individual can easily identify

In a network, not all individuals play an equal role. Some individuals are more
central. Central individuals have less distance from others. If someone knows
everybody in a district, that person is very central. Someone can also be central if
she knows very few people but if these people know a lot of people.
Some individuals have a high degree of connectedness. This simply means that
they have ties with many people. Research therefore suggests that programs
targeting behaviour change at a community level would do well to use such
information in selecting change agents.
The results show that among the respondents from ODF certified villages, a
majority of them (96.9%) expect that members of their reference networks use a
latrine every time.
The findings indicate that as many as 96.3% of the respondents from ODF certified
villages believed (and expect) that members of their reference network consider
them to be every time users of a latrine. Less than 6% believed there would be
deviations in expectations. These results validate similar results in the study where
respondents said we use a latrine every time because we believe that enough of
others in our reference networks expect us to use a latrine every time

Implications for Programming

Results of the Study suggest that social norms do indeed exist in communities that
have been declared open defecation free. The strongest correlation being in
Nambale and Nyando sub-counties. The evidence also suggests that sustainability
of ODF is strengthened by the existence of a social norm that supports latrine use.
This then points to the need for program planners and implementers to strongly
consider adopting various aspects of the social norms approach in behavior change
that very well fits in with CLTS.
Through analyzing both quantitative and qualitative data some key considerations
for programming are outlined below.

Pre-triggering
It is important the individual/s planning a triggering event:

Identify the key influencers in the community. Identify both formal and

informal leaders and ensure that they participate in the triggering event

The results show that the community health workers (CHWs) and the natural
leaders played the lead roles in CLTS mobilization.

Engage the local leadership and work with the community in selecting the

villages to trigger. It is important to also at this stage carry out an analysis of

existing norms and beliefs.

Take time to study the existing networks and referent groups within the

village

Understand the community well and issues such as seasonality and

community activities to help decide on the best season, time and day for triggering.
During the planting and weeding seasons in rural and mainly agricultural areas, it is
much harder to get adult household members before 2PM for a triggering meeting.
These and other local issues should alswys be borne in mind
Triggering
If pre-triggering and community mobilization is done well there should be a critical
mass of people at the triggering event, as well as the presence of key opinion
leader and influencers. During triggering it is important to look out for the
following:

Be alert and allow natural leaders to emerge. Even purposefully look

out for them during triggering. These are the individuals that show
enthusiasm for the new desired behavior and are willing to lead, initiate and
persuade others to change. They also have the predisposition to influence
others around them

When the community decides to collectively end open defecation they

make a common pledge. This could be by a symbolic gesture like raising of
hands, a verbal pledge or a signed pledge. Let the community through the
leaders they select make this pledge. In some ODF villages, it was the pledge

to support each other within the village and ensure the community was ODF
in a specified period of time.

Support the community in identifying their own acceptable sanctions

for those that fail to comply with the pledge. Let them decide on how/who
should enforce these- in some villages in the study, children were used to
blow whistles when an open defecator was spotted. The adult villagers would
then surround the violator and frog-march him, carrying the shit he had
deposited, to the chiefs office

Once the community makes a commitment to collectively end open

defecation, they will agree on a date by when this target will be met and
make plans on how to monitor their own progress

Publicize the agreed upon timeline(e.g through children at school),

through community meetings such a chiefs barazas, weddings and burial
meetings, church events etc

During social mapping identify existing local networks and central/high

level nodes. This information will be useful in planning follow-ups and in
targeting key influencers for fostering behavior change
Post-triggering
After community/village triggering, the process of social persuasion starts and goes
on for three to six months. Ideally communities should get to ODF during this
period. The follow-ups mainly by natural leaders who emerge during triggering, and
some PHO/Ts happens both at individual household visits and subsequent
community meetings.

In some villages in Bondo, school children participated in the process of persuasive

communication along with the natural leaders. Follow-ups happened weekly until all
households had constructed latrines and the village declared ODF, In some villages
the follow-ups go on to monitor for and support sustainability of ODF. Inclusion of
school

children

during

triggering

and

possibly

involvement

of

schools

in

communication and creating common knowledge of the social norm is an element

that program planners should consider where possible

The results show that 28 of the 42 villages (66.7%) received follow-up to ensure
that toilet use was sustained. In a majority of these villages (82%), the results
indicate that the government agents and CHWs provided the lead role. Their efforts
were complemented by NGOs (21.4%), the villagers (10.7%) and the village based
organizations (7.1%).
In order to accelerate progress to ODF and in the development of a social norm,
some of the actions that were found to work in the parts of rural Kenya where the
study took place are outlined below:

A good number of motivated and dedicated natural leaders carrying out

weekly household visits and addressing village meetings where they bust
misperceptions and communicate on the normative expectations with the aim of
creating common knowledge is useful

Another way of creating common knowledge besides using natural leaders is

that of using other communication approaches/channels such as public address

system within the village, public announcements at churches or market places, and
notice boards at the chief/local governments offices etc

Enforcing sanctions- When it was found that some households were resisting

change the community decided to introduce injunctive norms. In Nambale for

instance, children went in groups and stood near the defecation sites e.g. sugar
cane plantations. They were given whistles to blow whenever they found anyone
going into the open for defecation. In another village the area chief had a wall of
shame notice board where names of household heads of all households that had
not access to a latrine were written. Some schools also used a similar approach
with the head teacher reading out names of homesteads without latrines. During
focus group discussions people said that a large number of resistant individuals and
households adopted toilets after children started monitoring open field defecation in
their villages.

The role of local government and other key opinion leaders-The District

commissioner of Nambale visited most villages in the district to convince the

community about the benefits of access to sanitation facilities. He personally

participated in triggering events and in sensitizing households on the impact of

open defecation and the benefits of improved sanitation behaviors. His visits
became a key influencer for ending open defecation in Nambale which was
eventually the first district to be declared open defecation free in Kenya

Focus on behavior change- Over the years public health teams relied on

imposing the chiefs act where households that did not comply and build latrines
had the household heads arrested and fined. The evidence shows that this did not
have much impact in increasing latrine coverage. In areas where triggering involved
enabling the villagers understand the harmful effects of open defecation and then
decide

to

change

behavior, latrines

that

were

willingly

built

were

used.

Subsequently the new behaviour was strengthened when individuals realized that
other villagers approved the new practice and were also adopting latrine use.

Create and strengthen normative expectations by visible symbols such as

billboards. In some villages declared ODF there were large billboards erected that
read This village is ODF- Anyone caught defecating in the open will be punished

Addressing common challenges and cultural barriers- through the natural

leaders, innovations and technological options were shared among community

members that were facing problems in latrine construction. This included how to reinforce pits and digging round pits in areas with lose soils. Natural leaders and local
health workers were also used in busting myths and false beliefs around latrine use.

Conclusions
Triggering relies on energizing to end open defecation by instilling fear, shame and
disgust toward defecating in the open then helping the community itself to tackle
sanitation issues with no government or NGO funding or support. (Kamal Kar &
Robert Chambers, Hand book on Community Led Total Sanitation).

The 4 year experience in implementing CLTs in Kenya is that triggering, by itself, is

not sufficient in establishing a social norm for safe sanitation.
For a social norm to develop it has been observed that it is necessary to have:

Sustained community follow-up and persuasive communication over a period

of time, leading to normative influences and collective action by the community.

Normative change at both the collective and perceived levels is largely driven

by natural leaders who often are within a close network group and are a trusted
source of information within the community social networks

The involvement of children in some communities has been influential in

stimulating change and sustaining the social norm for safe sanitation behaviours

Social norms develop faster and much more easily in a homogenous

community where social networks are tight and households are in close proximity.
Communities that are more sparsely populated and are more heterogeneous
require a multi-pronged approach and more intense follow-up in developing and
strengthening the desired norm

Community generated sanctions that are culturally appropriate and are

instituted and enforced by the community members themselves are useful in

supporting the development and entrenchment of a new sanitation norm

None of the villages where Post ODF following was done had severe OD

reversal

This project and evaluation was funded by UNICEF KCO