Hygiene and sanitation among ethnic minorities in Northern Vietnam: does government promotion match community priorities?

TY - JOUR

T1 - Hygiene and sanitation among ethnic minorities in Northern Vietnam

T2 - does government promotion match community priorities?

AU - Rheinländer, Thilde

AU - Samuelsen, Helle

AU - Dalsgaard, Anders

AU - Konradsen, Flemming

N1 - Copyright (c) 2010 Elsevier Ltd. All rights reserved.

PY - 2010/9

Y1 - 2010/9

N2 - Improving sanitation and hygiene to prevent infectious diseases is of high priority in developing countries. This study attempts to gain in-depth understanding of hygiene and sanitation perceptions and practices among four Ethnic Minority Groups (EMGs) in a rural area of northern Vietnam. It is based on extensive participatory observations in 4 villages and 20 case households over a period of six months (May-October 2008). In addition, 10 key informants and 60 household-members were interviewed and 4 focus group discussions conducted. The study found that among the four selected EMGs the cultural perceptions of hygiene and sanitation which inform everyday hygiene practices did not differ substantially and were similar to hygiene explanations found in the rural majority population elsewhere in Vietnam. However, the difficult living conditions, particularly in highland communities, reinforce a sense of marginalization among the EMGs, which had great impact on how they perceive and respond to government sanitation interventions. The enclosed latrines promoted by authorities are met with reluctance by the EMGs due to cultural perceptions of the body as permeable and therefore, vulnerable to 'dirty air' such as bad smells from human faeces. In addition, the prioritization of specific sanitation hardware solutions by the central government aimed at increasing coverage creates expectations and dependency among the EMGs that hygiene 'comes from the outside society', resulting in low levels of community initiated actions. Based on these findings, we suggest that future hygiene promotion strategies aim for a closer match between community priorities and government hygiene policies, e.g. by allowing for a larger diversity of low-cost sanitation solutions. Scaling up participatory community-based hygiene promotion is also recommended to curb dependency and spark initiatives in ethnic minority communities. Finally, interventions should focus on hygiene "software"--promoting hygiene behaviour changes known to effectively prevent hygiene related diseases.

AB - Improving sanitation and hygiene to prevent infectious diseases is of high priority in developing countries. This study attempts to gain in-depth understanding of hygiene and sanitation perceptions and practices among four Ethnic Minority Groups (EMGs) in a rural area of northern Vietnam. It is based on extensive participatory observations in 4 villages and 20 case households over a period of six months (May-October 2008). In addition, 10 key informants and 60 household-members were interviewed and 4 focus group discussions conducted. The study found that among the four selected EMGs the cultural perceptions of hygiene and sanitation which inform everyday hygiene practices did not differ substantially and were similar to hygiene explanations found in the rural majority population elsewhere in Vietnam. However, the difficult living conditions, particularly in highland communities, reinforce a sense of marginalization among the EMGs, which had great impact on how they perceive and respond to government sanitation interventions. The enclosed latrines promoted by authorities are met with reluctance by the EMGs due to cultural perceptions of the body as permeable and therefore, vulnerable to 'dirty air' such as bad smells from human faeces. In addition, the prioritization of specific sanitation hardware solutions by the central government aimed at increasing coverage creates expectations and dependency among the EMGs that hygiene 'comes from the outside society', resulting in low levels of community initiated actions. Based on these findings, we suggest that future hygiene promotion strategies aim for a closer match between community priorities and government hygiene policies, e.g. by allowing for a larger diversity of low-cost sanitation solutions. Scaling up participatory community-based hygiene promotion is also recommended to curb dependency and spark initiatives in ethnic minority communities. Finally, interventions should focus on hygiene "software"--promoting hygiene behaviour changes known to effectively prevent hygiene related diseases.

KW - Attitude to Health

KW - Communicable Disease Control

KW - Culture

KW - Focus Groups

KW - Government Programs

KW - Health Promotion

KW - Humans

KW - Hygiene

KW - Interviews as Topic

KW - Minority Groups

KW - Observation

KW - Residence Characteristics

KW - Rural Health

KW - Sanitation

KW - Vietnam

U2 - 10.1016/j.socscimed.2010.06.014

DO - 10.1016/j.socscimed.2010.06.014

M3 - Journal article

C2 - 20619522

SN - 0277-9536

VL - 71

SP - 994

EP - 1001

JO - Social Science & Medicine

JF - Social Science & Medicine

IS - 5

ER -