Viet Nam: hygiene promotion should build on community action

The path down to a stream where children defecate. Viet Nam, Lao Ca province. Photo: Danida

More affordable sanitation technologies and participatory community interventions will make future hygiene promotion more effective, say two PhD-fellows Xuan Le Thi Thanh and Thilde Rheinländer. They have spent 16 months in ethnic minority communities in the Northern Province Lao Cai to do research on hygiene and sanitation promotion in the Danida-funded research project SANIVAT (Water Supply Sanitation and Hygiene Promotion in Vietnam). SANIVAT supports research and capacity building on the impacts of water, sanitation and hygiene interventions and investigates how people perceive hygiene, health risks and hygiene promotion.

Sanivat banner

Difficult sanitation promotion

During the field work, Thilde interviewed ethnic minority people and observed their daily routines. She found that promotion of household sanitation is challenged in many ways and progressing slowly particularly in highland communities. Most people are aware that sanitation is important from the ongoing information campaigns by the Government. But this knowledge hasn’t turned into behaviour change for several reasons Thilde says; “Most families cannot afford the standard model of ‘hygienic latrine’ which is partly subsidized by the Government. And there is also resistance towards having a latrine near their house because people fear the smell of excreta will make them sick. This is also why few families build simple latrines made of local materials. They prefer the forest, the fields or the fish ponds for defecation because of the privacy and fresh air.”

Thilde also found that communities have developed dependency on government support and subsidies. Community ownership for improving hygiene is therefore very low. “One way of increasing community demand for sanitation, which has been effective in pilot projects globally, is to promote a wider range of low technology latrines to choose from depending on the income and preferences of the families. The private markets can help push this process through effective supply chains, subsidized building materials and construction services in the local areas” Thilde suggests.

Read her paper: Hygiene and sanitation among ethnic minorities in Northern Vietnam: does government promotion match community priorities?. Social science & medicine (in press)

School-based sanitation promotion

Xuan Le Thi Thanh is focusing her studies on the hygiene practices of school children and has observed children’s lives while at home and at school. She has identified several challenges in teaching good sanitation behaviours to children. She observed that children frequently defecated in the village surroundings. They did not use the school or home latrines and were not encouraged to use them by teachers or parents. Also, the latrines were often difficult for children to access. Xuan therefore points out; “Like other children, ethnic minority children in this area are clever and active in their daily lives. They can easily learn about hygiene. Their practices are strongly influenced by their communities and by key persons in their lives such as teachers. To strengthen hygiene promotion for children, the community and schools need to cooperate and make decisions on how to teach and maintain good hygiene practices for children”.

Future hygiene promotion – bottom up

The two researchers agree that traditional hygiene information campaigns relying on posters, flyers and educational activities are insufficient promotion methods. If hygiene behaviours are really going to change, hygiene promotion should be more participatory and activate communities and the most important target groups. It could also involve private market agents and research based projects.

The Danish project coordinator, Anders Dalsgaard (University of Copenhagen) says; “Our research shows why you must have in-depth insight into people’s knowledge, attitudes and practices if sanitation behaviours are to be changed. The very important role that bad smell plays for people’s decisions on where and which technology to use when defecating is a good example of this. One of our main roles in SANIVAT is to research to what degree sanitation interventions in Vietnam lead to behaviour change and propose how interventions can be strengthened”.

Source: Danida Devforum, 31 Aug 2010

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