From skeptic to change agent

Building markets for sanitation always has challenges, but the conditions in Vietnam provide particular barriers. From the top levels of Vietnam’s communist leadership to local government employees, iDE needed to overcome negative perceptions of sales and marketing in order to drive latrine adoption and behavior change. Over the last 15 years, Vietnam’s leaders have become convinced that our market-based approach works, but the real test is ensuring that the local change agents believe in and embrace the methodology.

Mrs. Hoan Vo works in the Community Office of the Center for Preventive Medicine (CPM) in the Yen Thanh district of north Vietnam, with a population of 280,000 people. A former mid-wife, Mrs. Hoan oversees community-related issues (e.g., work safety, social diseases, water and sanitation) in this large district where more than half of the population still lack hygienic latrines. Because of these demographics, Yen Thanh was selected for implementing sanitation marketing under the Water, Sanitation, and Hygiene Scale Up Project (WASH-SUP) which provides government officials technical assistance from iDE with funding from the Australian government.

“To be honest I had doubts about this [WASH-SUP] project when iDE and the provincial CPM management discussed it with us two years ago,” Mrs. Hoan confessed. “I personally did not think this project would work with absolutely no handouts. My doubts even increased when I participated in iDE’s training on Sanitation Marketing and consultative promotion skills. I thought to myself: oh, they are some sort of multilevel marketing company and want me to sell things for them. Oh, I do not want to do that, I am a government worker, not a sales person.”

Some of the challenges at Yen Thanh are typical of sanitation marketing: rural households do not believe they can afford a latrine, and even when they can, latrine installation is not a priority for them. In other countries, iDE engages sales agents that work on commission to promote latrine adoption. In Vietnam, however, these change agents are local government officials like Mrs. Hoan. These agents are integral to making change happen: they lead community discussions where they engage the audience in games and activities that focus on the scale of open defecation, the resulting diseases and health effects to families, and the convenience and modernity of a household latrine. They also help establish a network of local latrine manufacturers who can deliver and install at an affordable price.

“With this project, I’ve done things so differently than I used to. Before when I talked about having a latrine, I would talk about having one to avoid diseases. Now I listen more to people to know what problems they face and give them advice. I also help commune health staff with latrine promotion. More importantly, we now pay more attention to the supply network: we train masons and ring producers, before we never worked with them, let alone trained them! I learned all of this from the project! Convincing people to build latrines is still very challenging, working with commune health staff and getting them do what they are expected to do still requires a lot of effort; but I do believe what I am doing is bringing value to the life of my district people."

After 6 months with the project, Mrs. Hoan had changed from a project skeptic who lacked confidence in the approach to a strong agent of change who is a champion for latrine promotion to her fellow CPM colleagues. She has proactively identified potential latrine suppliers/ring producers and then linked them to the right customers. She has traveled frequently to the field to speak with families lacking hygienic latrines. She has attended numerous village meetings to promote hygienic latrines and assisted local commune health staff in delivering hygiene messages. Her efforts have paid off. Yen Thanh is leading the five districts with 2,000 hygienic latrines installed since the beginning of the project.