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

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