In Pakistan, 25 million people still practice Open Defecation and women are the ones who are the worst affected. The death toll from diarrheal diseases shows that 53,000 Pakistani children under five die annually from diarrhea due to poor water and sanitation. The women are exposed to not only health hazards but sexual abuse and violence every single day and especially after nightfall.

Girls stop their education not for lack of desire, but for lack of sanitation. HANDS – WASH program is committed to the SDG target of providing clean water and sanitation to its target communities and to address the issue of sanitation Community Led Total Sanitation -CLTS approach has been adopted. CLTS is an innovative methodology for mobilizing communities to completely eliminate Open Defecation (OD).

Communities are facilitated to conduct their own appraisal and analysis of open defecation (OD) and take their own action to become ODF (open defecation free). Pakistan Approach to Total Sanitation- PATS emphasize towards behavior change and social mobilization endorsing the use of a number of branded total sanitation models, having a key role of communities, which include, Community Led Total Sanitation, School Led Total Sanitation, Component Sharing, Sanitation Marketing and Disaster Response HANDS has implemented Water and Sanitation activities with respect to ODF in 16 districts.

The target communities were sensitized with the help of Community Resource Persons – CRPs/Village Wash Committees- VWC regarding the hazards of open defecation/poor sanitary practices and its consequences. The receptive environment created through the collective efforts made it possible that all the target villages have been declared Open Defecation Free.

An ‘Open Defecation Free’ village is characterized by Excreta free open spaces, Excreta free open drains / discharges, Excreta free hands, and Sustaining of this status.

Overall 2822 villages have been declared Open Defecation Free

In the intervention districts the Open Defecation status has changed as compared to non- intervention districts and status of PDHS 2017-18 areas 55% of intervention areas have flush system to sewerage tank as compared to 40.3 in non intervention areas and 29.9% in PDHS 29% villages.