This chapter examines social inclusion outcomes of a rural WASH (water, sanitation, and hygiene) intervention in Vietnam (the Vietnam Project) through the Capability Approach, moving beyond output-based indicators to assess people’s real opportunities to achieve valued ways of living. Drawing on mixed-methods evidence from rural Vietnam, it applies the three determinants of capability change—effective access to WASH resources, effective agency, and socio-structural context—to analyse how gender, disability, poverty, and ethnicity shape inclusion. The analysis shows that access to WASH services, when combined with meaningful participation in training, community meetings, and consultations, is associated with improved well-being and expanded economic opportunities. Participatory processes that enabled active understanding and shared decision-making strengthened awareness of rights and inclusion, highlighting the dynamic relationship between material access and the development of individual agency. However, symbolic participation, financial constraints, and entrenched gender and institutional norms limited households’ ability to convert access into sustained empowerment. While the Project achieved significant gains in inclusive WASH access, its transformative potential remained uneven, constrained by persistent socio-structural barriers that continued to shape who could exercise real freedoms and voice.