Climbing the sanitation ladder: latrine promotion and household decision-making in Viet Nam

Abstract

We examine the relationship between promotion activities and sanitation decisions in the context of a program in the Mekong Delta that encouraged households to switch from fishpond latrines to septic tanks. Before and after the campaign, we surveyed households and promoters. Economic variables were important determinants of septic tank adoption, but whether the decision was woman-led and familiarity with the promoter were strongly predictive as well. Controlling for the pre-existing household decision-making structure, women were more likely to lead the sanitation decision if a promoter spoke to them rather than to a male householder. These household-based findings on the importance of promoters were supported by a supplementary analysis of sales. We found that promoters who were older, trained, and educated were more successful in selling septic tanks. Taken together, these findings highlight the importance of gender equity and trust in the promoter for encouraging last-mile households to invest in new health technologies. HIGHLIGHTS Data from a sanitation promotion campaign that focused on rural women are analyzed to identify predictors of women's participation in sanitation decisions, households' septic tank purchase, and promoters' septic tank sales.; Adjusting for households' pre-campaign decision-making structures, women were 33% more likely to take the lead in deciding whether to purchase a septic tank if they interacted with a promoter from the campaign.; Controlling for socioeconomic variables, septic tank purchase was 24% more likely in households with woman-led decision-making on sanitation.; Promoters sold more tanks if they were older, educated, and acquainted with households, highlighting the role of trust in introducing new health technologies.;

Keywords

• gender
• marketing
• rural development
• sanitation
• septic tanks
• social influences