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Evaluation database

Evaluation report

2016 Ethiopia: Outcome evaluation of community-led total sanitation and hygiene (CLTSH)

Author: BDS Consulting firm, Addis Ababa, Ethiopia

Executive summary

With the aim to continuously improve transparency and use of evaluation, UNICEF Evaluation Office manages the "Global Evaluation Reports Oversight System (GEROS)". Within this system, an external independent company reviews and rates all evaluation reports. The quality rating scale for evaluation reports is as follows: “Highly Satisfactory”, “Satisfactory”, “Fair” or “Unsatisfactory”. You will find the link to the quality rating below, labelled as ‘Part 2’ of the report, and the executive feedback summary labelled as 'Part 3'.


After the introduction of CLTSH in Ethiopia and seeing the power it has in mobilizing the rural communities for their action to stop practicing open defecation, UNICEF, in collaboration with the Federal Ministry of Health, agreed to make CLTSH the principal approach to promote rural sanitation in its 2012 - 2015 Country Program Document (CPD). These interventions were targeted at 86 of UNICEF’s learning woredas (districts) in all regions of the country.

The Water Supply and Sanitation Collaborative Council (WSSCC)/ Global Sanitation Fund (GSF) then initiated a program termed the Ethiopia Sanitation and Hygiene Improvement Program (E-SHIP) in 2013. Accordingly, it has been being executed in 40 woredas of Amhara, Tigray, SNNP and Oromia regions of the country. Both programs were implemented by the Ministry of Health through its Health Extension Program (HEP). 

In order to assess outcomes of the CLTSH program in general, and in the areas supported by UNICEF and WSSCC-GSF, and to see how far the National CLTSH Implementation Guideline is used as a major guiding document, UNICEF Ethiopia in collaboration with WSSCC-GSF and the Ministry of Health initiated this evaluation. The purpose of this evaluation was to see how CLTSH is effectively implemented and to draw lessons learnt from the process.

As there was no official ‘baseline’, for the purpose of this evaluation, two woredas (one intervention and one ‘control’) were selected from each of UNICEF’s operation regions (Amhara, Oromia, SNNPR, Tigray, Benishangul Gumuz, Gambela, Afar and Somali) and two woredas (one intervention and one ‘control’) were selected from each of WSSCC/GSF’s operation regions (Amhara, Oromia, SNNPR and Tigray). The intervention woredas were randomly selected from the lists of program woredas of the two organizations. The control woredas were selected purposively considering their socio-economic similarities and their proximity to the intervention woredas.


The main purpose of the outcome evaluation was to review lessons learnt from the implementation of the UNICEF and WSSCC supported CLTSH programs and use them to influence the approach to rural sanitation in the future UNICEF CPD and HSDP-V.


The methodology employed for the evaluation is desk assessment, household survey, Key Informant Interview and focus group discussion.

Findings and Conclusions:

  • Pre-triggering which did not produce essential outputs of consensus building workshop which were supposed to ensure strong inter-sectoral collaboration;
  • Triggering sessions that did not ensure community action plans were developed -  which is the road map to CLTSH implementation and follow up;
  • Post-triggering training sessions organized for CLTSH implementers which happened without considering CC/FD which again are supposed to empower the people at grass root level and serve as instrument for community led follow up.

All these findings reveal that the implementation of CLTSH in UNICEF’s and WSSCC/GSF’s program areas misses quality considerably and lack essential contents suggested by the National CLTSH Implementation Guideline.
Though the general status of outcomes of CLTSH program implementation in Afar and Somali is more or less similar as it is in the other regional states, considerable proportion of respondents from these regions have farmland for farming and the vast majority are illiterates. Though most of the respondents from Afar and Somali showed their interest to have own latrine at their home, this evaluation revealed that the great majority of households in these regions are still using open field for defecation. Large proportion of households in Afar and Somali are still getting water for household consumption from unprotected sources. On the other hand, good proportion of households in these regions reported that they are treating water at household level before use.


See specific recommendations at different levels such as federal, regional, woreda and health post levels in the report.


Full report in PDF

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Report information





WASH - Hygiene promotion; sanitation systems


WSSCC/GSF, FMoH-Ethiopia

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