Poor sanitation and hygiene are leading causes of high mortality rates among children under five in developing countries. In this video, Manisha Shah discusses the impact of a community-led total sanitation programme on child health outcomes in 160 villages in East Java, Indonesia. ‘Triggerers’ spending a day at rural communities to discuss sanitation practices and how they could be improved through the construction of latrines. No financial assistance was provided, however, and only the wealthier households ended up building latrines. Overall, the intervention had a limited impact on the health of children in poorer households. Coupling interventions with subsidies or financial incentives could prove much more effective.