The Water and Sanitation Program is an August 2009 international partnership for improving water and sanitation sector policies, practices, and capacities to serve poor people Field Note 71524 Total Sanitation and Sanitation Marketing Project: Indonesia Country Update June 2009 Learning at Scale The TSSM project is demonstrating a new combination of approaches in India, Indonesia and Tanzania, to generate sanitation demand and improve market supplies of sanitation products and services, at scale. In Indonesia the national government and local governments of East Java seized the TSSM opportunity to do things very differently than in the past and learn from the results. One of the most densely populated places on earth, with only 55% of the rural population having access to any kind of sanitation, and home to an estimated 20% of Indonesia’s poor, East Java presented a signi�cant challenge for a global project aimed at learning how to scale up sanitation and hygiene improvements sustainably. Executive Summary The four-year Total Sanitation and Sanitation Marketing (TSSM) project is now in its third year of implementation in India, Indonesia and Tanzania. In East Java, Indonesia, it is demonstrating a combination of innovative approaches at a province-wide scale, in partnership with the national government and local governments of East Java’s 29 districts. The project is operationalizing the Government of Indonesia’s new National Strategy for Community-based Total Sanitation. It is a collaboration between the Government of Indonesia, the Bill and Melinda Gates Foundation and the Water and Sanitation Program-East Asia and Paci�c. Implementation experience has been promising, with rapid increases in household sanitation access being reported from most districts, following project interventions. Local governments are co-funding project interventions, progressively internalizing the new methodologies and approaches, and scaling up their application to the whole district. A rich harvest of learning is being gathered about how to combine community-level demand creation with consumer-research- based enhancement of market supplies of improved sanitation products and services. What it takes to foster an enabling policy and institutional environment for sustainable sanitation programs is also on the project’s agenda for learning jointly with stakeholders. This Field Note is an update on TSSM’s progress in Indonesia and an attempt to identify what needs to be done before it concludes, in order that its learning experiences and knowledge products serve the purpose of scaling up access to improved sanitation in other provinces of Indonesia, as well as help neighboring countries in the region looking for strategies to help them achieve the Millennium Development Goal targets for sanitation. Stakeholder Learning Review, March 2009 2 Learning at Scale Country and Provincial Parameters A Sanitation Indonesia population (2008): 228.8 million Transformation Access to improved sanitation: Urban: 67% * Rural: 38% * Underway in East Java East Java Province: Population (SUSENAS, 2006): In November 2007, a rural Urban: 4.7 million Rural: 32.7 million sanitation transformation quietly got underway in villages of East Sanitation coverage Java with the commencement of (SUSENAS 2004): the Total Sanitation and Sanitation Urban: 69.8% Marketing (TSSM) project Rural: 54.9% activities in 10 districts. A year (Facilities not differentiated and a half later, sanitation access as improved/unimproved)** rates – growing by thousands of households every month and TSSM Project Intervention in East Java Province tripling in geometric progression Commencement of TSSM project activities at November 2007 every quarter – are beginning community level to put East Java in the national limelight like never before, and Number of communities declared and veri�ed 715 (as of May 2009) attracting a steady stream of open defecation free international visitors. Population gaining access to improved 325,627 persons The transformation is remarkable sanitation fully �nanced by households, since East Java is in Indonesia, between November 2007 and May 2009 a country where rural sanitation Percentage increase in local government average 68% progress has been sluggish, funding for rural sanitation after TSSM with national rural access to intervention (in FY08 and 09 budgets, over sanitation actually declining from 2007 baseline) 42% to 37% between 1985 and 2008 (JMP estimate) despite a Community investment in sanitation IDR 2-31 million, succession of large-scale water improvement leveraged per IDR 1 million (USD depending on district, and sanitation projects. 100 in May 2009) of rural sanitation program between January 08 and expenditure April 09 Most signi�cantly, all of the recent Value of total TSSM technical assistance per USD 86,000 over 2007-10 gains in access to improved East Java district including province level sanitation in East Java are fully research, development and national level �nanced by the community advocacy cost households themselves rather than through subsidized or free Value of direct technical assistance to each USD 26,100 approx. latrines or sanitation credit as in district previous projects, which had all failed to push up people’s access * 2008 Joint Monitoring Program (JMP) report (actually based on 2006 data) ** East Java: Sanitation coverage �gures from Susenas 2004 – includes users of private to sanitation. In many TSSM facilities, excludes public and shared facility users. districts, rural sanitation, which was once the neglected orphan 3 Instead of selecting areas for project intervention as is conventional practice, national policymakers and WSP-EAP jointly devised a strategy to start at scale with a stakeholder demand-driven approach. of local government budget of East Java seized the TSSM Government of Indonesia’s allocation exercises, is suddenly a project as an opportunity to try to new Community-based Total favorite sector with local leaders, do things very differently than in Sanitation Strategy (Sanitasi Total who are giving district sanitation the past, and learn from the results. Berbasis Masyarakat or STBM), programs unprecedented annual A comparison of the differences launched in September 2008. Box funding increases over the pre- between the conventional and the 2 illustrates the principal STBM TSSM allocations. They have seen TSSM approaches is presented components, which fully endorse that funding the new approaches at the end of this update, which the TSSM project’s three-pronged being promoted by TSSM summarizes what was done approach. This has made it has brought forth community differently and what has been possible for national government investments for sanitation learned thus far in Indonesia. and WSP to position the TSSM improvements in amounts 10- project as an opportunity to put 30 times larger than the cost Several years of sector experience into operation the new strategy of government interventions in analysis and multi-stakeholder on a province-wide scale in East different districts. dialogues have resulted in the Java1. This signi�cant change in a long- 1 Within its implementation period stagnant sector has come about (2007- 2010), the TSSM project will focus only on steps 1 and 2 of the through an innovative partnership four steps of Total Sanitation. between the Government of Indonesia, the Bill and Melinda Gates Foundation, and the Water Box 1 What is the TSSM Project Aiming to Do Globally? and Sanitation Program – East TSSM Project Causal Logic Asia and the Paci�c (WSP-EAP). Improve health for poor This partnership aims to help 1.4 households and communities million additional people in all districts of East Java gain effective Increase access to hygienic access to improved sanitation, as sanitation de�ned by the Joint Monitoring Program and appropriate national government standards. Generate Increase supply demand The Indonesian province of East Java is home to a population of 37 million people (SUSENAS 2006). Generate an enabling environment One of the most densely populated for demand and supply to grow freely and sustain each other places on earth, with only 55% of the rural population having access to any kind of sanitation, The Total Sanitation and Sanitation Marketing (TSSM) project is demonstrating a new and home to an estimated 20% combination of approaches in India, Indonesia and Tanzania, to generate sanitation of Indonesia’s poor (SUSENAS demand at scale and increase the supply of sanitation products and services at scale. 2004), East Java presented a The increased demand and supply are expected to increase access to hygienic sanitation, and improve health and well-being for poor households in rural villages and signi�cant challenge for a global informal urban settlements. project aimed at learning how to scale up sanitation and hygiene The global project focuses on generating and sharing knowledge about scaling up improvements sustainably. The these approaches cost-effectively, in order to influence programs in other areas and national government (Ministry of countries. It also rigorously evaluates health, social and economic impacts from sanitation improvements effected in all the three TSSM countries. Health) and the local governments 4 Learning at Scale Box 2 Community-Based Total Sanitation (STBM) Strategy, Indonesia, 2008 Create an Enabling Environment Institutionalization Increase DEMAND for Improve SUPPLY of “improved Sanitation “improved Sanitation & Hygiene services� & Hygiene services� The Community-Based Total Sanitation (STBM) strategy states that a community is considered to have achieved total sanitation when: 1. All households have access to and use improved sanitation facilities for all human excreta disposal. 2. All households habitually wash their hands with soap after defecation, after cleaning up infant feces, and before eating, feeding and handling food. 3. All households use safe handling and storage practices for food and drinking water. 4. All households use safe practices for disposal of their solid waste and domestic waste water. To Start at Scale – a Demand-Responsive Approach at All Levels Instead of selecting areas expectations of mega dollars of whether or not to participate. The for project intervention as is donor funds flowing into districts. national government leadership conventional practice, national To counter these expectations, introduced the TSSM project to policymakers and WSP-EAP TSSM was presented to district East Java district governments, jointly devised a strategy to governments as a short-term stressing that the onus was on the start at scale with a stakeholder window of opportunity to district governments to maximize demand-driven approach. learn how to become open the learning that they could derive defecation free within the next from the eight months2 of the All 29 districts in East Java few years. Investment-sharing TSSM opportunity – enabling were offered the opportunity for TSSM implementation was 2 To cover 29 districts in three years, imple- to participate in the project. By made an essential condition mentation was phased into three batches then, public awareness had of participation to safeguard of districts, each batch receiving eight already spread that TSSM was the sustainability of TSSM months of direct technical assistance, and another 4-6 months of limited follow-up funded by the Bill and Melinda interventions. However, local support. The remaining project time was Gates Foundation, giving rise to governments were free to choose needed for institutional preparation, pro- curement of services and wrap-up. 5 At the time of writing, of the 1,991 sub-villages thus triggered in 932 villages, 715 have declared themselves open defecation free, as de�ned and veri�ed by local governments. In the process, more than 325,600 people have gained access to improved sanitation facilities in 21 districts. them to become open defecation the TSSM opportunity to scale up were received from the villages free within target dates that they sanitation improvements district requesting a demand-triggering then set for themselves. wide. Community-led Total Sanitation (CLTS) event. The CLTS approach The approach bore ample fruit. The roadshows clari�ed that the was already well-known in East Within the next two months, project would begin interventions Java, due to its introduction in demand for participation with a at the sub-district and community the second Water and Sanitation cost-sharing commitment was levels only after the sub-district for Low Income Communities formally expressed to WSP-EAP heads formally expressed their (WSLIC) project in 2005. TSSM through letters of interest signed demand for the same and combined CLTS with interventions by the heads of 22 districts. The facilitated similar roadshows such as sanitation marketing and remaining seven districts came at sub-district level to inform local supply chain strengthening, on board a few months later. The village heads of the opportunity, and offered to demonstrate 10 districts that were ready with and formal Letters of interest CLTS triggering events in 30 their share of the funds in 2007 were included in the �rst phase Box 3 What is CLTS? of implementation. The second CLTS is an innovative methodology for mobilizing communities to completely eliminate phase covered 11 districts, where open defecation. Communities are facilitated to conduct their own appraisal and TSSM intervention concluded analysis of open defecation and take their own action to become open defecation mid-2009, and the third phase free (ODF). At the heart of CLTS lies the recognition that merely providing toilets does not guarantee their use, nor result in improved sanitation and hygiene.CLTS focuses will cover the last eight districts on the behavioral change needed to ensure real and sustainable improvements – during the second half of 2009. investing in community mobilization instead of hardware, and shifting the focus from toilet construction for individual households to the creation of “open defecation-free� At the district level, TSSM villages. intervention began with For more information please see www.communityledtotalsanitation.org/ roadshows as part of the project’s advocacy strategy to generate stakeholder buy-in. These one- Figure 1 TSSM Progress in 21 East Java Districts: No. of day interactions brought together Communities Triggered and No. That Became ODF (as of local government of�cials from April 30, 2009) related sectors, sub-district 350 administrative heads, district legislators, prominent NGOs, 300 Phase1: Nov'07 - April'09 opinion leaders, local media, Phase2: Sept'08 - April'09 250 and, where available, private sector sanitation suppliers. No. of communities 200 Roadshow participants were presented with facts and �gures 150 on the economic impact of poor sanitation at country and district 100 level, and on the social and 50 economic returns from investing in sanitation improvements. The 0 TSSM project goals, vision, and Pacit an Tren Tulu ggal ngag Kedir Ngan i juk Lum ajan Pasu ruan Bang Pam kala ekas Sum Pono Blita Jom Madi Nga Tuba Jemb enep rogo r bang un wi n er Bany Bond uwa owo Situb ondo Prob oling ek ung g n an ngi so go interventions were explained, Phase -1 Phase -2 and stakeholders’ views were On -going triggered communities 224 289 45 63 60 39 102 44 171 50 57 64 72 56 58 57 130 71 141 62 136 Number of ODF communities 174 99 14 32 32 77 15 36 59 26 17 11 14 14 9 1 17 11 13 14 30 sought about how best to utilize 6 Learning at Scale villages in each district. TSSM Figure 2 Household Investments Leveraged per Rp. 1 million TSSM contracted facilitators who used Investments in 21 Districts these 30 demonstrations to Probolinggo 18 build the capacity of district level Situbondo 9 Bondowoso 2 government and NGO personnel Banyuwangi 2 to trigger and facilitate change in Jember 2 Phase2 Tuban 0 other villages in the district. Ngawi 23 Madiun 12 Jombang 3 Sub-district level road shows Blitar 10 and meetings organized by sub- Ponorogo 5 Sumenep 7 district heads and sub-district Pamekasan 6 primary health centers spread Bangkalan 5 Pasuruan 7 the information to all villages, Phase1 Lumajang 30 and soon letters of interest from Nganjuk 6 village heads began pouring in. Kediri 6 Tulungagung 25 The majority of districts received Trenggalek 10 many more than the 30 letters Pacitan 31 - 5 10 15 20 25 30 35 of interest needed to start TSSM Household investment generated for improving sanitation access, intervention at the village level. per Rp 1 million program investment (in million rupiahs) Local governments decided that no letter of interest would Figure 3 Cost-Effectiveness of Household Sanitation Access Gains go unresponded. After TSSM- Resulting from TSSM Interventions Probolinggo 240 contracted facilitators triggered Situbondo 137 CLTS in 30 villages in each district Bondowoso 41 and provided hands-on training Banyuwangi 28 Jember 21 for local facilitators, the latter Phase 2 Tuban 9 took over and triggered other Ngawi 242 Madiun 141 interested villages. Jombang 36 Blitar 102 As of April 2009, a total of 932 Ponorogo 57 Sumenep 75 villages had asked for, and Pamekasan 73 received CLTS triggering in at Bangkalan 57 Pasuruan 59 least one sub-villages per village. Phase 1 Lumajang 256 A village may comprise 5-10 Nganjuk 68 sub-villages, and village and sub- Kediri 66 Tulungagung 261 villages heads have been active Trenggalek 102 in spreading the CLTS movement Pacitan 368 from one sub-villages to another. - 50 100 150 200 250 300 350 400 At the time of writing (June 2009), Additional households gaining access to improved sanitation per Rp. 1 million program investment, during year 2008 of the 1,991 sub-villages thus triggered in 932 villages, 715 have declared themselves open defecation free, as de�ned and veri�ed by local governments. In the process, more than 325,600 people have gained access to improved sanitation facilities in 21 districts. 7 In the 21 districts covered in the �rst 18 months of interventions USD 1.76 million worth of TSSM project assistance has leveraged more than USD 1.69 million of community investment for household sanitation improvement. In the process over 325,600 additional people have gained access to improved sanitation, and the numbers are still growing. Investments from households in leveraged more than USD 1.69 Monitoring data indicate that project communities for improving million of community investment demand is accelerating. The access to sanitation has been for household sanitation pace did not slacken once rising steadily (Figures 2 and 3). improvement. In the process TSSM intervention concluded In the 21 districts covered in the over 325,600 additional people in the phase 1 districts. In fact it speeded up, and is steadily �rst 18 months of interventions have gained access to improved spreading across each district - USD 1.76 million worth of sanitation, and the numbers are from the 30 communities initially TSSM project assistance has still growing. triggered by TSSM (Figure 4). Figure 4 TSSM Triggering Intervention Plus Spontaneous Spread, as of May 2009 8 Learning at Scale Sanitation Behavior Box 4 The SaniFOAM Difference Change Calls for Indonesia – SaniFOAM Framework Focus: Open defecators adopt improved sanitation a Multi-pronged Owners of unimproved adopt improved sanitation Identified Communication Approach Determinants Objectives Marketing Mix Mechanism and Tools Sanitation is Prioritize Integrate flexible Step up promotion in While CLTS has proved very considered improvement of terms of payments for harvest season; others effective for triggering a household existing facility households at one - mechanisms to be improvement stop sanitation determined (eg. tapping community-wide desire and effort which is low providers into arisans) to be free of open defecation, priority global experience shows that (Motivation – attempts to scale up CLTS to competing priorities) Limited many communities quickly is cash (Opportunity inevitably fraught with risk of – affordability ) loss of quality of both process and outcomes. Moreover, for a community to be able to sustain its open defecation free status, Indonesia – SaniFOAM Framework people have to be able to Focus: Open defecators adopt improved sanitation progressively upgrade to more Identified Communication permanent kinds of facilities and Marketing Mix Mechanism and Tools Determinants Objectives other key hygiene improvements Perception that Know that there Use sanitation - Provide over time. That calls for larger improved exist i mproved related formal facilitators, investments of community latrines are latrines options and informal sanitarians and resources than is required for expensive those are not community natural leaders (Ability - expensive as components to with an informed just declaring ODF status. Any affordability) perceived provide choice catalog attempt to influence the higher information on and flyers, both level household investment Open Open defecation improved latrine stressing low defecation is is no longer options starting price behaviors at scale must be common Based on Use character/ acceptable based on in-depth understanding practice and research, concept of Lik of consumer behavior related accepted promote feeling Telek to support (Opportunity - of the process of to sanitation. TSSM therefore social norm) embarrassment CLTS through an supplemented community level and fear of being integrated CLTS triggering with a formative subject of gossip campaign when practice (posters and radio research-based behavior change open defecation drama) communication strategy, and a market research-based supply improvement program. Consumer and market research in East Java helped identify what Several consumer segments were identi�ed, along with target behaviors speci�c for drives households to improve their each segment, e.g., • Open defecators – need to stop this practice sanitation and hygiene behaviors • Owners of unimproved sanitation – need to upgrade to improved sanitation and facilities, and what constrains • Sharers of other people’s latrines – need to acquire their own improved their making such changes. facility. The results have produced a strategic basis for TSSM’s The examples here illustrate how one segment of consumers (open defecators) is behavior changing interventions, addressed by the communication strategy, which targets the speci�c determinants called SaniFOAM – the Sanitation of their behavior, and uses channels that are the most credible and influential to them Framework of Opportunity, and times behavior-changing communication for when the consumers are most able Ability and Motivation, for to act on their decision to change. 9 As research �ndings began to emerge, they sparked discussions and debates with district-level partners, generating wider stakeholder awareness of supply side issues that needed to be addressed in each district, for consumer demand to be fully unleashed. East Java. SaniFOAM-based in remote communities and in and at the start of TSSM, communication efforts signal outreach health centers. WSP- government partners at the an essential departure from the EAP is currently also working district level were not clear about common “Information Education, with the East Java provincial what they were expected to do. Communication� approach, government towards their using which is often based on sanitation selected materials on province- It took almost 18 months of the program managers’ beliefs of what wide television networks, to TSSM implementation period to people need to be educated or capitalize on the high penetration complete the sanitation marketing informed about in order to change of television services in rural East research in East Java, and design their behaviors, rather than on a Java. tools and mechanisms for market researched understanding of why supply improvement based on people behave as they do. Box research �ndings. As research 4 provides an example of how Market Research- �ndings began to emerge, they the SaniNIFOAM addresses the based Supply sparked discussions and debates constraints to changing behavior with district-level partners, and capitalizes on people’s Enhancement – generating wider stakeholder motivations for change. awareness of supply side issues What Value Does It that needed to be addressed A set of prototypal media Add? in each district, for consumer materials have been designed demand to be fully unleashed. based on the SaniFOAM. In Following the experiences of Market research �ndings revealed early 2009, they were offered the second WSLIC project, that: to district governments as a national policymakers were communication tools menu in a already convinced that raising • There is a lack of a common form that is ready-to-replicate, demand through CLTS would de�nition/perception of what along with costing estimates. be insuf�cient for scaling up constitutes the “ideal� (safe, District governments have begun desirable sanitation behavior healthy, hygienic, good- to select media materials from change sustainably, and had to-have) sanitation facility, the menu, replicating them with included in the national strategy among consumers, sanitation their own funds and using them for Community-based Total suppliers, and engineers. in their districts. By March 2009, Sanitation a component to • Consequently, standards vary four districts had spent USD improve the supply capacities of widely, and create a general 4,500 from local budgets to local sanitation markets. TSSM impression that a good reproduce posters, stickers and supports activities for sanitation sanitation facility is unaffordable mobile display units featuring market development. However, for most consumers. This in items from the menu, which sanitation marketing is unfamiliar turn leads to low consumer were visible in village of�ces territory for government agencies, demand. • Complicating matters further, open defecation into water bodies is not only completely socially acceptable, it is also considered convenient, safe and quite clean as the feces are invisible and carried away by the water or eaten by �sh. Moreover it costs nothing! (Nielsen, Indonesia, 2008). The identi�ed challenge, and a set of interventions that have been designed in response and are being �elded in East Java districts, are described in Box 5. 10 Learning at Scale Box 5 Popularizing Safe Sanitation Options at a Wide Range of Prices A1 Roofless superstructure Wooden frame; plastic walls; gunny sack; or bamboo mat; roofless Advantages: Very low cost; can easily be built by family; without high skills needed; the �rst step to produce a better superstructure in the future. Disadvantages: Requires frequent repair and maintenance; may be damaged in a serious storm and is less convenient during the rainy season. Life span: Short T1 Bamboo clay-lined slab with a lid Bamboo frame with clay slab and wooden lid Advantages: Can easily be built by family; low cost; reduced smell; no much water needed for operation. Disadvantages: Slippery when wet; flies can enter if the lid is not re-placed after use; strength of bamboo may be weakened by termites and fluids; not easy to clean; slab may be holed as affected by water. Kerangka Life span: Short bambu Tutup lapisan Tip on construction: bamboo will be stronger if it has been soaked in water or sprayed with termite-repellent or smeared with tanah used lubricant B1 Unlined pit Advantages: Can easily be built by family; low cost; may last a long time depending on the pit’s depth; easy to cover up when full and dig a new pit nearby. Disadvantages: Not suitable in sandy soil; small hole; not suitable where groundwater table is (seasonally) high; groundwater pollution is more possible. Tip on construction: Note the distance to the water source (such as a well) used by the community at a minimum of 10 m; ground slope and soil/rock type. The “Real� Supply-Side Challenge: • How to popularize a common perception of what constitutes the “ideal� (safe, healthy, hygienic, good-to-have) sanitation facility, among consumers, sanitation suppliers (vendors and masons), and engineers. • To get the market (manufacturers, suppliers, vendors and masons) to deliver a range of sanitation options recognized as “ideal� and priced for different segments of consumers, with a particular focus on options for low-income consumers. TSSM Supply Improvement Measures Designed in Response: 1. Promotion of de�nitions of “improved� and “unimproved� sanitation based on global Joint Monitoring Program de�nitions, translated in a way that makes it easy to differentiate between the two at �eld level. Building these de�nitions consistently into all program implementation tools and resources. 2. “WC-ku Sehat� (my latrine is healthy/hygienic) a thumbs-up sign branding for facilities that meet the “improved sanitation� criteria. 3. Informed Choice Catalogue (ICC) of safe (improved, “WC-ku Sehat�) sanitation options: a) illustrating all possible combinations of lowest cost to highest cost components for below ground, on the ground, and above ground sections of latrines, and b) promoting the idea that safe/hygienic, good� to-have sanitation facilities can be affordable for all. 4. Mason training/accreditation program delivered by a leading technological training institute in East Java, to equip every district with masons capable of: a) facilitating informed choice-making by consumers from the ICC, and b) promoting and delivering WC-ku Sehat options from the ICC with quality assurance. 5. Vendor orientation program to promote WC-ku Sehat options and link consumers with trained masons. 11 If they have access to markets, and �nancing options are available, people seem to move up the sanitation ladder quickly, and even poor consumers �nd the means to pay for what they like. Spontaneous facilities in Indonesian villages. pay for the facilities of their choice Developments in Local An arisan in Wayang village in in six monthly installments. Other Ponorogo district provides IDR villagers, who did not join the Markets Sparked by 700,000 (USD 70), which is arisan, sold goats or their coffee TSSM Interventions suf�cient to build an improved harvest to pay for their facilities. latrine plus a bathing enclosure, TSSM is gathering evidence that to any one member every eight Stories of arisan being used to catalyzing demand and supply weeks. After TSSM triggered improve sanitation access or allows consumers to invest in what demand in Wayang using CLTS, upgrade existing unimproved they really want, thus unleashing people were no longer content to facilities have surfaced from many market forces which could have wait for weeks to get their own districts. In Pasuruan district, an enormous Kresikan village potential for residents have moved scaling up. on to environmental Some examples cleanliness initiatives presented here such as community- indicate that while based solid waste CLTS offers an recycling and explosive impetus composting, after for collective becoming ODF behavior change through credit made to stop open available from their defecation, the arisan. Another sub- East Javanese are villages in the same not really content village has used just to dig and a grant from the cover pits in order Choice of low-cost designs and payment options accelerate access for the poor - Ponorogo district National Community to become an Empowerment ODF community. If Program (Program they have access to markets, and facilities. The arisan group entered Nasional Pemberdayaan �nancing options are available, into an agreement with the local Masyarakat) supported by the people seem to move up the sanitation materials retailer to get World Bank, to set up a community sanitation ladder quickly, and their supplies on credit and build credit facility managed by the even poor consumers �nd the their facilities immediately, and pay village governance committee. means to pay for what they like. back in six monthly installments. At the request of interested The retailer has received a households, the committee pays Arisan is a group savings and guarantee for the credit from the the local sanitation materials store credit arrangement common in neighborhood head in Wayang, to deliver a latrine construction Java that enables poor households and his experience of paybacks package costing IDR 300,000 to raise funds for large expenses. has proved to be positive. (USD 30) to each household, and The group members meet and Wayang recently declared itself the household then repays the cost contribute agreed amounts of ODF, four months after triggering, of the package to the community money at regular time intervals. with people moving quickly from credit fund in installments. The The pooled amount is then made open defecation in the river sub-villages achieved ODF status, available to single members in and unimproved pits directly to with all households gaining access rotation, and has often been used improved facilities, because the to improved sanitation, within six to acquire household sanitation agreement made it possible to months. 12 Learning at Scale Sumadi, a trained mason in Following a test run of the mason Several districts have started Nganjuk district has devised three training for delivering WC-ku monitoring changes in population differently priced, and progressively Sehat options in Kediri district access to improved sanitation, upgradable, improved sanitation in February 2009, a local health thereby catalyzing demand. options that make use of locally of�cial collaborated with a local Stickers of different colors are available materials. His one- manufacturer of motor parts, af�xed by local health center staff page Informed Choice Catalogue to produce the �rst low-cost on the front walls of houses that explains the pros and cons and �berglass latrine pans in the have unimproved or improved the basis of costing of each province. By April 2009, they sanitation facilities. A green option. He also brokers installment were ready to sell �berglass pour- sticker (improved latrine) is a payment arrangements between flush pans at IDR 40,000 (USD 4), matter of pride, while a yellow one consumers and suppliers. which is half the price of ceramic (unimproved latrine), an indicator Sumadi is kept very busy by the pans. The light weight pans can of intent to change behavior. unprecedented demand he has be transported cheaply to remote generated by offering consumers Not having a sticker means the communities. Their ecosan both information and choice. version (separating urine and house lacks a sanitation facility, feces, for ecologically sustainable and the residents either share Bureaucrats and funding agencies waste management) in �berglass other people’s latrines or are may have something to learn from costs the same as ceramic pans. open defecators. This is fast Sumadi’s home-grown marketing The crux now is to �nd �nancing becoming a matter of social wisdom: institutions that will provide loans embarrassment, pushing the for working capital. This is where family towards becoming owners the local government might need and users of latrines or upgraders “Instead of advising communities to step in as guarantor. of their facilities. that they can become open defecation free by covering their latrine pits with a plank of wood, which would soon get eaten by termites, it is more useful to offer them choices for more permanent and healthier latrines. My customers don’t really want pits. What they really want is safe sanitation, but at prices and payment arrangements that they can afford. I try to meet those expectations.� (From Sumadi’s presentation at 2009 Stakeholder Learning Review, Surabaya, March 19, 2009) Community monitoring sticker on house walls, indicating the type of latrine owned – Pacitan district 13 Most importantly, the 2008 strategy unequivocally forbids the use of subsidies for household sanitation facilities, thus bringing about essential consistency in funding for rural sanitation from all sources and all donors. Policy and Strategy: In 2003, about essential consistency in the Government of Indonesia laid funding for rural sanitation from all An Enabling the foundations for sustainable sources and all donors. Environment to and equitable rural water supply and environmental sanitation Institutional Arrangements: Support Scaling up (WSES) development with the The Health Ministry and district and Sustainability Community-Based WSES Policy. government health of�ces are the To bring greater clarity to policy institutions responsible for rural Project outcomes often fail the and strategy issues in the rural sanitation programs in Indonesia. sustainability test once external This has been a major advantage sanitation sector, the Health funding ceases, and project because the Health sector has Ministry then initiated a national the best outreach capacity into bene�ts, even if sustained, remain strategy development dialogue, rural areas, through its sub-district limited to project areas without assisted by WSP-EAP. The result primary health centers, and health scaling up to other districts agencies measure program and provinces. For both impact in terms of health- scaling up and sustainability related outcomes rather than of the outcomes, an simply counting the number of enabling environment is latrines built. essential. TSSM de�nes an enabling environment Program Methodology and as the policy, institutional Implementation Capacity: and �nancial environment TSSM has introduced new that promotes mutually program methodologies self-sustaining growth of and tools for generating demand for, and supply of, improved sanitation. From demand, improving supply, global experience, eight and monitoring progress. It is different dimensions of the providing technical assistance enabling environment have to build local capacities for been identi�ed, and TSSM using these methodologies, interventions are focused on in ways that promote their improving all the dimensions, integration into routine local working with national and government program planning, local governments, NGOs, budgeting, implementation communities and the private and monitoring. Training sector as required. These are: was the National Community- modules developed with the Based Total Sanitation (STBM) Institute of Technology, Surabaya, • Policy, strategy and strategy, launched in September are currently in use to equip local direction 2008 by the Health Minister. The masons in every sub-district with • Institutional arrangements strategy endorses all of TSSM’s the skills to promote and deliver • Program methodology core principles and components, improved sanitation solutions • Implementation capacity which is now making it very easy to consumers, with a degree of • Availability of products and to get local government buy-in quality assurance. tools (for demand creation, and funding for adoption and supply improvement, replication of TSSM approaches. Availability of Products program management) Most importantly, the 2008 and Tools: Through formative • Financing strategy unequivocally forbids the research, a communication tools • Cost-effective implementation use of subsidies for household menu and prototypal behavior- • Monitoring and evaluation sanitation facilities, thus bringing change communication products 14 Learning at Scale have been developed, along makers is under way through both In the �rst two phases in 2007- with costing tools for their use TSSM and the Health Ministry to 2009, USD 1,763,237 worth of by local governments. District tackle this. TSSM project assistance has governments have begun to so far leveraged USD 220,245 select communication materials Cost-effective Implementation: of local government funding for from the menu, and replicate Through the project’s efforts implementing and scaling up and use them over local media to analyze cost-effectiveness TSSM-introduced approaches. channels with their own funds. of interventions, a culture of In addition, USD 33.7 million of Through market assessments and measuring and reporting costs national government funding has consumer research, an Informed versus results has begun to been made available for replication Choice Catalogue for sanitation grow at all levels in East Java. of TSSM approaches in other solutions has been developed Districts are routinely measuring provinces through existing large- and is being used by trained and reporting on costs per unit of scale national projects supported masons with their clients. It will outputs and outcomes at annual by the World Bank and the Asian also soon be used along with stakeholder meetings. District Development Bank. product branding, by vendors and health of�ces have begun to use suppliers of sanitation materials. these analyses to argue for and In 16 months between January gain larger budget allocations 2008 - April 2009, USD1.76 Financing: The new national from district legislators. Cost- million of TSSM interventions STBM strategy has brought much effectiveness graphics are found have resulted in more than USD needed consistency into �nancing posted on district health of�ce 1.69 million being invested by issues in the rural sanitation and primary health center walls communites for household sector. Although construction and discussed at management sanitation improvement in 21 subsidies to households are no meetings. Cost-effectiveness districts, and the numbers are longer �nanced by the Health calculations have begun to make still climbing. Cost-effectiveness Ministry and all donors funding proud appearances even on analysis carried out with rural sanitation programs must village notice boards. 21 districts has shown that comply with this requirement, TSSM approaches have to some districts still continue with Steadily rising budget support date stimulated community subsidies to households out for replicating TSSM-introduced investments up to 30 times the of local government funding. approaches seems to indicate project investment (Figures 2 Focused advocacy with district national and local government and 3). Lumajang district took political leaders and opinion con�dence in their effectiveness. the initiative to further analyze Sengon village board in Trenggalek district shows the break up of the IDR 69.7 million (USD 6,970) invested by community households in improving sanitation, following a CLTS triggering event organized by the local government, at a cost of IDR 1.5 million (USD 150) 15 Through the project’s efforts to analyze cost-effectiveness of interventions, a culture of measuring and reporting costs versus results has begun to grow at all levels in East Java. Districts are routinely measuring and reporting on costs per unit of outputs and outcomes at annual stakeholder meetings. the cost-effectiveness of TSSM approaches and the ideas it has TSSM’s performance monitoring approaches as compared to introduced seem to have taken plan incorporates key generic subsidy-based approaches of root. indicators for sanitation programs other programs. It found that Currently the districts of East Java and ways of measuring them. within a year the subsidy-free are debating whether the whole Capacities and mechanisms are TSSM approach had resulted in of East Java will become open being built to integrate these ten to �fteen times the number defecation free by 2012 or 2013. into existing local government of new household toilets being monitoring systems, and more constructed as compared to Monitoring, Learning, importantly, as learning tools the outputs from subsidy-based Evaluation: Reliable data on that catalyze action in response. approaches like “stimulant sanitation access and hygiene However, a lack of demand packages� or construction credit behavior are dif�cult to come by for such data from the existing (Figure 5). in most countries, and Indonesia monitoring system is proving to be is no exception. Thus, TSSM is an obstacle to institutionalization. Of East Java’s 29 districts, 21 have focusing on improving the quality concluded their share of TSSM and reliability of rural sanitation To facilitate rapid exchange interventions by June 2009. The data by developing a community- of experience and learning, remaining eight districts will be based monitoring system that TSSM is organizing annual covered between July 2009 and feeds access and behavioral data stakeholder learning reviews February 2010. TSSM will close regularly into local, provincial and at province, district and sub- in November 2010. However, the ultimately national databases. district level. These workshops Training local masons to deliver improved sanitation options to consumers 16 Learning at Scale Box 6 TSSM Benchmarking and Monitoring System – February 2009 Assessment Results BENCHMARKING AND MONITORING DISTRICT SANITATION PROGRAM PERFORMANCE TSSM PROJECT-EAST JAVA (February 2009) 80 70 68 60 64 59 59 57 57 50 50 Score 40 44 42 30 27 20 24 24 22 20 19 18 15 10 12 10 7 6 0 Districts -Phase1 & 2 Indicators for annual assessment—each with appropriate scoring and weightage 1. District sanitation budget allocation per district household without access to improved sanitation; 2. % of sanitation budget used for non-construction activities (e.g. for demand creation, market supply improvement, capacity building, monitoring and evaluation), does not include houshold subsides; 3. Number of villages requesting demand-triggering intervention; 4. Number of communities triggered; 5. Number of trained masons able to deliver WC-ku Sehat (hygienic latrines) per sub-district; 6. Number of communities veri�ed by local government as “open defecation free� and “progressing to total sanitation� during the assessment year; 7. % additional people that gained access to improved sanitation (over the baseline) during the assessment year; 8. Cost effectiveness of usage of local government sanitation budget, during the assessment year: • Community investment leveraged per IDR 1 million of program investment • Program investment per open defecation free community achieved • Number of additional people gaining sanitation access per IDR 1 million of program investment. Another supply indicator will be added later in 2009 and the scores adjusted: −Number of vendors per sub-district selling and promoting WC-ku Sehat 17 During the remaining project period, TSSM will need to divert some attention and resources towards �rming up strategic links with existing institutional programs of the Health Ministry, and also identify additional partners for the purpose of post-TSSM scaling up. A formal ODF declaration, and oath taking to remain ODF provide a collective progress the clients for the study �ndings. Some of these indicators and monitoring and mutual learning A baseline study was completed dimensions representing district forum for government of�cials in Indonesia in 2008. The end sanitation program performance and functionaries, community line study is scheduled after 24 have been picked up by a representatives and leaders, local months of intervention. prestigious provincial award politicians, media persons, and Recently, TSSM has introduced scheme that evaluates good private sector agencies active in a district performance governance and selects the sanitation. Some districts that are benchmarking system, featuring best performing district in East better learners are already helping selected indicators for the Java each year. The �rst round less advanced districts by offering enabling environment dimensions. of evaluation and presentation of study visits and training support. Innovations in one district are Figure 5 Comparison of Latrines Built through Investments by quickly transferred to others Different Programs after exposure at such meetings. Number of new household latrines built per Rp. 1 million ($110) investment by different Failures and mistakes are also rural sanitation programs in Lumajang district, East Java , 2007-08 40 freely reported for collective 37 learning bene�t, because TSSM 35 strives to foster an error-embracing 30 learning climate through annual No. of new household latrines built Learning Champion Awards to an 25 individual and a district. 20 A rigorously designed and 15 generously funded global impact 10 evaluation study is underway in all TSSM countries, including 5 3 2 1 Indonesia, executed by WSP. - Country governments are the Program CLTS-TSSM WSLIC2 - Revolving credit Gerbang Mas - Local govt. PNPM/UPP2 - WB projects. facilitating partners as well as (Nov'07-Apr '08) Stimulant pkg Stimulant pkg 18 Learning at Scale awards by the Jawa Pos Institut are still driven largely by these Existing large scale projects may pro-Otonomi (JPIP), which is part committed individuals within the serve the purpose partially, but of East Java’s biggest media local government system, mostly time- and target-bound project- network, took place in May in the district health of�ces. They based environments provide a 2009. JPIP’s decision to include have had a frustrating experience poor �t for the programmatic sanitation performance as an with past, top-down and subsidy- TSSM approaches required for indicator of good governance based approaches, and have scaling up sustainably. While is expected to spur local �nally found a methodology that TSSM has produced the tools for governments to achieve even seems to work. However, except operationalizing the new STBM more. Lumajang District won the in a few districts out of the 29, strategy, and a pool of trained 2009 JPIP award. Its district head such championship has not yet manpower in East Java, it is has already increased the annual percolated upwards to the district not yet clear how the national budget allocation for sanitation, leadership, whereby district heads government plans to utilize them in the post-TSSM period, for scaling and asked �ve new sub-districts to (Bupatis) would institutionalize up to other provinces. During the devise action plans for becoming all the mechanisms and funding remaining project period, TSSM ODF by 2010. needed to operationalize the will need to divert some attention national rural sanitation strategy and resources towards �rming (STBM) using TSSM-initiated Challenges on the approaches. To sustain the TSSM up strategic links with existing institutional programs of the Horizon momentum beyond counting ODF Health Ministry, and also identify communities and move on to additional partners for the purpose In the remaining months of the viable programs to achieve all the of post-TSSM scaling up. project, TSSM will have to gear four total sanitation goals in each up to face the tests of time as well district, the TSSM project needs Funding innovations through as scalability. Mainstreaming and to secure sustainable institutional government budgets, post- institutionalizing its innovations, and political commitment before TSSM: New TSSM interventions ensuring sustained �nancing of concluding at the end of 2010. such as sanitation marketing are its approaches, and influencing Helping all districts to develop proving promisingly effective, but other provinces of Indonesia District Strategic Plans for Total have also proved both skilled to adopt the demonstrated Sanitation as a part of Regional manpower-heavy and resource- new approaches of addressing Medium Term Plans for the 2010- intensive. Replicating them as rural sanitation are the principal 2015 period will be critical to they were demonstrated in East challenges. secure funding commitments to Java through the TSSM grant translate the new STBM strategy may not be feasible through Institutionalization for into operation at scale. existing government budgets sustainability: The TSSM available in other provinces. implementation experience has Vehicles for scaling up to Economies of scale and support spawned many champions, multiple provinces: Indonesia strategies will have to be identi�ed some at national and provincial does not yet have a national in consultation with the national level, and many more at sanitation program that can government, to enable new district and sub-district levels. serve as a primary vehicle to provinces embark on sanitation Successful TSSM interventions take TSSM lessons to scale. marketing interventions. 19 Different Results - from Doing Rural Sanitation Differently Program aspects Conventional sanitation program approach TSSM approach • Average 10-15% increase in sanitation • 49 % increase in access to improved sanitation over coverage over 4-5 years of project baseline access, within 18 months of intervention (as of RESULTS intervention June 2009) • Access gains mainly among the better off • Poorest households gaining access at rates higher than and middle income households. Majority of non-poor households poor households failing to gain access • 715 communities declared open defecation free, as • No open defecation free (ODF) communities de�ned and veri�ed by local governments, as of May 09 Targeting areas for Districts selected by national government and Demand-driven approach. Districts governments choose intervention donor agencies, based on sector-speci�c and to participate with cost-sharing and takeover commitment development indicators after 8 months of TSSM intervention Project focus/ De�ned in terms of sanitation coverage De�ned in terms of community behavior change goals/targets/ achieved, number of additional latrines achieved, and progress made towards country’s MDG Performance constructed target (access to improved sanitation) measurement criteria Forms of project • Subsidies for construction of household • Capacity building and technical assistance for assistance latrines consumer demand generation (triggering CLTS) • Hygiene education (IEC) materials and • Formative research-based communication tools menu activities based on program implementers’ development for sanitation behavior change beliefs about what people need to be • Market research-based local sanitation market supply educated about improvement • Capacity building for project implementation • Stakeholder learning analysis and sharing mechanisms, linked to M&E • Incentive system establishment for local government sanitation program performance measurement Local government Limited to getting project-provided funds, • Active participation by choice and cost-sharing by local and community materials and advice from outside and governments Communities participation by formally participation distributing them according to project rules expressed demand for TSSM intervention • No externally provided cash or materials at any level Sustainability of Usually tied to period of project implementation Long term – due to integration of TSSM approaches into approach and and project funding local government budgeting, planning, implementation results and monitoring systems Key motivating • External fund assistance at local government Self-respect and pride in own achievement, at local factors level government and community levels • Subsidies at community level Expectations of, High. Both local governments and Low. Both local governments and communities opt and dependency communities come to expect externally to participate after knowing that: a) no cash/in-kind on external provided handouts, which stifles local initiative handouts are available, and b) the only assistance support and self-help action available is a learning opportunity about how to become open defecation free Motivators Project staff and consultants Natural leaders in communities, local government outreach staff, occasionally district and sub-district administrators and politicians Replication Project-initiated, scope determined by external Spontaneous and multi-stakeholder-initiated. By funding available community members and leaders at sub-village, village and inter-village levels. Initiated by local government units using local operational budgets at sub-district and district level. 20 Learning at Scale Selected References: • Government of Indonesia, Badan Pusat Statistik, (2004): Survei Sosial Ekonomi Nasional • ______________________________________, (2006): Survei Sosial Ekonomi Nasional • Nielsen (2008) : Total Sanitation and Sanitation Marketing Research in East Java, Qualitative and 21 East Asia and the Paci�c Indonesia Stock Exchange Building Tower 2, 13th Floor Jl. Jend. Sudirman Kav. 52-53 Jakarta 12190 Indonesia Phone: (62-21) 5299 3003 Fax: (62-21) 5299 3004 E-mail: wspeap@worldbank.org Website : http://www.wsp.org August 2009 WSP MISSION: To help the poor gain sustained access to improved water and sanitation services. WSP FUNDING PARTNERS: The governments of Australia, Austria, Belgium, Canada, Denmark, France, Ireland, Luxembourg, the Netherlands, Norway, Sweden, Switzerland, the United Kingdom, the United States of America, the United Nations Development Programme, The World Bank, and the Bill and Melinda Gates Foundation. ACKNOWLEDGMENTS: This Field Note was prepared by Nilanjana Mukherjee, with inputs from Indrawati Josodipoero, Djoko Wartono, Amin Robiarto, ABOUT THE SERIES: Ari Kamasan, Effentrif and Jaqueline Devine. It was reviewed by Almud Weitz, Regional Team Leader, WSP-EAP and Eduardo A. WSP Field Notes describe and analyze projects and activities in water Perez, Senior Sanitation Specialist, WSP. We and sanitation that provide lessons for sector leaders, administrators, and gratefully acknowledge review comments individuals tackling the water and sanitation challenges in urban and rural and suggestions received from Bapak Wan areas. The criteria for selection of stories included in this series are large- Al Kadri, Ministry of Health and Bapak Oswar scale impact, demonstrable sustainability, good cost recovery, replicable Mungkasa, BAPPENAS. conditions, and leadership. Photo credits: Ronie Prasetyo, Effentrif, Nyoman Oka, Nilanjana Mukherjee The Water and Sanitation Program (WSP) The International Bank for Reconstruction and Development/THE WORLD BANK GROUP 1818 H Street, N.W. Washington, D.C. 20433, USA WSP Reports are published to communicate the results and learning from WSP’s work to the development community with the least possible delay. The �ndings, interpretations, and conclusions expressed in this paper are entirely those of the author(s) and should not be attributed in any manner to the World Bank, or its af�liated organizations, or to members of its board of executive directors or the countries they represent. 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