Who is managing the post-ODF process in the community? A case study of Nambale District in Western Kenya

Post-ODF follow-up is central to sustaining open defecation free (ODF) status, and needs to be integrated into CLTS programming from the outset. This paper explores who is to carry out these activities, and how they might be motivated and financed. It argues for the importance of identifying existing administrative and social structures prior to implementation. Looking at reasons for success in Nambale sub-county, which was declared ODF in 2012, the paper discusses the role of Community Health Workers (CHWs), who, under the Kenyan Community Health Strategy Approach (CHSA) have an expanded remit that includes CLTS, in follow-up and in reaching the poorest and most marginalised within communities. The paper highlights challenges which have arisen, such as incentives to motivate CHWs, as well as the risk that devolved government structures lead to inequity among districts, and varying levels of funding for the same activities, thereby threatening ODF achievement and sustainability.