Since 2010, Laos has steadily progressed in the rural water supply and sanitation sector with about 62% of the rural population reportedly having access to improved water supplies (UNICEF/WHO Joint Monitoring Report 2010). However, sanitation coverage in Laos continues to lag with only 50% of rural areas having access to improved sanitation facilities. Hygiene standards in most rural homes are still unacceptably low and therefore, open defecation is still common practice in the majority of rural villages and poses significant health risks to the population. In fact, about 2.5million rural residents (41% of rural population) still practice open defection.

The Lao Community Hygiene Output-Based Aid Pilot (Lao CHOBA Pilot) is a partnership between the Lao Women’s Union (LWU), a mass organization of 600,000 members throughout all levels of government in Laos, and the East Meets West Foundation (EMW), an INGO with over 24 years of experience in international development with particular knowledge and experience in output-based aid methodology applied in the water and sanitation sector. In LWU, there is capacity to directly engage poor households and provide ongoing sanitation promotion and advocacy at both the grassroots level and policy level with government authorities. Further, the potential to replicate and scale the Lao CHOBA Pilot to other areas of Laos is unparalleled to any other organization in Laos. In EMW, there is the unique combination of output-based aid experience in the WASH sector and delivering sanitation programs with strategic local partners such as the Vietnam Women’s Union and Cambodian Women for Peace and Development at the grassroots level. In fact, EMW is currently working with the Vietnam Women’s Union and the Cambodian Women for Peace and Development to deliver 100,000 and 10,000 household latrines to poor families in Vietnam and Cambodia respectively.

Accordingly, the Lao CHOBA Pilot aims to replicate the sanitation program success in Vietnam and transfer the knowledge, tools and experience in the Laos context. The Pilot aims to increase household sanitation adoption and hygiene behavior change among the poorest households in the Viengthong District of Bolikhamxay Province. At present, the poverty rate in Vienthong is about 30 percent where the average income of a poor household is less than US$ 1.50 per capita per day. Meanwhile, about half of the households in the district still do not have hygienic toilets. To directly address this situation, Lao CHOBA Pilot endeavors to leverage the knowledge and experience of EMW on output-based aid in the WASH sector as well as the LWU’s capacity to engage, organize and facilitate both sanitation hardware and ongoing sanitation education to bring about hygiene behavior change.

CHOBA Approach
The Lao CHOBA Pilot adopts output-based aid methodology with a combination of four sanitation development techniques to provide a holistic approach for poor households to not only procure hygienic latrines, but also adopt communitywide hygiene behavior change:

1. Sanitation promotion and demand triggering. This step involves both information, education and communication (IEC) campaigns and community led total sanitation (CLTS) triggering to realize community demand for hygienic toilets. The LWU also conducts a communitywide campaign through door to door engagement, community awareness meetings and trainings in the community. At the same time, the LWU works with local authorities including the commune and district officials to ensure selection and certification of poor households by using the same criteria used in the issuance of poverty cards. Note that poor households are typically issued a poverty status card, but the LWU also works with the local authorities to ensure that the potentially qualified poor households in the program are also included if for some reason some poor households do not have poverty status cards. Moreover, if households holding poverty status cards do not match the verification for program qualification, then these households will not qualify for the household rebate. The qualification list will be used by EMW during monitoring and evaluation activities for reimbursement purposes.

2. Sanitation marketing. This step involves identifying and building up sanitation supply networks in the local community. Training suppliers and builders while furthering the network to include local stakeholders including local authorities, community leaders and volunteers to help connect sanitation supply with household demand. The LWU will organize suppliers and provide technical assistance through additional partnerships with the Department of Public Works and Transportation as well as experienced NGOs such as EMW and Gret.

3. Access to finance. This step involves identifying sources of micro-credit loans in addition to other forms of credit including informal lending, credit from suppliers and/or builders and sometimes material donations/volunteer labor to help poor households. The LWU will work with local microcredit institutions, NGOs with microcredit programs as well as informal lenders in the area.

4. Household Rebate and Community Reward. This step involves providing a partial smart subsidy of US$ 35 or about 30-50% rebate of the hygienic latrine cost to the poor household after results can be verified. Results are determined on physical inspection of the hygienic facilities for both proper installation and usage. The Community Reward of US$ 1,000 is provided to the district leadership to be used for the purposes of a clean water and sanitation project for the district if the sanitation coverage can increase by 25 percentage points. Therefore in Vienthong, the sanitation coverage rate must increase from 52% to 77% where the targeted poor households would account for the initial 10% increase. The upshot of this incentive is to promote non-poor households to increase along with the poor households by an additional 15% to reach the benchmark of 25 percentage points increase.

Technology
Two types of pour-flush latrine options and one dry pit version are offered in the Pilot. These designs are approved by the Ministry of Health and used in various projects by other NGOs including Concern and Gret in Laos. See Attachment 1 for latrine specifications, cost and diagrams.

Since the Lao CHOBA Pilot is based on output-based aid methodology, the ownership of the hygienic latrines belong to the poor households at the very start. The crux of the Pilot and efforts by EMW and LWU is to create a sustainable and enabling environment so that poor households (as well as non-poor households) can uplift the sanitation coverage of the community.

The Lao CHOBA Pilot is not directly connected to any Lao government program. However, the Pilot is very much aligned with the Laos Water and Sanitation Strategy for 2020, which is to increase rural sanitation to 80%. Through the strength of the LWU, the Pilot is able to directly target rural communities and poor households, the Pilot addresses the most difficult challenges in advancing the Lao progress toward Millennium Development Goal 7.