A friend has raised the question of why "open defecation" has been going up, even though improvements have been noted elsewhere. Answers on the post card please!
There is a big initiative that gained ground in the last 5-10 years called Community Led Total Sanitation. I think some villages in Zambia are part of that but it may not be wide spread yet. The pioneers, Kamal Kar and Robert Chambers champion it for rural areas. It principally depends on local people understanding the linkages between excreta and health and other indicators using simple maps drawn by communities themselves. Eventually they plan their own actions and drive their own plans with little external support. The key for CLT is monitoring without which you are almost guaranteed failure.