Taking Sanitation to Scale in Vietnam


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A resident in Hoa Binh Province is happy with his newly built toilet. Photo: World Bank’s Water and Sanitation Program

Sanitation brings numerous benefits such as reducing the burden of disease, improving quality of life, promoting the safety of women and girls, not to mention the excellent economic investment that sanitation represents. Yet, to realize these benefits, new approaches are needed that work at scale and promote equality of access. As Eddy Perez, Lead Sanitation Specialist at the World Bank’s Water and Sanitation Program, recently highlighted in his excellent blog posts, eliminating inequalities and achieving universal access requires transformational change and a departure from ‘business as usual’. (Read ‘How and Why Countries are Changing to Reach Universal Access in Rural Sanitation by 2030’ and ‘Fixing Sanitation Service Delivery for the Poor to Meet the Twin Goals’).

As Eddy notes in his second post above, there is a clear geographical correlation that exists here in Vietnam, between the lack of access to sanitation and the rates of poverty and stunting in the country. In the Northern Mountains and the Central Highlands regions, rates of stunting and poverty are high and access to sanitation is among the lowest in Vietnam. Approximately 21% of the rural population in these regions defecate in the open. However, in addition to these linkages, a further dimension of sanitation inequality exists in Vietnam, that of ethnicity. In the Northern Mountains and Central Highlands regions, the rate of open defecation increases to 31% for the ethnic minorities.

The biggest lesson learned so far in Vietnam and other countries is that eliminating open defecation is not driven by construction of toilets. It is driven by changing behavior at the community level based on quality, evidence-based interventions. What is also clear is that approaches must be tailored to the specific context with careful consideration of local factors such as ethnicity.

The second biggest lesson learned is that strong political will and leadership at the highest national and provincial levels, combined with local administrative commitment, are key facilitators in achieving and sustaining success.

Vietnam is among the countries committed to eradicating open defecation by 2025. To meet this target will require two key things to happen. First, all stakeholders will need to come together to make a high level commitment to tackling open defecation. Second, we will need to involve leading experts such as the London School of Hygiene and Tropical Medicine, which is world renowned for its expertise in behavior-centered design to develop truly innovative and context specific approaches to change and sustain sanitation behaviour on a large scale.

On the World Toilet Day, I would like to ask for your thoughts on how to improve equitable access to sanitation in Vietnam. Please share with us!


Parameswaran Iyer

Program Leader and Lead Water and Sanitation Specialist

December 04, 2014

I am living in Hoa Binh province. After reading this article "http://khampha.vn/suc-khoe/hoa-binh-chi-co-hon-40-nha-tieu-hop-ve-sinh-…; and your blog, I am shocked to realize that nearly 60% of Hoa Binh people do not access to good toilets. When going out of the city, I knew that there're many people in HB defecate openly, but I guessed the percentage of 40%. There's a fact that Vietnamese people drink 3 billion litre of beer annually. This equals to 3 billion USD. If all of beer expenses are used to build good toilets, we can build 20 millions household toilets (As I know, Childfund spent about 150 USD on building a good household toilet). If Vietnamese people save beer expenses to build toilets, we can eradicate open defecation in few coming years. I have an idea to open a communication campaign on saving beer expenses to built toilets. We can draw pictures using cans of beer to form a toilet, a healthy man with less beer drinking, healthy and happy woman and children having good toilets to use. I hope to find someone who could help to make my idea come true. Then I could make a little contribution in bringing a better life for my people. :)

Le Thi Kim Thoa
November 25, 2014

I think it is uneasy reach (to eradicating open defecation by 2025). We need to do alot of things.
First, how to change behaviors of people regarding the use of unhygiene latrines to use hygiene latrines, who will come to the communities and work with people (who pay for their works). Second, who will pay for communication strategies to introduce sanitation toilet models, for examle, bio irrigation treament model which is one of good model or simple toilets (cheap ones) for people to build in large scale.

quamrul Islam
November 24, 2014

You might have known that my organization in Bangladesh (Village Education Resource Center VERC) has innovated the community empowering CLTS approach, we can help you in promoting sustainable hygiene behaviour change communication interventions if you are really interested in this respect. Make contact with us or try to explore more about CLTS and its origin on website.

Atul Bhide
February 11, 2016

Great insights on whats happening outside India on Sanitation.
In last two years, through our Rural Sanitation project 'Right To Go' we have empowered 371 families with their own individual toilet blocks in Sogav and Nandwal village of Shahapur taluka of Thane District in Maharashtra state of India.
The major reasons behind the success of these two projects are:
• Availability of water
• Beneficiary centric approach, it has to be a need based project
• Involvement of Beneficiaries through their sweat labor as well as financial contribution
• Appointment of local contractor
• Taking care of the behavioral aspects and habits through counselling
• Soft training in hygiene and toilet maintenance
• Identification of active/influential group of people in village and involving them in mobilization of villagers.
Currently the third project is being undertaken in Dahigaon village with next 250 individual toilet blocks.
I have taken this as my personal mission and will be happy to guide anyone on this.
The next plan is to make this scalable in bigger way, instead of one village in one year, plan to do 4 to 5 villages in each year.
I have seen that if you are true to your cause and passionate about it, finance is never a problem.
We have been financially supported by Indian American Dr. Renuka Desai, Rotary Foundation and of course my own club Rotary Club of Thane Hills, India.
There are many Corporate who wish to come forward if they find 'right' people to work with.
Now that Government of India has roped in Mr.PARAMESWARAN IYER for Swatch Bharat mission, we expect a lot happening in this sector.
I am positive about India!