In rural areas of Lao PDR, children living in villages where community members defecate in the open or use unhygienic sanitation facilities are on average 1.1 cm shorter than children living in villages where everybody uses improved sanitation. Stunting makes children more vulnerable to infectious diseases and more likely to die from them. Stunted children are also more likely to have poorer cognitive abilities and achieve lower educational outcomes in late childhood and adolescence.

To address these critical issues, the Enhancing Nutrition of Upland Farming Families (ENUFF) project is developing and applying a Community-led Total Sanitation and Nutrition (CLTS&N) approach. CLTS&N is an integrated, nutrition-sensitive approach to agricultural production and water, sanitation & hygiene (WASH). The project is initiated by SNV in partnership with Agrisud International, and funded by the Swiss Agency for Development and Cooperation (SDC). The project is implemented together with government counterparts and other development partners with the aim to improve family and child nutrition in remote and ethnically diverse upland farming communities through nutrition-sensitive agriculture production, sustainable management of natural resources and dissemination of good practices in health and hygiene.

The CLTS&N approach includes a series of Behavioural Change Communication (BCC) activities in the areas of food and body hygiene, safe faeces disposal, use of safe sources of water, infant breastfeeding, enhanced young child feeding and dietary diversity at home, and improved nutrition sensitive food production through home gardening and agro-ecological practices. In early October, 40 government staff from the District Health, Agriculture and Forestry and Lao Women Union offices in four target districts in the Oudomxay and Houaphanh provinces, gained knowledge on the CLTS&N approach.

A focus group in Houaphanh province

A five-day training session was conducted simultaneously in the two provinces by teams from the National Centre for Environmental Health and Water Supply (Namsaat), the Rural Development Agency (RDA) and SNV. The session consisted of a 3-day review of the theory on BCC and CLTS&N, 1-day practical application of the theory and 1-day feedback work and action plan development. Following this training, district staff triggered demand for healthier living conditions in the 40 villages targeted by the ENUFF project. A large number of households decided to build or improve their sanitation facilities as well as to better manage their environment. This will contribute to better and more hygienic living conditions for their children.

The ENUFF project targets 4,000 farming families in 40 villages across the four districts of the Oudomxay and Houaphanh provinces. Coming next, new BCC activities will focus on the identification, operation and maintenance of safe water supply sources. Demand will thus be triggered for community leadership regarding protection of the water supply and the use of safe water for household consumption and agriculture.


Ranjan Shrestha

Agriculture Sector Leader - Lao PDR