Internationally, there has been debate over the last decade about effective ways to increase access to sanitation as a basic human right and essential service to support public health. Within Laos, a similar debate is underway, with a history of provision of hardware subsidies through public or non-governmental organisation funding, and more recently a shift towards demand-driven approaches to motivate household investment and market support to enable more efficient, affordable supply of sanitation products.

Plan began working in the Lao WASH sector in 2010, piloting Community Led Total Sanitation (CLTS) to create community demand for toilets. In 2011-12, government and Plan staff conducted CLTS activities in 35 villages and schools in Phaoudom, Paktha, and Mueng in Bokeo Province. After seven months, eight villages reached 100% coverage. Overall, there was a 24% increase in coverage and reported use across all communities. Costs for building toilets were perceived as an inhibiting factor among some villages however, and in 2011, Plan conducted a sanitation survey in nine villages in the target districts to ascertain attitudes and behaviours among the villagers and a basic supply chain survey. A price range of LAK 200,000 – 300,000 (USD 25-38) per toilet unit was identified to be acceptable by many villagers, though not all could afford this price. The Bokeo Provincial Health Department (PHD), responsible for sanitation services in the province, encouraged Plan to develop targeted support for the poorest households.

This report details findings of research to underpin the design of this targeted support. The intent was to develop a ‘smart’ subsidy design that could achieve effective targeting and would avoid undermining the demand-driven CLTS approach and market response.