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It is estimated that Ghana loses about GH�42 million annually due to inadequate sanitation and hygiene services. Mr Vincent Adzato Ntem, Chief Director, Ministry of Local Government stated this at the signing of a contract between Ministry of Local Government and six community based organisations in Accra yesterday. The community based organizations are Pronet North, Obomma Rural Action Program, Foundation for Better Tomorrow, Youth and Social Enterprise Fund, Green Shephard Ghana, and Gbang Watsan Service Limited. Mr. Adzato Ntem said the Water, Sanitation and Health (WASH) sector recognized the role Nongovernmental Organizations (NGOs), civil society organizations and partner organisation played in WASH services delivery and their capacity to reach people at the community level. He said in Ghana, access to sanitation was very low with the country ranked second from the bottom in the open defecation ladder in West and Central Africa, adding �About 70% of outpatient attendance in Ghana is due to poor sanitation.� He said for Ghana to meet its development target for sanitation, it was imperative that stakeholders introduced effective programmes and also collaborated in their activities. The Community Led Total Sanitation (CLT) which was first introduced in 2006 by UNICEF, Water Aid, Plan, and the Community Water and Sanitation Agency had made some achievements. The approach had been adopted in the revised Environmental Sanitation Policy (2010) of the Ministry of Local Government and Rural Development. Adding her voice, Mrs. Loretta Roberts, WASH Specialist at UNICEF, the main sponsor of the CTL programme, said they were going to add two more regions to the original four.