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We examine the relationship between promotion activities and sanitation decisions in the context of a program in the Mekong Delta that encouraged households to switch from fishpond latrines to septic tanks. Before and after the campaign, we surveyed households and promoters. Economic variables were important determinants of septic tank adoption, but whether the decision was woman-led and familiarity with the promoter were strongly predictive as well. Controlling for the pre-existing household decision-making structure, women were more likely to lead the sanitation decision if a promoter spoke to them rather than to a male householder. These household-based findings on the importance of promoters were supported by a supplementary analysis of sales. We found that promoters who were older, trained, and educated were more successful in selling septic tanks. Taken together, these findings highlight the importance of gender equity and trust in the promoter for encouraging last-mile households to invest in new health technologies.

Climbing the sanitation ladder: latrine promotion and household decision-making in Viet Nam