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Community – led sanitation often neglects the poorest and most disadvantaged people in society as they are often unable to participate. This paper looked at the experiences of three CLTS communities in Bangladesh. It found that a well being ranking, amongst other things, should be used to help identify vulnerable members in the community and that vulnerable people themselves strongly believe in the power of CLTS to improve their livelihoods and their importance in the participation of CLTS activities. Furthermore, vulnerable people are motivated to move up the sanitation ladder and most households have made improvements to their latrine. Finally, the installation of toilet seats on latrines to aid disabled people has in some cases decreased the sanitation independence of other household members 

Since establishing a programme in Nigeria in 1995, WANG and partners have tried several approaches to promoting sanitation which have not yielded sustainable changes. In its attempt to seek a more sustainable methodology, WANG initiated the pilot testing of the Community Led Total Sanitation (CLTS) approach which aimed to facilitate a participatory process of empowering local communities to improve their sanitation situation. This evaluation report assesses the efficiency, effectiveness and relevance of the CLTS programme, and recommends ways of improving and scaling up the programme in Nigeria. The evaluation provides wide ranging evidence that that CLTS is an effective approach to establishing hygiene and sanitation practice in Nigeria, but the effectiveness varied depending on certain conditions which will need to be taken into consideration when scaling up the initiative