It Takes a Village: Voice and Choice Help Scale up Demand for Sanitation in East Java

East Java is one of the most densely populated places on earth with more than 37 million people and home to 20 percent of Indonesia’s poor. Efforts to increase sanitation within rural communities have had limited success; 55 percent of the citizens remain with inadequate services and many continue to defecate in the open.

A new partnership, between the Government of Indonesia, the Bill and Melinda Gates Foundation, and the Water and Sanitation Program, set out to develop a new approach that focuses on both building demand for improved sanitation as well as making sure appropriate and affordable products are available to citizens who want them. The initiative, Total Sanitation and Sanitation Marketing (TSSM), offers technical support to any of the 29 districts in East Java wanting to substantially scale up efforts to improve sanitation services.  

The program has recently achieved a milestone: after less than two years, 715 villages in 21 districts have declared themselves “open defecation free” and over 325,000 people have gained access to improved sanitation facilities.

The partners have learned from previous development programs that merely providing toilets or subsidies to build them does not guarantee their use. Without real consumer demand for change or the availability of affordable products they knew the program would fail.

To better understand why defecation has been the norm, what types of products were needed and what people were willing to pay, the partners carried out detailed consumer and market research in all 29 districts of East Java surveying more than 2,000 households and 30 suppliers such as construction and mason workers and store owners.

To date, the research has shown that there was no real agreement on what constituted the “ideal” sanitation facility among consumers, sanitation suppliers or engineers. It also revealed that demand was low because most consumers didn’t think they would be able to afford sanitation services and that providers had failed to offer a range of sanitation options for different segments of consumers.

Research has also shown that in rural areas, open defecation was considered safe, socially acceptable and most importantly it was free. Citizens also thought that when they defecated in waterways their feces would be carried away by water and eaten by fish without contaminating the water.

Unfortunately, this is not the case. Rivers throughout the country are highly contaminated from human waste. The research from eight districts also showed that people who use the river for washing and bathing had a higher incidence of diarrhea particularly children.

“As the research findings began to emerge they really sparked a healthy debate and brought attention to the issues,” said a writer who reported on the program.

As part of the campaign, the government featured talk shows on television that featured the health minister and heads of districts to show how they were able to scale up and improve sanitation services and eliminate open defecation. A writing competition was also held on sanitation with the winners announced in local newspapers.

Making sure that customers were aware of all of the types of latrines available was a critical part of the program’s success. Community facilitators and masons provided a catalogue with all the tools to educate citizens on the advantages and disadvantages as well as the costs of the various options from roofless superstructures to bamboo clay-lined slabs with lids.

Financial commitment from the communities also made the program sustainable as fund sharing was a condition of participation. The latrines have been fully financed by households, rather than through subsidies or hand outs that helps guarantee long-term use and sustainability of the facilities built. In total, the TSSM program has contributed more than US$1.76 million in East Java which then leveraged more than US$1.69 million from the communities.

The Head of Trenggalek District, Suharto, said that his administration adopted the approach as a policy to develop rural sanitation and is committed to providing sufficient funds to achieve an open defecation free status by 2010. Since 2008, he has carried out a program during the fasting month to visit each village to promote the program. His program also provides incentives for villages who achieve open defecation-free status. For example, a village in Trenggalek will be awarded IDR5 million for income-generating activities such as communal farming or for new infrastructure such as bridges and roads if they achieve open defecation free status.

The initial results show tremendous progress, but there are still more than one million people to go. In its remaining year of implementation, the focus will be on strengthening the capacity of local governments to build upon their own district sanitation strategic plan. The goal is to redirect existing funds that support distribution of ‘hardware’ to increase support for ‘software’ initiatives that focus on behavior change and sanitation marketing. Another critical component will be to link the nascent sanitation market with access to microfinance and other services to enable it to grow further.