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Globally, access to water sanitation and hygiene (WASH) facilities remains crucial to human health and overall development because inadequate disposal of human excreta is largely associated with numerous diseases including diarrhoeal and polio. Although Nigeria has made progress towards developing policies and strategies for improved WASH, the country continues to struggle to translate these frameworks into action as access to WASH facilities is still very low. Indeed, some 70 million people still lack access to safe drinking water and more than 110 million lack access to improved sanitation, and a consequence the prevalence of open defecation (OD) which stands at 29 per cent, posses a grave risk to public health. The shortcomings of these approaches led to the adoption of approaches such as Community Led Total Sanitation (CLTS). This paper assesses emerging issues in CLTS implementation in northeast Nigeria. Some policy prescriptions are suggested towards addressing the observed challenges.