Open defecation is a practice where people “free themselves” (defecate) in the open environment. This practice is worse in the rural part of Ghana especially; the northern enclaves were West Mamprusi Assembly is located. In 2015, global sanitation figures show that, 2.4 billion people lack improved sanitation and 946 million people practiced Open Defecation. Fecal contamination of the environment from poor sanitation together with poor handwashing caused an estimated 57,700 deaths annually (Jonny Crocker, 2016). In 2020, 54% of global population (4.2 billion) have access to safely managed sanitation services. Out of this number, 1.7 billion people still do not have toilets or latrines in their homes but manages with others and public toilets. Interestingly, 494 million people defecate in the open such as bushes, gutters, and water bodies – WHO, 2022.In Africa and Ghana, poor sanitation is linked to diarrhea disease which causes about 16% to 25% of deaths among children under five years according to secondary data. Government as part of her efforts and mandate to improve sanitation created a ministry of sanitation to help in the achievement of the principle of Sustainable Development Goal six (6) (Access to adequate and equitable sanitation and hygiene for all). It also took further initiatives to identify a program called Community Led Total sanitation (CLTS) in the year 2000 to meet the SDGs by 2030.The Community Led Total sanitation program is an innovation strategy to mobilize communities to practice desired environmental hygiene to eliminate Open Defecation (OD). The program started in Bangladesh in 1999 and later spread through 60 countries, mostly Africa and the Asia (Valentina Zuin et al, 2019). It is a pilot program in the northern part of Ghana and West Mamprusi Municipal Assembly in perspective. The program enabled construction of latrines, handwashing education and sanctions to ensure compliance. A community is ODF if all houses own and use latrines effectively.The program focuses on behavioral changes needed to ensure real and sustainable improvements instead of constant government and NGO supply. It relies on facilitators from the communities called “Natural Leaders” to spearhead the CLTS activities. This is supported by traditional leaders of various communities. It is against this background that the research is fashioned to find out the effectiveness and sustainability of the Community Led Total Sanitation (CLTS) strategy that has been successfully implemented in the West Mamprusi Municipality since its operation in November 2012. The objective of the research includes following.1. Analyze the sanitation situations in the communities before and after the introduction of CLTS.2. Examine the contributions of the CLTs program in the West Mamprusi Municipality.3. To find out if the program is sustainable.The research is anticipated to address the sanitation needs of the people by the lessons learnt from the CLTS program implementation, bring efficient institutional framework that will ensure effective and sustainable implementation of CLTS and add to existing knowledge in shaping the sanitation policies.The researcher used a mixed method approach (qualitative and quantitative methods) to carry out the research. This was done through interviews, observations, focus group discussing, etc on one side and the use of survey through google forms on the other. With the survey, questionnaire was designed for respondents from the selected communities, staff, and NGOs. It also relied on secondary data from the Environmental Health DepartmentThe study administered 300 respondence including household heads chosen through rigorous random sampling with a fixed interval of 3, focus group discussion and interview. A statistical tool call SPSS was employed with the help of Microsoft Excel to create frequency tables, graphs, and pie charts. Thematic analysis was used to assess qualitative data, and the combined findings of quantifiable information in the form of narrations or direct quotes. The research was conducted in ten communities of the Municipality: Daboya, Takuka, Booku Duuri, Yelwaku, Gbimsi, Wulugu, Yama, Tinguri, Guabuliga and Janga.Semi-structured research questionnaires in the form of google forms were used for the quantitative data. Participants were given questionnaires to complete by skilled research assistants who also helped them in doing so. Focused group discussions (FGD) sessions were undertaken with household heads, one from each sub-location depending on the community. These sessions produced qualitative data. The research assistants recorded the participants' opinions by asking questions and taking down notes. The research revealed the following findings.1. No visits nor communications between environmental officers and most communities especially, the interior part of the Municipality before.2. Communities had no adequate knowledge about the cause of diarrhea disease associated with poor sanitation3. CLTS induced knowledge sharing among community members.4. The program has proven to be the most effective tool to tackling sanitation issues.5. The programs sustainability depends on adaptability, types pf latrines constructed and willingness of the people to accept punitive measures educated them.Research limitation.The researcher could not reach out to some communities due to flooding making roads inaccessible.The time for the conduct of the research was not appropriate because it was at the peak of farming season. Hence, participation was affected.Inadequate finance to have covered more communities