Effects of Community-Led Total Sanitation (CLTS) Boosting and Household Factors on Latrine Ownership in Siaya County, Kenya.

Community-led total sanitation (CLTS) is a widely used approach for enhancing sanitation practices. However, the impact of boosted CLTS on household latrine ownership has not been adequately evaluated. This study aims to investigate the factors associated with latrine possession among households, with a specific focus on single and CLTS-boosting implementation. A community-based repeated cross-sectional study was conducted in Siaya County, Kenya, involving 512 households at the baseline and 423 households at the follow-up. Data were analyzed using the mixed-effects logistic regression model. At the baseline, latrine possession was significantly associated with CLTS implementation (adjusted OR [aOR]: 3.01; 95% confidence interval [CI]: 1.41-6.44), literacy among households (aOR: 1.83; 95% CI: 1.12-2.98) and higher socioeconomic status (SES) (second level: aOR: 2.48; 95% CI:1.41-4.36, third level: aOR: 3.11; 95% CI: 1.76-5.50, fourth level: aOR: 10.20; 95% CI: 5.07-20.54). At follow-up, CLTS boosting (aOR: 7.92; 95% CI: 1.77-35.45) and a higher SES were associated with increased latrine ownership (second level: aOR: 2.04; 95% CI: 0.97-4.26, third level: aOR: 7.73; 95% CI: 2.98-20.03, fourth level: aOR: 9.93; 95% CI: 3.14-28.35). These findings highlight the significant role played by both single and CLST boosting in promoting universal latrine ownership and empowering vulnerable households to understand the importance of sanitation and open defecation-free practices.

Kenya Comprehensive School Health Policy: Lessons from a Pilot Program.

The study assessed the implementation of Kenya comprehensive school health pilot intervention program. This pilot program has informed the Kenya Comprehensive School Health Policy which is a critical document in the achievement of Millennium Development Goals relating to child health, gender equality, universal education and environmental sustainability. The study was based on focus group discussions, field observations and in-depth interviews with government officers who implemented the pilot program. The findings were categorized into implementation process, what is working well, what is not working well and lessons learned. During the course of the study, it was noted that involvement of all stakeholders enhances program ownership and sustainability but if they are not well coordinated or where supportive supervision and monitoring is not carried out, then some components of the comprehensive school health program may not be sustainable. We learnt that comprehensive school health program increases students' enrolment, attendance and retention, factors that are very important in a country's human resources development. The study has shown that although the formulation of a policy may be participatory and bottom-top, the implementation requires allocation of enough resources and coordination to bridge the gap between policy formulation and implementation.