Abstract | Development projects in rural areas have lagged behind their urban equivalents in post-decentralisation Pakistan. What little investment is going into sanitation projects from various line departments and municipal administrations is output oriented. The projects are implemented using traditional approaches with heavy focus on the creation of infrastructure. The project planners and implementers are interested in counting the numbers, the tangible outputs of any infrastructure project, at the end of the project cycle. None of the projects count "outcomes", that is, the end impact or likely impact on the health of beneficiaries and the environment. Another dilemma for the sanitation sector is that there is little focus on "softer" issues, such as healthy hygiene and behaviour change, either as part of a project or independently. Most infrastructure projects fail because they are not demand driven, through a lack of ownership, and because they do not address the issue of behaviour change. Consequently the project becomes dysfunctional some time after completion. The new partnership between WaterAid and Integrated Regional Support Programme (IRSP) paved the way for the introduction and scaling up of Community Led Total Sanitation (CLTS) in Takht-e-Bhai in coordination with the Tehsil Municipal Administration (TMAs) in Mardan district of North West Frontier Province (NWFP). With its focus on "behaviour change" and "outcomes", the CLTS approach was implemented properly and gained success. [authors abstract] |