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In The Netherlands we organise WASH Debates on wicked topics facing the sector.

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IRC WASH Debate: Building institutional capacity for behaviour change & sanitation programming

11th Sep 2018

Held on 11 September 2018, the debate discussed the use of the Community-Led Total Sanitation approach as an effective method to achieve changes in behaviour and ending open defecation. Read the report.

The Ministry of Foreign Affairs of the Netherlands puts Community-Led Total Sanitation (CLTS) central in its approach to sanitation and behaviour change, recognising it has been a very effective method to achieve changes in behaviour and ending open defecation. At the same time, it recognises the need to have complementary approaches and methods to climb the sanitation ladder and develop the sanitation value chain. This could include issues such as faecal sludge management and supply-side measures. In addition, there is need to institutionalise the promotion of behaviour change in the relevant (local) authorities, in order to be able to sustain behavioural changes.

This WASH debate - jointly organised by IRC and IHE Delft - aimed to bring greater attention to the variety of behaviours that make up good sanitation, and the range of actors involved in keeping a toilet functional and an environment clean. Specifically it focused on questions such as:

  • How can CLTS be best combined with other sanitation approaches?
  • And, in situations where CLTS might be mismatched for local contexts, what alternative methods can be applied to effect change?
  • How can the capacity for behaviour change and sanitation programming be institutionalised?

Through this, the debate aimed to:

  • Present behaviour science approaches to complement the gaps identified in the Dutch policy framework.
  • Offer guidance on ways we can strengthen and expand upon ongoing change initiatives across the sanitation value chain.
  • Reflect on programmatic elements of building institutional capacity to support and maintain behavioural change over time and at scale.

Panel speakers:

  • Dr Kamal Kar, CLTS Foundation
  • Dr Om Prasad Gautam, WaterAid
  • Dr Lina Taing, IHE Delft

As usual, the WASH Debate consisted of presentation by speakers, followed by a moderated plenary discussion with the panel members. 

Kamal Kar and Om Prasad Gautam are guest lecturers for a module on 'Behaviour Change & Advocacy' in IHE Delft's new 12-month Sanitation MSc, which Lina Taing is coordinating. The module highlights the significance of behavioural change across the sanitation value chain.

Read the WASH Debate report titled "Instituting sanitation change", which includes a recording of the live stream and the presentations.


7AM, Buitenhof 47
2513 AH The Hague

How to get to 7AM >

Time and date

17.00-18.30, 11 September 2018


16:30 – 17:00Welcome: Coffee and tea/networking

17:00 – 17:05

17:05 – 17:10

Welcome by Bryony Stentiford, Head of strategic partnerships, IRC

Introduction to the programme and speakers by the moderator: Stef Smits, Senior Programme Officer, IRC



Collective behaviour change: Key to enhance large-scale investment efficiency in sanitation and public health. By Kamal Kar, Founding Chairman, CLTS Foundation

Hygiene behaviour change at scale: what works and what doesn't. By Dr. Om Prasad Gautam, Senior WASH Manager, Global Lead on Hygiene Behaviour Change at WaterAid UK

Extending the playing field: The significance of institutions in instituting sanitation change. By Lina Taing, Postdoc Researcher, IHE Delft

Panel & plenary discussion


Plenary debate, led by the moderator will focus on the perspective from the audience, focusing on guiding these questions:

  • How can CLTS be best combined with other sanitation approaches?
  • And, in situations where CLTS might be mismatched for local contexts, what alternative methods can be applied to effect change?
  • How can the capacity for behaviour change and sanitation programming be institutionalised?
18:25-18:30Closing remarks and an invitation to drinks and networking
19:30 End

Speaker bios


Dr. Kamal KarDr. Kamal Kar is a renowned international development specialist in rural development and a prolific social entrepreneur who has taken the challenge of ending open defecation head on in Asia, Africa and Latin America. He pioneered the Community-Led Total Sanitation (CLTS) approach in Bangladesh in 1999-2000. The CLTS methodology, which is based on a no-subsidy policy and rooted in a model of community empowerment and mobilisation, has radically transformed global sanitation policy focus from toilet construction to the process of collective behaviour change. It has spread to more than 69 countries across Asia, Africa and Latin America where more than 40 million people are now living in open defecation free (ODF) environments. CLTS has also been mainstreamed in the sanitation policies of more than 25 countries in these regions.

Om Prasad GautamDr. Om Prasad Gautam is a public health professional and behaviour change scientist with more than 18 years of work and research experience in Water, Sanitation & Hygiene (WASH), child health, behaviour change, immunisation, food hygiene/safety, diseases surveillance and HIV/AIDS programmes. He completed his PhD from the London School of Hygiene and Tropical Medicine (LSHTM). Dr. Gautam currently is the Senior WASH Manager - Global Lead on Hygiene Behaviour Change at WaterAid UK, where he is involved in providing strategic technical guidance on behaviour change intervention design, programme development, management and evaluation. Dr. Om previously worked with LSHTM, WaterAid in Nepal, the World Health Organization, Immunization Preventable Diseases and the Association of International NGOs. Om is passionate about the role that water, sanitation and hygiene play in human development, and brings his skills to the development sector in order to improve the health and wellbeing of the poorest, excluded and most vulnerable groups.

Dr. Lina TaingDr. Lina Taing is a Researcher and Module Coordinator/Lead Lecturer for a two-week MSc Sanitation module on Behaviour Change and Advocacy at IHE Delft. She previously worked for various health NGOs in the UK, US, Liberia and South Africa and conducted research with the Universities of Oxford and Cape Town. Funding from the European Commission's Marie Sklodowska-Curie COFUND allows Lina to conduct sanitation implementation research in sub-Saharan Africa.

Live stream and recording

If you are not able to attend the WASH Debate in The Hague you can follow the live stream on IRC's Twitter page from 17:00-18:30 CEST [convert to your local time]. A video recording of the debate will be available shortly after the event.

Reading list

CLTS Institutional Triggering examples

Behaviour change approaches

Significance of behavioural determinant targeting in sanitation programming

  • Simiyu S, Swilling M, Cairncross S, et al. (2017) Determinants of quality of shared sanitation facilities in informal settlements: case study of Kisumu, Kenya. BMC Public Health 17(1). BMC Public Health: 68. DOI:
  • Winter S, Dreibelbis R and Barchi F (2018) Context matters: a multicountry analysis of individual- and neighbourhood-level factors associated with women’s sanitation use in sub-Saharan Africa. Tropical Medicine and International Health 23(2): 173–192. DOI:


Stef Smits,
Dechan Dalyrimple,