Transforming gender relations through water, sanitation, and hygiene programming and monitoring in Vietnam

TLDR: The types of changes reported by women and men of different ages and ethnicities and the reasons for their occurrence are discussed, which highlights the roles that WASH initiatives can play in furthering strategic gender needs and hence promoting gender equality and women’s empowerment.

Abstract: This article presents the results of empirical research conducted in Central Vietnam in 2016 into water, sanitation, and hygiene (WASH) initiatives. It uncovered changes in gender relations and power dynamics at both household and community levels, aiming to explore the extent to which both practical and strategic interests of women can be influenced and changed by WASH policies and programming. In particular, we were interested in assessing the impact of a Gender and WASH Monitoring Tool (GWMT), developed by Plan International Australia and Plan Vietnam, on women’s strategic gender needs. In this article, we discuss the types of changes reported by women and men of different ages and ethnicities and the reasons for their occurrence. There were a wide range of reported reasons for change, with implications for our understanding of the relationship between changes in gender relations at the household and community levels. We also consider the relationship between wider shifts in social norms in the...

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Tr ans fo rming+gender+relations:+Achieving+and+reinforcing+change+through+
water,+sanitation+and+hygiene+programming+and+monitoring+in+Vietnam!
Caitlin Leahy,+Keren+Winterford,+Tuyen+Nghiem,+John+Kelleher,+Lee!Leong,+and+Juliet!
Willetts
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This%article%presents%the%results%of%empirical%research%conducted%in%Central%Vietnam%in%2016%
into%WASH%initiatives.%It%uncovered%changes%in%gender%relations%and%power%dynamics%at%both%
household%and%community%levels,%aiming%to%explore%the%extent%to%which%both%practical%and%
strategic%interests%of%women%can%be%influenced%and%changed%by%WASH%policies%and%
programming.%In%particular,%we%were%interested%in%assessing%the%impact%of%a%Gender%and%
WASH%Monitoring%Tool%(GWMT),%developed%by%Plan%International%Australia%and%Plan%
Vietnam,%on%women’s%strategic%gender%needs.%In%this%article,%we%discuss%the%types%of%changes%
reported%by%women%and%men%of%different%ages%and%ethnicities%and%the%reasons%for%their%
occurrence.%There%were%a%wide%range%of%reported%reasons%for%change,%with%implications%for%
our%understanding%of%the%relationship%between%changes%in%gender%relations%at%household%
level%and%community%level.%We%also%consider%the%relationship%between%wider%shifts%in%social%
norms%in%the%context%of%rural%Vietnam.%The%Vietnam%research%highlights%the%roles%that%WASH%
initiatives%can%play%in%furthering%strategic%gender%needs%and%hence%promoting%gender%
equality%and%women’s%empowerment.%It%also%shows%the%importance%of%addressing%SDG5%(on%
gender%equality)%and%SDG6%(on%water%and%sanitation)%tog ether.%+
Keywords:%gender%equality,%gender%outcomes,%water,%sanitation,%hygiene,%Vietnam%%
Introduction++
This!article!aims!to!contribute!to!evidence!of!the!ways!in!which!water,!sanitation!and!
hygi ene!(WASH)!programmes!can!influence!and!change!the!underlying!gender!relations!
between!men!and!women!–!and!how+the!strategic%gender%needs!of!women!can!be!met!
through!a!combination!of!WASH!programming!and!effective!monitoring.!Strategic!gender!
needs!are!defined!as!distinct!from!practical!gender!needs!(based!on!the!work!of!Moyneux!
(1985)!on!gender!interests),!and!a!useful!definition!is!provided!by!Moser!(1993):!
Strategic%gender%needs%are%the%needs%women%identify%because%of%their%subordinate%position%
to%men%in%their%society.%Strategic%gender%needs%vary%according%to%particular%contexts.%They%
relate%to%gender%divisions%of%labour,%power%and%control%and%may%include%such%issues%as%legal%
rights,%domestic%violence,%equal%wages%and%women’s%control%over%their%bodies.%Meeting%
strategic%gender%needs%helps%women%to%achieve%greater%equality.%It%also%changes%existing%
roles%and%therefore%challenges%women’s%subordinate%position.%
Practical%gender%needs%are%the%needs%women%identify%in%their%socially%accepted%roles%in%
society.%Practical%gender%needs%do%not%challenge%the%gendered%divisions%of%labour%or%women’s%
subordinate%position%in%society,%although%rising%out%of%them.%Practical%gender%needs%are%a%

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response%to%immediate%perceived%necessity,%identified%within%a%specific%context.%They%are%
practical%in%nature%and%often%are%concerned%with%inadequacies%in%living%conditions%such%as%
water%provision,%health%care,%and%employment.%
This!article!draws!on!research!in!three!locations!in!Central!Vietnam!to!provide!insights!into!
how!WASH!programming!implemented!by!district!and!commune!level!government!agencies,!
with!the!support!of!the!international!NGO,!Plan!International![1]!was!able!to!contribute!to!
meeting!women’s!strategic!gender!needs.!
WASH!is!not!only!a!practical!technical!concern:!lack!of!water!and!sanitation!–!and!other!basic!
needs!-!arises!from!complex!societal!inequalities,!including!gender!inequality.!!At!the!level!of!
policy,!the!relationship!between!poverty,!deprivation!and!inequalities!is!recognised!in!
current!global!thinking!on!development.!During!the!era!of!the!Millennium!Development!
Goals!(MDGs)!there!was!a!growing!awareness!in!the!international!community!that!to!fulfil!
the!ambition!of!safe!water!and!sanitation!for!all,!women’s!empowerment!and!gender!
equality!needed!to!be!addressed!simultaneously!(Willetts!et%al.!2010).!!The!Sustainable!
Development!Goals!(SDGs)!and!the!2030!Agenda!for!Sustai nab le!Development!go!further!in!
many!respects!with!a!twin !focus!on!basic!needs,!and!equal!rights.!However,!this!
commitment!still!does!not!fully!address!issues!of!poverty!and!inequality!together.!While!
gender!equality!is!the!fo cus!o f!the!stand-alone!‘gender!goal’,!SDG5,!gender!issues!are!also!
integrated!to!a!varying!extent!into!the!other!16!goals.!!SDG6,!which!aims!to!attain!water!and!
sanitation!for!all!(implying!women,!men,!girls!and!boys),!also!explicitly!mentions!women!and!
girls!in!one!target!(6.2),!however!the!relevant!global!indicators!are!not!designed!to!
adequately!capture!gender!differences,!since!they!focus!on!household ,!rather!than!intra-
household,!differences.!!
At!the!level!of!practice,!gender!mainstreaming!efforts!over!the!past!two!decades!have!
attempted!to!integrate!gender!equality!into!sectors!of!development!which!focus!on!
satisfying!the!practical!needs!of!women!and!men!living!in!poverty,!including!the!need!for!
water!and!san itation.!Many!WASH!programmes!now!also!actively!seek!to!make!
contributions!to!gender!equality!or!women’s!empowerment!outcomes,!based!on!the!
realisation!that!WASH!can!be!a!strategic!entry!point!for!further!change!in!gender!relations!
(Carrard!et.%al.,!2013).!Yet!understanding!of!what!this!means,!and!in!particular!the!need!to!
focus!on!women’s!strategic!needs,!is!not!as!widespread!as!it!could!be!and!the!implications!
for!programming!less!well-understood.!
With!this!in!mind,!this!article!supports!the!idea!that!integration!of!these!SDGs!5!and!6!is!
essential,!and!offers!insights!here!from!our!research!from!Vietnam!to!contribute!to!an!
evidence!base!on!this.!We!hope!that!this!will!support!WASH!practitioners!to!develop!their!
ability!to!work!to!address!both!practical!and!strategic!gender!needs,!in!an!integrated!way.!!

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Research+background:+the+empowering+potential+of+WASH%
From!the!early!days!of!gender!and!development,!it!has!been!recognised!that!men!and!
women!will!be!affected!differently!by!development!initiatives,!given!their!different!socially!
constructed!roles!and!responsibilities,!opportunities!and!constraints!influenced!by!these!and!
the!value!placed!on!gendered!roles!and!responsibilities.!Women’s!interests!relating!to!water!
and!sanitation!provision!have!a!direct!impact!on!the!way!they!experience!life,!the!tasks!they!
perform,!their!potential!and!the!opportunities!and!difficulties!they!face!(Fisher!2008).!
Women’s!practical!needs!(Moser!1989)!can!be!met!by!furnishing!women!with!resources,!
including!water,!sanitation!and!hygiene,!to!meet!needs!arising!from!their!positioning!in!the!
existing!(unequal)!gender!division!of!labour.!But!in!addition,!women!have!a!strategic!gender!
interest!(Molyneux!1985)!in!challenging!gender!inequality,!which!can!be!furthered!by!
development!interventions!of!various!kinds.!!!
The!provision!of!safe!clean!water,!sanitation!and!hygiene!affects!women!–!and!men!-!on!both!
practical!and!strategic!levels.!Biological!differences!between!women!and!men!create!gender-
specific!needs!in!relation!to!WASH.!In!addition!to!those!health!needs!they!share!with!men,!
women!have!a!range!of!gender-specific!health!needs!relating!to!reproductive!and!maternal!
health.!These!require!WASH!programming!that!includes!menstrual!hygiene!management!
and!the!provision!of!safe!water!and!sanitation!facilities!to!improve!outcomes!for!pregnant!
and!new!mothers!and!their!babies!(Tarrass!&!Benjelloun,!2012).!!
In!addition!to!these!practical!health!needs,!WASH!also!clearly!has!an!impact!on!other!
practical!needs!of!women!arising!from!women’s!positioning!in!relation!to!men!in!society.!
Women!typically!perform!care!work!for!their!households,!ranging!from!water!collection!to!
preparing,!cooking,!and!serving!food!and!drinks,!and!delivering!basic!hygiene!and!health!
care!to!children!and!older!people.!Improving!WASH!conditions!in!households!usually!
supports!women!in!these!unpaid!domestic!caregiving!roles,!linkin g!to!SDG5’s!focus!on!
caregiving!and!unpaid!domestic!work!as!a!driver!and!a!result!of!gender!inequality!(Razavi!
2016).!!!
In!relation!to!violence!against!women!and!girls!(VAWG),!the!distinction!between!practical!
and!strategic!needs!is!less!clear.!Women!and!girls!are!often!at!risk!of!violence!when!
collecting!water,!bathing,!or!living!in!locations!without!adequate!sanitation!designed!with!
safety!in!mind.!Considerations!such!as!facilities!closer!to!home!meet!practical!needs!and!can!
be!very!effective!in!reducing!vulnerability!to!VAWG!(House!et.%al.,!2014).!Conversely,!if!WASH!
interventions!are!planned!without!considering!such!issues,!they!may!result!in!programming!
that!aggravates!the!problem!of!VAWG,!rather!than!solving!it,!for!example!if!women!start!to!
take!on!traditionally!male!roles!in!households!or!communities!(Ibid).!!!
Above!and!beyond !practical!needs,!WASH!programmes!can!explicitly!aim!to!address!
women’s!strategic!gender!needs.!WASH! has!an !impact!at!a!strategic!level!in!terms!of!the!
processes!used!in!the!planning!and!implementation!of!programming.!WASH!programming!

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can!further!women’s!strategic!gender!interests,!by!supporting!women’s!leadership!and!
participation!in!development!and!governance!(Willetts!et.%al.!2010).!Finally,!WASH!
provisioning!has!potential!to!have!a!strategic!impact!on!women!and!girls!by!freeing!them!to!
spend!time!in!activities!that!bring!material!benefits,!notably!income!generation!or!
education,!however!the!global!evidence!base!on!these!impacts!is!relatively!weak!and!
requires!further!research!to!prove!with!rigour.!!
Different!authors!writing!specifically!on!WASH!and!empowerment!vary!in!their!view!of!the!
role!of!WASH!programming!in!the!empowerment!of!women.+Saskia+Ivens!(2008)!cautions!
against!assuming!that!fulfilling!practical!needs!of!women!leads!to!increased!gender!equality,!
pointing!to!a!lack!of!evidence!showing!that!advancement!of!women’s!access!to!water!and!
participation!in!WASH-related!decision-making!has!led!to!women’s!empowerment.!In!her!
work,!Saskia!Ivens!draws!on!a!UNFPA!definition!of!empowerment,!that!it!is!identifying!and!
redressing!power!imbalances!in!order!to!give!women!more!autonomy!to!manage!their!own!
lives.!!Programming!that!delivers!benefits!for!women!may!appear!to!be!intrinsically!
empowering,!but!some!studies!show!that!if!issues!of!power!and!the!political!nature!of!
participation!are!not!adequately!considered!in!WASH-related!decision!making!bodies,!
women’s!influence!will!be!limited!(Kemerink!et.%al.!2013).!!!
Notwithstanding!these!cautionary!comments,!there!is!a!growing!recognition!that!WASH!
programming!can!provide!an!entry!point!for!gender!equality,!and!can!lead!to!genuine!shifts!
in!power!between!women!and!men!(Fisher!2008;!O’Reilly!2010;!Willetts!et.%al.!2010;!Kilsby!
2012).!To!achieve!these!changes,!however,!requires!a!specific!effort!to!use!empowering!and!
participatory!approaches!(Ivens!2008).!Although!she!does!not!explicitly!focus!on!WASH![2],+
Naila!Kabeer’s!model!of!empowerment!conceptualises!the!provision!of!material!resources!to!
women!as!the!starting!poi nt!for!a!process!whereby!they!are!able!to!put!their!choices!and!
aims!into!action,!ultimately!achieving!empowerment.!!
It!has!been!argued!that!within!WASH!programming,!in!particular,!a!comprehensive!means!of!
documenting!and!assessing!strategic!gender!outcomes,!as!distinct!from!practical!gender!
needs,!has!been!lacking!(Carrard!et.%al.!2013).!The!case!to!address!gender!issues!in!WASH!is!
often!made!on!grounds!of!enhanced!efficiency!instead!of!on!the!grounds!of!empowerment!
or!gender!equality!as!policy!rationales.!Since!the!1970’s!and!the!UN!Water!Decade!of!the!
1980s,!there!has!been!wide!acknowledgement!among!development!practitioners!that!when!
women!and!men!are!equally!involved!in!WASH!programmes,!for!example!through!equal!and!
active!participation!in!decision-making!committees!(commonly!water!management!
committees),!the!programmes!can!be!made!more!effective!and!sustainable!(Gross!et.%al.!
2000;!Fisher!2010;!O’Reilly!2010).!!!
Despite!a!recognition!that!access!to!water!and!sanitation!are!human!rights,!there!is!a!
tendency!in!the!WASH!sector!to!target!interventions!to!meet!practical!needs,!with!a!focus!on!
efficiency!and!sustainability!of!WASH!outcomes,!and!the!strategic!needs!that!are!linked!to!
these!are!not!often!a!central!focus.!However,!there!is!growing!realisation!that!these!links!

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need!to!be!better!understood,!not!least!in!light!of!the!clearer!link!articulated!in!the!SDG!
framework!between!gender!equality!and!WASH.!!%!
The+Gender+and+WASH+Monitoring+Tool!
Against!this!backdrop,!the!Gender!and!WASH!Monitoring!Tool!(GWMT)!was!originally!
developed!in!2011!by!Plan!International!Australia!and!Plan!Vietnam![3].!In!2011,!discussions!
with!other!development!agencies!in!Vietnam!had!highlighted! that!a!number!of!agencies!
were!facing!similar!challenges!in!monitoring!strategic!gender!changes!in!communities!where!
WASH!programming!was!being!implemented.!It!was!proposed!that!a!simple!monitoring!tool!
could!help!overcome!this!challenge.!The!GWMT!duly!aimed!to!monitor!changes!in!gendered!
social!norms,!power!relations,!and!the!status!of!women!and!men!(Thomas!2015).!!As!Plan!
stated!in!its!guide!to!the!tool:!
!
Promoting%gender%equality%demands%significant%attention%in%every%WASH%intervention%as%
gender%relations%are%integral%to%the%ef fectiveness%and%sustainability%of%WASH.%The%literature%
suggests%that%measuring%change%in%the%context%of%gender%relations%presents%ongoing%
challenges%for%monitoring%and%evaluation%(M&E).%!
!
(Plan!2014,!3)!
!
The!GWMT!couples!a!regular!monitoring!activity!with!active!exploration!of!gendered!
relations!through!a!facilitated!community!dialogue!process,!to!meet!two!aims.!!The!first!of!
these!focuses!on!programme!staff!and!partners,!working!at!community!level!on!WASH,!and!
within!government.!The!GWMT!aims!to!support!them!to!develop!gender!analysis!skills!and!
better!understanding!of!the!role!that!WASH!can!play!in!promoting!gender!equality.!The!
second!aim!of!the!GWMT!is!to!raise!awareness!among!communities!about!gender!roles!and!
relationships!in!household!and!community!WASH!activities,!and!to!promote!aspirations!for!
gender!equality,!providing!opportunities!for!women!and!men!to!discuss!gender!relations,!
and!to!set!their!own!agendas!for!change!(Ibid.).!!
!
Our+research+in+Vietnam+
+
Findings!discussed!in!this!paper!draw!on!a!12!month!study!undertaken!by!ISF-UTS!in!2016!in!
collaboration!with!Plan!International!Australia,!Plan!Vietnam!and!the!Centre!for!Natural!
Resources!and!Environmental!Stud ies!(CRES)!at!the!Vietnam!National!University.!The!
research!was!designed!to!uncover!women!and!men’s!perceptions!of!changes!in!gender!
relations!in!Central!Vietnam,!to!determine!whether!the!GWMT!was!directly!contributing!to!
the!achievement!of!strategic!gender!outcomes.!It!aimed!to!explore!the!contribution!of!the!
GWMT!(as!well!as!WASH!poli cies!and !programming)!to!changes!in!gender!relations!
experienced!during!the!duration!of!GWMT!implementation![4].!%

Frequently asked questions

Q1. What contributions have the authors mentioned in the paper "Transforming gender relations: achieving and reinforcing change through water, sanitation and hygiene programming and monitoring in vietnam" ?

This article presents the results of empirical research conducted in Central Vietnam in 2016 into WASH initiatives. In this article, the authors discuss the types of changes reported by women and men of different ages and ethnicities and the reasons for their occurrence. The authors also consider the relationship between wider shifts in social norms in the context of rural Vietnam. The Vietnam research highlights the roles that WASH initiatives can play in furthering strategic gender needs and hence promoting gender equality and women ’ s empowerment. 

Q2. What was the common outcome of the study?

The most commonly reported outcome experienced at the household level, was improved communication between male and female household members, in which women increased their influence over decision-making. 

Q3. How many votes were cast for each of the six strategic gender outcomes?

On average, 68 per cent of all votes cast by both women (72) and men (67) were cast for ‘a lot of change’ in relation to each of the six strategic gender outcomes identified at household and community level. 

Q4. How many participants participated in the research?

In total, the research engaged 187 men and women: 48 participants in semi-structured interviews, and 139 participants in pocket-voting. 

Q5. What are the main reasons for the need for improving WASH conditions in households?

Improving WASH conditions in households usually supports women in these unpaid domestic caregiving roles, linking to SDG5’s focus on caregiving and unpaid domestic work as a driver and a result of gender inequality (Razavi 2016). 

Q6. What can be done to help improve the gender of the WASH program?

genderresponsive monitoring tools can be used as an important capacity building approach for program staff and partners. 

Q7. What were the factors found in the Timor-Leste study?

Other factors found in the Timor-Leste study (Kilsby 2012) which were less commonly reported in their research included: women in new roles acting as role models for others; funds and technical support from NGOs; and women staff working in communities. 

Q8. How many of the participants described a change in power relations?

Thirty-nine of the 48 participants interviewed (that is, 81 per cent) described at least one change over the previous three years that indicated a positive shift in power relations between men and women. 

Q9. What did the older Vân Kiu woman report about her increased self-confidence?

One younger Vân Kiều women reported her increased self-confidence as a result of a change in household composition;Four years ago, since The authormoved to live independently, The authorwas more forcible and less shy because the authors had common children and my husband must help to take care of the children. 

Q10. What are the main reasons why women and girls are at risk of violence?

Women and girls are often at risk of violence when collecting water, bathing, or living in locations without adequate sanitation designed with safety in mind. 

Q11. What are the benefits of facilities closer to home?

Considerations such as facilities closer to home meet practical needs and can be very effective in reducing vulnerability to VAWG (House et. al., 2014). 

Q12. What were the locations selected for inclusion in the research?

The research locationsSeven communities across three Central Provinces in Vietnam; Quảng Trị, Quảng Bình and Kon Tum were selected for inclusion in the research. 

Q13. What is the main idea of Naila Kabeer’s model of empowerment?

Although she does not explicitly focus on WASH [2], Naila Kabeer’s model of empowerment conceptualises the provision of material resources to women as the starting point for a process whereby they are able to put their choices and aims into action, ultimately achieving empowerment. 

Q14. What is the evidence base on the impact of WASH on women and girls?

WASH provisioning has potential to have a strategic impact on women and girls by freeing them to spend time in activities that bring material benefits, notably income generation or education, however the global evidence base on these impacts is relatively weak and requires further research to prove with rigour. 

Q15. What is the role of the GWMT in the WASH programme?

Making the distinction between practical and strategic gender needs in the design, implementation and monitoring of WASH programmes, including through the use of the GWMT, provides a significant opportunity to ensure that WASH programmes are going beyond an approach that includes women on grounds of efficiency, or claim aims of gender equality without a real understanding of how to achieve this. 

Q16. Why did the Vân Kiu ethnic people have never washed clothes?

Their Vân Kiều ethnic people are used to distributing all housework to their wives, men have never washed clothes because they are shy, and they are afraid that someone else would see them wash clothes. 

Q17. Why is the case to address gender issues in WASH often made on grounds of enhanced efficiency?

The case to address gender issues in WASH is often made on grounds of enhanced efficiency instead of on the grounds of empowerment or gender equality as policy rationales. 

Q18. What was the reason for the increase in men’s drinking?

One explanation for this was an increase in standards of living, which resulted in men drinking and not wanting to help with other activities. 

Q19. What is the role of the GWMT in bringing about gender equality?

this depends on the explicit use of contextually appropriate strategies to bring about genuine changes in power dynamics and increased gender equality through programming and monitoring. 

Q20. What is the main argument for a comprehensive means of documenting and assessing strategic gender outcomes?

It has been argued that within WASH programming, in particular, a comprehensive means of documenting and assessing strategic gender outcomes, as distinct from practical gender needs, has been lacking (Carrard et. al. 2013).