Scaling Up Rural Sanitation and Hygiene in Indonesia
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World Bank, Washington, DC
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This report is a synthesis of the
technical assistance (TA) Scaling Up Rural Sanitation and
Hygiene in Indonesia, carried out by the World Bank - Water
and Sanitation Program (WSP). It was developed in
consultation with the Directorate of Environmental Health,
Directorate General of Public Health and Centre for Health
Promotion of the Ministry of Health (MoH) and with key
institutions in the focus provinces in West Java, Central
Java, East Java, Bali, and West Nusa Tenggara. Reform in the
rural sanitation sub-sector began in 2005 following the
successful introduction of Community-Led Total Sanitation
(CLTS) in 6 districts. In 2007, the Water and Sanitation
Program (WSP) supported the Ministry of Health (MoH) to
complement the use of CLTS with behavior change
communication (BCC) and development of the sanitation
market. This new approach was piloted at scale in 28 out of
29 districts in East Java Province in 2007-2011 under the
Total Sanitation and Sanitation Marketing (TSSM) TA.
Impressive results were achieved in just ten months, with
262 villages becoming Open Defecation Free (ODF). In
response, MoH adopted the district-wide approach in 2008 and
launched a new rural sanitation development strategy called
Community-Based Total Sanitation (Sanitasi Total Berbasis
Masyarakat) or STBM. The STBM strategy has three elements:
demand creation through CLTS and BCC; supply chain
improvement through developing the local sanitation market;
and creation of and enabling environment through advocacy
for local formal and informal regulations and resource
mobilization. This project was was also complementary to a
large-scale World Bank-funded program called PAMSIMAS, which
has evolved from a project to a national platform through
which the government intends to reach its newly adopted
target of universal access to water supply and sanitation by
2019. Some of the key results and achievements are as
follows : i) Well-functioning STBM Secretariat set up to
co-ordinate STBM implementation nationwide, ii) Local
government capacity in implementing STBM through demand
creation, supply improvement and enabling environment
increased, and iii) More effective STBM implementation at
provincial and district Level. Some of the lesson learned:
i) A capacity building framework to strengthen institutions
at all levels is key for scaling up in a decentralized
environment; ii) Well-crafted advocacy and communications
are valuable for disseminating tested approaches and
facilitating their adoption at scale; iii) Engagement of a
range of institutions also strengthens campaign outreach;
iv) An effective monitoring system is invaluable and it use
should be formally integrated into the routine operations of
government agencies; v) Local government can help to develop
the rural sanitation market; and vi) The scaling up tested
approaches can be enhanced greatly through their
incorporation into established programmes.
Palabras clave
SANITATION, WASTE, SOCIAL NORMS, MASS MEDIA, E-MAIL, ECONOMIC GROWTH, MATERIALS, PREVENTION, HAND WASHING, FAMILY WELFARE, LOCAL GOVERNMENTS, COMMUNITY HEALTH, INFORMATION, WATER SUPPLY, MONITORING, INFRASTRUCTURE DEVELOPMENT, NATIONAL DEVELOPMENT, LEGAL STATUS, COPYRIGHT, MEDIA COVERAGE, HEALTH, GOVERNMENT CAPACITY, CONSULTANTS, WASHING, CAPACITY BUILDING, PUBLICATIONS, VERIFICATION, ENVIRONMENTAL HEALTH, NATIONAL LEVEL, NUMBER OF PEOPLE, GOVERNMENT SUPPORT, SOAP, BASIC SANITATION, CATALYST, PUBLIC HEALTH, ENABLING ENVIRONMENT, REGIONAL MEETINGS, KNOWLEDGE, COMMUNICATIONS, INSTITUTIONS, UNIVERSAL PRIMARY EDUCATION, TECHNICAL ASSISTANCE, FINANCIAL REPORT, MINISTRY OF HEALTH, RISING DEMAND, MILLENNIUM DEVELOPMENT GOAL, TRAINING, DEVELOPMENT PLANNING, SANITATION TECHNOLOGY, RURAL WATER SUPPLY, COMMUNICATION CHANNELS, INTERVENTION, RESOURCE MOBILIZATION, FAMILY HEALTH, HEALTH CENTERS, DEMOCRACY, PRETESTING, NURSES, ADOPTION, OBSERVATION, MARKETING, DISSEMINATION, SERVICE PROVISION, MASS MEDIA COVERAGE, MATERIAL, SERVICE DELIVERY, NATURAL RESOURCES, GROSS DOMESTIC PRODUCT, TOILETS, SANITATION ACTIVITIES, MORTALITY, HEALTH PROMOTION, TELEPHONE, POSTERS, PROGRESS, INFANT MORTALITY, INFANT, KNOWLEDGE MANAGEMENT, RURAL COMMUNITIES, WORKERS, TRAINING COURSES, SOCIAL SECTOR, NATIONAL STRATEGY, POLICIES, RESULTS, FLUSH TOILETS, POLICY MAKERS, NATIONAL GOVERNMENT, UNIVERSAL ACCESS, HYGIENE, WORKSHOP, HOME AFFAIRS, EARLY CHILDHOOD, DECISION MAKING, SCHOOL CURRICULA, INSTITUTIONAL CAPACITY, NUTRITION, WORKSHOPS, HANDWASHING, SUPPLY CHAIN, QUERIES, EXCHANGE OF INFORMATION, POLICY, HOUSEHOLD WASTE, E-LEARNING, GOVERNMENT PROGRAMS, HEALTH SYSTEM, LOCAL COMMUNITY, POPULOUS COUNTRY, GOVERNMENT AGENCIES, MILLENNIUM CHALLENGE, SANITATION SERVICES, LICENSES, DRINKING WATER, HUMAN RESOURCES, RURAL AREAS, COMMUNITY ACTION, PERFORMANCE, HEALTH CENTRE, CENTER FOR HEALTH, LIMITED RESOURCES, ONLINE TRAINING, POPULATION, STUDENTS, SANITATION IMPROVEMENT, INSTITUTIONALIZATION, COMMUNICATION, STRATEGY, PRIMARY EDUCATION, COMMUNICATION STRATEGY, MISUNDERSTANDING, SANITATION SERVICE DELIVERY, BEHAVIOR CHANGE, IMPLEMENTATION, TARGET, HUMAN DEVELOPMENT, SANITATION FACILITIES, MIDWIFES