Women Are Key to Improving Rural Sanitation: On World Toilet Day, a marketing campaign in Viet Nam sheds light on effective partnerships with civil society for development projects

On World Toilet Day, a marketing campaign in Viet Nam sheds light on what makes civil society organizations effective partners for development projects

Women Are Key to Improving Rural Sanitation

On World Toilet Day, a marketing campaign in Viet Nam sheds light on what makes civil society organizations effective partners for development projects.

Blog by Milan Thomas, Young Professional (Economist), Economic Research and Regional Cooperation Department, Asian Development Bank

In Viet Nam, women are key to encouraging households to adopt new sanitation practices. Photo: Asian Development Bank

In rural areas, lack of familiarity with new technologies is often compounded by financial constraints, making unhealthy or inefficient practices persistent—even when it comes to toilets. Upgrading to a more sanitary toilet would improve the health of many households, along with their neighbors’. But new hardware is expensive, and the social cost of continuing to use a less sanitary toilet is not often fully understood.

How can healthy changes in rural sanitation be encouraged? A recent successful effort in Viet Nam suggests that involving women is the key.

In Viet Nam’s Mekong Delta, residents face an additional sanitation hurdle. Frequent flooding means that even some modern devices, such as pour-flush toilets, can pose a threat to public health. Plastic septic tanks are a safe alternative, but their advantages are not widely understood. Also, purchasing the tank and building a superstructure requires an equivalent of nearly two months’ income for the average farming household.

To promote the use of more hygienic toilets, our partners at East Meets West (a nonprofit that promotes sanitation in Southeast Asia) work with local chapters of the Viet Nam Women’s Union (a civil society organization with over 14 million members) to conduct door-to-door campaigns and provide sanitation information at village meetings. Engaging the Union members makes it easier to share knowledge of healthy sanitation practices with women, whose involvement in household decision-making is critical for affecting intergenerational change, according to many studies.

In April 2017, the two groups launched a 12-month campaign to promote plastic septic tanks in 25 communes of Ben Tre Province. We surveyed 1,250 households that did not use a septic tank as the campaign began. At the time, 60% of them practiced open defecation, while the rest used non-hygienic means such as pit latrines. We followed up with those households in May 2019 to learn which of them installed a septic tank—and why. By then, 44% of the surveyed households had switched to using a septic tank.

Source: A Flourish scatter chart

First, we investigated the basic premise of the campaign. Were women who interacted with a Women’s Union promoter more likely to participate in their household’s decision to purchase a septic tank? The answer was yes—in fact, they were about one third more likely to do so as a result.

Next we identified the drivers of septic tank adoption. Economic factors were indeed critical, as wealthier households were much more likely to invest in a septic tank. But we also uncovered predictors that underscore the key role of social factors.

For instance, purchasing a septic tank was 24% more likely for households in which a woman leads home construction decisions. Households were 38% more likely to buy a septic tank if a close friend had recommended one prior to the campaign. And they were 24% more likely to buy one if they were familiar with their local Women’s Union promoter prior to the campaign.

Exposure to sanitation information was also strongly predictive. Purchase of a septic tank was 17% more likely in villages where a demonstration of one took place. Meanwhile, respondents with awareness of the environmental hazards of open defecation were 13% more likely to buy a septic tank.

To gain more insight on what made the campaign resonate with some households, we surveyed Women’s Union promoters who marketed septic tanks door-to-door and in village meetings. The average promoter facilitated 38 septic tank sales during the campaign, but sales performance varied substantially. Older, more educated promoters sold more tanks, while those knowledgable on their benefits—and locally available financing options—sold an average of 20 additional tanks.

Taken together, the evidence is encouraging. Positioning women as advocates is key when encouraging households to make the leap with an unfamiliar hardware, along with other essential investments along the sanitation service chain. For households already linked to civil society, familiar faces and trusted resources are effective campaigners for healthy behavioral change. And for households less plugged into local networks, strengthening women’s participation in key decisions through demonstration and information-sharing is critical for making villages healthier places for all.

Published: 16 November 2021

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Asia Needs Fleets of Busses to Get Vaccines to the World’s Most Populous Region

The People’s Republic of China has shown how busses can be used to dramatically increase the number of people vaccinated against COVID-19. The region should follow their example. 

Asia Needs Fleets of Busses to Get Vaccines to the World’s Most Populous Region

Blog by Najibullah Habib, Senior Health Specialist, East Asia Regional Development, Asian Development Bank

The People’s Republic of China has shown how busses can be used to dramatically increase the number of people vaccinated against COVID-19. The region should follow their example. 

Asia’s ubiquitous busses are being put work toward the task of distributing vaccines to the region’s hard-to-reach populations. Photo: Asian Development Bank

They look like sleek, bright tour buses, some vaguely insect-like with long-necked rearview mirrors. But the people lined up outside them in the People’s Republic of China aren’t sightseers.

From Beijing in the north to Haikou in the southern island of Hainan; from Shanghai on the east coast to Xidu, Hunan and Wuhan, Chongqing, and Wuxi in the interior; and in many other towns and cities, the buses bring COVID-19 vaccinations to people who can’t easily make the trip to sometimes inaccessible vaccination centers.

It’s not just people living in remote mountainous areas such as Ouhai in Wenzhou, Zhejiang who benefit but also urban office workers, who don’t have to take time off to get their shots, and the elderly and handicapped. 

The buses are kitted out with vaccination stations, smart medical refrigerators that keep temperatures at 2–8°C and send an alert to the Chinese Center for Disease Control and Prevention if they deviate, and first-aid facilities in case of an adverse reaction. Vaccinated people are screened, registered, inoculated, and observed afterward. Regulators can monitor the information remotely.

The buses speed up inoculation, efficiently bringing millions of doses to downtown neighborhoods and more remote locales. The People’s Republic of China has reason to make haste. Its population of about 1.4 billion is spread across more than 9.3 million square kilometers, including coasts and mountains and everything in between and some regions that are harder to get to than others.

In April, Nature reported that the country was vaccinating about 5 million people a day on average. In June, for more than a week, that number swelled to 20 million a day on average. As of 6 June, the journal stated, 778 million doses had been administered.

In the first week of October, according to Reuters, the average daily number of doses administered was about 1.42 million. A total of at least 2,218,826,000 doses, enough for about 79.4% of the population, have been administered.

The news outlet said that the country has had 96,374 infections and 4,636 COVID-19–related deaths since the pandemic began in late 2019. New infections reportedly average 24 a day, or 1% of the highest daily average reported in February 2021.

The remarkable feat of vaccinating more than a billion people in less than two years was made possible by the decision to produce its own vaccines rather than rely on other countries and by getting the vaccines to its people efficiently. The vaccination buses are part of this logistically extraordinary achievement.

Health facilities have often been stretched to capacity, transport can be inefficient, and vaccination centers can be difficult to reach and expensive to build. 

Some other parts of Asia have been using vans and buses for health work. In the Philippines, for example, mobile x-ray machines serve tuberculosis patients, family-planning caravans have delivered contraception to communities, and now mobile clinics bring COVID-19 vaccination to cities and villages. 

In September, Thailand rolled out its first vaccination bus, in Bangkok, which needs only six people to operate it and to inoculate 1,000 people a day. Pekanbaru, Indonesia launched its vaccination buses on 1 June and doubled their number to 10 within 2 weeks.

In July, the Cambodia government delivered 10 vaccination vans to the defense ministry, which was already inoculating people, and promised one or two vans each to the provinces, depending on their population.

In India, the Karnataka government and the private sector launched the 4–6-month Vaccination on Wheels in August. In Fiji, Rights, Empowerment and Cohesion for Rural and Urban Fijians (REACH) Project buses started bringing vaccines to communities in early 2020.

Some of the least developed countries might not have the high technology that the People’s Republic of China does, but they use the technology on hand to get the job done. Health workers can use cellphones to inform residents of mobile clinic arrivals, register vaccinees, remind them of vaccination schedules, and transmit information to government agencies. Smart refrigerators might not always be an option, but solar panels can keep the cold chain going.

The World Health Organization and United Nations Secretary-General António Guterres appealed to the leaders attending the 76th UN General Assembly, held in September, to ensure that poor and rich countries have equitable access to COVID-19 vaccines. An impassioned secretary-general called vaccine equity “the biggest moral test before the global community.”

Continuing imbalanced access means not only that not enough vaccines are reaching the least developed countries but also that their health systems are deficient. Even if the countries were to receive more vaccines than they are, of what use would they be if they expire in warehouses or at ports because they cannot be distributed? Or, in the case of one brand, if they cannot be kept at minus 70°C? 

To reach levels of success seen in the People’s Republic of China, other countries need stronger health systems, more vaccines, and greater vaccine outreach.

WHO and the UN are right to be alarmed. Only 47.7% of the world’s population has received at least one dose of the COVID-19 vaccine but only 2.5% of people in low-income countries.

Vaccination buses are just one solution and an effective one. They do traverse some countries, but not enough of them and in not enough countries. Imagine what fleets of them could do.

Published: 18 November 2021

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Asian Development Bank and Japan to Strengthen Cooperation on Clean Energy in ASEAN Region
The Asian Development Bank (ADB) and Japan’s Ministry of Economy, Trade and Industry (METI) have signed a memorandum of cooperation (MOC) to enhance their joint efforts to promote clean energy in Southeast Asia.

ADB, Japan to Strengthen Cooperation on Clean Energy in ASEAN Region

by Asian Development Bank (ADB) | News Release | 2 February 2021

MANILA, PHILIPPINES (2 February 2021) —

Signed by ADB Vice-President for Knowledge Management and Sustainable Development Bambang Susantono and METI Vice-Minister for International Affairs Shigehiro Tanaka, the MOC will strengthen cooperation between the two organizations under the Cleaner Energy Future Initiative for ASEAN (CEFIA). The cooperation will focus on the areas of renewable energy, energy conservation and efficiency, and other technologies that will facilitate the transition to low-carbon energy.

“Southeast Asia has experienced unprecedented growth in recent years, making it critical to ensure sustainable development in the region,” said Mr. Susantono. “Japan is a very important partner for ADB and through this MOC, we will further strengthen our cooperation and commitment to help accelerate the ongoing energy transition and drive climate action within the ASEAN region.”

Under the MOC, ADB and METI will conduct consultations and advise on the development and implementation of CEFIA’s flagship projects. The two organizations will also develop policy research and capacity building activities, as well as share data analysis, knowledge, and experiences in the energy sector.

CEFIA, established in 2019, facilitates the collaboration of the public and private sectors in accelerating the deployment of sustainable energy and low-carbon technology in the region. The MOC was signed at the 2nd CEFIA Forum held online and hosted by the Ministry of Energy of the Government of Thailand, in cooperation with METI and supported by the ASEAN Centre for Energy.

ADB has invested more than $25 billion in clean energy through sovereign and nonsovereign initiatives from 2008 to 2020. ADB’s clean energy investments in the ASEAN region amounted to $440 million in 2020, accounting for 22% of its overall portfolio. Under its Strategy 2030, ADB aims to provide $80 billion in cumulative climate financing from its own resources by 2030 and for at least 75% of its country operations to feature climate adaptation and mitigation measures. 

ADB is committed to achieving a prosperous, inclusive, resilient, and sustainable Asia and the Pacific, while sustaining its efforts to eradicate extreme poverty. Established in 1966, it is owned by 68 members—49 from the region.

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$123 Million Asian Development Bank Loan to Help Build Elevated Walkways in Manila
MANILA, PHILIPPINES (14 December 2020) — The Asian Development Bank (ADB) has approved a $123 million loan to help the Philippines build safe, wide, well-lit, and disaster-resilient elevated walkways for pedestrians along Manila’s most congested thoroughfare, the Epifanio de los Santos Avenue (EDSA).

$123 Million Asian Development Bank (ADB) Loan to Help Build Elevated Walkways in Manila

News Release by Asian Development Bank | 14 December 2020

The EDSA Greenways Project will help the government construct 5 kilometers of covered walkways, which will be linked to mass transit stations along EDSA, namely the Balintawak, Cubao, Guadalupe, and Taft stations. The 5-meter-wide structures, equipped with elevators and monitoring systems, will be easily accessible for pedestrians, including the elderly, pregnant women, young children, and people with disabilities.

“The EDSA Greenways Project is an integral part of the government’s transport strategy to make Metro Manila a better place to live, work, and visit,” said ADB’s Southeast Asia Transport and Communications Director Hiroaki Yamaguchi. “This project is an important part of our contribution to helping make that vision a reality for Filipinos.”

The project is part of the government’s “Build, Build, Build” infrastructure development program aimed at boosting public spending on infrastructure to attract investments, provide improved connectivity, and spur economic growth.

“This project will encourage more Filipinos to switch from private vehicles to public transport, which is being strengthened with the North–South Commuter railway, the Metro Manila subway, and the upgraded Light Rail/Metro Rail Transit systems. The project, to be built with cutting-edge technology for cantilever overhead walkways, will provide safe, inclusive, and equitable access for commuters while lowering CO2 emissions,” said ADB Senior Transport Specialist for Southeast Asia Shuji Kimura.

Metro Manila is considered the most congested city in Asia in terms of population, land area, and length of road networks, based on ADB’s 2019 Asian Development Outlook. Annual average daily traffic on EDSA reached 405,882 vehicles in 2019, up about 6% from 383,828 in 2018, according to the Metro Manila Development Authority, a government agency.

The project will support Metro Manila’s recovery from the coronavirus disease (COVID-19) pandemic. It is expected to create much-needed jobs during the construction period, with Php3 billion ($61 million) to be spent on local raw materials. The civil works contracts for the project are expected to be awarded during the first half of 2021.

The project, including improving existing walkways and building new elevated walkways, is expected to cause minimal traffic disruptions. An international consulting firm has been hired to work on the project’s feasibility study with the Department of Transportation, with funding from ADB’s Infrastructure Preparation and Innovation Facility.

The project will also be supported by a $15 million loan from the Association of Southeast Asian Nations (ASEAN) Catalytic Green Finance Facility, which will be administered by ADB.

ADB is committed to achieving a prosperous, inclusive, resilient, and sustainable Asia and the Pacific, while sustaining its efforts to eradicate extreme poverty. Established in 1966, it is owned by 68 members—49 from the region.

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