Until now, public interventions have achieved limited success in their attempts to address the global handwashing crisis. In Vietnam there have been enormous investments in handwashing behavior-change campaigns (BCC) and information, education and communication (IEC) campaigns. Such projects typically involve education, hygiene awareness raising, and do-it-yourself products such as plastic jugs and buckets. In contrast to these efforts, recent research by the World Bank’s Water and Sanitation Program (WSP) in Vietnam and WaterSHED’s formative research in Cambodia identified that a fundamental obstacle to handwashing is not a lack of awareness, but a lack of purpose-built, affordable, and aspirational handwashing hardware.
Situation in Vietnam
Handwashing with soap (HWWS) is one of the most reliable ways to prevent diseases such as diarrhea, parasites, and respiratory infections. In spite of that, only 7% of rural Vietnamese inhabitants on average habitually wash their hands. Vietnam has one of the highest rates of child malnutrition in large part because 80% of the children are infected with digestive worms. HWWS prevents the spread of intestinal parasites, and can cut rates of diarrhea, another prime cause of child mortality in Vietnam, by up to 47% (UNICEF). HWWS also mitigates outbreaks caused by H5N1 and EV-71. The transmission of hygiene-related ailments, primarily from caretakers to children, carries an estimated economic cost in Vietnam of USD $262 million annually, yet most rural mothers do not practice HWWS before cooking or after using the toilet (Hutton, 2008).
The data leads to an obvious question: why don’t more people, especially mothers, practice HWWS? Evidence suggests a lack of access to soap and water at critical times is a determining factor. Specifically, researchers in Vietnam found that soap was widely available in households but that cleansing agents were generally found in toilet and bathing areas – far from cooking facilities (Indochina Research Ltd., 2007). Also important is knowledge, yet hygiene awareness interventions have reached 20 million people across 600 Vietnamese communes. Still, 93 percent of this population still does not practice proper HWWS (UNICEF).
- Hutton, G., Thang, P., Tuan, H., Economic impacts of sanitation in Vietnam. World Bank, Water and Sanitation Program. 2008.
- UNICEF. “Study on Household Environmental Sanitation, Household Water Supply, Mothers Hygiene Behavior for Children under 5 and the Status of Child Nutrition in Vietnam”, 2010