Using a community participatory approach to assess health through a water, sanitation and hygiene sustainability project

Background: Laotians face significant challenges in the delivery of sustainable and equitable access to water and sanitation in rural areas. Water, Sanitation, Hygiene (WaSH) for Health is a health promotion program created for rural populations which addresses health and hygiene problems related to water and sanitation with the goal of improving the health of families, coupled with positive health behavior changes through regular health promotion, evaluation, community contribution and ownership. Methods: A community-based participatory approach utilizing a needs and assets assessment was conducted in Northern Laos with the intent of gaining a greater understanding of the health determinants underlying the poor health of local villagers. A quantitative study of eight villages consisting of key informant interviews with village chiefs, (n= 8) and focus groups with villagers (n= 371) were conducted. Villagers were also asked to create community maps to identify health centers, water sources, toilets, and schools. A prioritization chart narrowed down village concerns to three and linguistically, culturally and socially appropriate focus group questions inquiring about health practices, water collection and latrine facilities reflected the true needs of the community. Results: Data analyzed using grounded theory resulted in emerging themes. Northern Laotians identified and prioritized 1) clean water, 2) latrines, and 3) fully functional health centers as their top three needs. Conclusions: In addition to improving health status, this project also contributes to achieving the Millennium Development Goal for water and sanitation of halving, by 2015, the proportion of people without sustainable access to safe water and basic sanitation.