Lao

Progress has and is being made in the water supply and sanitation sector with ~60% of the national population reportedly having access to improved water supplies (UNICEF/WHO 2008) (~53% in rural areas). However, sanitation coverage in Laos continues to be low, with less than half of the population (48%) having access to improved sanitation facilities (38% in rural areas), leaving roughly three million people without access to sanitation facilities! Hygiene standards in most rural homes are still unacceptably low and therefore, open defecation is still common practice in the majority of rural villages and poses significant health risks to the population.

A research assignment conducted in 2008 by SNV, the Netherlands Development Organisation supported by IRC, International Water and Sanitation Centre, revealed that most sanitation programmes in Laos relied on significant (hardware) subsidies to increase the numbers of people with access to improved sanitation. In some cases revolving funds have been established to finance latrine construction – though their effectiveness has still to be evaluated. No programme necessarily aims to eradicate Open Defecation practices in their operational areas. The research also revealed that sanitation technologies applied were uniformly pour flush squat toilets.

Community-Led Total Sanitation (CLTS) concepts were really only introduced to Laos in 2008, as an “alternative” to the more traditional approaches. Concern Worldwide, the Water and Sanitation Programme (WSP) of the World Bank, and SNV, the Netherlands Development Organisation, organised study tours to expose government leaders to CLTS programmes in Cambodia and Indonesia. In September 2008, Plan International invited Kamal Kar to give a presentation on CLTS to an audience of interested WASH sector actors in Vientiane.

Before the end of 2008, Concern Worldwide and WSP, stimulated and encouraged by what they had seen during the study tours, designed and started their own CLTS pilot programmes in the north and the south of Laos respectively. CLTS trainers from Cambodia and Indonesia were invited to conduct CLTS facilitator trainings for project and government staff.

The Concern Worldwide CLTS pilot covered 24 villages in two districts in Houaphan province, while the WSP CLTS pilot covered 2 villages in Champasak and Sekong provinces. The Concern Worldwide CLTS pilot was peer reviewed by SNV in August 2009. The report, available below, gives a good overview of achievements to date, lessons learned, challenges and provides a range of recommendations to improve the quality and thereby the sustainability of CLTS programmes in Laos. The review revealed that CLTS has the potential to be a powerful approach for rapid sanitation behaviour change in rural areas in Lao PDR, by focusing on eradicating open defecation practices and establishing improved sanitation and hygiene practices. However, the review also raised concerns about the hygienic nature and sustainability of the majority of the latrines that had been constructed. The review concluded that for CLTS to be successful it needs to go beyond triggering by putting more emphasis on post-triggering follow up as this is critically important.

In early 2009, Plan International supported by SNV, took the initiative to interpret into Lao language Kamal Kar’s (2005) Practical Guide to Triggering Community-Led Total Sanitation and to post and disseminate it through the Lao PDR WASH Technical Working Group (TWG) Google Group website . The Lao version of the practical guide was seen as an uncomplicated means to inform sector actors and policy influencers on CLTS.

In November 2009, a Lao country delegation participated in the regional workshop on CLTS organised by the Institute of Development Studies (IDS) and the Cambodian Ministry of Rural Development. WSP and Concern Worldwide were represented by individuals who had been instrumental in the CLTS pilots. The Government of Lao PDR was represented by two officials of the Ministry of Public Health. The Ministry is overall responsible for the facilitation, coordination and direction of the rural water supply and sanitation sector throughout the country and as such a key partner in developing and testing alternative approaches.

Although a significant number of development organisations working on WASH issues in Laos are showing interest in CLTS (7 organisations out of 16 reporting), initiatives for scaling up CLTS are still limited. Community-led approaches towards achieving total sanitation are still not mainstreamed in Laos and although some organisations have made moves to implement these approaches across their programmes, most actors have not. Even so the openness to consider CLTS is some good news. Both Concern Worldwide and WSP are taking steps to scale up their initial CLTS pilots. Plan International is about to start a CLTS pilot programme in one of the poorest and most remote provinces’ in the north-west of Laos. Care International and SNV have been working on separate funding proposals and UNICEF Laos has taken the decision to move away from the traditional subsidy approach. At present WSP and SNV are collaborating in adapting and testing CLTS materials and tools (total sanitation guidelines) for the culturally diverse Lao context. The same organisations are also exploring possibilities to collaborate – potentially with others – to develop in-country training capacity by setting up a core team of CLTS trainers. Furthermore, a number of organisations are considering to set-up a community-of-practice focusing on alternative sanitation approaches.