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Oakland, California and Da Nang, Vietnam –  After completion of a successful program that brought needed sanitation to more than 160,000 mostly poor, rural households in Vietnam and Cambodia, East Meets West and the Vietnam Women’s Union have joined forces again to launch a second phase of the program that plans to provide an additional 35,000 households with hygienic latrines.

The program, called “Community Hygiene Output-Based Aid II,” or CHOBA II, will be implemented over two years in five rural Vietnamese provinces. The Bill & Melinda Gates Foundation, a key funder of CHOBA I, is the primary funder of this second phase.

The first CHOBA project began in 2012 and has been implemented in 10 provinces in Vietnam and Cambodia.  The program used an innovative output-based aid (OBA) approach, which has proven to be a highly effective method for increasing sanitation in rural areas. Pioneered by East Meets West in 2009, the program provided ‘smart subsidies,’ or rebates, to families and implementing partners upon verification of the latrines’ completed construction, thus holding all parties accountable and ensuring that the work will be achieved.

“A performance-based approach gives us better buy-in by all involved,” said Loan Hong Duong, Ph.D., Chief Program Officer for East Meets West, a program of the U.S.-based Thrive Networks. “It helps rural households and poor communities to increase their awareness about sanitation and hygiene, and encourages them to participate in construction. The OBA approach proved to be the most cost-effective way to reach the poor and increase their access to improved sanitation.”

According to the World Bank, poor sanitation costs Vietnam $780 million U.S. every year – equivalent to 1.3% of the country’s Gross Domestic Product – due to its impact on economic productivity. Increasing access to sanitation and improving hygiene behaviors are critical objectives for the Vietnamese government as it seeks to achieve its rural development targets as well as its sustainable development goals.

Nguyen Van Phuc (father, left); his son Tien Manh; and wife Kim Chi stand next to their newly constructed hygienic latrine behind their house in Long Hung commune, Chau Thanh district, Tien Giang province.

Nguyen Van Phuc; his son Tien Manh; and wife Kim Chi stand next to their newly constructed latrine in Long Hung, Tien Giang province.

CHOBA I highly successful

CHOBA I had a large, positive impact on helping Vietnam to reach its objectives. The program accounted for one third of all latrines built by poor Vietnamese households since 2012, making a significant contribution to the country’s target of 65-percent rural sanitation coverage by 2015. One study showed that in provinces that utilized CHOBA, the uptake rate of latrine production was four times faster than in those provinces that used an ‘input-based’ approach.

Construction of the latrines led to changed sanitation habits, which in turn has resulted in additional benefits as well. “The project helped families to live a more civilized life,” said Tran Thi Huong, Vice President of the Vietnam Women’s Union. “It helped to improve living standards as well as the overall health of family members, and helped women in particular to feel more confident and secure in their homes. The program also helped the Women’s Union to build its capacity to participate in development work at all levels.”

“Having something as basic as a latrine is a real game-changer, and can have a big impact on the lives of the poor,” said Jan-Willem Rosenboom of the Bill & Melinda Gates Foundation. “But achieving this goal in low-resource, rural settings isn’t easy, and it’s clear that East Meets West and the Vietnam Women’s Union have hit upon a model that works. The success of CHOBA I is undeniable, and we look forward to supporting CHOBA II in its efforts to have an even greater impact on bringing sanitation to this region.”

Next steps: self-sustaining program

The success of CHOBA I prompted the Gates Foundation to support the next phase of this work, but with a different ultimate objective in mind. Although a key goal of CHOBA II is to expand the number of households with sanitation by 35,000, the implementation methods and some of the desired outcomes differ from the program’s first phase. The new program is designed to test ways to make the effort self-sustaining, whereby the income generated would cover the costs of the implementing agencies.

As part of its effort over the next two years, CHOBA II will work with the Vietnam Women’s Union, Center for Rural Water Supply and Sanitation, and local authorities to connect households with reputable suppliers and lenders. The program will continue to offer subsidies to these suppliers and lenders; it is expected that the Vietnamese government will gradually phase in its support by providing poor households with financial rebates.

“We would not be able to implement this model on a large scale without support from officials at the central level as well as from provincial partners in Vietnam,” said Duong. “Of course, the support from the Gates Foundation and our partnership with the Vietnam Women’s Union also are critical for our project’s success.

“We’re thrilled to have the chance to continue the work we began under CHOBA I,” Duong added. “It’s our hope that this model can be replicated to improve hygiene and sanitation worldwide.”