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European Journal of Applied Sciences – Vol. 13, No. 1
Publication Date: February 25, 2025
DOI:10.14738/aivp.131.18360.
Simbe, J. Y. & Agoi, L. M. (2025). Factors Influencing Poor Implementation of Community Led Total Sanitation in Kajiado County,
Kenya. European Journal of Applied Sciences, Vol - 13(1). 429-438.
Services for Science and Education – United Kingdom
Factors Influencing Poor Implementation of Community Led
Total Sanitation in Kajiado County, Kenya
Juliana Yunia Simbe
School of Social and Human Studies,
Atlantic International University, Pioneer Plaza,
900 Fort Street Mall 905, Honolulu, Hawaii 96813, USA
Lusiola Musa Agoi
Kenyatta University, Nairobi, Kenya
ABSTRACT
The purpose of the study was to investigate the factors influencing poor
implementation of CLTS in Magadi Ward, Kajiado County. Specifically, the study
wanted to identify the socio-cultural factors influencing the poor implementation
of CLTS, assess the accessibility of households to latrines, determine the latrine
coverage and find out the community’s attitude, practice and knowledge on
sanitation. A cross sectional descriptive study was adopted. Magadi was divided
into four strata, each stratum represented its villages. The first household head to
be interviewed was picked at random from the household register provided by the
village headmen. Systematic random sampling was used to determine the number
of villages and households to be interviewed. Data was collected by use of
questionnaire and observation checklists. This was done by face to face
interviewing of the respondents by trained CHVs. Qualitative data was processed
through manual cleaning of the questionnaires by counter checking for
completeness and then coded for easy entry. SPSS version 22.0 was used and
descriptive findings presented in form of tables and pie charts. The study results
revealed that 33% of the respondents had fully implemented CLTS while 67%
strongly disagreed that OD caused diarrheal diseases and eye infections. Socio- cultural factors such as the community’s attitudes, practices and knowledge, low- latrine coverage and inaccessibility of households to latrines are the results of
failure to proper implementation of CLTS. The study further revealed that 58% of
respondents were not educated and 40% thought that CLTS is not necessary
because of their nomadic lifestyle. The study findings concluded that the poor
implementation of CLTS was caused by low knowledge levels and negative attitudes
due to lack of education, poverty and nomadic lifestyle of the community.
Keywords: Sanitation, CLTS, ODF, Functional latrine, Kajiado.
INTRODUCTION
The concept of Community Led Total Sanitation was introduced and spearheaded by Kamal Kar
together with VERC, a partner of Water Aid Bangladesh, in 2000 in Mosmoil while assessing a
traditionally subsided sanitation program. He advocated change in institutional attitude and
the need to draw on intense local mobilization and waste situation and bring about collective
decision-making to stop open defecation. Community Led Total Sanitation was adopted by the
government of Kenya Ministry of Health in 2011, as a national sanitation strategy to achieve
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ODF in rural areas in Kenya, this was followed by successful piloting by sector players in 2007.
A roadmap dubbed ODF Rural Kenya 2013 was created and launched on 11th May 2011. The
roadmap involved dealing with organizations and devolves structures throughout Kenya to
reach all communities and guarantee that they are ODF. The National ODF Kenya 2020
Campaign Framework builds on the ODF Rural Kenya Roadmap 2013. It aims to eradicate open
defecation and declare 100% villages in Kenya ODF by 2030. An estimated 14% of Kenyans
practice open defecation. Kenya intends to achieve 100% ODF status by 2030 as per the SDG
number 6. The aim of SDG 6 is to ensure accessibility and sustainable administration of water
and sanitation for all. A fundamental objective of this goal is to accomplish access to adequate
and equitable hygiene for all and end OD, focusing on the necessities of women and girls in
vulnerable situations.
In Kajiado County there is no sanitation or sewerage administration provided by the national
or county government; and there is also chronic water shortage in the greater part of the year.
The region is classified as an ASAL area. Just 28% of the populace has access to sanitation.
Nonetheless, this coverage actually remains far beneath the national figure of 85.2% and
provincial figure of 78.4%. Because of this low household sanitation coverage, diarrhea and
worm infestation remains among the top five leading causes of morbidity in the area.
Percentage distribution of persons accessing toilets/latrines is exceptionally low at 26% in
rural areas and 47% in the urban areas. OD is still practiced in the county with just 25% ODF
certified villages hence the need to focus on the behavior change strategies. Poor sanitation has
contributed to contamination of open water sources in the region. Latrine coverage is around
80% in urban areas and 20% in rural areas. There has been no proof of progress in latrine
coverage from the earlier years. Evaluating the existing situation in the area is important to
enable attainment of relevant information in Community Led Total Sanitation status from a
local viewpoint and hence initiating the essential interventions.
PROBLEM DESCRIPTION
Kenya is one of the countries that did not accomplish the MDG for increasing access to water
and sanitation. Just 30% of Kenyans have access to improved sanitation, or at least, the use of
sanitation facilities that hygienically separate excreta from human contact. This suggests that
around 30 million Kenyans are at this point using dangerous sanitation methodologies like
simple kinds of latrines, and nearly 6 million are defecating in the open. This poses a challenge
in accomplishing Vision 2030 national targets to accomplish universal access to sanitation.
Although the figure is higher assuming shared facilities are included, it is the pace of increase
in access to improved sanitation that is worrying. Access to improved sanitation increased by
only 5% in the scope of 1990 and 2015 in rural and urban areas. In rural areas, people keep on
defecating in the open basically on account of open land, yet moreover it is seen as culturally
appropriate in certain regions. It is estimated that if the current trend of sanitation coverage is
maintained, it would take Kenya 200 years to accomplish universal sanitation coverage. The
constitution of Kenya makes access to some fundamental services including sanitation a basic
right for all, further building up the need to answer the common prevailing sanitation
emergency direly. The initial step is to acknowledge that we have an immense challenge that
calls for reconsidering of methodologies, and to have champions of change both at the local and
national levels.
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Simbe, J. Y. & Agoi, L. M. (2025). Factors Influencing Poor Implementation of Community Led Total Sanitation in Kajiado County, Kenya. European
Journal of Applied Sciences, Vol - 13(1). 429-438.
URL: http://dx.doi.org/10.14738/aivp.131.18360
RESEARCH OBJECTIVES
1) To identify the socio-cultural factors influencing poor implementation of CLTS,
2) To assess the accessibility of households to latrines,
3) To find out the community’s attitude, practice and knowledge on sanitation,
4) To determine latrine coverage in Magadi Ward, Kajiado County.
MATERIALS AND METHODS
The study was conducted in Magadi Ward, Kajiado West sub-county, Kenya. Majority of the
population is nomadic pastoralists that practice open defecation due to poor implementation
of CLTS. The sub-county is an ASAL region that covers 2,640 Sq. KM. The population is 27,559
and 1021 households. (12) The four selected sub-locations included Oldoinyo-Onyokie, Magadi,
Olkiramatian and Entasopia sub-locations.
Study Population
The study population was the heads of households or their spouses in Magadi Ward. These are
adult men and women ages 18 – 64 years because this is the definition of an adult in the Kenyan
constitution.
Study Design
A cross-sectional descriptive study was conducted to collect data for a period of one month.
Sample Size Determination
The minimum sample size was determined using Fisher’s formulae;
n = Z
2 ×
pd
d
⁄ 2
Where n is the required sample size
Z = standard normal deviate set at 1.96 corresponding at 95% confidence interval
p = proportion of the target population estimated to have particular characteristics of interest
d = degree of accuracy desired set at 0.05
n = the sample size desired, sample size (>10,000)
The probability of getting people in the area not using latrines p = 0.50
q = 1 – 0.05
q = 0.5
d = minimum error
Z
2 = (1.96)2
n = (1.96)2 (0.5) (0.5) / (0.05)2 = (3.8416 ×0.25) / (0.0025)
= 0.9604 / 0.0025 = 385
n = 385 individuals.
This number was adjusted to 400 because of potential non-response.
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Sampling Procedure
Random sampling was used to determine the number of villages and households, and the
intervals from one household to another. A simple random sampling method was used to
determine the number of households to be interviewed. After simple sampling to determine the
first households, systematic random sampling was done to determine the second households
then dividing the number randomly picked by two which gave an interval of three.
Method of Data Collection
Data collection was done by use of questionnaires and observation checklists. This was done
by face to face interviewing of the respondents by trained CHVs. The questionnaires consisted
of open and close ended questions which were used to interview household heads. They were
written in English but the CHVs translated them to Maasai language for interview to ensure
accurate answers. The researcher employed seven knowledgeable CHVs who are fluent in both
English and Maasai languages to undertake the translations. The questions wee formulated
from the objectives of the study in plain language for easier understanding. The questionnaire
was designed in such a way as to help the researcher to gain in depth understanding,
interpretation, attitudes, beliefs and perceptions of different respondents on CLTS. Observation
checklists were used to observe environmental conditions and especially the sanitation around
the households for evidence of human excreta.
Method of Data Analysis
Data was first processed through manual cleaning of the questionnaires through counter
checking for correctness and completeness. The questionnaires were hen coded for easy entry.
Descriptive summary statistics in form of charts (cross-tabulations, pie and bar) are presented.
Chi-square tests of association were conducted to assess dependence relationships among
potential factors.
Verification Ethical Consideration
The major ethical issue considered in this study was confidentiality and privacy of the
respondents and participants involved in the study. This was done using codes instead of heir
names so as not to infringe on their rights. Participation in the study was made voluntary and
those who consented were considered. The participants of the study included household heads
sampled from the specific villages of Magadi Ward of Kajiado West sub-County who lived in the
study area for more than six months.
RESULTS AND DISCUSSION
Demographic characteristics of the respondents
Table 1: Summary of demographic characteristics of study participants (n = 367)
Independent Variable Respondent Response Frequency(n) Percentage (%)
Age Above 18 years 367 100
Gender Male 176 48
Female 190 52
Marital Status Single/Separated 80 22
Married 286 78
No. of family members Below 2 members 36 10
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Simbe, J. Y. & Agoi, L. M. (2025). Factors Influencing Poor Implementation of Community Led Total Sanitation in Kajiado County, Kenya. European
Journal of Applied Sciences, Vol - 13(1). 429-438.
URL: http://dx.doi.org/10.14738/aivp.131.18360
2 to 4 members 154 42
Above 5 members 176 48
Level of Education Formal education 212 58
Not formally educated 154 42
Level of Income Employed 92 25
Self-employed 84 23
Unemployed 190 52
The influence that demographic factors have on the implementation of CLTS is varied
depending the degree to which a factor is interconnected with sanitation. Results portrayed
that there is no link between implementation of CLTS and gender. However, males are observed
to be less interested to implement CLTS as compared to females as is observed in their limited
use of sanitary facilities in the socio-cultural factors as compared to women. 42 percent of the
participants that lacked formal education projected lack of awareness of the need to effectively
implement CLTS as compared to 58 percent that had formal education. Majority of them cited
lack of adequate income as a factor for not effectively implementing CLTS. Unemployed
participants cited poverty as a reason for inadequately implementing CLTS as they considered
building latrines and renting with toilets a secondary basic need. The competing basic needs of
food, clothing and shelter makes it difficult to consider paying for latrines or hoses with one.
Attitude towards CLTS
Table 2: Attitude of participants on CLTS
Attitude-based question Strongly
Disagree
Disagree Agree Strongly
Agree
Do you think CLTS is good for the community? 2% 5% 56% 37%
Do you think open defecation is a nuisance? 26% 26% 18% 22%
Do you think implementing CLTS in your home/
community is unnecessary?
7% 13% 60% 20%
Should there be more public toilets? 2% 3% 90% 5%
The nomadic way of life favors the concept of OD as compared to utilizing toilets. Nonetheless,
90% believed that there should be more public toilets in the region as 90% considered that
CLTSwould be good for the community. As such, their attitude towards CLTS could be positively
altered if public health programs and projects provided subsidized materials for constructing
public toilets and would ensure easy availability of sanitary facilities.
Latrine Coverage
Table 3: Latrine coverage among participants
Type of sanitary facility Frequency (n) Percentage (%)
Flash toilet 29 8
Public/ private pit latrine 190 52
Personal trench 106 29
None 40 11
Dry weather conditions and inadequate access to clean and safe water favors the use of
personal trenches and pit latrines as compared to flush toilets that demand adequate supply of
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safe water. Of concern is that 11 percent of the participants lacked any form of sanitary facility.
The 11% are representative of the Magadi population that has no coverage of latrines which
raises public health concern in regard to the spread of fecal-oral diseases in the region due to
rampant OD.
Accessibility of Households to Latrines
Table 4: Accessibility of households to latrines
Accessibility of latrines Frequency (n) Percentage (%)
Households with inside toilets 29 8
Households with outside toilets 92 25
Households that share latrines 205 56
Households with no inside/ outside latrines 40 11
Participants preferred personal trenches to pit latrines that could be easily constructed with
readily available materials as compared to flush toilets. Households prefer sharing sanitary
facilities as compared to constructing individualized latrines that would be costlier. 11 percent
of the population lack access to any form of latrine which inevitably contributes to OD practice
in the area.
Implementation of Community Led Total Sanitation
The figure below presents the number of respondents who had fully implemented the CLTS
program. The figure revealed that a majority 245 (67%) of the respondents had not fully
implemented the CLTS program in comparison to only 122 (33%) who had fully done so.
Figure 1: Implementation of CLTS among respondents
Functional Pit Latrine to Household Ratio
The figure below illustrates the ratio of functional pit latrine to the population in Magadi Ward.
Implementation of CLTS among
respondents
CLTS Implemented
CLTS Not-Implemented
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Simbe, J. Y. & Agoi, L. M. (2025). Factors Influencing Poor Implementation of Community Led Total Sanitation in Kajiado County, Kenya. European
Journal of Applied Sciences, Vol - 13(1). 429-438.
URL: http://dx.doi.org/10.14738/aivp.131.18360
Figure 2: Functional pit-latrine to household ratio among respondents
The results revealed that the majority of respondents (56%) did not have a functional pit
latrine. This means that 10 households would share about 3 pit latrines, which is equal to a ratio
of 3:10. As a result, there was an acute shortage of pit latrines in the community hence the poor
implementation of CLTS program. The implication for the study is that poor latrine coverage
was directly associated with poor adoption of CLTS program recommendations within Magadi
Ward.
Knowledge on CLTS
Table 5: Knowledge on proper latrine usage and disease prevention
Knowledge on Proper Latrine
Usage and Disease Prevention
Number of Respondents Proportion
(%)
Strongly Disagree 34 9.3
Disagree 201 54.8
Agree 78 21.3
Strongly Agree 54 14.7
These findings imply that poor implementation of CLTS interventions in Magadi Ward was a
result of the inhabitants’ low level of knowledge on how poor sanitation is linked with the
causation and spread of fecal-oral diseases. This means that poor implementation of CLTS
interventions in the community is directly associated with their low level of knowledge on how
pit latrines are useful in prevention of diseases. From the above findings, it is clear that there
was a direct relationship between the low level of knowledge on CLTS and the failure of its full
implementation in Magadi Ward.
Socio-Cultural Factors and Implementation of CLTS
Table 6: Socio-cultural factors on implementation of CLTS
Socio-cultural Factors Number of
Respondents
Proportion
(%)
Poverty is a barrier to CLTS implementation YES 311 85
NO 56 15
Nomadic pastoralist lifestyle is a barrier to CLTS
implementation
YES 322 88
NO 45 12
Customs and beliefs affect CLTS implementation YES 268 73
Functional Pit Latrine Coverage
NO
YES
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NO 99 27
Pit latrines are unsafe, smelly and unnecessary YES 242 66
NO 125 34
Since CLTS implementation requires some form of financial input, most of the respondents felt
that their financial status was a hindrance towards their adaptation of sanitation practice
recommended by CLTS. As a result, CLTS was not accorded financial priority by most of the
respondents. As nomadic communities, most respondent of Magadi Ward were reluctant to
adopt the use of pit latrines and handwashing facilities as their nomadic lifestyle meant that
such an expense would be a temporary solution to their sanitation challenge. As a result, they
preferred to use trenches or continue with the disgusting open defecation practices as it was
best suited for their nomadic lifestyle. The study also found out that there was direct
relationship between the perception of pit latrines being hazardous and the adoption of CLTS.
Most respondents (66%) were of the opinion that pit latrines were unsafe. There have been
reports of children falling to their deaths in substandard pit latrines within Magadi Ward hence
the fear of using pit latrines.
CONCLUSION
The study shows that majority of the inhabitants of Magadi Ward are Maasai semi-nomadic
pastoralists community whose major occupation is livestock keeping. Constant droughts
causing water scarcity, poverty and insecurity contributes to movements of pastoralists groups
and reduce the degree to which sanitation is seen as a high priority. This means that one may
sometimes call for triggering meetings and have a very poor turn-out from households or
community leaders.
Pastoralists tend to be at least partially mobile. Commonly the men of the households (including
morans who are the young men with traditional warrior roles) move their livestock during the
dry seasons, while women, children and the elderly remain at the homesteads. In areas closer
to urban centers with alternative livelihood opportunities, households may entrust the care of
livestock to relatives in more remote rural areas while culturally they continue to consider
themselves pastoralists.Among the highly nomadic groups, focus should be on sensitizing
rather than full CLTSimplementation, as these communities continue to perceive OD as the best
option for their mobile lifestyle, are unlikely to adopt latrines at this point, and may be less
vulnerable to health risks associated with OD due to their frequent movements. Implementors
should meet communities where they are, and these sensitization efforts will be particularly
valuable as existing trends towards more permanent settlement progress and people begin to
consider latrine adoption.
The study revealed that health education promotions areslowed by high illiteracy levels among
adults, which is more than 58%. There are strong negative socio-cultural factors significantly
affecting the implementation of CLTS that prohibit sharing of latrines. Even the thought of
discussing the challenges caused by open defecation in a community meeting that includes
children, parents and in-laws is very much frowned upon thus little attention is paid to the
implementation of CLTS despite its launch in Kajiado County since 2011. This study concluded
that the overall latrine coverage in the study area was very low. No budgetary allocations by
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Simbe, J. Y. & Agoi, L. M. (2025). Factors Influencing Poor Implementation of Community Led Total Sanitation in Kajiado County, Kenya. European
Journal of Applied Sciences, Vol - 13(1). 429-438.
URL: http://dx.doi.org/10.14738/aivp.131.18360
the government were available to aid in the promotion of sanitation coverage and no
government subsidies are put in place despite the MPHS objective to raise latrine coverage by
10% by the end of every financial year.
RECOMMENDATIONS
These are based on the researcher’s and respondents’ ideas to resolve the OD shame; Health
education and promotion should be intensified during the community dialogue days that are
held regularly. Discussions on health and sanitation matters are facilitated by PHOs, CHVs and
key community leaders to discuss ways to provide support and behavior change within the
community. These key leaders should be targeted as sanitation ambassadors to encourage the
community to accelerate the uptake and use of available sanitation facilities. The county
government should, NGOs and stakeholders should embark on awareness raising activities that
emphasize sanitation and also help households to invest in sanitation by creating programs and
projects that will alleviate poverty and increase family income such as introducing pre-paid
metering of all the communal water sources so that financial sustainability of community water
projects can be ensured. In order to address socio-cultural barriers caused by low latrine
coverage the government should focus on sanitation financing interventions by creating a
strong enabling environment through dedicating funding to sanitation in count budgets with
needed subsidies to ensure funds are allocated appropriately and sufficiently to cover complete
implementation of CLTS, including ensuring that PHOs and CHVs are able to conduct trainings,
facilitation for constructing more public latrines, monitoring and follow-up activities. Due to
high levels of illiteracy, effective community sensitization should be intensified by all
development partners using simple methods that the community understands like PHAST. The
county government should recruit more PHOs and CHVs to address gaps, scale up home visits
and actively involve community members in the CLTS programs in order to create a sense of
ownership towards their total sanitation. CLTS should be adopted as a government policy for
the purpose of policy formulation towards improving implementation rates. In order to
improve latrine coverage, partners and stakeholders should endeavor to work together and
support the MPHS, consolidate their gains and embed the approach in all the national
decentralizes systems to ensure its sustainable spread. The county government should make
all efforts to implement the roadmap that aims to make the county ODF by harmonizing
approaches between sectors such as health, water, education, urban planning and
development. Existing regulations, legislations and policies both at national and county levels
should be reviewed and multi-sectoral approach adopted that aims to improve sanitation in
rural areas. Further research is needed on the upscaling of CLTS implementation in the
community to address the gap between knowledge and practice because the low level of
education and its consequences strongly came out. Further studies should be carried out to
determine whether the implementation of CLTS has succeeded to improve sanitation standards
and reduced disease morbidity in the communities.
ACKNOWLEDGEMENT
I wish to gratefully express my appreciation to the County Government of Kajiado, department
of Public Health and Sanitation who made the study possible. I also recognize all the Public
Health staff and Community Health Volunteers who provided me with research assistance.
Special appreciation goes to my family for their financial, moral and spiritual support in the
course of my study.
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LIST OF SYMBOLS
ASAL: Arid and Sem Arid Land
CHV: Community Health Volunteer
MDG: Millennium Development Goal
MPHS: Ministry of Public Health and Sanitation
NGO: Non-Governmental Organization
OD: Open Defecation
ODF: Open Defecation Free
PHAST: Participatory Hygiene and Sanitation Transformation
PHO: Public Health Officer
SDG: Sustainable Development Goal
VERC: Village Educational Resource Centre
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