In 2000 a new approach to increasing sanitation coverage, called community-led total sanitation (CLTS), was first introduced in Bangladesh in a small village in the Rajshahi District by Dr. Kamal Kar in co-operation with WaterAid Bangladesh and the Village Education Resource Centre (VERC).
These perceived shortcomings led to the development of the CLTS approach in Bangladesh, shifting the focus on personal responsibility and low-cost solutions.