The Improved Water, Sanitation and Hygiene (IWASH) program implemented Community-Led Total Sanitation (CLTS) in counties of Liberia to analyze the relationship between Open Defectation Free (ODF) status with the Ebola Virus Disease (EVD). The purpose of the study was to validate informal claims that IWASH communities with ODF status experienced no cases of EVD and to identify which community-based EVD activities were most effective. The study included various quantitative and qualitative methods which found a strong correlation between communities who achieved ODF status and were EVD-free, but did not prove causality. In general, CLTS communities showed lower incidence of EVD and this was attributed to training via Natural Leaders, behavior change, and good hygiene practices.
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