RURAL SANITATION IN VIETNAM

Transcription

1 MINISTRY OF HEALTH RURAL SANITATION IN VIETNAM Hanoi, 12 July 2016

2 CONTENT 1. Current status of rural sanitation 2. Barriers and challenges in rural sanitation 3. Ministry of Health (MOH) s orientation in the coming time 2

3 CURRENT STATUS OF RURAL SANITATION 3

4 Coverage of hygienic latrines in households Miền Northern núi phía mountain Bắc 79 Đồng Red River bằng sông DeltaHồng 85 Bắc North trung Bộ Central 72 Duyên Central hải miền Coastal Trung 65 Toàn Nationwide quốc Tây Central Nguyên Đông Southeastern Nam Bộ Đồng Mekong bằng Highland Delta sông Cửu Long Rural households without latrines: 10% Hygienic latrines in households account for 65% Uneven coverage of hygienic latrines across ecological areas; open defecation and fishpond latrines remain Source: NTP on RWS

5 20 MILLION rural population without access to hygienic latrines.

6 HOÀNG SA 6 MILLION TRƯỜNG SA open defecation 6

7 Open defecation, or fishpond latrines remain popular 7

8 10 PROVINCES HOÀNG SA with hygienic latrine TRƯỜN G SA coverage below 50%! 8

9 Coverage of hygienic latrines at communal health centers (CHCs) Đồng Red bằng Bắc North trung Duyên Central hải sông River Hồng Delta Central Bộ Coastal miền Trung Toàn Nationwide phía moun- Bắc quốc Miền Northern núi tain Central Tây Highland Nguyên Đông Southeastern Bộ sông DeltaCửu Nam Đồng Mekong bằng Long -By end of 2015, 93% communal health centers have clean water facilities and latrines -Need more focus on sustainable maintenance of hygiene of latrines in CHCs 9

10 Coverage of hygienic latrines in schools % Cả Nationwide nước ĐB Red Sông Hồng River Delta Bắc North Trung Duyên Central hải Central Bộ Miền Coastal Trung Miền Norther núi phía n mountain Bắc Central Tây Đông Southeastern Bộ Cửu Delta Long Nam ĐB Mekong Sông Nguyên Highland 78,6% of schools having hygienic water sources and latrines. Need more focus on sustainable maintenance of hygiene, hand washing with soap 10

11 11

12 ANNUAL DIARRHEA INCIDENCES 12

13 million Children suffer from rickety or low height as a result of poor hygiene, and most of these reside in remote and rural areas (25% and 28-31% children with rickety in rural and mountainous areas respectively) 13

14 3.7cm shorter, 5-11 IQ points lower among under-5s in communities with unhygienic latrines (including families with hygienic latrines in such communities) than their peers in communities with hygienic 14 latrines

15 Annual economic losses in Vietnam due to poor hygiene/sanitation =780 m US$ =9,26US$ p.c. =1,3% GDP 15

16 16

17 6. INVESTMENT IN H/S IS VIETNAM S POLITICAL WILL 1. INVESTMENT IN H/S IS TO ENSURE ACCESS TO HYGIENE FOR ALL 5. INVESTMENT IN H/S IS INVESTMENT FOR SUSTAINABLE LIVING ENVIRONMENT 2. INVESTMENT IN H/S IS INVESTMENT FOR DEVELOPMENT OF AN EQUAL, FAIR AND SAFE SOCIETY. 4. INVESTMENT IN H/S IS INVESTMENT FOR THE HEALTH OF THE NATION AND FUTURE GENERATIONS 3. H/S IS AN AREA OF INVESTMENT WHICH GREATLY BENEFITS THE COUNTRY

18 BARRIERS AND CHALLENGES IN RURAL SANITATION 18

19 MAIN BARRIERS 1. Believe they can t afford. Lack of information on costs of latrines. 2. Lack of knowledge of regulations/no social pressure. Unhygienic latrines still acceptable. 3. Lack of knowledge of benefits from hygienic latrines. 4. Don t want to borrow. Investment in latrines does not generate returns. Hygienic latrines just built thanks to WASHOBA project in Thai Nguyen 19

20 KEY CHALLENGES 1. Lack of attention from local authorities to H/S. No strong sanctions and regulations to terminate open defecation, eliminate fishpond latrines, and encourage the construction and use of hygienic latrines. 2. People do not have high awareness of the construction, use and maintenance of hygienic latrines. 3. Construction works sustainability affected by improper habitual use and maintenance. 4. NTP on RWS ended in 2015 affecting sustaining and replication of sanitation initiatives. 5. Weak participation of private sector. Undeveloped sanitation market. 20

21 MOH s ORIENTATIONS IN THE COMING TIME 21

22 VIETNAM S SANITATION GOALS % VILLAGES TERMINATE OPEN DEFECATION 90% HOUSEHOLDS USE HYGIENIC LATRINES % VILLAGES ACHIEVE ODF 100% HOUSEHOLDS USE HYGIENIC LATRINES SANITATION FOR ALL % VILLAGES TERMINATE OPEN DEFECATION 75% HOUSEHOLDS USE HYGIENIC LATRINES COMMUNE-WIDE SANITATION % VILLAGES TERMINATE OPEN DEFECATION 65% HOUSEHOLDS USE HYGIENIC LATRINES SANITATION CRITERIA INCORPORATED IN SOCIO- ECONOMIC PLANS

23 Impvore sanitation services and develop supply chain Focus on BCC and create demands among population Enhance knowledge and experience sharing Create enabling environment (policies, institutions, resources)

24 ORIENTATIONS IN MAINTENANCE AND REPLICATION OF MODELS FOR SANITATION PROMOTION Lack of enabling environment and institution Criteria for socioeconomic development (national, local) and new rural areas Sanitation in NTP on New rural areas Guidancce on termination of open defecation Weak activities in demand creation and market development Increase investment in BCC Strengthen appropriate and effective communication approaches Capacity building at all levels Select appropriate models Replication of effective approaches: - OBA, WASHOBA - PforR - CLTS, ODF Encourage private sector s participation 24

25 EFFECTIVE APPROACHES FOR SANITATION PROMOTION Summary Features Focus CLTS Activate communities extensive changes of sanitation conditions Activate Work toward termination of open defecation Low cost solutions, local materials Create demands CLTS + CLTS + Strengthen sanitation supplies CLTS Training for masons and strengthen supply chain Create demands Develop sanitation market Sanitation marketing Make use of social and commercial marketing to promote sanitation Market research Develop appropriate products Develop trade in private sector Create demands Develop sanitation market OBA Financial assistance mechanisms through grant packages Output-based assistance Verification of performance Policies, institutions Group meetings Develop sanitation market PforR Output-based disbursement mechanism (number of new latrines, number of communes with good sanitation, etc.) Output-based assistance Verification of performance Disbursement indicators associated with water supply and sanitation Policies, institutions Develop sanitation market

26 CHOBA - WASHOBA Attention from local authorities at various levels; good mobilization of other local resources Increase proactiveness: planning, implementation, supervision and improved capacity of implementing agencies and officials Increase responsibility of implementing agencies: associate water supply indicators with sanitation link responsibility of stakeholders ensure high sustainability of programs Reach the poor (the most difficult target group) Rapid increase of hygienic latrines (increase rates verifiable thanks to supervision system for output-based incentive payments being executed with transparency and accuracy)

27 Efficiency in increase rates of hygienic latrines in provinces with CHOBA WASHOBA 70% 60% Before June 2012 From July 2012 to Aug % % 50% 20.00% % % 40% % % % % % 7.280% % 15.00% % 30% % 10.00% 20% 38% 33% 31% 24% 31% 32% % 10% 23% 5.00% 0% Hải Dương Ninh Bình Thanh Hóa Hà Tĩnh Quảng Bình Tiền Giang Trà Vinh Đồng Tháp.00% Thai Nguyen Bac Giang Binh Dinh Ben Tre CHOBA after 3 years implementation WASHOBA after 2 years (Jan 2014 Aug 2015) 27

28 Playing key roles in rural sanitation promotion through healthcare networks from national to village levels Local authorities - Collaborators; - Sanitation supply services Health care networks Women Union s networks Bank for Social Policies 28

29 PRIORITY SOLUTIONS FOR SANITATION PROMOTION ACROSS LOCALITIES Localities with % of households having hygienic latrines Under 30% 30-50% 50% - 65% Over 65% Policies Increase effective models of sanitation promotion BCC + Sanitation market, loans from Bank for Social Policies Support of latrine technology Budget Top priority should be given to localities with <30% hygienic latrines, followed by those with 30 50%. For those with >65%: solutions to maintain and foster natural increase of hygienic latrines.

30 DEMANDS Now that the NTP on RWS has ended, Government s resources for sanitation promotion mostly come from NTP on New Rural Areas, and the Program for output-based replication of water supply and sanitation in 21 provinces. Continue to maintain and replicate OBA and WASHOBA models in localities with low rates of hygienic latrines Apart from leadership in implementation, MOH needs to provide technical assistance to: o Develop sanitation policies and institutions in new contexts o Improve capacity of district, commune and grassroots healthcare officials for rural sanitation work o Monitor, supervise and sustain outputs that have been achieved. o Learn, share experiences and awards for replication. 30

31 Thank you for your attention! Supported Latrines Self-constructed latrines 31