Approximately 84% of its poor are rural inhabitants, with almost 2 million rural dwellers falling below the poverty line. More than half the population lives in upland areas with a critical lack of infrastructure, presenting huge technical, social and physical challenges to sanitation service delivery.
Nevertheless, the country has made progress since 1990 in increasing access to improved sanitation in rural areas. This is a story of rapidly increasing access to improved sanitation and of gradually improving government systems for service delivery. This progress is to an extent ‘unsung’ – Lao PDR’s current sanitation challenges tend to eclipse its positive steps forward. But progress has been made in a difficult sector from an extremely low base, even if major challenges remain.
Policy and institutional change: There have been three major interrelated reform processes: i) development (1997), revision (2004) and implementation of a national strategy for rural water supply and sanitation; ii) creation and capacity building of the National Centre for Environmental. Progressive institutionalization of ‘improved’ approaches to service delivery, including an increased focus on demand responsiveness, community participation and hygiene promotion.
Household investment and wider socioeconomic change: Household investment in latrine construction largely unsubsidized and driven by non-poor rural households living close to roads and markets. More so, the government requirement, in some areas, for people to build latrines in order to receive a water supply and exposure of some households to hygiene messages.
Hardware, technology and infrastructure: Subsidized sanitation hardware, technology and infrastructure from government and development partners. Service delivery has focused largely on rapid construction, which has contributed to the fast-paced coverage expansion. The dominant technology has been pour-flush latrines, because they are odour-free and more hygienic. Getting large numbers of people on the sanitation ladder is arguably good progress.
Government ownership and the politics of sanitation: Small steps have been taken towards increasing national ownership of and political commitment to sanitation in Lao PDR. The government is relatively open to sanitation ideas and investment. In 2008, it established a National Steering Committee for Sanitation to oversee International Year of Sanitation activities, which marked a step forward.
- Progress outside the sector can contribute to sector progress. Wider socioeconomic progress and levels of inequality may have a significant impact on access to basic sanitation. In Lao PDR, household investment in latrines has been connected in part to rising incomes for some groups.
- In Lao PDR, coverage targets, such as those in the MDGs, are cited as one reason for the rapid latrine construction. However, such targets risk drawing attention away from sustainability and equity outcomes.
- Changes in behaviour and culture are needed. Relatively limited promotion of sanitation and hygiene education and social mobilization in Lao PDR has slowed progress towards the provision of more sustainable sanitation systems. Changing cultural practices is complex, however, often requiring considerable time, resources and effort.
- There is no one blueprint for progress in sanitation delivery. Services can be delivered in different ways– e.g. household investment or direct programmatic efforts – and due attention should be given to leveraging the most appropriate mode of delivery and to selecting the most appropriate type of technology.