Factors Affecting the Implementation of Community-Led Total Sanitation in Four Selected Chiefdoms of Chipangali District, Eastern Province, Zambia

Introduction: Community-Led Total Sanitation (CLTS) is a participatory approach aimed at improving sanitation and hygiene practices by empowering communities to achieve open defecation-free (ODF) status. Despite being implemented in eight Chiefdoms of Chipangali district, Zambia, none have achieved ODF status five years after the project's initiation. This study assessed the factors influencing CLTS implementation in four chiefdoms: Mshawa, Mkanda, Chanje, and Mnukwa, all of which share similar cultural, demographic, and resource backgrounds. Materials and methods: Using a mixed-methods, cross-sectional analytical study design, data were collected from 267 households through systematic random sampling, as well as from CLTS facilitators and stakeholders using purposive sampling. Semi-structured questionnaires and interview guides were used for data collection. Qualitative data were analyzed using Nvivo, and quantitative data using descriptive and inferential statistics in Statistical Package for the Social Sciences, with significant associations established at p < 0.05. Results: The study found that Chanje Chiefdom had the highest sanitation coverage (65%), though the majority (68.2%) of respondents still used pit latrines without a smooth, cleanable floor. Key factors affecting CLTS implementation included geographical location, community awareness, leadership, external support, and collaboration. These factors significantly contributed to the varying sanitation coverage across the four chiefdoms. Conclusion: The study concludes that CLTS implementation is influenced by a combination of geographical, leadership, policy, and external support factors. To improve CLTS implementation, the study recommends proactive community engagement, the use of traditional sanctions by leaders to promote latrine construction, and periodic sensitization by local authorities for CLTS implementers.