Satoshi Kaneko

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.