Globally, 3.6 billion people lack access to improved sanitation and 494 million people practice open-defecation (OD), of which 92% are living in rural areas of Central and Southern Asia and sub-Saharan Africa (JMP, 2021). United Nations has reaffirmed the importance of sanitation by including it in the Sustainable Development Goals (SDG6.2), which calls for an end to OD and for universal access to adequate and equitable sanitation (UN, 2015). To achieve the SDG6.2, several sanitation projects are being implemented. A sanitation project entails seeking an improvement of the living conditions of a population. These conditions are sanitary, environmental and economic. Funding is therefore mobilized and several stakeholders are involved. Unfortunately, funding has created a culture of dependence on subsidies by the beneficiary communities, leading them to stop making efforts to solve their sanitation problems and always reach out, even in situations where they have the means to do so by themselves (Kar and Pasteur, 2005). Additionally, financial supports have led to uneven adoption, sustainability problems and partial use of the sanitation facilities. OD through the fecal-oral contamination cycle continue to spread diseases. In response to this situation, behavior change (BC) approaches have been developed. They are fundamental to achieve sustainability in communities through the identification of new, and strengthening the existing positive practices (Afzal et al., 2022). It is considered central to the quest for a sustainable future and solves community problems, which require large scale shifts in human behavior with regard to long held habits (Yusliza et al., 2020). In the context of growing concern over the quality of human life and development of communities, BC interventions are considered essential to achieve sustainability in communities (Dickin and Gautam, 2019). Among BC approaches, there is the Community-Led Total Sanitation (CLTS) has emerged in 2000. CLTS has started in Bangladesh and has spread to rural areas in 66 countries in Asia, Africa, and America (Fig. 1). 36 countries have adopted CLTS as part of their national rural sanitation strategy and/or policy (Institute of Development Studies, 2019). Currently, CLTS is one of the most widely deployed behavioral hygiene and sanitation interventions (Zuin et al., 2019) ( .

CLTS enables paradigm shift from teaching to communities facilitating their own analysis, from subsidizing the poor to communities doing it (Sah and Negussie, 2009). It enables a shift from top-down hierarchical standardization to bottom-up approach, and from investing on equipment to investing on human resources (UNICEF Mali, 2014). CLTS is meant to receive no funding unlike previous approaches. It focuses on the behavioral change needed to ensure lasting improvements. These include investing in community mobilization rather than infrastructure, and shifting the focus from building latrines for individual households to creating Open-Defecation-Free (ODF) villages. By raising awareness that “as long as even a minority continues to practice OD, everyone is at risk of disease”, CLTS triggers the community's desire for collective change, pushes its members to action, mutual support, and locally solutions (Mukherjee and Mukherjee, 2017).

Attention to community participation has become a priority of the 2030 Agenda for Sustainable Development. SDG6.2 also supports participation of local community in improving water and sanitation management (UN Water, 2019). In this context, CLTS has a role to play in achieving this goal because it is participatory and has shown promise in addressing OD (Pickering et al., 2015). CLTS is currently considered by most international donors to be the most effective approach to scaling-up sanitation (Galvin, 2015). Being implemented for, with and by the community, CLTS should have had greater sustainability in terms of sanitation facilities use and hygienic behaviors than previous sanitation approaches. Unfortunately, experience reveals that this has not been the case in some communities. While the SDGs emphasize the need to reach everyone, there is growing evidences that CLTS outcomes may not be sustainable as expected (Robinson et al., 2016; USAID, 2018a). Poorer households more likely to revert to OD after a period of time (Odagiri et al., 2017; Robinson and Gnilo, 2016; USAID, 2017). Studies conducted by Cavill et al. (2015); Chambers and Myers (2016); Crocker et al. (2017a); Kouadio (2019); Abebe and Tucho (2020) revealed that after an initial excitement at the beginning of the CLTS implementation and the achievement of ODF-status, there was a slackening of communities often after two years of the change in behaviors advocated by CLTS are no longer followed. CLTS is now being questioned, particularly with regard to its methods, its results and the sustainability of the ODF-status.

Being a participatory approach, the objective of CLTS is to lead to sustainable behavioral changes. In spite of the community involvement in CLTS implementation, we are still witnessing a slackening. How then can we explain slippage (return of OD or the partial use of latrines) in some communities that had adopted CLTS and had been certified ODF 2–4 years ago?

Several authors have investigated on the sustainability or slippage of sanitation interventions in general and on CLTS in particular (Abdi, 2016; Abebe and Tucho, 2020; Ayalew et al., 2018; Barnard et al., 2013; Bhatt et al., 2019; Crocker et al., 2017; Galan et al., 2013; Garn et al., 2017; Kouadio, 2019; Osumanu et al., 2019; Patwa and Pandit, 2018). Crocker et al. (2017); Hanchett et al. (2011); Mukherjee et al. (2012) and Tyndale-Biscoe et al. (2013) have reported on sanitation outcomes and that the period of return to OD is 2–4 years after the end of CLTS.

This paper therefore identifies, categorizes, and analyzes the slippage factors towards OD following CLTS implementation. It is essentially based on literature review. It proposes a graph showing all the slippage factors and their associated categories. It highlights shortcomings and develops a set of actions that could be taken in order to improve the sustainability of ODF-status.