WATER AND SANITATION PROGRAM: WORKING PAPER 72095 Scaling Up Rural Sanitation Enabling Environment Endline Assessment: Indonesia Andy Robinson November 2011 The Water and Sanitation Program is a multi-donor partnership administered by the World Bank to support poor people in obtaining affordable, safe, and sustainable access to water and sanitation services. By Andy Robinson This report is based on �eldwork and research funded by the Bill & Melinda Gates Foundation through the Water and Sanitation Program (WSP). The �eldwork and research could not have taken place without the support and assistance of the Government of Indonesia (Ministry of Health, BAPPENAS), the Government of East Java, and the Water and Sanitation Program. Special thanks are due to Djoko Wartono, Nilanjana Mukherjee, Deviariandy Setiawan, Ari Kamasan, Amin Robiarto, Effentrif, Wano, Saputra, and Sasya Ari�n for their kind assistance and support in Indonesia. Additional thanks are owed to Almud Weitz, Eddy Perez, Nilanjana Mukherjee, Djoko Wartono, and Deviariandy Setiawan for their peer reviews. Today, 2.6 billion people live without access to improved sanitation. Of these, 75 percent live in rural communities. To address this challenge, WSP is working with governments and local private sectors to build capacity and strengthen performance monitoring, policy, �nancing, and other components needed to develop and institutionalize large scale, sustainable rural sanitation programs. With a focus on building a rigorous evidence base to support replication, WSP combines Community-Led Total Sanitation, behavior change communication, and sanitation marketing to generate sanitation demand and strengthen the supply of sanitation products and services, leading to improved health for people in rural areas. For more information, please visit www.wsp.org/scalingupsanitation. This Working Paper is one in a series of knowledge products designed to showcase project �ndings, assessments, and lessons learned through WSP’s Scaling Up Rural Sanitation initiatives. It is conceived as a work in progress to encourage the exchange of ideas about development issues. For more information please email Andy Robinson at wsp@worldbank.org or visit www.wsp.org. WSP is a multi-donor partnership created in 1978 and administered by the World Bank to support poor people in obtaining affordable, safe, and sustainable access to water and sanitation services. WSP’s donors include Australia, Austria, Canada, Denmark, Finland, France, the Bill & Melinda Gates Foundation, Ireland, Luxembourg, Netherlands, Norway, Sweden, Switzerland, United Kingdom, United States, and the World Bank. WSP reports are published to communicate the results of WSP’s work to the development community. Some sources cited may be informal documents that are not readily available. The �ndings, interpretations, and conclusions expressed herein are entirely those of the author and should not be attributed to the World Bank or its af�liated organizations, or to members of the Board of Executive Directors of the World Bank or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. © 2012 Water and Sanitation Program Scaling Up Rural Sanitation Enabling Environment Endline Assessment: Indonesia Andy Robinson November 2011 Executive Summary The Water and Sanitation Program (WSP) has imple- districts, and led to its subsequent adoption as the main mented the Global Scaling Up Rural Sanitation Project methodology for sanitation improvement in several large since 2007. One of the central objectives of the project is sector programs. to improve sanitation at a scale sufficient to meet the 2015 sanitation Millennium Developmental Goal (MDG) tar- Global Scaling Up Rural Sanitation Project in gets in Indonesia, India, and Tanzania. Indonesia The WSP decided to implement the project in East Java be- The baseline assessment of the enabling environment was cause the province had an unusually good response to CLTS completed in July and August 2007, during the start-up interventions. Lumajang District in East Java has been the phase of the overall project. This follow up endline assess- most prominent success story of the CLTS experience in ment was carried out three years later in mid-2010. This Indonesia, and key stakeholders from East Java (including report presents the main findings and recommendations several local doctors) have been amongst the most visible from the endline assessment of the ability of the enabling and vocal supporters of these new approaches to sanitation environment to scale up, sustain, and replicate sanitation development. improvements in East Java, Indonesia. Baseline Assessment of Enabling In order to ensure consistency in the assessment findings, Environment WSP developed a conceptual framework for assessing the Strong central and local government involvement in the enabling environment for sanitation. This framework was previous CLTS interventions had built consensus and sup- developed based on a literature review and a series of dis- port for the total sanitation approach in Indonesia, which cussions with key actors. The framework consists of eight paved the way for the project. A national total sanitation dimensions considered essential to scaling up the total sani- policy and strategy was under preparation at the time of the tation and sanitation marketing approaches in rural areas: baseline assessment, and the World Bank-supported Third Water Supply and Sanitation for Low Income Communi- • Policy, strategy, and direction ties Project (known as PAMSIMAS1) was due to imple- • Institutional arrangements ment total sanitation and sanitation marketing approaches • Program methodology in 15 other provinces. However, inter-ministerial rivalries • Implementation capacity were affecting the development of the enabling environ- • Availability of products, tools, and information ment, and were reported to be limiting the political priority • Financing and incentives given to rural sanitation improvement. The five-year na- • Cost-effective implementation tional development plan for 2005–2009 included the target • Monitoring and evaluation of 100 percent open defecation free status by 2009, but no strategy or medium-term expenditure plan was developed Total Sanitation in Indonesia to support this ambitious goal, and it was clear in mid-2007 Community-Led Total Sanitation (CLTS) was introduced that this target was unlikely to be reached in even the most into Indonesia in May 2005 through field trials in six prov- progressive and successful areas of sanitation improvement. inces. The remarkable success of these field trials, imple- mented with assistance from the MoH and two of its large Province and district level activities, including project rural water supply and sanitation programs, caused the roadshows in East Java, were at that time developing local CLTS approach to spread to several hundred additional government support and financial allocations for rural communities, generated significant demand from other sanitation improvement. However, with the exception of 1 From the Bahasa Indonesia acronym for Water and Sanitation for Low-Income Communities. www.wsp.org iii Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Executive Summary districts that had taken part in the World Bank-funded rural sanitation champion pushing for stronger support or Second Water Supply and Sanitation for Low Income investment at the national level. Commuunities Project (WSLIC 2), few local governments had adequate rural sanitation experience, and few sanitar- Nevertheless, the project has made a significant impact on ians were actively engaged in sanitation promotion and the enabling environment for rural sanitation in the prov- monitoring. The project was in the process of hiring re- ince of East Java. There is clear evidence of an acceleration source agencies to provide technical assistance, implemen- in sanitation progress in project communities—estimated tation backstopping, and capacity building to the district to be roughly ten times faster than the national average— governments in East Java, but it remained unclear whether and many of the improvements appear to be embedded this support would be sustainable and effective. in district institutions and processes, and should therefore prove scalable and sustainable over time. Finally, the direct implementation activities of the project were targeting only about 11 percent of the rural communi- Sanitation remains a local government responsibility, and as ties in East Java, which allowed interventions to be imple- a result the decentralized and demand-responsive approach mented largely in above-average communities. As a result, adopted by the project in East Java has proved highly ap- it remained unclear whether, when scaled up to cover more propriate and effective. In the absence of any larger central below average and low performing communities, the strate- programs, district governments were convinced to use their gies and approaches utilized by the project would achieve own institutions and resources to implement the project, the large-scale results required to reach the 2015 MDG for resulting in sustainable arrangements and finance, cost- sanitation. effective use of local resources, as well as proactive efforts to learn from others, innovate, and develop locally appropri- Endline Assessment of Enabling ate approaches. The private resource agencies contracted by Environment the project were effective in supporting the districts dur- The 2010 endline assessment found significant improve- ing this learning and development phase, and most district ments in the enabling environment for rural sanitation im- governments now appear to be confident in managing and provement. The national environment grew stronger with sustaining their rural sanitation programs. the MoH’s 2008 issue of a Sanitasi Total Berbasis Masyara- kat (National Strategy for Community-Led Total Sanitation, There is increasing consensus nationally that total sanita- or STBM using its Bahasa Indonesia acronym), which sub- tion and sanitation marketing approaches are effective pro- sequently led to the inclusion of an STBM program in the gram methodologies, with most rural sanitation programs five-year national development plan for 2010–2014. How- in Indonesia now utilizing some form of total sanitation ever, these developments have yet to be institutionalized, as approach and many showing interest in developing a sani- there are currently inadequate budget allocations to meet the tation marketing component. Both UNICEF and Plan In- ambitious STBM targets, and the STBM secretariat is largely donesia have made explicit requests to WSP for assistance reliant on development partners to finance its activities. in developing sanitation marketing components for their large-scale sanitation programs. US$1.6 billion has been allocated for the five-year imple- mentation of the Accelerated Sanitation Development of The main exception is the MoPW and its PPSP program, Human Settlements (PPSP) program, marking the first which in the future will cover both urban and rural set- time that the sanitation development budget has exceeded tlements using the urban strategic sanitation planning that for water supply development, but this amount is approach developed by the Indonesia Sanitation Sector De- largely for urban sanitation infrastructure through the Min- velopment Project (ISSDP). PPSP will divide responsibility istry of Public Works (MoPW). Rural sanitation improve- between the MoH and MoPW, with MoH responsible for ment remains a relatively low priority for both the Ministry behavior change and sanitation promotion, and MoPW re- of Health (MoH) and the MoPW, with no evidence of a sponsible for technical activities and infrastructure projects. iv Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Executive Summary The MoH is likely to utilize the approaches advocated by health post sanitarians in courses devised to train sanitation WSP in its promotional activities, but there remains a risk entrepreneurs, but few have become active to date. This as- that the more infrastructure and public finance-based ap- sessment raises doubts over the possible conflict of interest proaches advocated by the MoPW may set the PPSP agenda faced by sanitarians with responsibility for sanitation pro- and dominate program activities unless the MoH makes a motion, private service provision, and sanitation outcome stronger and more consistent case for the effective use of the monitoring. approaches developed under the project. There is still no national award or incentive scheme for Further work is required to increase the scale and cost- rural sanitation, and several central stakeholders suggested effectiveness of the sanitation marketing approach, as it has that there was currently little support for this sort of in- been successful, so far, in only relatively small areas. The centive mechanism due to the negative publicity associated project team recognizes the importance and potential of with India’s Nirmal Gram Puraskar (Clean Village Award). this component, and considerable learning has been gained Despite this central stasis, the Java Post Institute of Pro- from the experiences to date. As a result, the team is now Autonomy (JPIP) sanitation award given to the elected working to develop an improved approach to identifying head of the best performing sanitation district in East Java and developing sanitation entrepreneurs, and to solving has proved to be a powerful and effective incentive for in- some of the credit constraints faced by rural households. creased political commitment to rural sanitation improve- ment, and provides a useful model for the development of The approaches used to develop the enabling environment similar incentive schemes in other parts of Indonesia. in East Java have been particularly successful. Exposure vis- its and regular learning events were central to the spread of The project benchmarking tool, which forms the basis for innovation and the steady improvement of implementation the JPIP sanitation award criteria, is the only mechanism methodologies across the province, to the extent that sev- that encourages the reporting and use of cost-effectiveness eral of the districts have taken the initiative to finance and data in East Java. Few districts compile the data them- organize their own visits and events. selves, but the inclusion of three cost-effectiveness crite- ria in the JPIP sanitation award has heightened attention The main challenge faced by committed districts today is on the measures that influence these criteria, including the effective use of their capacity and resources, rather than household latrine investments, cost per ODF community, finding or developing basic implementation capacity, which and investment per improved sanitation facility. The cost- were the obstacles at baseline. Health departments in the effectiveness data confirm the good performance of the high performing districts in East Java are now facilitating project to date, which in turn suggests that the enabling en- sub-district implementation activities through organizing vironment has been working well: the 43 percent ODF suc- training, providing technical assistance, and benchmarking cess rate has exceeded the target set at baseline; the number progress, rather than managing direct project implementa- of verified ODF communities is at 98 percent of the project tion activities. This arrangement is a more effective use of target; the program cost per ODF community and cost per the extensive human resources at lower levels, enabled by improved latrine in use are both estimated to be lower than the increased local budget allocations that financial decen- the endline targets; and the program and local government tralization provides to sub-districts, health posts and village investments have leveraged five times more investment by governments. rural households. Despite these improvements, there remain significant chal- The Indonesian National Socioeconomic Survey (SUSENAS) lenges in providing adequate incentives for sanitarians to provide a biennial source of nationally representative latrine convince them undertake sanitation roles and responsibili- usage data, but there is still no institutional system for more ties, as well as in finding entrepreneurs interested in work- regular monitoring and evaluation of national progress on ing as latrine providers in rural areas. The project includes rural sanitation improvement. In addition, the response www.wsp.org v Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Executive Summary categories in the SUSENAS surveys remain too broad to has been recognized by a large number of domestic and enable accurate classification of household latrines into im- international stakeholders, with strong regional interest in proved and unimproved sanitation facilities. study tours and exposure visits to East Java, and high de- mand for more information and tools on the project ap- As a result, most monitoring and evaluation is conducted proaches. Effective response to these demands, such as the through temporary project processes, with little evidence recent training course on total sanitation approaches that that the data from these processes are being used to inform the project team provided for stakeholders in Laos, will be improved policy and programming. The project has devel- a significant factor in the spread of these approaches within oped a province-wide monitoring system to collect monthly the region. data on sanitation progress, but this system focuses on la- trine construction rather than on the sustainability of sani- Recommendations tation outcomes, and has not yet been adopted or replicated The project’s undoubted success within East Java means in any other provinces. The project is supporting a number that the majority of the recommendations concern further of interesting evaluations at the moment, but there is little efforts to strengthen the enabling environment for rural evidence that other stakeholders have been persuaded of the sanitation improvement at national level. value of investing in evaluations of effectiveness, sustain- ability, or impact. The Environmental Health Directorate Recommendation 1: Strengthen the Rural Sanitation of the MoH has no budget for program evaluation, and Elements of PPSP thereby remains dependent on externally derived effective- PPSP is developing into the principal vehicle for sanitation ness data for its policy and investment decisions. development in Indonesia, attracting substantial budgets, resources, and political priority. WSP’s four-year Indonesia The short message service (SMS) monitoring system cur- Sanitation Sector Development Program (ISSDP) has been rently being implemented in East Java seems likely to successful in influencing the development of a strong frame- improve the reliability and cost-effectiveness of rural sanita- work for urban sanitation planning and finance, including tion monitoring, but has not yet been widely adopted even PPSP, through its activities with national and strategic urban within some of the better performing districts. Further ef- partners. On the other hand, much of the project team’s ef- forts are required to promote this system at both national forts have been directed to implementation activities in East and provincial levels. Java. Therefore, it is recommended that the project team invest greater effort in influencing the incorporation of Despite impressive improvements in the enabling environ- STBM into PPSP, particularly to ensure that the universally ment for rural sanitation and visible gains in East Java, there acclaimed project approaches are built into the rural policy, is not yet any evidence of the large-scale spread and replica- programs, and practice of the PPSP. In addition, further tech- tion of more cost-effective and sustainable rural sanitation nical support should be provided to the STBM secretariat to approaches to other provinces. The lack of any effective assist it to be more effective and to improve recognition of government system to monitor progress towards the gov- the importance of its role by government decision-makers. ernment’s rural sanitation goals exacerbates this problem. As a result, Indonesia is not on track to meet either its rural Recommendation 2: Review and Strengthen the sanitation MDG or the government’s National Medium- Sanitation Component of the PAMSIMAS Program Term Development Plan (RPJMN) target of 100 percent The PAMSIMAS program still has the potential to be an open defecation free (ODF) status by 2014. important vehicle for scaling up project approaches, subject to revitalization of the sanitation component and stronger However, the project has contributed substantively to the consensus on the way to remedy previous program weak- spread of the CLTS and sanitation marketing approaches to nesses. A multi-stakeholder evaluation would be useful to Lao PDR, and to recent sanitation innovation and progress identify the reason for the current problems, with careful in Timor-Leste. The success of the program methodologies efforts made to establish whether the approach has failed, vi Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Executive Summary or whether—as seems likely—the problems derive from and commit key political leaders to action on rural sanita- poor implementation and institutional problems related tion improvement. to the different priorities of the two main implementation agencies. Recommendation 5: Facilitate the Spread of Project Approaches to other Provinces Recommendation 3: Incorporate Rural Sanitation There remains only limited awareness and understanding Improvement into the National Community of the fundamentals of the approaches used by the proj- Empowerment Program ect, particularly in the realms of sanitation marketing and Another potential vehicle for scaling up rural sanita- enabling environment activities, by other sanitation stake- tion is the National Community Empowerment Program holders. There are also some reservations about the rel- (PNPM). In the past, some PNPM components have pro- evance of the approaches developed in East Java to more vided household latrine subsidies that have been reported remote and disadvantaged parts of Indonesia, where differ- to undermine the project approaches. There is, however, a ent market conditions and consumer priorities recommend conditional grant system incorporated in the PNPM Gen- the need for separate market research and communications erasi, which focuses on improving twelve health and educa- strategy development. tion indicators. There is considerable potential to use this program to direct finance towards rural sanitation improve- WSP does not have the human resource capacity to imple- ment and to use PNPM community block grants to finance ment similar projects in a number of provinces, but it does environmental sanitation improvements such as drainage have the specialist skills and experience needed to design and solid waste management systems. In particular, WSP formative and market research, and to develop the com- has been examining the potential to include a communal munications strategies and marketing tools critical to wider sanitation indicator, such as ODF status, as a pre-condition implementation. Therefore, WSP should encourage groups for some of the conditional payments designed to improve of interested local governments and development partners health and nutrition, in the understanding that the effec- to co-finance regional sanitation research and development tiveness of some of the PNPM nutrition interventions is activities designed to provide local sanitation projects with limited by continuing diarrheal disease and tropical enter- information and tools specially tailored for the effective opathy linked to inadequate sanitation and hygiene. implementation of project approaches in each region of Indonesia. Recommendation 4: Attract Greater Political Support to Rural Sanitation Improvement The success of the project resource agency model may be The endline assessment makes clear the importance of difficult to replicate across Indonesia given the shortage gaining political support for rural sanitation improvement. of experienced agencies in many areas, so it is also recom- While many elements of the political economy are beyond mended that WSP should support the government in es- the influence of rural sanitation interventions, it is clear tablishing regional sanitation resource centers capable of that more institutional approaches are required to attract providing regular technical assistance, backstopping, and political support, tackle succession problems, and sequence capacity building to project-based programs, which could interventions around election and budget cycles. Lessons be financed through contributions from the agencies and drawn from successful efforts to attract greater political programs that utilize the resource centers. support for urban sanitation suggest that regular summits between interested and progressive leaders provide oppor- Recommendation 6: Develop Project-Based tunities for incremental commitments, and generate suf- Process Indicators ficient political capital to draw in previously disinterested The varied project implementation approaches adopted by elected representatives to future sector policy, planning, and the 29 districts in East Java and the wide variety of sani- strategy processes. WSP can play an important role in fa- tation marketing proposals currently being discussed by cilitating high-profile rural sanitation summits that engage other stakeholders suggest that it would be useful for WSP www.wsp.org vii Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Executive Summary to identify the core elements and processes required to create demand, strengthen supply, and improve the enabling environment for rural sanitation. While it remains important to encourage programming flexibility and innovation, the project team agreed that some core elements are essential to cost-effective and sus- tainable implementation of project approaches, and that further work is required to identify a simple set of process indicators that could be employed to assess the quality of other interventions and to ensure that critical elements are neither left out nor underutilized. Recommendation 7: Incorporate Feedback Loops into Capacity Building Programs The mason training program illustrated the importance of reviewing the effec- tiveness of capacity building activities, and of creating a feedback loop that allows the findings of the review to inform the improvement of future capacity building activities. These reviews should examine whether the capacity building programs result in any new or improved actions that utilize the built capacity, as well as whether the right capacities have been built in the right people. Therefore, all project capacity building activities should include some performance assessment; these assessments can then used to develop improved selection criteria before investing in capacity building. Recommendation 8: Seek to Replicate the JPIP Sanitation Award in Other Provinces Given limited appetite in the central government for the national ranking of dis- tricts based on sanitation service provision, and some skepticism regarding large outcome-based incentive systems, it may prove difficult to establish a national sanitation award scheme without further evidence of the benefits. Therefore, it is recommended that award schemes similar to the JPIP sanitation award in East Java should be identified in other provinces, and that efforts should be made to introduce sanitation awards or criteria into these existing systems. When sev- eral provincial awards are operational, it will become easier to push for national recognition of the best performing local governments, and to work towards the creation of a national sanitation award system. viii Scaling Up Rural Sanitation Contents Executive Summary.................................................................. iii Abbreviations and Glossary ..................................................... xi I. Introduction ............................................................................... 1 II. Assessment Framework and Methodology ............................. 2 2.1 Assessment Dimensions ...................................................... 2 2.2 Methodology of Assessment ................................................ 3 III. East Java Context ..................................................................... 5 3.1 Population ............................................................................ 5 3.2 Health data ........................................................................... 5 3.3 Poverty ................................................................................. 5 3.4 Legal Framework .................................................................. 6 IV. Rural Sanitation Improvement .................................................. 7 4.1 MDG Progress in Indonesia ................................................ 7 4.2 Indonesia Sanitation Sector Development Program ......... 7 4.3 CLTS in Indonesia ................................................................ 7 4.4 Global Scaling Up Rural Sanitation in Indonesia ............... 8 V. Baseline Findings ...................................................................... 9 VI. Endline Findings ...................................................................... 10 6.1 Policy, Strategy, and Direction ........................................... 10 6.2 Institutional Arrangements ................................................. 16 6.3 Program Methodology........................................................ 20 6.4 Implementation Capacity ................................................... 22 6.5 Availability of Products, Tools, and Information ................. 25 6.6 Finance and Incentives....................................................... 28 6.7 Cost-Effective Implementation ........................................... 34 6.8 Monitoring and Evaluation.................................................. 36 VII. Conclusions ............................................................................. 41 7.1 Policy, Strategy, and Direction ........................................... 41 7.2 Institutional Arrangements ................................................. 41 7.3 Program Methodology........................................................ 42 7.4 Implementation Capacity ................................................... 43 7.5 Availability of Products, Tools, and Information ................. 44 7.6 Finance and Incentives....................................................... 44 7.7 Cost-Effective Implementation ........................................... 45 7.8 Monitoring and Evaluation.................................................. 45 VIII. Recommendations .................................................................. 46 8.1 Policy, Strategy, and Direction ........................................... 46 8.2 Institutional Arrangements ................................................. 47 www.wsp.org ix Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Contents 8.3 Program Methodology........................................................ 47 8.4 Implementation Capacity ................................................... 48 8.5 Availability of Tools, Products, and Information ................. 49 8.6 Finance and Incentives....................................................... 50 8.7 Cost-Effective Implementation ........................................... 50 8.8 Monitoring and Evaluation.................................................. 51 References ............................................................................... 53 Annexes 1: Activities in Indonesia ........................................................ 55 2: Interview Guide .................................................................. 57 3: Terms of Reference ............................................................ 62 Figures 1: Indonesia Infant Mortality Rate (1994–2007) ....................... 5 2: Global Scaling Up Rural Sanitation Project Progress In Indonesia (July 2007–May 2010) ....................................... 12 3: District Allocations to Sanitation Development 2007–2010 (Provincial Development Budget) ..................................... 28 4: Benchmarking: District Performance According to Java Post Institute of Pro-Autonomy (Jpip) Criteria ................... 33 5: Total Investment In Rural Sanitation, East Java (2007–2010) ....................................................................... 35 6: Progress in the Enabling Environment: Probollingo District, 2007–2010 ............................................................ 38 Tables 1: Project Areas and Numbers of Beneficiaries (Millions) ........ 2 2: Enabling Environment: Policy, Strategy, and Direction ...... 10 3: Enabling Environment: Institutional Arrangements ............ 17 4: Enabling Environment: Program Methodology .................. 20 5: Enabling Environment: Implementation Capacity .............. 23 6. Enabling Environment: Availability of Goods and Services ...................................................................... 27 7: East Java: District Financial Commitments to Rural Sanitation (IDR Millions) ..................................................... 29 8: Enabling Environment: Finance and Incentives ................. 33 9: Evidence: Cost-Effective Implementation.......................... 34 x Scaling Up Rural Sanitation Abbreviations and Glossary Bahasa Indonesia The official language of Indonesia BAPPEDA Development Planning Agency BAPPENAS National Development Planning Agency Bupati District Head, an elected official CLTS Community-Led Total Sanitation CSR Corporate Social Responsibility DHS Demographic and Health Survey EASan East Asia Ministerial Conference on Sanitation IDR Indonesian Rupiah IFC International Finance Corporation IMR Infant Mortality Rate ISSDP Indonesia Sanitation Sector Development Program ITS Technical Institute of Surabaya JMP WHO-UNICEF Joint Monitoring Program for Water Sup- ply and Sanitation JPIP Java Post Institute for Pro-Autonomy MDG Millennium Development Goal MoH Ministry of Health MoPW Ministry of Public Works M&E Monitoring and Evaluation NAP National Action Plan NGO Non-Governmental Organization NGP Nirmal Gram Puraskar (Clean village award) ODF Open Defecation Free PAMSIMAS Third Water Supply and Sanitation for Low Income Com- munities Project PHAST Participatory Hygiene and Sanitation Transformation PMU Project Management Unit PNMP National Community Empowerment Program PPSP Accelerated Sanitation Development of Human Settle- ments (Bahasa Indonesia acronym) Puskesmas Sub-district health centre RPJMD District Medium-Term Development Plan (Bahasa Indone- sia acronym) RPJMN National Medium-Term Development Plan (Bahasa Indo- nesia acronym) RSM Rural Sanitary Mart SMS Short Message Service (text message) STBM National Strategy for Community-Led Total Sanitation (Bahasa Indonesia acronym) www.wsp.org xi Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Abbreviations and Glossary SUSENAS Indonesian National Socioeconomic Survey TSSM Total Sanitation and Sanitation Marketing UNICEF United Nations Children’s Fund WASH Water, Sanitation, and Health WASPOLA Water and Sanitation Policy and Action Planning Project WHO World Health Organization WSLIC-2 Second Water Supply and Sanitation for Low Income Com- munities Project WSP Water and Sanitation Program xii Scaling Up Rural Sanitation I. Introduction WSP has implemented the Global Scaling Up Rural Sanitation Project since 2007. One of the central objectives of the project is to improve sanitation at a scale sufficient to meet the 2015 sanitation Millennium Development Goal (MDG) targets in Indonesia, Tanzania, and the Indian states of Himachal Pradesh and Madhya Pradesh. A consultant was contracted to perform an endline assessment of the program- matic and institutional conditions (referred to by the project as the enabling environment) needed to scale up, sustain, and replicate the total sanitation and sanitation marketing project approaches in the province of East Java, Indonesia. The Terms of Reference (TOR) is detailed in Annex 3. This report is the main output of that consultancy. The baseline assessment of the enabling environment was carried out during the start-up phase of the project in July and August 2007. This follow up assessment was carried out three years later in mid-2010, following the one-year extension of the project from its original mid-2009 end date. The endline assessment’s purpose is three-fold: • Assess the extent to which the programmatic conditions for scale up and sustainability have improved by the end of the project. • Recommend what should be done to address any gaps identified by the assessment during the remainder of the project implementation period, or in the future if a follow-on project is undertaken. • Determine whether an appropriate enabling environment is in place to meet the 2015 MDG sanitation target, and assess whether these condi- tions are likely to be sustained. The fundamental determination that the endline assessment should make in rela- tion to Indonesia is if the enabling environment has be institutionalized to sup- port scaling up in a sustainable manner, and whether that scale up can continue after 2010: without assistance, with less assistance, or with difference assistance from the project. This report presents the main findings and recommendations from the endline assessment of the enabling environment to scale up, sustain, and replicate sanita- tion improvements in East Java, Indonesia. www.wsp.org 1 II. Assessment Framework and Methodology In order to improve the comparability of the findings from three-year 20102 targets in the project and the MDG tar- the assessment in Indonesia with those from the assessments gets for 2015 (see Table 1). in Tanzania and India, a common assessment framework was developed by the WSP headquarters team and its special- 2.1 Assessment Dimensions ist advisers in Washington DC. The assessment framework The eight assessment dimensions3 represent a conceptual consists of eight dimensions that are considered essential to framework for assessing scalability and sustainability. the scaling up, sustainability, and replication of total sanita- tion and sanitation marketing approaches in rural areas: 2.1.1 Policy, Strategy, and Direction Establishing a shared vision and strategy and ensuring • Policy, strategy, and direction the political will to implement a program is the start- • Institutional arrangements ing point for scale up. Developing this shared vision and • Program methodology strategy in a collaborative manner is also the foundation • Implementation capacity for coordination and for creating motivation at all levels. • Availability of products, tools, and information Policy is defined as the “set of procedures, rules, and al- • Financing and incentives location mechanisms that provide the basis for programs • Cost-effective implementation and services. Policies set the priorities and often allo- • Monitoring and evaluation cate resources for implementation. Policies are reflected in laws and regulations, economic incentives, and the Definition of Scale Up: Increase the scale, rate of provi- assignment of rights and responsibilities for program sion, and sustainability of sanitation services to reach the implementation.�4 TABLE 1: PROJECT AREAS AND NUMBERS OF BENEFICIARIES (MILLIONS) People Who Will Gain Access to Additional Access to Project Areas People without Access to Sanitation during Three-Year Sanitation Needed to Meet 2015 (population) Sanitation (2006 estimate)* Project (estimate) MDG Targets** Tanzania (26.7 million rural) 14.25 0.75 6.5 East Java, Indonesia (36.5 million total) 18.60 1.40 10.0 Himachal Pradesh, India (5.5 million rural) 4.30 0.70 1.2 Madhya Pradesh, India (45 million rural) 43.60 1.10 20.0 Totals 80.75 3.95 37.7 * Best estimates given poor status of data ** Accounts for population growth estimates 2 The original project design included two-year 2009 targets, but these were revised to three-year 2010 targets when the project period was extended. 3 The baseline report included nine assessment dimensions, but the partnerships dimension was particular to the handwashing project and was therefore merged with the institutional arrangements dimension for this endline assessment. 4 Elledge et al. (2002). Guidelines for the Assessment of National Sanitation Policies Washington, DC: United States Agency for International Development, Environmental Health Project, Strategic Report 2. 2 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Assessment Framework and Methodology 2.1.2 Institutional Arrangements training, staff salaries, transportation, office equipment and In order for total sanitation and sanitation marketing ap- supplies, and the development of communication and edu- proaches to be scaled up, the right institutions must be in cation materials as well as programmatic line items in bud- place with all key roles and functions covered and clearly gets for program and promotion activities. understood. These institutions must also have the resources to carry out their roles. In addition to clear roles and re- 2.1.7 Cost-Effective Implementation sponsibilities, institutional arrangements include the mech- While it will not be possible to assess the cost-effectiveness anisms for actors at all levels to coordinate their activities of the approach or how best to achieve economies of scale and establish partnerships between the public, private and and scope until the end of the project, data must still be col- non-governmental organization (NGO) sectors, and be- lected during implementation to make this determination tween communities and local governments. at the end of the project. Therefore, the focus in this assess- ment category is to ensure that systems and procedures for 2.1.3 Program Methodology collecting cost information are in place from the outset and The program methodology consists of the program rules that the capacity to use the collected information exists. along with specific activities and their timing and sequence. Each country will adapt and apply the program methodology 2.1.8 Monitoring and Evaluation making it specific and appropriate to the country context. A Large-scale sanitation programs require regular monitoring workable program methodology that is clear and agreed upon and periodic evaluation and, perhaps more importantly, by all key stakeholders is a key programmatic condition. the willingness and ability to use the monitoring process to make adjustments in the program. Effective monitor- 2.1.4 Implementation Capacity ing will identify strengths and weaknesses in the program Institutions at all levels must have the capacity to carry out methodology, implementation arrangements, and cost ef- their roles and responsibilities. Institutional capacity includes ficiencies. Overall monitoring responsibility must be at the adequate human resources with the full range of skills required highest level of the program, but must be based on informa- to carry out their functions, an “organizational home� within tion collected at the local government or community-level. the institution that has the assigned responsibility, mastery of the agreed upon program methodology, systems, and proce- 2.2 Methodology of Assessment dures required for implementation, and the ability to monitor An international consultant carried out the endline assess- program effectiveness and make continual adjustments. ment in Indonesia with significant support from the WSP team, notably Deviariandy Setiawan, and with overall direc- 2.1.5 Availability of Products, Tools, and Information tion and management by the WSP Task Team Leader (Djoko The ability of target consumers to adopt the promoted Wartono), the Regional Team Leader (Almud Weitz), and behavior(s) is highly dependent on the existence and avail- the WSP Global Task Team Leader (Eddy Perez). ability of products, tools, and information that respond to consumer preferences and their willingness and ability to pay The endline assessments were conducted through a series for them. Any and all relevant products and services need to of one-to-one interviews with key stakeholders at national, be considered, specific to each country situation. [NB: As province, district, and village level. Based on the assess- each project area will be conducting market surveys and market ment framework a generic interview guide form was pre- analysis in conjunction with the private-sector partners, this as- pared, and further revised and developed by the consultant sessment dimension will be dealt with in broad, general terms and the project team in order to match the questions and with a focus on the government role and its policy implications.] language more closely to local contexts and norms. The Indonesia-specific interview guide was used in each inter- 2.1.6 Financing view, although some dimensions and questions were not This dimension assesses the adequacy of arrangements considered relevant (or appropriate) to some stakeholders for financing the programmatic costs. These costs include (e.g., asking local retailers about national strategy issues). www.wsp.org 3 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Assessment Framework and Methodology All the dimensions of the assessment framework were covered, but not by every stakeholder. The interview guide is included as Annex 2. Primary data sources were main stakeholders and partners for the in-country program work, including but not limited to government agencies, international agencies, international NGOs, local NGOs, private-sector businesses, and com- munity-based organizations. These primary data sources were contacted at all ap- propriate levels: national, provincial, district, and local. Secondary data sources comprised key documents, and potential influencers or secondary implementers such as media, ministries with no direct involvement, advocacy groups, and so on. Due to the limited time available, only two (of the twenty-nine) districts in East Java were visited during the assessment. Based on performance information pro- vided by the project team, one above-average district and one below-average district were selected5 from the districts where more than 100 community interventions had taken place. Trenggalek district was originally selected as the above-average district, but the WSP team noted that a new Bupati (district head, an elected position) was recently elected and that he is not supporting the sanitation efforts. Therefore, Lumajang district, the only other district with above-average perfor- mance and more than 100 triggered communities was selected. Jombang district was selected from the four below average districts with large-scale implementation. Lumajang was one of the top performing districts, but was initially only rated as an above average district due to its relatively low ODF success rate: only 42 percent of the 360 triggered communities have been declared open defecation free compared to 54–100 percent ODF communities in the other high-performing districts. However, the assessment was conducted in the awareness that Lumajang district was the pioneer of CLTS development in Indonesia, and that there remains a strong commitment and an unusually high level of political support for sanitation. After the district selection was made and the schedule was fixed, updated project benchmarking data for March 2010 revealed that a broader assessment of perfor- mance, including several cost-effectiveness measures, ranked Lumajang as the second best performer out of the 29 districts. This higher performance rating was supported by the assessment, and was factored in during the analysis of the assessment findings. Jombang was rated as a ‘below average’ district based on its low ODF success rate (19 percent) and below average financial allocations. Jombang was ranked 15th out of the 29 districts in the March 2010 performance benchmarking, but was nevertheless reported to have a good enabling environment and progressive dis- trict governance, as reflected by its early adoption of the SMS monitoring system. 5 Districts were divided into four performance categories: high performing, above average, below average, and low performing. 4 Scaling Up Rural Sanitation III. East Java Context 3.1 Population 3.3 Poverty East Java contains 16 percent of the 223 million total Indonesia has made progress in reducing poverty but many population of Indonesia.6 The rural-urban population split people remain poor and vulnerable. Sustained economic in East Java mirrors the national ratio, with 18.2 million growth has helped more Indonesians escape poverty by creat- (52 percent) rural inhabitants out of the 35.6 million total ing more jobs and increasing public expenditures for health, population. East Java is dominated by tropical coastal and education and infrastructure. Since the 2004 national elec- inland volcanic habitats, with a wide and somewhat un- tions, the poverty headcount has fallen from 16.7 percent to predictable variation in the availability of water. East Java 14.2 percent. Despite these gains, 32.5 million Indonesians is divided into 29 districts, in which 31.9 million people currently live below the poverty line and approximately half live (in 657 sub-districts and 8,506 villages7). The district of all households remain clustered around the national pov- populations exclude that of the nine major cities, but in- erty line (IDR 200,262 or US$22.308 per month)9. clude both urban and rural areas, with some 13.7 million people among the district population reported to be urban The gap between the poor and non-poor has widened, residents. The 2007 Indonesia Demographic and Health and regional disparities persist; eastern Indonesia lags be- Survey (DHS) suggests an average of 4.0 members per rural hind other parts of the country, notably Java. Furthermore, household, down from 4.2 members per rural household 17 percent of rural people are poor, compared to 11 per- in the 2002 DHS, with a total of about 4.5 million rural cent of urban people, which, because of the larger rural households. population, means that 70 percent of the poor live in rural 3.2 Health Data The infant mortality rate (IMR) in East Java has dropped significantly in the last five years, from 43 deaths per 1,000 FIGURE 1: INDONESIA INFANT MORTALITY RATE (1994–2007) live births reported in the 2002 DHS to 35 deaths per 1,000 live births in the 2007 DHS. As a result, the infant 70 66 62 mortality rate in East Java is now lower than the national Infant deaths per 1,000 live births 60 average of 39 deaths per 1,000 live births. No disaggregated 52 data are available for East Java, but IMR rates at national 50 43 43 level are much higher in rural areas at 45 deaths per 1,000 39 40 36 35 live births, than in urban areas where 31 infant deaths occur per 1,000 live births (see Figure 1). 30 20 Health data from the 2007 DHS suggest that East Java has average health outcomes: acute respiratory infection rates 10 in children under the age of five were slightly worse than 0 average, at 12 percent compared to 11.2 percent nationally; 1994 1997 2002 2007 fever rates were 34.3 percent compared to 31.6 percent na- Key East Java Indonesia tionally; and diarrhea rates were slightly better than average, at 13.3 percent compared to 13.7 percent nationally. Source: IDHS 2007 6 UN 2009. 7 Administrative unit names in Bahasa Indonesia language: district = kabupaten; sub-district = kecamatan; village = desa; and community = dusun. 8 At the time of the assessment in July 2010, the official exchange rate was US$1 = Indonesian Rupiah (IDR) 8,975. 9 http://data.worldbank.org/country/indonesia, accessed online 18 August 2010. www.wsp.org 5 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment East Java Context areas. Poverty levels are marginally higher than average in vibration, and offensive odors. However, the current legal the province of East Java: 20 percent (6.5 million people) framework lacks an environmental monitoring system, of the population were below the poverty line in 2004, and which is a major prerequisite for implementing or enforc- seven districts were reported to have poverty levels above ing such laws and regulations. 25 percent.10 Law No. 23/1992 on Health contains a section on envi- The 2004 SUSENAS household survey data reveals sub- ronmental quality, which in Article 22, states, “improve- stantial differences in the living conditions of rural house- ments to produce sound environmental quality should be holds in East Java: implemented in public places, settlements, working envi- ronment, public transportation and others. A healthy en- • 33 percent houses have dirt or earth floors (com- vironment means improvement in water and air quality pared to only 11 percent in West Java and 22 percent and better control of solid waste, wastewater, gas waste, nationally) radiation, noise, vector diseases and other health and safety • 34 percent houses have non-brick walls (compared issues.� to 51 percent nationally) 3.4.1 Community Water and Sanitation Policy Since 2007, the Government of Indonesia has launched In 1998, the Government of Indonesia embarked on an several large poverty reduction programs, including the initiative to develop a national policy for the develop- PNPM Rural (Mandiri), which provides community block ment of community-based water supply and environ- grants to support a wide range of sub-district infrastructure mental sanitation through the Water and Sanitation Policy proposals, including water supply and sanitation; and the Formulation and Action Planning (WASPOLA) project.11 PNPM Generasi, which provides annual block grants and The new community-based policy was approved in 2003 conditional grants designed to improve twelve basic health and a national level inter-ministerial working group and education indicators. Both of the PNPM programs op- funded by the Government of Indonesia, known as the erate in East Java, with significant impacts on the imple- AMPL Pokja (working group on water supply and sanita- mentation of rural sanitation programs due to the large and tion),12 was set up to guide the policy implementation extensive community investments provided through these process. programs. 3.4.2 Decentralization 3.4 Legal Framework In 2004, the Government of Indonesia devolved a num- Environmental laws and regulations are well established ber of functions to district governments under Law No. in Indonesia, at least as a theoretical framework. An en- 32/2004, including responsibility for the provision of vironmental legal system to match the level of developed both urban and rural sanitation services. The autonomy countries has been promulgated, from the Environmental provided to district governments by this law is now a sig- Management Act, which is a basic law for environmental nificant factor in central/district relations, as the central policy as a whole, to a variety of laws and regulations relat- government has limited powers to enforce implementation ing to water pollution, air pollution, waste management, of central policies or programs if these are at odds with dis- environmental assessment, and standards concerning noise, trict requirements. 10 Ibid. 11 Government of Indonesia partnership with the Water and Sanitation Program—East Asia and the Pacific. 12 AMPL Pokja is an abbreviated form of the Bahasa Indonesia for Water Supply and Sanitation working group. 6 Scaling Up Rural Sanitation IV. Rural Sanitation Improvement 4.1 MDG Progress in Indonesia access to improved sanitation in Indonesia since 1990 than Indonesia is not currently on track to achieve its sanitation in any other country except China and India. MDG. Government investments including donor funds have remained around US$27 million annually for the past 4.2 Indonesia Sanitation Sector Development 30 years, yet conservative estimates state that achievement Program of the sanitation MDG targets will require new investments The Indonesia Sanitation Sector Development Program17 of around US$600 million per year until 2015.13 A number (ISSDP) was established to strengthen and develop the of large sanitation improvement programs are now under- sanitation sector. ISSDP ran from April 2006 until January way, but few of them cover more than a handful of prov- 2010 with several goals: to create an effective enabling and inces. As a result, there has been little measurable impact on investment framework for sanitation; to stimulate sanita- national sanitation coverage. tion demand through a targeted public awareness and mar- keting campaign; and to build local government capacity A review of the JMP progress estimates suggests that rural for sanitation planning, implementation, and management. sanitation coverage in 2008 was 36 percent, up from only 22 percent in 199014. This represents a higher rate of prog- Despite its apparently broad area of responsibility, ISSDP ress than previously estimated, and sets the rural sanitation was primarily an urban program. ISSDP worked with the MDG at 61 percent (with the total sanitation MDG set at BAPPENAS-led inter-ministerial working group and with 67 percent).15 Shared sanitation coverage is high in rural In- small to medium sized municipalities, using the lessons donesia, with 11 percent estimated to use shared or public from this experience to inform advocacy and guide policy sanitation facilities of an otherwise improved type.16 Open in support of a national sanitation strategy that would raise defecation continues to be prevalent in rural areas, with the the profile of urban sanitation and create an enabling en- two most recent surveys, the 2007 DHS and SUSENAS vironment for accelerated progress in urban sanitation surveys, finding that 32-39 percent of rural households nationwide. practice open defecation. A key success of the ISSDP was the formal adoption and At the current rate of progress, only 41 percent of the rural launch of the 2010–2014 roadmap for the Accelerated population will be using improved sanitation by 2015— Sanitation Development of Human Settlements (PPSP in some 20 percent short of the rural sanitation MDG. How- Bahasa Indonesia), which contained commitments to scale ever, while the JMP estimate of rural sanitation coverage up both planning and investment in over 300 cities. in 2008 is five percent lower than the estimate made two years earlier, the faster rate of progress indicated by recent 4.3 CLTS in Indonesia survey data suggests that the rural sanitation MDG will be During December 2004 a high-level Government of Indo- reached by 2040, some 75 years quicker than indicated in nesia team visited Bangladesh and India to see the results of the 2007 baseline assessment. It is significant that the 2010 the zero-subsidy Community-led Total Sanitation (CLTS) JMP report noted that more people (59.7 million) gained approach. The visit sparked significant interest in testing 13 WSP (2007) It’s Not a Private Matter Anymore! Urban Sanitation: Portraits, Expectations and Opportunities Jakarta: World Bank Water and Sanitation Program and National Development Planning Agency (BAPPENAS). 14 JMP (2010) Progress on Sanitation and Drinking Water: 2010 Update Geneva: World Health Organization. 15 The 2010 JMP report contained revised sanitation estimates for Indonesia, as recent surveys indicated a faster rate of progress than previously assumed, which lowers the 1990 baseline estimate, and thus also alters the MDG target. 16 The Government of Indonesia counts the use of shared sanitation facilities as MDG progress; whereas the JMP classifies the use of shared or public sanitation facilities as unimproved sanitation. This use, therefore, is not counted in the JMP estimate of MDG progress. 17 ISSDP is a partnership between the Government of Indonesia, Water and Sanitation Program—East Asia and Pacific, and the Government of Netherlands. www.wsp.org 7 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Rural Sanitation Improvement the approach in the Indonesian context. In May 2005, Java, the project team conducted a series of district field trials were launched in six districts in six provinces roadshows to explain the project, generate demand, and covered under two large-scale Rural Water and Sanitation encourage district administrations to commit resources programs.18 After two years of field trials and another three to the project. Districts that wanted to participate in years of large-scale implementation, the CLTS approach is the project submitted formal letters of intent confirm- now widely used, spreading from the initial 11 sites to sev- ing that they would like to take part in the project and eral thousand communities across Indonesia. Hundreds of were willing to finance district implementation activi- these communities have now been declared Open Defeca- ties (beyond the training and support activities financed tion Free (ODF). through the project). 4.4 Global Scaling Up Rural Sanitation in The original plan was to target 30 communities in each Indonesia district (a total of 870 communities across the 29 districts) WSP implemented the project in the province of East Java over the two to three year duration of the project, with the because of its unusually good response to recent CLTS in- intention of achieving a minimum of 300 open defecation terventions. In 2007, Lumajang District in East Java was free communities. the most prominent success story of the CLTS experience in Indonesia, and key stakeholders from East Java (including The key project components were as follows: several local doctors) have been amongst the most promi- nent and vocal supporters of new approaches to sanitation 1. Project roadshows and ownership workshops de- development as a preventive health intervention. signed to spark the interest of districts, sub-districts and villages in being selected as project participants. In addition, East Java is not covered by the US$275 million 2. Identification of project institutional framework World Bank-supported PAMSIMAS project, currently and technical assistance agencies. the largest rural sanitation and hygiene improvement pro- 3. Sanitation market assessment, development of local gram in Indonesia. The PAMSIMAS project includes a supply improvement program, and implementation US$25 million component for improving sanitation and of supply improvements. hygiene behavior and services, based on a similar program 4. Capacity building of local government agencies, design and methodology to the project, thus PAMSIMAS local sanitation service providers, and community was originally intended as the vehicle for scaling up the organizations so that they could undertake their implementation tools developed and field tested by the program roles. project. 5. Development and implementation of demand- generation activities for sanitation and hygiene im- The Global Scaling Up Rural Sanitation project as im- provement through both community-level initia- plemented in Indonesia covers all 29 districts of East tives and mass media channels. Java province. The design of the project is demand- 6. Monitoring and evaluation, documentation, and responsive. Building on prior CLTS successes in East dissemination of lessons learned. 18 World Bank-supported Second Water and Sanitation for Low Income Communities (WSLIC 2) Project and the Asian Development Bank-supported Community Water Sanitation and Health (CWSH) project. 8 Scaling Up Rural Sanitation V. Baseline Findings The baseline assessment of the enabling environment for scaling up rural sanita- tion in East Java was completed in August 2007. The main findings were that successful CLTS interventions had built significant policy consensus and support for implementation of the total sanitation approach, but that inter-ministerial rivalries had limited political awareness and impeded the scaling up of rural sani- tation improvement in Indonesia. However, a draft rural sanitation strategy promoting total sanitation ap- proaches was under preparation, and the large-scale PAMSIMAS program was due to introduce the project methodology in 15 provinces. It was hoped that the learning from the project would inform the large-scale implementation of the PAMSIMAS program and build national support for further scaling up. While central ownership of rural sanitation activities appeared relatively low, in- tensive promotional efforts at the district level in East Java had produced strong local commitment to rural sanitation improvement using project approaches. There was already evidence that districts were prepared to allocate development resources to finance and implement rural sanitation activities, and that similar institutional arrangements to those developed under WSLIC-2 could be used for effective district implementation. The baseline assessment identified severe capacity constraints across the sub- sector; very few professional staff had any experience in the field building house- hold sanitation facilities in rural areas, or knowledge of promotional tools such as CLTS and sanitation marketing, and very little government finance was al- located to rural sanitation. The project was in the process of recruiting resource agencies to provide capacity building and technical support to the district teams, but the lack of district finance for rural sanitation activities by health center staff remained a critical constraint. The baseline assessment also queried whether the project would operate on a large enough scale to have a province-wide impact on rural sanitation. The proj- ect was targeting direct implementation in only 11 percent of the rural com- munities in the province, which could allow districts to target easy opportunities (pick the low-hanging fruit) and neglect the more challenging problems found in communities with difficult physical and social conditions. It was hoped that the sanitation marketing approach would reach a larger proportion of the popu- lation, but this approach was untried in East Java at the time of the assessment. www.wsp.org 9 VI. Endline Findings 6.1 Policy, Strategy, and Direction Sanitation Summit was held in November 2009, following up on the commitments made in the first summit. Key Findings • While there has been an increase in political support for Indonesia also sent representatives to the first regional sanitation and hygiene improvement, there remains a sanitation conference, the East Asia Ministerial Confer- lack of vision and leadership for rural sanitation. • Policy alignment has improved in the rural sanitation ence on Sanitation and Hygiene (EASan), held in Japan and hygiene sector, most significantly with the approval shortly after the national summit in late 2007, and later of the National Strategy for Community-Led Total to the second EASan held in Manila in January 2010. The Sanitation (STBM). high-level participants at these regional sanitation confer- • Other international actors have appealed to WSP for ences pledged to improve sanitation, with several repre- information and assistance in the design of sanita- sentatives at the second EASan noting that these regular tion marketing interventions linked to total sanitation projects. high-level conferences put pressure on governments to make good on their promises and demonstrate real pro- gress (see Table 2). A number of significant sanitation events have taken place since the 2007 baseline assessment of enabling environ- 6.1.1 Political Support ment. The first Indonesian Sanitation Summit took place Political support for sanitation and hygiene improvement in November 2007, at which a number of ministers,19 gov- has improved. The current five-year National Medium- ernors, mayors and district heads signed a National Sanita- Term Development Plan 2010–2014 (RPJMN) includes tion Commitment recognizing the impact of poor sanitation US$1.6 billion allocated to the PPSP, with provision for on health and economic development, and committing an increased allocation in the latter stages of the plan. For the government to increase the coverage and effectiveness the first time ever, the RPJMN allocated more finance to of sanitation services through multi-stakeholder partner- sanitation development than water supply development. ships between government, non-government organizations, However, while there is substantially more central sanita- private sector and communities.20 A second Indonesian tion investment than included in previous plans, PPSP is TABLE 2: ENABLING ENVIRONMENT: POLICY, STRATEGY, AND DIRECTION Indicator 2007 Baseline 2009 Target 2010 Achieved Strategic planning STBM approved No Yes Yes District strategies implemented 0 14 (48%) 6 (21%) Political support RPJMN sanitation allocation US$1.3 million US$2.2 million US$800 million* Policy alignment: total sanitation UNICEF No Yes Yes Plan No Yes Yes MoPW No Yes Partial *Note: The majority of this amount is earmarked for urban sanitation infrastructure. 19 Ministers of National Development Planning (BAPPENAS): Public Works, Health, Home Affairs, Industry and Environment. 20 Colin 2009. 10 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings largely an urban program, resulting in little of the funds for working with district and sub-district governments on being designated for investments in rural areas. rural sanitation. In particular, the special sanitation account provided to districts under PPSP is intended for sanitation The 2010–2014 RPJMN sets the same 100 percent open infrastructure under technical guidance from the MoPW, defecation free (ODF) target for 2014 that was included in and the relevant ministries have not yet agreed upon the the previous five-year plan ending in 2009. The baseline as- details of using these funds for the promotion of rural sani- sessment noted that no specific finance, programs, or other tation through the MoH. resources were provided to support the achievement of the ambitious 2009 target, and BAPPENAS recognized that 6.1.2 National Vision and Sector Leadership the previous failure to attract adequate support for sanita- Despite the significant sector progress described above, tion targets reflected the lack of a detailed national strategy. there remains a lack of vision and national leadership in the During the development of the current five-year plan, the rural sanitation sub-sector. Several stakeholders commented PPSP roadmap for urban sanitation was used to good ef- that the rural sanitation sub-sector advanced rapidly during fect in attracting finance, whereas the STBM roadmap is the first two years of the project, but that recent retirements still being finalized, meaning that little central budget was and promotions among key government stakeholders have allocated to rural sanitation outside of that already com- left the sub-sector lacking strong or influential champions. mitted through donor-supported programs. Despite assur- ances that STBM is an important government strategy, only As a result, the development of the enabling environment a limited government budget has been allocated to support for rural sanitation at national level has lost some momen- the nascent STBM secretariat, thus it is currently being fi- tum, and urban stakeholders now dominate many of the nanced largely through short-term arrangements with ex- sector discussions and activities. ternal support agencies. This lack of leadership is also evident in the limited atten- PPSP is becoming established as the primary national sani- tion paid to sanitation MDG progress in Indonesia. De- tation program, with growing support. The government bates about differences between the national definition of recently decided that STBM should come under the same improved sanitation, which includes shared sanitation facil- umbrella and follow a similar modality. Therefore, each ities and low-cost latrines, and the international classifica- local government will be required to: develop a “white tion, which does not include shared facilities, have obscured book� summarizing the baseline sanitation data; conduct the slow sanitation progress reported by JMP. However, a an Environmental Health Risk Assessment; undertake recent ministerial MDG progress meeting highlighted this sanitation mapping to identify priority areas for sanitation discrepancy and led to the President of Indonesia encourag- development; and produce a strategic sanitation plan. The ing the sector to promote jamban sehat (healthy latrines) Environmental Health Directorate in the MoH report that and work towards the MDG. 41 districts began the rural version of the PPSP process in 2010, and that 100 districts will undertake PPSP activi- 6.1.3 National Targets ties in 2011. By 2014, the MoH plans to have used the In 2006, the Ministry of Pubic Works issued the National PPSP process to implement the STBM strategy in 20,000 Action Plan (NAP), which targeted rural sanitation cover- villages, or about 27 percent of the total number of villages age of 64.5 percent by 2009; and 71.4 percent access by in the country. 2015. As with the RPJMN, the 2006 NAP appeared to be a largely theoretical exercise, with no evidence of any match- The establishment of a funded national sanitation program ing investments, implementation, or actions. that covers both rural and urban areas will be a significant step forward, but the proposed approach was developed by It remains unclear whether Indonesia is on track to achieve the ISSDP for small and medium-sized cities, and does not the NAP targets due to the different sanitation definitions appear to recognize the processes developed by the project and classifications used by the Government of Indonesia www.wsp.org 11 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings and its Bureau of Statistics. The 2007 SUSENAS house- FIGURE 2: GLOBAL SCALING UP RURAL SANITATION PROJECT PROGRESS IN INDONESIA (JULY 2007–MAY 2010) hold survey found that 59.2 percent of rural households used improved sanitation facilities; and the 2007 DHS 3,500 found 52.4 percent rural coverage. However, these coverage figures include the use of shared and public sanitation facil- 3,000 ities, which the government classes as improved sanitation 2,500 even though the JMP excludes shared usage due to concerns 2,000 Units about the risk of less hygienic outcomes. In addition, the JMP does not include all sanitation facilities classified as 1,500 “traditional latrines� because some of these may be unim- 1,000 proved facilities. As a result, the JMP estimated that access 500 to improved sanitation coverage including shared facilities was 47 percent in 2008, but only 36 percent of the rural Jul-11 Sep-1 Nov-1 Jan-12 Mar-1 May-1 Jul-12 Sep-1 Nov-1 Jan-13 Mar-1 May-1 Jul-13 Sep-1 Nov-1 Jan-14 Mar-1 May-1 population was estimated to use an improved sanitation fa- cility that is not shared or public. 2007–2010 Key The project monitoring data show more rapid progress in Triggered (number of communities) more than 3,000 project communities in East Java, but the Open defecation free (number of communities) total population of these small dusuns is only 2.7 million, Sanitation coverage (number of households) or about 15 percent of the rural population of the province. The project has increased access to improved sanitation in 23 percent of households in these project communities, totaling more than half a million people; an increase of 3.4 percent in rural sanitation coverage across the province without any project assistance. In practice, progress has during the three years of the project. been ten times faster than the national average, with im- proved sanitation coverage growing by 23 percent during While the absolute numbers appear relatively low when 2007–10. compared against the provincial population, the project monitoring data are starting to show acceleration in pro- 6.1.4 Policy Alignment gress (see Figure 2).21 Data collected in 2010 show that rapid Policy alignment has improved in the rural sanitation and gains have been made in the number of ODF communities hygiene sector. The most significant development has been and the population gaining access to improved sanitation. the 2008 approval of the STBM. While the final version This recent acceleration suggests that project investments in of the strategy differed from the draft reviewed during the developing the enabling environment and building district baseline assessment, the main elements remained similar, ownership are beginning to show benefits. including: The JMP estimates that rural sanitation coverage in In- • Include three main strategy components for achiev- donesia has increased by six percent in the last eight years ing total sanitation: enabling environment, increased (see section 5.8 Monitoring), at an average of 0.75 percent demand, and improved supply; per year. Taking this average progress as the counterfactual, • Provide no subsidies for basic sanitation facilities; improved sanitation coverage in the project communities • Provide subsidies only for communal sanitation fa- would have grown by 2.25 percent in the last three years cilities; and 21 Some caution should be exercised in using these data as they are often collected and reported by those responsible for implementing and promoting the project. No rigorous or independent household survey data are yet available to confirm whether the progress indicated by these district and project monitoring data is genuine and sustained. 12 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings • Develop a community reward system to as an incen- support for this approach from the MoH. In 2010, both tive to improve and maintain the sustainability of UNICEF and Plan are utilizing CLTS variants22 as cen- total sanitation tral components of their sanitation programs, and most other stakeholders are either starting CLTS interventions It is significant that STBM adopts a broader environmental or planning them. sanitation definition of total sanitation than that used in the project. STBM states that total sanitation is achieved when The most significant exception to this greater policy a community has met the following five criteria: alignment is the MoPW. The ministry is one of the most important stakeholders in the sector, yet many officials • Does not defecate openly (open-defecation free) remain ambivalent about CLTS. The MoPW is manag- • Washes hands with soap ing implementation of the US$275 million World Bank- • Treats drinking water and handles food safely supported PAMSIMAS project, which includes a sub- • Treats garbage properly stantial CLTS component being implemented through • Treats household wastewater safely the MoH, but sanitation progress has been slow. Given that PAMSIMAS was seen as one of the major vehicles The approaches used in the project focus largely on the first for scaling up the project approaches, this is a significant two pillars of the STBM, in the understanding that inter- disappointment. ventions that attempt to change multiple hygiene behaviors are often less effective than more focused interventions, and While a review of the PAMSIMAS project was not part that the priority should be to ensure the hygienic separa- of this assessment, several conclusions may be drawn. It tion of human excreta from human contact. However, each appears that PAMSIMAS implementation has not been local government develops its own STBM strategy. There- linked to the project; that the sanitation component fore, some variation across districts is found, and also some has not been well supported or prioritized within the variation within districts with some communities identify- PAMSIMAS program; that the sequencing of commu- ing other pillars of the STBM as critical to their local sanita- nity activities outlined in the PAMSIMAS design, which tion situation. started with the achievement of open defecation free sta- tus, has not been followed; and that institutional issues, 6.1.5 Support for the Total Sanitation Approach such as the priority use of the community facilitator team The MoH reports that as many as 250 out of the 349 for water supply development, have constrained the pace districts in Indonesia are now implementing CLTS inter- and effectiveness of sanitation development. Some stake- ventions in some form, with some implementing a full five- holders suggested that these problems reflect the unrealis- pillar STBM approach and others focusing on achieving tic nature of the original design, which sought to improve ODF status. While the quality and effectiveness of these in- cost-effectiveness through implementing further activities terventions remains uncertain, there has been a significant only when communities proved responsive to the CLTS spread since mid-2007 when only 54 districts were reported triggering process, but did not allow for the difficulty of to be implementing a total sanitation approach. achieving ODF status at scale; whereas other stakeholders suggested that the “design is ideal� and that the problems The STBM has greatly increased policy alignment, po- are the result of poor implementation due to policy, man- litical support, and programming of total sanitation ap- agement, and institutional issues related to the executing proaches that aim to end open defecation without using agency’s preference for infrastructure development. In ad- hardware subsidies. In 2007, several major stakeholders, dition, there is a tension between the executing agency’s including UNICEF, Plan Indonesia, and the MoPW, were target-driven approach and the more demand respon- not convinced of the benefits of CLTS despite strong sive and community development driven approaches to 22 UNICEF has developed an approach called Community Approaches to Total Sanitation. www.wsp.org 13 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings sanitation development required by the PAMSIMAS im- approach, and are now keen to move households up the plementation process. sanitation ladder to the use of more durable and hygienic improved sanitation facilities. The MoPW has now recognized the shortcomings of the PAMSIMAS sanitation implementation and has requested While some of the district stakeholders reported that they WSP assistance in improving project performance. Initial were not using the marketing communications materials investigations by WSP confirm the problems and con- prepared by the project, and the majority of the trained straints mentioned above, but it remains unclear whether masons were found to be no longer active in latrine con- these program issues can be easily resolved given the current struction or sanitation development, there was considerable institutional arrangements. interest and enthusiasm for the entrepreneur-based ap- proach currently being promoted by WSP. 6.1.6 Support for Sanitation Marketing While limited understanding of the principles of sanita- Nevertheless, it remains important to differentiate sanita- tion marketing among rural stakeholders remains, there tion marketing from the unsuccessful supply-driven ap- is growing demand in the region for information on, and proaches used in the past (e.g., the provision of free latrine support for, sanitation marketing interventions. The gov- material packages; and the provision of latrine pan molds ernment’s adoption of the STBM strategy has strengthened for the production of cement pans) using clear explanations this support due to the inclusion of the policy mentioned of the key principles and tools of the marketing approach, in Section 6.1.4 that there should be no subsidies for basic and reliable evidence of the scale, cost-effectiveness, and sanitation facilities. sustainability of this approach. The scaling up of total sanitation-based approaches has 6.1.7 Decentralization generated widespread demand for rural sanitation services. Deepening decentralization has a significant effect on local There is increasing recognition among implementers of the policy, strategy and political support. Several of the districts durability problems associated with low-cost pit latrines, in East Java, notably Lumajang district, have a clear vision and a number of international stakeholders have requested and commitment to rural sanitation improvement, which is information from WSP about the sanitation marketing reflected in the progressive and comprehensive approaches component of the project in East Java. adopted. On the other hand, other districts, especially Tuban district, remain unconvinced by the zero-subsidy policy em- UNICEF Indonesia and Plan Indonesia made formal ap- bedded in the national STBM strategy and in the total sanita- proaches to WSP for information and assistance in the de- tion approach promoted by the project, and therefore continue sign of sanitation marketing interventions linked to total to implement subsidy-based rural sanitation interventions. sanitation projects, and the AusAID-supported East Timor Rural Water Supply and Sanitation Project also requested This wide variation in policy and programming is a result of information. the autonomy accorded to the Bupati by Law no. 32/2004, and is reflected in the highly variable progress across the 29 Support for sanitation marketing is less apparent from cen- districts. Policy alignment is improving as more information tral government officials, with the main focus of govern- is shared between districts through horizontal learning activi- ment interest being on the now-familiar total sanitation ties; as stronger evidence emerges of more cost-effective imple- approach—due in large part to the successful approval and mentation by some districts; and as improved benchmarking adoption of the STBM. However, there is considerable in- exposes the worst performing districts to greater scrutiny. terest in sanitation marketing at the local government level, as many of the district programmers and implementers Following two years of steady progress in increased dis- have witnessed the limitations of a total sanitation-based trict commitment, and improving policy and strategy 14 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings alignment, the last year of the project has begun to be activities that are currently project funded, such as specialist affected negatively by the electoral cycle. Trenggalek was trainings, coordination activities, benchmarking, and learn- one of the leading districts until the Bupati changed in ing events. early 2010, but the new Bupati does not see sanitation as a priority and the altered planning and resource al- 6.1.9 Strategic Planning locations have slowed sanitation progress considerably. The STBM Secretariat and the Sanitation Working Another 16 of the 29 districts face elections in the next Group is finalizing an STBM roadmap. This should year, and reports are already emerging that previously provide some strategic assessment of relative sanitation approved sanitation budgets are being slashed to help priorities and specific challenges found across the diverse finance more populist investments linked to the forth- islands of Indonesia. It should also attempt to link sec- coming elections. tor targets, such as the RPJMN goal of ODF status by 2014, the NAP coverage targets, and the 2015 sanitation 6.1.8 Evidence of Local Support for the Project MDG, with realistic investment plans and implementa- All twenty-nine districts are now taking part in the project: tion programs. • Phase 1: 10 districts (Oct. 2007 to April 2008) PPSP will include both urban and rural elements, and now • Phase 2: 11 districts (May–Oct. 2008) provides a mechanism for more coherent planning of urban • Phase 3: 8 districts (Nov. 2008–April 2009) and rural sanitation development, which should be able to identify gaps between activities in the two sub-sectors, and All but one of the districts allocated a proportion of their encourage coordination of the currently separate planning annual development budget to project implementation. processes, programs, and activities. District investments over the last three years have varied considerably, from zero in Mojokerto district up to IDR The project undertook a strategic assessment and plan- 1.47 billion (US$163,500) in Jember district, with an an- ning process in East Java by asking each of the 29 districts nual district average of IDR 118 million (US$13,100). to conduct baseline surveys, prepare comprehensive plans These budget allocations highlight an increase in the use for achieving universal rural sanitation, and estimate the of district funds for rural sanitation improvement, but still financial requirements of these plans. The initial focus represent a relatively small proportion of the district bud- was on implementation in 30 rural communities in each get. However, WSP has also been encouraging districts to district, but there has since been a wider planning and as- use other national sources of finance for sanitation develop- sessment process to raise awareness, introduce some more ment, including corporate social responsibility and PNPM strategic thinking, and encourage district governments community development budgets, resulting in a steady to plan activities beyond those directly supported by the growth of funds being directed towards rural sanitation project. promotion. Project support was provided to ten districts to prepare a Provincial budget allocations have also been increasing an- detailed District Sanitation Strategy, but only six districts nually, from IDR 828 million in 2008 to IDR 1.1 billion managed to complete their strategy; twenty-three districts in 2010 (US$92,000–122,000). A wide range of activities remain without a medium or long-term sanitation strategy. is now supported at the province level, including: prepa- The endline assessment also suggests that, even in the few ration of district strategies, CLTS refresher trainings, fol- districts where the strategy development process encour- low-up with trained sanitarians, coordination, monitoring, aged the local government to look further ahead and adopt and financial support of horizontal learning events. These multi-year strategies, political expediencies and the annual activities suggest that provinces may be able to provide a planning processes favored by local government made effec- substantial proportion of the finance required to continue tive use of multi-year strategies difficult. www.wsp.org 15 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings 6.2 Institutional Arrangements Institutional issues appear to be one of the main constraints in the PAMSIMAS program, due largely to the division of Key Findings responsibilities between two competing agencies. The main • The STBM secretariat has been moved to the WASH implementing agency (MoPW) has favored its water sup- working group offices in an effort to improve utility and ply interventions over the sanitation interventions man- effectiveness. • The national sanitation working group remains an im- aged by the MoH, with the result that local governments portant coordination body through which many sub- and communities have limited incentives or resources for sector activities are planned and monitored. the implementation of sanitation improvements through • The project approach generated strong local commit- PAMSIMAS. As a secondary agency, the MoH has felt little ment and investment in district sanitation projects. accountability for the PAMSIMAS sanitation interven- tions, and has not been active in improving the institutional arrangements. Little change has taken place in institutional arrangements at the national level. The MoH remains the main institu- 6.2.1 Project Approach tion responsible for rural sanitation improvement, and the The institutional model used by the project, which leaves WASH working group (Pokja AMPL) remains the main the district government directly responsible for all imple- coordination mechanism through its sanitation working mentation, has been successful in developing ownership group. among the district governments, both in leveraging the use of local government funds and resources for rural sanita- Efforts are being made to establish a stronger institutional tion, and in providing the flexibility required to encourage set-up for rural sanitation, with the nascent STBM secretar- innovative approaches and context-specific solutions. In iat recently moved out of the MoH, where it was receiving addition, this approach has encouraged cost-effectiveness, little support or attention, to the WASH working group of- as the district stakeholders employ far more cost-effective fices in the hope that its proximity with other key sector co- approaches when the funds are coming from their own ordination actors will improve its utility and effectiveness. tight budgets rather than from an externally financed project. The main tasks of the STBM secretariat are to coordinate government and external activities in rural sanitation, pro- Most project activities have been demand-responsive, vide master trainers for CLTS and STBM capacity building, making districts and sub-districts responsible for decid- provide information on STBM, and advocate for STBM at ing whether to adopt particular approaches, utilize project both national and provincial levels. As noted earlier, insuf- tools, or take part in capacity building and training activi- ficient government budget was allocated for the operations ties. As a result, there has been a wide range of institutional of the STBM secretariat in 2010. outcomes and a considerable amount of learning. One of the institutional weaknesses identified by the as- This district-based demand-driven model contrasts strik- sessment was the lack of any high-level champions for rural ingly with the PAMSIMAS institutional model, which is sanitation. The main government actors are at director level based on central program management with implemen- or below, with few more senior officials showing interest tation through district program management units and or taking an active role in supporting rural sanitation. As technical assistance by centrally contracted management a result, rural sanitation issues rarely receive any priority consultants. The more centralized PAMSIMAS institu- in high-level forums. The central projects are viewed as tional arrangements limit local ownership and financial the main vehicles for any government involvement in rural allocations, resulting in a less flexible and less demand- sanitation, but there is little high-level attention to the per- responsive program. The centralized model is designed to formance and outcomes of these projects, despite large gov- tackle the problem of inadequate capacity and poor gov- ernment contributions. ernance in remote rural districts, but fails to commit local 16 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings governments to rural sanitation improvement or generate for the current level of implementation, but greater finance any local accountability for the intervention outcomes. and resources will be required to achieve the sanitation MDG or the government’s 100 percent ODF target. 6.2.2 Resource Agency The main mode of project support to the districts was All stakeholders noted that the horizontal learning events through the two resource agencies contracted to support organized by the project had been particularly useful in project implementation. WSP provided some training to providing the motivation and knowledge sharing needed the resource agencies at the outset of the project since few to improve effectiveness, and requested that these events suitable agencies were available with prior experience and should be continued in the future. The provincial health knowledge of the rural sanitation sub-sector in East Java, or office has allocated funds for these events in its 2010 bud- of the total sanitation and sanitation marketing approaches. get, and it is anticipated that WSP will provide technical assistance in the implementation of these learning events. The resource agency contracts finished shortly before the en- abling environment endline assessment took place, and the The strong ownership felt by many districts for their rural districts were in the process of adjusting to implementation sanitation programs has led to independent efforts to orga- without regular assistance and backstopping from the district nize study tours, for instance visits to other districts that were coordinators that the resource agencies placed in each district. known to be successful in CLTS or in sanitation marketing. It was also recognized that, in the absence of the resource agency In general, the districts were coping well with the reduced support, the district government could contract directly with support, with no discernible slowing of implementation or specialists if required. Several private consultants who had narrowing of scope. The main area in which the lack of re- previously worked for the resource agencies had already of- source agency support was visible was in the collection and fered their services in support of district implementation. reporting of monitoring and benchmarking data, which was becoming harder for WSP’s provincial coordinator to 6.2.3 Coordination obtain in a timely fashion. The national sanitation working group remains an impor- tant coordination body through which many sub-sector Interestingly, the main comment from the districts was that activities are planned and monitored. The meetings of the sufficient district finance and human resources were now sanitation working group are, at endline, more frequent than available for implementation, with the challenge being how at baseline, with regular monthly meetings reported com- to best use these resources effectively. However, only a few pared to quarterly meetings three years ago (see Table 3). districts have made a strategic assessment of the resource and However, the sanitation working group still lacks an insti- capacity requirements required to meet their medium-term tutional space to distinguish it from the more established sanitation targets. Institutional arrangements are sufficient WASPOLA-driven WASH working group, the AMPL TABLE 3: ENABLING ENVIRONMENT: INSTITUTIONAL ARRANGEMENTS Indicator 2007 Baseline 2009 Target 2010 Achieved Sector coordination Last meeting: Last meeting: Last meeting: National sanitation group 3 months 3 months 1 month East Java sanitation group — 1 month 2 months District WASH groups (average) — 6 months 4 months Lead rural sanitation agency National — MoH — District Health dept. Health dept. Health dept. www.wsp.org 17 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings Pokja. Neither the national sanitation working group nor starting with the Urban Poverty Project due to the closer AMPL Pokja has been afforded legal status and therefore starting alignment of STBM and Urban Poverty Project they have no power to enforce compliance or ensure in- policies on household contribution. The substantial budget volvement in key sector decisions. attached to the various PNPM programs mean that its poli- cies have significant influence on local governments, but Following indications that the active members of both the many of the key stakeholders in these poverty alleviation WASH and sanitation working groups in local government programs do not participate in the sanitation coordination tend to be the same people, BAPPENAS recently announced bodies. Therefore, it is important that WSP and its sector that the two coordination groups would be combined at prov- partners target improved alignment and harmonization ince, district and sub-district level. On the surface, this appears with these large and influential programs. to be a retrograde step in the struggle to ensure that sanitation receives some distinct priority and political attention from 6.2.5 Sanitarian Role that accorded to water supply, but BAPPENAS argues that The health center sanitarian is a key actor in the sanitation equal space and priority will be given to each sub-sector in improvement process. The provincial environmental health the working group meetings, and that the combined format section and the project have worked to re-activate sanitar- will be more efficient for the busy members of these work- ian involvement in sanitation improvement in East Java, as ing groups. The endline assessment found that most district many of them had turned to non-sanitation related roles WASH groups do not meet as regularly as intended, although due to the low priority previously accorded to sanitation. meetings are now being held on average every four months. The sanitarian now plays a key role in the total sanitation trig- 6.2.4 Interproject Coordination and Policy Alignment gering process, and in the monitoring of sanitation progress. In most cases, coordination between local stakeholders is More recently, provincial health officials have encouraged reported to be good. The exception is coordination between sanitarians to adopt the role of sanitation service provider, centrally managed projects, which tend to follow central based on the successful business model developed by an en- policies and implementation plans, with little recognition terprising sanitarian in Nganjuk district, and the project has of common or overlapping objectives, project areas, or re- supported this trend through the training of 14 sanitarians as source usage by projects run by other ministries or agencies. sanitation entrepreneurs. The intention is that these sanitar- ians will establish “one-stop shops� that enable consumers to Examples were given of the PNPM Mandiri project financ- order a latrine in one visit, with the purchase and transport of ing the construction of household latrines, including pay- materials as well as the design and construction of the latrine ments for labor provided for latrine construction in the being undertaken by the sanitation entrepreneur. same areas where other projects were promoting no-subsidy total sanitation and sanitation marketing approaches. In Only 14 sanitarians out of the 632 currently working in general, involvement in sanitation development by broader East Java23 have been trained as sanitation marketing entre- community development programs has undermined proj- preneurs, just two percent of the total. Nevertheless, the six ect implementation due to the different policies and ap- trained sanitarians who have already established latrine busi- proaches adopted; however, some cases were found where nesses are extremely happy with the arrangement. Three of local governments have used PNPM funds to subsidize fa- these entrepreneur sanitarians were interviewed during the cilities for poor households within the framework of the assessment, and all three commented that this new role fit- total sanitation activities being promoted by the project. ted well with their mandate to promote improved sanitation, to monitor sanitation improvement, and solved the growing BAPPENAS is now working with the central management problem of what to do when total sanitation interventions of the PNPM poverty programs to align subsidy policy, result in households asking for advice in choosing latrine 23 The East Java Bureau of Statistics states that there were 833 public health centers (Puskesmas) operating in the districts in 2008, thus at most 75 percent of sanitarian positions are filled. 18 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings technologies and service options. The sanitarians view this requisite skills and drive to build such a business alongside business as a chance to generate some private income while their existing government roles and responsibilities. also contributing to local sanitation improvement: a win-win situation. However, there is a substantial risk of a conflict of 6.2.6 Partnerships interest between the sanitarian’s various roles as sanitation Project activities are largely local government driven, with promoter, service provider, and monitor. few other partners. While a number of stakeholders are in- volved at community and sub-district level, the planning, There is already evidence that the sanitarian entrepreneurs decision-making and management of interventions are en- favor the more expensive latrine options, which they believe tirely by the local government. offer a higher and more hygienic level of service. The risk is that this belief leads to short-circuiting of the demand- At the national level, WSP has shared the progress and learn- responsive total sanitation process, with these promoter/ ing from the project through the sanitation working group, suppliers encouraging households to buy the technologies and WSP was also active in the development of STBM strat- and services that are most profitable. At present, the sani- egy. However, there has been no significant change since the tarians have no rivals, and clear advantages through their baseline assessment when it was noted that few formal part- respected position at the health center, and their knowledge nerships exist between the project and central government. of the sanitation improvement program. While the current In part this reflects the provincial nature of the project and small batch of sanitarian entrepreneurs appear altruistic and its district-driven process, but it appears that the limited committed enough to provide objective information and partnership between the project and central government affordable services to rural households, the scaling up of has allowed other policies and approaches to gain central this approach may risk some government sanitarians put- support at the expense of the project’s approaches. For in- ting private profit before their public health roles. stance, the planned adoption of the urban planning process in STBM reflects the close relationships developed by the The project is planning to encourage other stakeholders to ISSDP program and its central government partners. become sanitation entrepreneurs, through broadening the selection criteria for trainees, but notes that the sanitar- The government clearly values WSP as an important sec- ians value this business opportunity more highly than most tor partner, but insufficient knowledge management and other stakeholders. The ideal institutional arrangement advocacy at national level mean that this regard has not yet would provide functional separation—with the regulatory translated into national policies and programs that build on and monitoring role undertaken by the government sani- project learning. Given the important transition that is tak- tarian, the promotional role by NGOs or other indepen- ing place at the moment, with the introduction of STBM dent agencies (on contract to the health department), and into PPSP, it will be critical for WSP to forge stronger links the main sanitation service provider role by local firms or at the national level in order to ensure that STBM builds on private individuals. the valuable learning from the project. In addition, few sanitarians appear to have the entrepreneur- 6.2.7 Private Sector Partnerships ial drive required to develop a viable sanitation business. The The project attempted to partner with some large private sanitation entrepreneur model currently being formulated by companies in the sanitation marketing component, no- WSP in Indonesia requires individuals capable of taking on tably the HOLCIM cement corporation, but no formal the business aggregator role, which means financing sales and partnerships have been completed. HOLCIM was reported marketing activities, coordinating transporters and suppliers, to be interested in including sanitation services linked to managing cash flow, supervising artisans, and assuring the the project in their franchise model, but only if given ex- quality and durability of installations. While many sanitar- clusive rights to this franchising model. The exclusivity ians now recognize the potential income from a successful requirement runs counter to the open and competitive ap- sanitation business, it is likely that few of them will have the proach being promoted by the project, and no commercial www.wsp.org 19 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings enterprises have yet been willing to become involved in pro- 6.3 Program Methodology viding branded sanitation services without some form of commercial advantage to sweeten the deal. Key Findings • The basic elements of the program methodology, which combines total sanitation, sanitation marketing, and en- The International Finance Corporation (IFC) sanitation abling environment activities, are now well accepted by market assessment24 examined the potential for private sec- most sector stakeholders. tor participation in rural sanitation improvement through • Program methodology has improved since baseline, small local businesses, such as hardware stores, district-level especially the use of sub-district roadshows to intro- small and medium enterprises, and large established busi- duce the methodology and market the approaches of nesses. Few operational models were found, and the study the project. • Each district was free to determine the size of its pro- concluded that medium-sized businesses used to working gram, the local priorities, and the strategy that it wished with local suppliers and service providers offered the best to follow, allowing a number of different targeting strat- potential in the short-term. These findings contributed to egies to be tested and adopted. the WSP development of the business aggregator model, which encourages a move up the supply chain towards me- dium-sized enterprises capable of managing finances, orga- Three years after the baseline assessment, total sanitation nizing service providers (suppliers, transporters, masons), approaches remain the main elements of the project (see marketing products, and supervising sales teams. Table 4). The sanitation marketing approaches are develop- ing fast, but the focus of most government stakeholders is Corporate Social Responsibility (CSR) initiatives provide on scaling up and improving the effectiveness of total sani- another avenue for private sector involvement in sanitation tation approaches. improvement. Several district governments have now signed memorandums of understanding for financial support from While support for sanitation marketing is spreading, few private companies with CSR programs, for example, Bojo- of the activities or outcomes are yet visible or operational negoro District with Exxon Mobile, and Gresik District with at large scale. More than 1,700 masons were trained, Hertz. The impact of these CSR initiatives was uncertain at but only three percent are reported to be active in pro- the time of the assessment, but it seems likely to encourage viding sanitation services; and only one percent of the better performance monitoring and reporting by local govern- sanitarians in East Java have established one-stop shops. ments, and may lead to the introduction of more effective pri- On average, the sanitation entrepreneurs have only sold vate sector approaches to market research, sales and follow-up. 200–300 latrines in the last six months, with most finding TABLE 4: ENABLING ENVIRONMENT: PROGRAM METHODOLOGY Indicator 2007 Baseline 2009 Target 2010 Achieved Total Sanitation at scale Districts using total sanitation 54 (15%) 150 (43%) 252 (72%) UNICEF Indonesia No Yes Yes Plan Indonesia No Yes Yes Sanitation marketing at scale Districts using sanitation marketing 0 — 28 UNICEF Indonesia No Yes Planning Plan Indonesia No Yes Planning * At least one district in East Java (Tuban) has not adopted the main elements of the TSSM methodology. ** Both UNICEF Indonesia and Plan Indonesia have made explicit requests to WSP for assistance in developing sanitation marketing interventions. 24 Glitner and Surianingrat 2010. 20 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings that, while demand is high, the majority of their potential district-to-district study tours and training events in order customers need a simple credit facility, such as payment to learn in more detail about new approaches and ideas. by installments, before they can afford a market-bought In addition, the learning events put some peer pressure on latrine. low performing districts, and renewed enthusiasm for rural sanitation improvement. The basic concept of the program methodology, which involves combining total sanitation, sanitation market- 6.3.2 Program Targeting ing, and enabling environment activities, is now well The program methodology did not provide detailed guid- accepted by most sector stakeholders, but few stakehold- ance on community selection since each district was free ers have adopted the program methodology wholesale. to determine the size of its program, the local priorities, UNICEF and Plan Indonesia are eager to add sanitation and the strategy that it wished to follow. As a result, a marketing to their existing total sanitation projects, and number of different targeting strategies were tested and have made explicit requests to WSP for assistance in de- adopted. veloping their sanitation marketing interventions, with both organizations noting that there was only limited The project supported implementation in 30 communities information available on the sanitation marketing inter- in each district through the two resource agencies, with the ventions in East Java. Other stakeholders, such as World districts then adding to this number depending on their Vision International and Mercy Corps, have focused commitment and resources. By June 2010, five districts had largely on the total sanitation component and want triggered interventions in less than 50 communities; twelve to see how this core approach works in practice before had triggered 50–100 communities; and another twelve introducing additional elements such as the sanitation had triggered 100–360 communities. marketing approach. In general, the districts opted either to cluster the trig- 6.3.1 Evolution of the Program Methodology gered communities in one area, or in sub-districts where The program methodology has been improved over the conditions were considered conducive, or to use a more last three years. In particular, the introduction of sub- scattergun approach, with the intention that the trig- district roadshows increased the speed and effectiveness gered communities would provide models that spread of implementation. During the roadshows stakehold- to the surrounding communities. In almost all cases, ers below district level are introduced to the program priority was given to communities that were thought methodology and efforts are made to market project ap- likely to achieve ODF status quickly; most of the trig- proaches to them. gered communities had above-average baseline sanita- tion coverage. The sub-district and health center staff are the front-line implementers—if their local managers are not convinced The most interesting learning was in Lumajang, where of the efficacy and priority of rural sanitation interventions, efforts to achieve entirely ODF sub-districts found that then it becomes much harder for the district officials to the previous methodologies were not effective in trigger- drive the process. ing behavior change in difficult communities. The head of the public health center (Kepala Puskesmas) in Senduro The annual learning events, which were held at provin- sub-district noted that their initial efforts failed in eight cial, district, and sub-district levels, were also reported villages due to pessimistic facilitators, ineffective coordi- to be highly effective. These events provided a forum for nation, and inadequate monitoring. A new action plan practitioners to discuss their experiences, share innova- was drawn up based on a more structured, organized, and tions, and benchmark themselves against their peers in integrated approach, including advocacy, detailed moni- other areas. The learning events led to direct communica- toring and intensive CLTS elements. In several cases, paid tion between districts, with several subsequently arranging informers were introduced into communities to discover www.wsp.org 21 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings the real reasons for not building and using latrines, as 6.4 Implementation Capacity well as to demonstrate good practices. This comprehen- sive and intensive approach was ultimately successful, Key Findings with 11,237 households in 55 communities now declared • Since baseline, the project has successfully built ca- pacity at the local level, with many districts now con- entirely ODF. fident in their ability to continue the program without external support. Similar learning was derived from the Pacitan experi- • Low staffing on the local governmental level remains a ence, where a clustered approach was used to achieve concern. ODF status in areas that already had high levels of pit • There remains a shortage of capacity and experience latrine usage. Pacitan had triggered 354 communities by for effective sanitation marketing. June 2010, and reports a 100 percent success rate with all 354 communities declared ODF. It appears that a critical saturation was reached when most communities Local government capacity to implement the project has in a sub-district were ODF, which enabled much faster proved adequate, with all districts implementing in more progress due to the growing pressure from the encircl- communities than originally envisaged despite the limited ing communities and local governments on the last few budget provided by the project for direct implementation. communities. At the start, most stakeholders were unsure how the project 6.3.3 Methodological Weakness: Safe Disposal of was going to work given its dependence on district govern- Infant Excreta ments that previously lacked the finance, experience, and The baseline assessment identified the safe disposal of infant capacity to undertake many of the tasks devolved to them. and child excreta as a methodological weakness as there did In 2007, district governments were still coming to terms not appear to be any implementation approaches or moni- with their responsibilities, whereas most districts now sug- toring indicators designed to address this important sanita- gest that they have sufficient funds and resources for the tion issue. Infant and child excreta contain higher pathogen implementation of rural sanitation interventions but are levels than adult excreta, and are often disposed close to still developing the knowledge and experience to make the home, and it follows that safe disposal can be critical to effective use of these resources. Over the last three years, the health benefits derived from interventions designed to the project has provided much of the required knowledge improve rural sanitation. and has assisted in building local capacity, with the result that many districts are now confident in their ability to No development was evident in this area. The main proj- continue the rural sanitation program without external ect monitoring indicators remain improved sanitation support. coverage and ODF status, with little specific monitoring of critical hygiene practices, such as handwashing with 6.4.1 Project Capacity soap after defecation, or intra-household differences in The baseline assessment noted that the WSP team lacked sanitation practice, such as the safe disposal of infant capacity for the significant management, monitoring and excreta. technical assistance required by the project. In contrast, the endline assessment found that the WSP team was ade- The total sanitation and sanitation marketing approaches quately staffed and was coping well with the many demands focus largely on the use of improved household sanitation of this large project. facilities, and there was little evidence that either hand- washing with soap or safe child excreta disposal were being The one exception was in the production of formal promoted by the project. knowledge management products, now much in demand 22 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings by other stakeholders in and outside Indonesia. The day- Community midwives are reported to undertake most of to-day demands of the project leave little extra time for the sanitation and hygiene monitoring roles when sanitar- the preparation of the detailed documentation, training ians are unavailable. However, not only do these midwives packages, and advocacy materials that are needed to share lack the technical training and knowledge to undertake the project learning effectively with a wider audience. In many of the sanitarians’ other tasks, but many were already addition, the limited capacity assigned to this role has over-burdened by their core midwifery and community resulted in a growing backlog. While the project plan health duties before being asked to cover for unfilled sani- scheduled the preparation of the bulk of the knowledge tarian positions. management tools and products towards the end of the project, once the learning from implementation and the 6.4.3 Sanitation Marketing Capacity evaluation data were available, the feedback from other There remains a shortage of capacity for effective sanita- sector stakeholders suggests that a more constant feed of tion marketing. As noted earlier, some 1,700 latrine masons knowledge products and events is important to inform the were trained, but more than 97 percent are reported to be ongoing spread, replication, and improvement of the proj- either inactive or using their improved skills in other sectors ect’s approaches. or areas. The training provided by the Technical Institute of Surabaya (ITS) appears to have been adequate in providing 6.4.2 Sanitarian Staffing technical skills and awareness, but few of the trained ma- Given the central role played by the sanitarian in project sons saw latrine construction as a viable long-term business, methodology, the current low government staffing levels or were able to tap into the growing demand for sanitation give cause for concern (see Table 5). The MoH reported services created by the project. It seems that some masons that, in 2010, only 632 sanitarians were employed in East migrated to higher-paying urban work, others continued in Java’s 833 rural health posts. Given that some of these sani- their previous activities, and very few started active sanita- tarians are stationed in district health offices, rather than tion businesses. at the lower health post level, these MoH data suggest that less than 75 percent of the sanitarian positions in East Java The selection process for trainees is clearly one factor in are currently filled. In the Jember, Banyuwangi, and Bang- this disappointing outcome. Working masons were selected kalan districts, barely one in three health posts employs a from a small number of villages in each district, with two sanitarian. masons chosen from each of the 870 communities initially TABLE 5: ENABLING ENVIRONMENT: IMPLEMENTATION CAPACITY Indicator 2007 Baseline 2009 Target 2010 Achieved Knowledge management Exposure visits (people per year) 0 200 160* Best practice seminars 0 4 4 provincial WSP field notes 0 1 1** Active Sanitarians East Java: filled positions 620/826 (75%) 750/833 (90%) 632/833 (76%) East Java: active entrepreneurs 0 29 6 * Fourteen internal district-to-district and nine international/external (from Cambodia, Laos, East Timor, Philippines, Vietnam, India, Pakistan, WSLIC-2, and the Asian Development Bank-supported Community Water Services and Health Project) exposure visits over the last two years ** WSP 2009. www.wsp.org 23 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings targeted by the project. Not all of the selected masons stakeholders that require CLTS training towards districts turned up for the training, but those that did were provided like Lumajang that have developed effective implemen- with business development training and latrine construc- tation approaches and comprehensive internal training tion skills. Both ITS management and the project team programs. now realize that, even though appropriate capacity had been built, very few of these trainees had the right mix of Lumajang district has introduced a budget line for annual dynamism, ambition, people skills, and technical capacity sanitation training courses designed to refresh internal needed to develop viable sanitation businesses. skills, disseminate updated guidelines and approaches, and ensure that learning and capacity are not lost when key This finding suggests that a tougher selection process is sanitation personnel are transferred. During the endline important to winnow out trainees that lack the entrepre- assessment fieldwork, six teams from World Vision Inter- neurial spirit or commitment to use their new skills and national were being provided with CLTS training by the capacities. It also informed the design of the entrepreneur Lumajang district team, without assistance from any ex- training and one-stop shop model, due to the recognition ternal trainers. that a business aggregator mechanism was needed to con- nect household demand, material suppliers and service This horizontal training model appears more cost- providers. effective and sustainable than the vertical center-to- district model because it allows districts to compete for A second phase of training was designed with the aim of the provision of training services, thus ensuring a higher developing a small cadre of sanitation entrepreneurs. Four- quality of training. It also allows practitioners to select teen sanitarians were trained in the first batch, of which training partners with comparable contexts and condi- around six have gone on to start up active latrine construc- tions. Perhaps most importantly, the Lumajang trainers tion businesses. Some of these sanitarian entrepreneurs are have gained significant experience in the real life chal- now employing project-trained masons to install latrines, lenges of scaling up and sustaining CLTS interventions thereby using some of the previously built capacity as origi- through local government and as a consequence have a nally intended. more relevant and appropriate perspective than many of the central trainers. While it is yet early days in this process, the sanitation en- trepreneur model appears to be a much stronger and more 6.4.5 Central Government Capacity sustainable way of building local sanitation services than There remains a shortage of staff dedicated to rural the previous mason-training model. In order to scale up sanitation improvement in central government. A small direct marketing activities across the province, the key chal- number of individuals in the MoH and BAPPENAS lenge is how best to identify local individuals or enterprises are tasked with the enormous job of developing poli- with the right mix of skills and engagement, and how to cies, strategies, investment plans, and implementation persuade these agents that latrine construction is a viable, programs for rural sanitation improvement, while also long-term business. keeping up with the diverse monitoring and evaluation requirements across the thousands of islands that com- 6.4.4 Training Capacity prise Indonesia. The establishment of the STBM secre- The STBM secretariat established a core team of master tariat should have tackled these capacity issues through trainers that were assigned the responsibility for con- the provision of a specialist and dedicated team, but the ducting CLTS training across Indonesia. In practice, limited support and finance provided by the government this relatively small group of central trainers has proved to this secretariat have hindered progress and constrained unable to keep up with the national training demands. the development of the national enabling environment As a result, the WASH working group is now directing for rural sanitation. 24 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings 6.5 Availability of Products, Tools, and communications and marketing products (brands, logos, Information product promotion packages); and districts were encour- aged to use the pool of trained personnel and communica- Key Findings tions materials in their sanitation implementation activities. • At baseline the market for sanitation goods and ser- vices was relatively well developed, allowing the main Valuable learning was gained from these early experiences, focus of the project to be improving the quality, avail- ability, and affordability of existing goods and services. with the key development being recognition that, despite • Demand-led interest has resulted in an increase in retail the ready availability of materials and services, latrine con- sales of sanitation supplies. struction remained a fairly complicated process. Following • Indications are that many poor households would be the initial discussion and choice of a latrine model, the cli- willing to invest in the mid-priced pour-flush latrine op- ent still had to purchase construction materials and sanitary tions if some form of credit to enable payment by in- wares from a variety of different suppliers, arrange to trans- stallments was available. • Further investigation is needed to ascertain why some port the materials to site, hire a mason, and supervise con- districts and sanitation entrepreneurs are not using proj- struction. Therefore, it was realized that a “one-stop shop� ect supplies marketing materials, and what revisions to approach was needed, whereby customers could organize la- content, pricing, and distribution would be needed to trine construction in one easy visit, making the shop respon- improve utilization. sible for the purchase and delivery of latrine materials, and • Several technical innovations were discovered during the supervision of the timely installation of the selected la- the assessment fieldwork, but no formal system is in place at district, province, or national level to collate trine model. The project has given entrepreneur training to and share innovative designs and technical options. 14 sanitarians to encourage them to set up one-stop shops, although to date only six have started active businesses. The Nielsen Total Sanitation and Sanitation Marketing The sanitation entrepreneur model was based on the ini- Research Report confirmed that the market for sanitation tiative of Sumadi, a sanitarian from Nganjuk district who goods and services was already relatively well developed re-launched his flagging latrine construction business when in East Java at the outset of the project.25 Most sanitation the project introduced him to more effective demand gen- goods were readily available from local suppliers at reason- eration and marketing approaches. Sumadi developed a able prices, and several competent service providers were number of affordable pour-flush latrine models that sell for available in most areas. There were few gaps in the market, US$40–100, which have proved highly popular in his area letting the main focus of sanitation marketing activities be due to the easy menu-driven service that enables house- to improve the quality, availability, and affordability of ex- holds to choose from a range of attractive latrine designs, isting goods and services (rather than to create new supply and the lower costs enabled by his efficient operations. chains or service categories) and to ensure that demand cre- ation and enabling environment activities were linked and These improved latrine designs and technology options coordinated with marketing activities. have now spread into many of the districts in East Java, both through project training courses and knowledge shar- Since 2008, the project has undertaken a number of ac- ing at stakeholder events. The prior CLTS activities had al- tivities to strengthen the supply of sanitation goods and ready increased the number of low-cost dry latrine options services: masons have been trained in latrine production available, and the sanitation marketing activities have now and marketing techniques; a sanitation marketing com- improved the affordability and availability of more durable munications strategy was developed, including a range of pour-flush latrine options. 25 Nielsen 2009. www.wsp.org 25 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings 6.5.1 Retail Sales Increasing in Some Areas earth-covered slab, or are unwilling or unable to invest the Despite the relatively small scale of the direct marketing suc- additional US$25 required to build a pour-flush latrine. cesses, the impact is already evident among local suppliers These data fit well with the housing data reported in the in the vicinity of these nascent sanitation businesses. The baseline assessment, which found that 33 percent of rural Nielsen research conducted in 2008 found that local retailers houses in East Java have earthen floors and non-brick walls, sold “up to 30 [pour-flush pans] per month,�26 whereas one and thus suggested that simple latrines with earth floors of the suppliers visited in Jombang district during July 2010 might be appropriate for the poorest third of the population. reported sales of 200–500 pans per month.27 It seems likely that much of this growth is through self-supply by those However, the strong demand for pour-flush sanitation fa- households able to organize and finance latrine construction cilities with concrete slabs revealed by the sanitarian entre- without assistance, but further investigation is required to preneurs suggests that the more attractive and affordable confirm whether these sales result directly from the broader technology options being promoted by these entrepreneurs promotional activities or whether the sanitation entrepre- may be changing spending preferences, and that many poor neurs are already having an impact on local sales patterns. households would be willing to invest in the mid-priced pour-flush latrine options if some form of credit to enable 6.5.2 Level of Service payment by installments was available. Based on the district feedback, the WSP provincial coordi- nator estimated that the following technology options were No recent information was available on user satisfac- utilized in East Java: tion with sanitation facilities so it was not possible to as- sess whether satisfaction had increased since baseline. The • 10 percent dry pit latrines (average cost IDR 180,000 2008 Nielsen survey found 85 percent satisfaction among = US$20) improved sanitation users, 57 percent among users of un- • 60 percent pour-flush pit latrines (average cost IDR improved sanitation facilities, and only 34 percent among 400,000 = US$45) users of shared sanitation facilities28 (see Table 6). • 30 percent pour-flush latrines with offset lined pits and soakaway system (IDR 800,000–1,100,000 = 6.5.3 Demand for Marketing Communications US$90–125) Materials The project literature presented a compelling picture of Slightly different technology preferences were found in well-branded products and well-designed communications Lumajang district, where the CLTS approach has proved materials adding value to the sanitation marketing com- popular with both local governments and communities, and ponent. The design of these communications tools and 100 percent latrine coverage has been achieved in four sub- materials was informed by the SaniFOAM29 conceptual districts (which requires the use of latrines by even the poor- framework for sanitation behavior change, and through for- est households). The Lumajang district officials suggested mative research in East Java. The professional production of that up to 40 percent of households had built dry latrines the tools and materials was financed by WSP through the with earth-covered slabs, approximately 45 percent had built project, with further reproduction and implementation to pour-flush pit latrines, and the remaining 15 percent had be financed by districts following their choice of appropri- built more expensive twin pit and septic tank systems. ate tools and materials from a menu of options. The inten- tion was to develop a sustainable and self-financing system These data suggest that 10–40 percent of the population that would provide effective communications and market- either prefer a simple dry pit latrine, generally with an ing materials to the districts for reasonable prices. 26 Nielsen 2009. 27 Ten pour-flush latrine pans had been sold on the day of the assessment interview. 28 Nielsen 2009. 29 SaniFOAM (Sanitation Focus, Opportunity, Ability and Motivation) focuses attention on what and whose behaviors need to be improved, and categorizes sanitation behavioral determinants under three headings: Opportunity, Ability, and Motivation. 26 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings TABLE 6: ENABLING ENVIRONMENT: AVAILABILITY OF GOODS AND SERVICES Indicator 2007 Baseline 2009 Target 2010 Achieved Technology options Promoted by local producers (nr) 5 10 6 Found in poor households (nr) 2 4 3 Rural service providers Number of trained masons 0 +25% +3% Number of sanitation businesses 0 +44% 6 nr User satisfaction Improved latrine owners Unknown 75% 85%* Unimproved latrine owners Unknown — 57% Shared latrine users Unknown — 34% * User satisfaction data from Nielsen (2008) needs updating, but illustrates that user satisfaction is far higher among owners of improved latrines, thus that average satisfaction should increase as improved sanitation coverage rises. Little evidence of the use of the printed marketing materials content, pricing, and distribution would be needed to im- was found in the two districts visited during the assessment, prove utilization. even though 50 percent of the active sanitarian entrepre- neurs were interviewed. However, regular radio spots were 6.5.4 Technical Knowledge Management being broadcast in Jombang district, and the project video Several technical innovations were discovered during the was used in the mobile campaigns in Lumajang district. assessment fieldwork, but no formal system is in place at The project team reported that some districts decided not district, province, or national level to collate and share in- to buy any of the materials and others opted to purchase novative designs and technical options. This sort of knowl- only one or two of the tools or products. When asked why edge management is critically important in programs that the branded materials had not been more widely adopted, encourage local solutions to sanitation problems, as local the district health officials in Lumajang gave the blanket innovators often develop highly cost-effective approaches. response that “they were not effective.� One example was seen in Jombang district, where a mason The sanitarian entrepreneurs in the two districts visited was using a construction technique that he’d witnessed in were using either photocopied or self-printed leaflets to a local concrete yard for the fabrication of concrete rings. promote and sell their products, with no branding or nam- Several stakeholders had noted that the construction of these ing of products, and no use of the thumbs-up or WC-ku rings required expensive steel molds bought from Surabaya sehat logos. The original source of these amateur leaflets was for IDR 1.6 million (US$180), whereas this mason was apparently Sumadi, the successful sanitarian from Nganjuk using tin sheeting, old bicycle rims, wooden spacers, and district who provided the model for the sanitarian entre- steel-fixing wire that had cost only IDR 100,000 (US$12). preneurs, and all of the leaflets contained the same range of The quality of the concrete rings produced using these local latrine options with only minor variations in price. production tools appeared similar to those from the more expensive molds, yet none of the stakeholders present were The project team reports that the intention of the com- previously aware of this production technique. Many similar munication materials and strategy were to provide ideas innovations and developments are likely to be happening on how to promote services, which has led to some service across the province as service providers experiment and scale providers developing their own brand names and promo- up activities, but the project and its local government part- tional materials. However, further investigation is needed ners are not currently collecting, documenting and sharing to ascertain why some districts and sanitation entrepre- technical best practice and innovation through the annual neurs are not using the materials, and what revisions to stakeholder reviews or through any other active system. www.wsp.org 27 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings 6.6 Finance and Incentives For the first time ever, RPJMN (2010–14) committed more development funding to sanitation than to water supply. How- Key Findings ever, the vast majority of these funds are allocated to urban • For the first time, more funds have been committed to sanitation activities through PPSP. As noted earlier, the STBM sanitation than to water supply, but most of these funds secretariat remains without government funding, and the ma- are earmarked for urban sanitation activities. • A clear difference in spending priority is visible between jority of central government finance for rural sanitation is chan- the few districts that developed and implemented stra- neled through donor-supported projects that work in specific tegic medium- and long-term sanitation plans, and geographical areas rather than through a national program. those that continue with an annual planning process driven by short-term priorities. Rural sanitation allocations have increased in East Java, • Finance for sanitation in East Java remains below the with both the provincial government and the district levels needed to achieve the sanitation MDG at prov- ince level. governments increasing their commitments as a result of • There is currently no national incentive framework in project activities (see Table 7). By 2010, IDR 14.4 billion place, there seems to be little support in central gov- (US$1.6 million) had been contributed to rural sanitation ernment for the concept. improvement by the province and its 29 districts through their annual development plans (see Figure 3). FIGURE 3: DISTRICT ALLOCATIONS TO SANITATION DEVELOPMENT 2007–2010 (PROVINCIAL DEVELOPMENT BUDGET) Jembar Lumajang Trenggalek Sampang Bangkalan Bondowoso Sumenep Kediri Situbondo Pamekasan Nganjuk Pasuruan Tulungagung District Banyuwangi Tuban Jombang Probolinggo Magetan Ponorogo Bojonegoro Ngawi Gresik Blitar Madiun Malang Sidoarjo Pacitan Lamongan Mojokerto IDR - IDR 500 IDR 1,000 IDR 1,500 IDR 2,000 Key District investment in rural sanitation (IDR millions) FY07 FY08 FY09 FY10 28 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings TABLE 7: EAST JAVA: DISTRICT FINANCIAL COMMITMENTS TO RURAL SANITATION (IDR MILLIONS) Local Government 2007 2008 2009 2010 Total PROVINCE 0 828 811 1,100 2,740 Jember 263 400 800 8 1,471 Lumajang 60 245 149 110 1,265 Trenggalek 132 430 400 11 973 Sampang 0* 150 350 250 750 Bangkalan 300 100 225 100 725 Bondowoso 0* 200 300 13 513 Sumenep 50 50 141 270 511 Kediri 37 240 80 135 492 Situbondo 80 95 225 90 490 Pamekasan 140 100 145 100 485 Nganjuk 63 245 149 0 457 Pasururan 60 139 100 135 434 Tulungagung 240 62 30 50 382 Banyuwangi 0* 150 100 120 370 Tuban 0* 75 175 75 325 Jombang 0* 68 50 135 253 Probolinggo 50 50 150 0 250 Magetan 0* 25 75 150 250 Ponorogo 0* 150 75 13 238 Bojonegoro 0* 0 30 135 165 Ngawi 20 44 98 0 162 Gresik 0* 0 0 150 150 Blitar 0* 130 18 0 148 Madiun 0* 40 0 90 130 Malang 0* 30 0 50 80 Sidoarjo 0* 0 50 25 75 Pacitan 25 25 0 6 56 Mojokerto 0* 0 0 0 0 Total 1,520 4,071 5,427 3,351 14,369 Source: WSP * No contribution due to later start (Phase 2 and 3 districts). Most district governments in East Java have increased pub- those that continue with an annual planning process driven lic finance of rural sanitation, but by little more than was by short-term priorities. previously allocated to the WSLIC-2 project. A clear differ- ence is visible between investment levels and resource use in Nevertheless, these development allocations to rural sanita- the few districts that developed and implemented strategic tion represent a substantial step forward as they are driven by sanitation plans that highlighted the medium-term invest- district priorities rather than by centrally determined proj- ments needed to achieve district sanitation targets, and ect contributions. The amounts remain low, averaging only www.wsp.org 29 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings IDR 200 per capita per year (US$0.02), or about IDR 1,600 non-poor households in East Java lack a latrine, and the (US$0.16) per unserved household, but the district funds are second wave of orders came from poorer households that being used more cost-effectively than before and are there- asked to pay by installments. The sanitarians agreed to these fore reaching more unserved households. In practice, the requests, but soon found that they were only able to ob- district investments have been focused in only 13 percent tain one month of credit from their suppliers, whereas most of communities, making the effective investment per capita customers wanted to pay by installments over three to nine higher in the project communities. These local government months. This difference in credit terms quickly led to cash investments have managed to leverage substantial amounts of flow problems, and most of the sanitarians have now had to household investment (see Section 6.7 on Cost effectiveness). stop offering credit themselves and encourage their custom- ers to find other sources of credit. As a result, progress has At the outset of the project, when districts funds were unavail- slowed and most of the sanitarians now have a large backlog able, some sub-districts used part of the scarce operational of orders that cannot be filled until more credit is available. funds allocated to rural health centers to support and develop the project interventions. At the time of the endline assess- A number of informal credit mechanisms were reported dur- ment, increased budgets had been provided to most levels of ing the assessment. A local businessman is providing credit local government, and since 2011 the MoH has allocated an to toilet customers in Nganjuk district, with full payment increased operational budget for public health centers that will made to the sanitarian when each customer signs an agree- enable the sanitarian and other staff to be paid travel costs and ment agreeing to pay the total plus an additional ten percent expenses while undertaking sanitation improvement activities. over a period of less than one year. Similar arrangements, known as factoring, have been made by an entrepreneur in These additional investments are difficult to determine re- Sidoarjo district who finds local investors that provide the liably and so are not included in the sanitation develop- credit and carry the risk, with the village head notarizing ment expenditures listed above. Neither are a large number the contracts.30 Several of the sanitarians reported that tra- of other local government costs, including a proportion of ditional arisan revolving-credit groups had been established, the salaries of staff that work on sanitation improvement, as whereby a number of households pay a fixed amount each well as relevant government office and overhead costs. month and one household per month is given the money to pay for a new toilet, with the scheme continuing until all This discrepancy helps to explain why Pacitan district appears contributors have received a toilet. In some of the commu- to have invested so little in its rural sanitation program, only nities visited during the assessment, better off households IDR 56 million (US$6,200) according to the district develop- were loaning cash for poorer households to build latrines as ment allocations, yet has one of the largest and most successful a philanthropic gesture. However, these informal loans were district programs in terms of ODF achievements. Inputs by only made available to neighbors considered to be low risk lower level (sub-district and health center) health staff and by debtors, excluding many of the poorest households. other government departments operating in campaign mode were significant in Pacitan but were not accounted for in these Several of the sanitarians also suggested that they were short development budgets. Therefore, those figures have not been of the working capital needed to scale up their services, captured in the project estimates of cost-effectiveness. notably due to the high cost of production tools such as the metal forms used to fabricate concrete rings. One of 6.6.1 Credit Constraints the sanitarians in Lumajang district has taken out a IDR The six sanitarian entrepreneurs operating in East Java 20 million (US$2,200) loan from the Health Department found that demand was strong for their sanitation prod- Cooperative in order to finance his rapidly growing sani- ucts, and that initial customers were able to pay the full tation business, with a significant proportion of this loan amount for these products up front in cash. However, few invested in the purchase of a pick-up truck to transport 30 Glitner and Surianingrat 2010. 30 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings materials and latrine components. However, the Health US$1.50 per household. It is also likely that the project com- Department Cooperative only provides loans to health of- munities started with better than average sanitation condi- ficials because it is able to deduct the repayments directly tions, as many districts have deliberately targeted progressive from their salaries to avoid defaults. This credit mechanism and well-developed communities in order to achieve some is not available to other sanitation entrepreneurs. early gains. Therefore, it is likely that the cost per commu- nity will rise as more challenging and under-developed com- A recent IFC study31 examined microfinance and credit munities are addressed. Assuming that current project cost options for sanitation improvement but noted few viable efficiency can be maintained across the province, US$2.1 mil- options for the provision of household sanitation credit. Dis- lion per year would be required to cover every community by cussions with an IFC representative in Jakarta confirmed that 2015, which is roughly four times the total annual investment few existing microfinance or credit options would be avail- by local government during the last three years. able to poor households that lack credit history (for exam- ple, through the repayment of previous loans) or sufficient These figures ignore project expenditures, which have aver- collateral to provide loan security, or are unable to meet the aged about US$900,000 per year, approximately 70 percent bureaucratic demands of cautious financial institutions. The higher than the investments by local government. The ma- IFC is currently working with WSP to build a case for mak- jority of project investments have been in capacity building, ing sanitation credit more attractive to financial institutions, institutional strengthening, formative research, develop- with the possibility of IFC funding being used to provide ment of promotional tools and materials, awareness raising, loan guarantees, commercial risk assessment, or two-step and knowledge management activities that will have long- loans to enable smaller household loans by local banks. lasting benefits; it is hoped that provincial investments will increase as the province assumes more of the facilitation, 6.6.2 Finance to Reach Sanitation MDG in East Java capacity building, and monitoring roles previously under- Finance for sanitation in East Java remains below the levels taken by the project, and that district investments will rise needed to achieve the sanitation MDG at province level. as political pressure grows to reach the national develop- The project has achieved a 23 percent increase in improved ment goals, such as 100 percent ODF by 2014. However, sanitation coverage in its 3,151 project communities during the recent trend shows district sanitation investments de- the three years since the project launched, which is broadly creasing, apparently because local leaders are distracted by similar to the 25 percent increase in rural sanitation cover- the requirements of forthcoming elections. There remains a age needed to achieve the sanitation MDG in Indonesia.32 definite need for expenditure tracking and budget advocacy activities to maintain and increase sanitation investments. On this basis, similar interventions will be required in every community in East Java in order to reach the rural sanitation 6.6.3 Finance to Reach Sanitation MDG in Indonesia MDG.33 There are 24,180 dusun (sub-village communities) Considerable investments in rural sanitation are being made in East Java, of which only 13 percent have been covered through PAMSIMAS, and through other donor-supported under the project. Some 21,000 communities have not yet rural water supply and sanitation projects. However, little been triggered, thus 4,200 per year will need to be triggered monitoring data were available from these projects, mak- in order to cover all of the communities by the end of 2015. ing it difficult to estimate whether similar progress is being made in other parts of Indonesia. The average local government development expenditure has been about US$500 per community, which is less than Sector stakeholders suggest that the accelerated progress half that estimated in the baseline assessment, and less than reported under the project is not being mirrored in most 31 Glitner and Surianingrat 2010. 32 1990 baseline for rural sanitation coverage = 22 percent; 2015 MDG target for rural sanitation = 61 percent; 2008 JMP estimate for rural sanitation coverage = 36 percent; therefore, there has been a 14 percent increase in rural sanitation coverage since 1990, and another 25 percent is required to reach the MDG. 33 The baseline assessment of enabling environment assumed that only 50 percent of communities would need to be covered in order to reach the sanitation MDG. www.wsp.org 31 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings other projects or areas. In addition, large parts of Indonesia sanitation award based on the top-performing district identi- are not covered by any projects or interventions. Therefore, fied by the benchmarking system developed by the project. it seems likely that other part of Indonesia will require an initial investment in capacity building and institutional The JPIP award is based on the following eight indicators: strengthening, along the lines of the project, as well as dra- matically increased local government investments. 1. Local government sanitation budget allocation per unserved household (10 percent) The incorporation of STBM strategy into PPSP provides 2. Proportion of local government sanitation budget an opportunity for scaling up implementation through in- used for software (10 percent) creased investment in rural sanitation. The MoH report 3. Number of communities triggered in last year that it is planning STBM interventions in 20,000 villages (10 percent) by 2014, although the central plan only included a budget 4. Number of trained and accredited masons per sub- of about US$1.3 million for STBM. Other funding may be district (5 percent)* available for STBM interventions through the PAMSIMAS 5. Number of accredited sanitation vendors per sub- Asian Development Bank-supported Community Water district (5 percent)* Services and Health Project, and ICWRI programs, whose 6. ODF success rate (15 percent) combined total budgets exceed US$33 million, but the 7. Proportion of population gaining access to improved details of STBM’s financial strategy remain uncertain. If sanitation (15 percent) successful, STBM interventions would reach close to 30 per- 8. Leverage ratio: US$ household investment per US$ cent of Indonesia’s rural communities, but this means that local government invested (10 percent) they would need to achieve almost 100 percent improved 9. Cost per ODF community (10 percent) sanitation coverage in every community for the 25 percent 10. Bang for buck: number of people gaining access to coverage rise required to reach the rural sanitation MDG. improved sanitation per US$110 of local govern- Therefore, it appears that current investments remain well ment investment in last year (10 percent) below the level needed to achieve the rural sanitation MDG. * Indicators 4 and 5 have not yet been utilized due to a lack of information in this area. 6.6.4 Outcome-Based Incentive Frameworks Both BAPPENAS and MoH expressed interest in the de- velopment of a national incentive framework during the The JPIP sanitation award was won by Lumajang District baseline assessment and it appeared likely that some sort of in 2009, but several other districts are challenging for the framework would be put in place once adequate financing award in 2010. Significant publicity is accorded to the was sourced. However, there is currently no national incen- JPIP awards through the Java Post newspaper, thus the dis- tive framework in place, and several key officials reported trict Bupatis have shown unusual interest and attention to that there is currently little support in central government the award. Following the last award, several Bupatis con- for an incentive system due to concerns that these incen- tacted WSP and the provincial government to ask what tive systems can encourage coercive interventions with low they needed to do to win the award, and many districts quality and unsustainable outcomes. have now expanded their monitoring systems to cover the benchmarking criteria included in the JPIP award. In contrast, the project has been successful in introducing a province-level sanitation award linked directly to district- The East Java provincial government awarded IDR 5 mil- level sanitation outcomes (see Figure 4). For the last two lion (US$560) to 40 villages that declared ODF status in years, the Java Post Institute for Pro-Autonomy34 (JPIP) has 2009, and Trenggelek district awarded the same amount to extended its annual awards to district Bupatis to include a 25 of its ODF villages in the same year (see Table 8). While 34 An institute financed by the Java Post daily newspaper. 32 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings FIGURE 4: BENCHMARKING: DISTRICT PERFORMANCE ACCORDING TO JAVA POST INSTITUTE OF PRO-AUTONOMY (JPIP) CRITERIA 60 50 Score (out of 100) 40 30 20 10 0 Pamekasan Lumajang Probolinggo Nganjuk Sumenep Situbondo Pasuruan Bangkalan Tulungagung Ponorogo Sampang Magetan Pacitan Trenggalek Jombang Jember Bondowoso Mojokerto Banyuwangi Gresik Kediri Ngawi Blitar Tuban Madiun Lamongan Bojonegoro Sidoarjo Malang Key District Additional access to improved latrines (per US$1 million in program investment; scored 0–10) Program investment, ODF* communities (scored 0–10) Program investment vs. generated community investment (scored 0–10) Increased access to improved latrines (scored 0–15) Progress of ODF* communities above baseline (scored 0–15) Triggering progress above baseline (scored 0–10) Local government sanitation budget for non-construction (scored 0–10) Local government budget per household (scored 0–10) *ODF = open defecation free TABLE 8: ENABLING ENVIRONMENT: FINANCE AND INCENTIVES Indicator 2007 Baseline 2009 Target 2010 Achieved Sanitation finance Annual sanitation budget (East Java) US$169,000 US$750,000 US$372,000* Sanitation incentives National sanitation award No Yes No East Java sanitation award No Yes Yes East Java ODF incentive 0 US$67,000 US$22,000** *Total budget allocations by the provincial government and 29 district governments peaked at US$603,000 in 2009, then declined to US$372,000 in the 2010 election year. **IDR 200 million awarded in 2009, but stopped in 2010 due to problems in meeting strict government audit rules regarding accountable use of public funds. small amounts, these financial awards also provided some ruled that these payments contravene government expen- prestige and recognition to the village leaders, and were suc- diture rules, as they were taken from development budgets cessful enough that additional finance had been proposed intended to finance measurable outputs. No further provin- for the 2010 awards. Government auditors subsequently cial awards have been budgeted. www.wsp.org 33 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings 6.7 Cost-Effective Implementation High-level interest in JPIP performance means that dis- trict officials are now paying more attention to these cost- Key Findings effectiveness measures, but the WSP provincial coordinator • Cost-effectiveness data were unavailable at the na- remains the main force behind efforts to compile and pres- tional level, and largely unavailable at the district level. ent the cost-effectiveness data. Remarkably, the benefits that • The latest monitoring data suggest that the average cost per ODF community, including both local govern- more cost-effective policy and implementation would have ment and project expenditures, is now 30 percent lower on the scale and impact of improved sanitation outcomes, than the baseline assessment target. and on the effective use of district funds, appear less im- • The project has contributed 15 percent of the total portant to district leaders than the higher JPIP scoring that investment, compared to nine percent by local gov- improved cost-effectiveness brings to the JPIP rankings. ernment, and the remaining 76 percent by private households. • ODF success rate has been much higher than anticipated. 6.7.1 ODF Success Rate One of the key elements of the total sanitation methodology is the focus on achieving collective outcomes, rather than No data on cost-effectiveness were available at national just counting completed latrines. The Project Implementa- level, although some national stakeholders were aware that tion Plan stated that the project target was that at least 300 the project collects data on cost-effectiveness, and there was of the 870 project communities be declared open defeca- a widespread perception that the project was cost-effective. tion free (ODF), implying an ODF success rate of 34.4 per- cent. This target ODF success rate is marginally lower than In East Java, few cost-effectiveness data were available at the average ODF success rate of 37 percent found across all district level. The districts reported that cost-effectiveness CLTS interventions in Indonesia in mid-2007,35 thus the was assessed at the annual stakeholder review, but there was baseline assessment proposed that the baseline ODF success little evidence that these data had led to any revisions in rate be taken as 35 percent, with the target to raise this suc- policy or programming. However, the JPIP award includes cess rate to 40 percent by the end of the project. three cost-effectiveness criteria: leverage ratio (US dollars in household investment leveraged by each US dollar of local In fact, the project has been successful in surpassing both government investment), cost per ODF community (local the Project Implementation Plan target and the higher tar- government investment per ODF community declared) get suggested by the baseline Enabling Environment Assess- and “bang for buck� (number of people that gained access ment. To date, 1,367 ODF declarations have been made to an improved sanitation facility for each US$110 invested among 3,151 triggered communities, which suggest an by local government). ODF success rate of 43 percent (see Table 9). Interestingly, TABLE 9: EVIDENCE: COST-EFFECTIVE IMPLEMENTATION Indicator 2007 Baseline 2009 Target 2010 Achieved Effectiveness (East Java) Nr. triggered communities 0 4,046 3,121 (78%) Verified ODF communities 0 1,395 1,367 (98%) ODF success rate 35% 40% 43% Cost-effectiveness (in US$) Program cost per ODF community 6,400 4,000 1,060 Program cost per latrine in use 9 5 4.26 Leverage ratio (household: program) 2:1 4:1 5.3:1 35 149 ODF communities declared from 400 CLTS triggered communities. 34 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings the ODF success rate among the 18 Phase 1 and Phase 3 household latrine investments leveraged during each year districts has been considerably higher, averaging 54–56 per- of the project. Combined project and local government cent, but the overall average has been pulled down by the investments of US$343,000 in 2007 leveraged more than much lower ODF success rate among the Phase 2 districts, US$1 million in household investments—a leverage ratio where the ODF success rate has averaged only 18 percent— of around 3.0—whereas in 2010, US$1.257 million of well below the national average. combined project and local government investment lever- aged US$6.68 million of household latrine investment—a Further investigation is required to determine why the leverage ratio of 5.3. Overall, the project has contributed ODF success rate has been so much lower in these second 15 percent of the total investment, compared to 9 percent phase districts, although several stakeholders noted that the by local government, and the remaining 76 percent by pri- impact evaluation affected community selection in these vate households (see Figure 5). districts, and it is conceivable that the additional activities may have had a negative impact on community willingness 6.7.4 Sustainability to participate in the project. Other factors may be that the Given the high investment by the project in capacity build- second phase districts were less interested and committed ing, communication tools, and strategy development, and than the first phase districts; while the third phase districts other short-term enabling activities, it seems likely that benefited from awareness raised by the earlier phases and these improvements in cost-effectiveness will continue to from the introduction of improved approaches, for example increase over time. the sub-district roadshows, that were not available when implementation started in the second phase districts. As noted earlier, these costs ignore the cost of routine gov- ernment involvement in sanitation interventions. Signifi- 6.7.2 Cost per ODF Community cant district health office and rural health centre time and The baseline assessment found that about US$1,200 per resources are required to implement effective large-scale community was being spent on CLTS activities, and esti- sanitation interventions, but routine costs (salaries, train- mated that, when sanitation marketing costs and project ing, overheads) are not yet counted in cost-effectiveness costs were included, the average cost of achieving an ODF assessments. community was about US$6,700. The baseline assessment suggested that the project should aim to reduce this cost FIGURE 5: TOTAL INVESTMENT IN RURAL SANITATION, EAST by 40 percent, thus set a target of US$4,200 per ODF JAVA (2007–2010) community. $9,000,000 The latest monitoring data suggest that the average cost per $8,000,000 ODF community, including both local government and $7,000,000 project expenditures, is about US$2,900, some 30 percent $6,000,000 US dollars lower than the baseline assessment target. The local govern- $5,000,000 ment component is only US$1,060 per ODF community, $4,000,000 or about US$5 per household. $3,000,000 $2,000,000 6.7.3 Leverage Ratio Preliminary estimates of total investment in the project in $1,000,000 East Java suggest that the total project investment is about $0 2007 2008 2009 2010 70 percent higher than the local government development Key budget allocations during the four-year project period. The Household Local Government importance of developing a sustainable enabling environ- Project ment is clearly demonstrated by an analysis of the growing www.wsp.org 35 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings 6.8 Monitoring and Evaluation 6.8.1 Sanitation Coverage Trends The latest JMP estimates suggest that rural sanitation cov- Key Findings erage has increased from 30 percent to 36 percent in the • The annual SUSENAS socio-economic household sur- eight-year period 2000–2008, with roughly four million vey provides nationally representative data on the use rural inhabitants, or just under one million households, of household sanitation facilities, and implementation projects provide more detailed monitoring data in spe- gaining access to improved sanitation facilities.37 cific project areas, but no other data are reported on a regular basis. The SUSENAS socio-economic household surveys provide • There remains no regular or reliable monitoring of sani- a somewhat different picture. The 2004 and 2007 house- tation outcomes like latrine usage, open defecation hold surveys found that the proportion of households using rates, the practice of handwashing with soap, or the a private toilet facility has barely changed, from 51.3 per- safe disposal of infant excreta. • A number of project-related evaluations are currently cent to 52.0 percent38 in this two-year period. In East Java, underway in East Java, including action research to the survey found that the proportion using private sanita- examine the factors that influence the achievement of tion facilities decreased marginally from 50.8 percent to open defecation free (ODF) status. 50.4 percent39 in the same period. The SUSENAS surveys are reported to be representative at There remains no functional national monitoring system the district level, with more than 15,000 households sur- for rural sanitation. The annual SUSENAS socio-economic veyed in East Java; these data should be a reasonable reflec- household survey provides nationally representative data on tion of household sanitation practices at the province level. the use of household sanitation facilities, and implemen- tation projects provide more detailed monitoring data in A more detailed analysis suggests that the positive trend specific project areas, but no other data are reported on a shown in the JMP progress estimate reflects households up- regular basis beyond the high-level indicators required by grading their latrines from simple pit latrines, pit latrines BAPPENAS to monitor against national and district devel- with slab in the JMP terminology, to pour-flush latrines opment plans (RPJMN and RPJMD). with “septic tanks.� The SUSENAS surveys in 2004 and 2007 indicated that the total number of households using The MoH is planning to introduce an STBM monitoring improved sanitation facilities (including shared facilities) system designed to monitor progress against the national had barely changed, from 59.7 percent to 59.2 percent, but strategy for total sanitation (STBM). This system focuses in the same period around seven percent of the population on process rather than outcomes, with monitoring likely to were found to have upgraded from simple pit latrines to be against the following goals in the 20,000 target villages:36 pour-flush latrines. • Establishment of a village WASH forum The SUSENAS household surveys provide a regular and • Formulation of a village STBM plan reliable national mechanism for monitoring sanitation cov- • ODF declarations in 1–2 communities (dusun) erage, but are not used adequately by national sector stake- holders. In addition, there remains a tendency for national While this system will raise awareness of sanitation priori- agencies to over-report the findings, with the national re- ties, it does not appear to be linked with a large-scale public porting generally including all shared and all traditional pit health system designed for systematic monitoring of sanita- latrine facilities, whereas the international JMP estimates tion and hygiene progress or outcomes. exclude shared and public sanitation facilities, and only 36 From a total of 74,000 villages (desa). 37 Rural population has declined from 119 million in 2000 to 110 million in 2008 (UN Population division, 2009). 38 This proportion contains all households using pit latrines and shared latrines, and is therefore higher than the JMP estimate of improved sanitation coverage. 39 http://dds.bps.go.id (accessed 26 August 2010). 36 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings count 50 percent of pit latrines due to concerns that this The total population that has gained access to improved category includes unimproved sanitation facilities with in- sanitation in East Java is reported as 622,000, well short adequate slabs and open pits. of the project target of 1.4 million people; however, the lower than anticipated progress is partly a reflection of As a result, there is a significant gulf between progress the definition of an improved sanitation facility adopted estimates—a national MDG progress report in 2007 reported by the project. The project monitoring criteria assume that 60 percent improved sanitation coverage in rural areas in dry pit latrines without a squat-hole cover, and dry pit la- 2006, and suggested that the sanitation MDG had already trines with wood or earth covered slabs, are unimproved been met;40 whereas the latest JMP estimate for Indonesia, sanitation facilities whereas the JMP classification for an which is based on the household survey data available in 2008, improved pit latrine with slab does not require that the was 36 percent improved sanitation coverage in rural areas. squat-hole is covered, or that the slab is concrete. If the lower international definition of an improved sanitation fa- Following a recent JMP-supported workshop on harmoni- cility were adopted, the population assessed to have gained zation of monitoring, and the President of Indonesia’s in- access to improved sanitation would be considerably higher. tercession at the MDG summit in Bali, the MoH reports that a more conservative interpretation of the household 6.8.3 Monitoring of Enabling Environment survey data will be used in future, with a focus on ensuring The project introduced an annual assessment of the en- that only jamban sehat (hygienic latrines) are included in abling environment in each district based on a performance national sanitation coverage reports. scale developed for each of the eight dimensions. The an- nual assessments are marked on an eight-armed “spider dia- 6.8.2 Definition of an Improved Sanitation Facility gram� with subsequent assessments overlaid so that progress The SUSENAS surveys do not differentiate adequately be- in each dimension is apparent. tween an improved pit latrine with slab and an unimproved pit latrine without slab, as there is only one dry latrine re- The performance scales developed in Indonesia are not the sponse possible: Cubluk (pit). As a result, the JMP counts same as those used in the other country projects, due to dif- only half the simple pit latrines as improved sanitation fa- ferences in the project mode and manner in each country. cilities, thus halving the decrease in the proportion consid- The Indonesia scales require some subjective assessments, ered to be using improved pit latrines and resulting in an such as whether there is “political support from stakehold- estimated 3.3 percent rise in improved sanitation coverage ers� or whether “funding sources [are] being utilized ef- estimated between the SUSENAS 2004 and SUSENAS fectively.� The intention was that each district government 2007 surveys. would make a self-assessment of its progress in improving the enabling environment, and that this process would both The project monitoring data suggest that progress has been monitor progress and encourage local governments to think much faster in the 3,039 “triggered communities� in East harder about non-implementation issues, thereby promot- Java. Since 2007, there has been an increase of 23 percent ing more investment of time and effort in strengthening any in the proportion of households reported to use improved areas of weakness suggested by the self-assessment process. sanitation facilities, and 56 percent of the 2.71 million pop- ulation now live in ODF communities (where everyone is In practice, the spider diagrams have been of limited value reported to use some form of latrine).41 However, these dis- for local governments. As can be seen in the Probollingo trict monitoring data focus largely on facility construction district example in Figure 6, some districts gave themselves rather than latrine usage, and have not yet been verified by high marks at the outset, despite mediocre overall perfor- a large-scale household survey. mance, and then had little room to show any subsequent 40 UNDP (2007) Let’s Speak Out for MDGs: Achieving the Millennium Development Goals in Indonesia Jakarta: United Nations Development Programme. 41 This proportion is likely to include households that use unimproved sanitation facilities and shared sanitation facilities, and is reported by the promoters and communities themselves without any independent or third-party verification of ODF status. www.wsp.org 37 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings improvements. In contrast, some of the better performing fully the range of elements within each dimension of the districts marked themselves harder at the beginning, often enabling environment framework, and some recognition due to a deeper understanding of the enabling environment should be given to the need to apply different weightings to improvements required, and thus were reported to have a the various dimensions, for instance to recognize that pro- worse enabling environment than their lower performing gress in the policy, strategy, and direction dimension is likely neighbors. These districts have since been able to measure to be more critical to scale, sustainability, and impact than and report genuine progress, although their status still ap- progress in the cost-effective implementation dimension. pears to compare badly with those of the less carefully as- sessed districts. 6.8.4 Outcome Monitoring There remains no regular or reliable monitoring of sanita- There has been little demand for this information from the tion outcomes like latrine usage, open defecation rates, the district governments. It remains a project requirement to practice of handwashing with soap, or the safe disposal of monitor progress in improving the enabling environment, infant excreta. The RPJMD requires that each district re- but few of the districts would prepare these data without port annually against its ODF and sanitation coverage tar- specific requests from the WSP project team, and even gets. As a result the district health department must supply fewer use these data themselves. these data to BAPPEDA, but there are no clear instruments or guidelines to verify open defecation status, measure la- There remains some potential to use the spider diagrams trine usage over time, or assess hygiene behavior. to monitor enabling environment progress at the national level, and they might be used to encourage the collection The project has encouraged the districts to collect latrine and reporting of performance indicators linked to en- usage data on a monthly basis, through completion of a abling environment improvements. However, the rating standard monitoring form by each sanitarian. The latest scales would need to be improved in order to capture more version of the monitoring form classifies each household facility as a “permanent hygienic toilet� (Jamban sehat per- manent), “semi-permanent hygienic toilet� (Jamban sehat semi-permanent) or “open defecation.� FIGURE 6: PROGRESS IN THE ENABLING ENVIRONMENT: PROBOLLINGO DISTRICT, 2007–2010 These categories differentiate between latrines with a concrete slab (permanent) and a non-concrete slab (semi- Policy, Strategy, and Direction permanent), but now differ significantly from the JMP 6 definitions as any household facility that has an open squat- Monitoring and 5 Institutional hole (i.e., dry latrine without a tight-fitting lid) is classified Evaluation 4 Arrangements 3 as an “open defecation� household. These revisions to the 2 1 monitoring criteria, which used to be aligned more closely Cost-Effective 0 Program with the JMP categories, mean that the use of unimproved Implementation Methodology latrines is no longer reported separately from open defeca- tion. This change reflects concerns about the durability Financing Implementation of low-cost homemade latrines and the sustainable use of Capacity these low-cost latrines, with the intention being to monitor Availability of Products whether households are using hygienic facilities, as defined and Tools Key nationally,42 and if they are moving toward sustained use 2007 2008 2009 2010 of improved and durable sanitation facilities. In practice, the sanitation behavior change associated with fixed point 42 STBM defines hygienic toilets as those that “prevent the transmission of disease,� which has been informally elaborated to include flyproofing (GoI, 2008). 38 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings defecation is no longer measured or reported, even though or a preference for the old paper-based system. It was also upgrading these basic latrines to improved sanitation facili- noted that the implementing districts had not yet recon- ties often requires only minor upgrades, such as the addi- ciled the SMS and paper-based systems, with some sani- tion of a tight-fitting lid. tarians continuing to use paper reports while others had adopted the SMS reporting. These districts were unable to More significantly, there was little evidence that the current produce current progress figures without separate consulta- monitoring system is effective in capturing sustainability tions of the SMS database and the paper files. The findings losses due to collapsed, damaged or abandoned latrines. The suggest that many of the districts remain unconvinced of current system is designed to measure incremental increases the value of the SMS monitoring system, which raises ques- in latrine coverage as a result of newly constructed latrines, tions about the sustainability of the system once the direct with little emphasis on regular monitoring of the function- project support and monitoring demands cease. ality and use of existing latrines. The project also set out to collect disaggregated monitoring data on sanitation cover- 6.8.6 Evaluation age among poor households, but the current monitoring A number of project-related evaluations are currently un- forms do not include any disaggregated categories due to derway in East Java, including action research to examine revisions made to simplify the SMS monitoring system. the factors that influence the achievement of open defeca- tion free (ODF) status and the project impact evaluation. 6.8.5 SMS Monitoring System In addition, an external process evaluation by Mathematica Regular outcome monitoring is difficult at scale. The public Policy Research is taking place to examine differences be- health institutional structure in East Java allocates respon- tween the project monitoring data and longitudinal assess- sibility for sanitation monitoring to the sanitarian housed ments of outcomes and impact, and to investigate reasons in each rural health center. If all of the sanitarian positions for differential progress across the different phases of the were filled, then each sanitarian would be responsible for project. monitoring sanitation outcomes in about 29 dusuns con- taining around 2,500 households. Collecting monitoring The UK-based Institute of Development Studies is also data from this many communities and households every starting up a health impact study, which will attempt to month presents significant challenges, as does the process- correlate clinical data from rural health posts with sani- ing and utilization of the data by district, provincial, and tation monitoring data. The intention is to determine central monitoring staff. whether improved sanitation outcomes, such as ODF sta- tus, are associated with measurable improvements in health The project encountered these practical monitoring prob- outcomes. lems as the number of project communities rose into the thousands, which led to the development and introduction There remain few centrally financed or administered evalu- of a SMS text-based monitoring system. The SMS moni- ations of rural sanitation due to the limited budget available toring system had only been implemented in three of the for these activities. This gap appears to reflect the lack of twenty-nine districts in East Java at the time of the endline a national sanitation program and the consequent depen- assessment, but the early responses in these districts dem- dence of project-based and geographically focused imple- onstrate the potential of this system to facilitate large-scale mentation and monitoring systems. monitoring of household sanitation outcomes. 6.8.7 Knowledge Management Despite this potential, some teething problems were evi- The project developed an effective horizontal learning dent. Some of the leading districts have expressed little in- program through regular exposure visits and annual stake- terest in the system, and some sanitarians were reluctant to holder reviews at province, district and sub-district levels. utilize the SMS system due to unfamiliarity with mobile The review process proved to be a highly cost-effective way phones, concerns about the cost of the monitoring texts, of exchanging views and experiences, sharing innovation www.wsp.org 39 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Endline Findings and learning, and building relationships between administrations and stakehold- ers. The East Java provincial government has included funding for next year’s annual stakeholder reviews in its 2010 budget, and has requested technical assis- tance from WSP in organizing and facilitating the reviews. The provincial budget allocation and demand indicate the value of this process and recommend further efforts to support and enhance this sort of horizontal learning. External stakeholders, both within and outside Indonesia, expressed strong de- mand for more information on the processes, outcomes and learning from the project, with particular interest being shown in the sanitation marketing and SMS monitoring activities. This demand confirms high regard for the TSSM ap- proaches and the quality of WSP’s knowledge management products. However, to date, the project team in Indonesia has produced few learning products or tools, which suggests that insufficient capacity and resources were allocated to this important task. Several products and tool kits are currently under preparation, but this assessment suggests that more specific resources and responsibility need to be allocated to knowledge management as few of the project implementation team have time or space available to produce high quality documents and learning products. While a number of informal knowledge exchanges have taken place, there remains a risk that opportunities to influence the policy and programming of significant sector stakeholders have been missed as a result of the slow production of more formal learning products. 40 Scaling Up Rural Sanitation VII. Conclusions 7.1 Policy, Strategy, and Direction but it will be difficult to repair the damage done to the en- There have been significant improvements in the enabling abling environment through the poor performance of this environment for rural sanitation since the baseline assess- ostensibly similar program. ment in mid-2007. STBM has been approved and is now being implemented, either wholly or partially, in about Indonesia does not appear to be on track to meet its rural 70 percent of Indonesia’s 349 districts. The MoH is also sanitation MDG, or to achieve the RPJMN target of planning to implement STBM strategy in 20,000 villages 100 percent ODF by 2014, in large part because improve- (27 percent total) under the current 2010–2014 national ments in the national enabling environment have not been development plan, and has formulated a draft roadmap to matched by the strong political commitment and bureau- reach the ambitious sanitation targets for 2014. cratic consensus needed to drive a national program that could scale up cost-effective approaches and learning across As a result, policy alignment has increased dramatically, the country. with most sector stakeholders now using total sanitation approaches in their implementation programs. Interest in New developments, such as the incorporation of STBM sanitation marketing has also increased due to recognition into the large-scale PPSP program, are promising for larger of the demand for low-cost goods and services created by scale progress in the future, but the inadequate attention total sanitation approaches, although few stakeholders are given to the PAMSIMAS sanitation program, and the fail- yet implementing programs with well-designed sanitation ure of central government to allocate any finance to the marketing components. STBM secretariat, provide more objective indicators of the limited political support for rural sanitation improvement. Sanitation has a higher profile in Indonesia than it did three years ago, but much of this progress has been driven by Nevertheless, the project has made a significant impact urban priorities. US$1.6 billion has been allocated to PPSP, on the enabling environment for rural sanitation in East but this budget is almost entirely for urban sanitation ac- Java. There is clear evidence of an acceleration in sanitation tivities and will be implemented using the urban sanitation progress in project communities—estimated to be roughly planning approach developed by the ISSDP project. The ten times faster than the national average—and many of rural component of PPSP is currently being planned, with the improvements appear to be embedded in district insti- early indications being that little learning from the project tutions and processes, and thus should prove scalable and will be incorporated into the design due to the dominance sustainable over time. In addition, the project has contrib- of urban stakeholders in the process. uted to the spread of CLTS and sanitation marketing ap- proaches to Lao PDR, and to recent sanitation progress in These national developments are linked to the absence of a Timor-Leste, through the provision of support to exchange high-level advocate for rural sanitation, and recent changes visits, capacity building activities, and the dissemination of in personnel in key government ministries. While the im- knowledge management products. pact of personnel changes is difficult to predict or influence, this assessment suggests that the disappointing performance 7.2 Institutional Arrangements of the PAMSIMAS sanitation component, which should There have been no significant changes in institutional have been a vehicle for scaling up and institutionalizing the arrangements during the last three years, but existing ar- project policies and approaches, has been another major rangements are working reasonably well. The WASH and factor in undermining the impact of the project on the na- sanitation working groups have provided effective coordina- tional stage and diminishing support for rural sanitation. tion at national level. Most stakeholders are aware of sector WSP is becoming involved in supporting the PAMSIMAS developments, and there was evidence of efforts to harmo- sanitation program following a request from the MoPW, nize rural sanitation approaches and coordinate activities. www.wsp.org 41 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Conclusions The STBM secretariat could play an important role in in- personal profit motive will override public health concerns stitutionalizing total sanitation approaches and increasing and lessen promotion of less profitable sanitation solutions. support for rural sanitation improvement, but it remains an under-supported and under-funded institution. The incor- 7.3 Program Methodology poration of STBM into PPSP provides an opportunity for a There is increasing consensus that total sanitation and larger role within a well-funded government program, but sanitation marketing approaches are effective program also carries the risk that STBM requirements will remain methodologies, with most rural sanitation programs in In- secondary to the urban priorities and infrastructure bias of donesia now using some form of total sanitation approach the MoPW. and showing interest in developing a sanitation marketing component. Rural sanitation continues to carry low priority among the broad responsibilities of either the MoH or the MoPW. The The main exception is the MoPW and its PPSP program, two ministries have not worked well together on the sanita- which will cover both urban and rural settlements using the tion component of the PAMSIMAS program, and inter- urban strategic sanitation planning approach developed by ministerial and inter-project coordination remain major the ISSDP project. PPSP will divide responsibility between institutional weaknesses. the MoH and MoPW, with MoH responsible for behav- ior change and sanitation promotion, and MoPW respon- Sanitation remains a local government responsibility. As a sible for technical activities and infrastructure projects. The result, the decentralized and demand-responsive approach MoH is likely to use project approaches in its promotional adopted by the project in East Java has proved highly ap- activities, but there remains a risk that the more infrastruc- propriate and effective. In the absence of any larger cen- ture and public finance-based approaches advocated by the tral programs, district governments were convinced to use MoPW may set the PPSP agenda and dominate program their own institutions and resources to implement the activities unless the MoH makes a stronger and more con- project, which has resulted in sustainable arrangements sistent case for the use of more district-based and demand- and finance and cost-effective use of local resources, as driven approaches. well as pro-active efforts to learn from others, innovate, and develop locally appropriate approaches. The private At district level, the project has been successful in market- resource agencies contracted by the project were effective ing the program methodology to district governments— in supporting the districts during this learning and devel- initially through district and sub-district roadshows, and opment phase, and most district governments now appear subsequently through the stakeholder reviews and bench- to be confident in managing and sustaining their rural marking activities. The majority of the district governments sanitation programs. in East Java have adopted the approaches promoted by the project, and have become increasingly convinced that of The role of the sanitarian is the one area of institutional the advantages of these approaches as implementation has concern at district level. The project has promoted sanitar- scaled up. A few exceptions remain, such as Tuban district ians as potential entrepreneurs, which conflicts with their where a subsidy-based latrine program continues to operate other important roles as sanitation promoters, monitors, due to the personal convictions of the Bupathi, but in most and regulators. Given that the sanitarian is likely to remain cases district stakeholders have reached consensus on the tasked with monitoring the status of public health, (which best program methodologies and tools. includes assessing whether installed latrines are working well and producing sanitary outcomes) and with promot- As coverage has increased in districts like Lumajang, im- ing sanitation and hygiene (which involves encouraging provements have been made to the program approaches people to address sanitation problems through viable local in order to reach difficult or resistant communities. More solutions) then it seems clear that they should not also structured and institutional approaches have been used, be allowed to sell latrines, as this carries the risk that the with a focus on intensive door-to-door promotional 42 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Conclusions activities, analysis of the root causes of non-compliance 7.4 Implementation Capacity and non-adoption, and detailed monitoring of practices 7.4.1 National Implementation Capacity and progress. It has also become clear that a “clustered� The assessment identified shortages in national manage- approach to village selection, whereby efforts are made to ment, monitoring and training capacity, evidenced by the saturate specific sub-districts until every village and com- current limited knowledge of sector progress by central gov- munity is reached, has advantages over a “scattered� ap- ernment, by the ongoing problems faced by the STBM sec- proach in which project villages are selected across the retariat, and by the inability of the central training cadre to entire district. Success in achieving an ODF sub-district, keep up with district demands for capacity building. even when due to favorable conditions and committed staff, demonstrates that universal outcomes are possible. Within WSP, a shortage of knowledge management capac- This success engenders learning as the last few communi- ity was apparent. The main implementation team has been ties are reached and creates competitive pressures on other strengthened considerably since the baseline assessment, sub-districts. Once the majority of communities in an area but still lacks capacity for the regular capture of learning, are verified as ODF, the local authorities are able to con- and for the production of the high quality documents and centrate their efforts on the exceptions and it becomes ex- tools required for the rapid spread of programmatic learn- tremely difficult for these exceptions to resist the pressure ing around the region. One project-based WSP Field Note to conform. has been produced since 2007, but there remains significant demand for more detailed information on both the total Further work is required to increase the scale and cost- sanitation and sanitation marketing aspects of the project. effectiveness of the sanitation marketing approach, as it has been successful in only relatively small areas to date. 7.4.2 District Implementation Capacity The project team recognizes the importance and potential Where local governments are committed to the sanitation of this component. Therefore, the team has been working program and are well governed, implementation capacity hard to develop an improved approach to identifying and does not appear to be a major constraint. Where political developing sanitation entrepreneurs, and to solving some of support and governance are lower, the release of appropri- the credit constraints faced by rural households. ate government finance, resources, and capacity for rural sanitation improvement becomes an issue. The approaches used to develop the enabling environment in East Java have been particularly successful. Exposure vis- The main challenge faced by committed districts is in ef- its and regular learning events were central to the spread of fective use of their capacity and resources, rather than in innovation and the steady improvement of implementation finding or developing implementation capacity. Health methodologies across the province, to the extent that sev- departments in the high performing districts in East Java eral of the districts have taken the initiative to finance and are now facilitating sub-district implementation activities organize their own visits and events. by organizing training, providing technical assistance, and benchmarking progress, rather than managing direct proj- The success of the program methodologies has been rec- ect implementation activities. This arrangement is a more ognized by a large number of domestic and international effective use of the extensive human resources at lower lev- stakeholders, with strong regional interest in study tours els, enabled by the increased local budget allocations that and exposure visits to East Java, and high demand for financial decentralization provides to sub-districts, health more information and tools on the project approaches. posts, and village governments. Effective response to these demands, such as the recent training course on total sanitation approaches that the Despite this, there remain significant challenges in provid- project team provided for stakeholders in Laos, will be a ing incentives for sanitarians to undertake their sanitation significant factor in the spread of these approaches within roles and responsibilities, and in finding entrepreneurs in- the region. terested in working as latrine providers in rural areas. The www.wsp.org 43 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Conclusions project has attempted to tackle both issues by training 7.6 Finance and Incentives health post sanitarians as sanitation entrepreneurs, but only Central government finance of rural sanitation remains six have become active to date, and this assessment raises largely project-based, with little accountability for project doubts over the possible conflict of interest faced by sani- performance, and few incentives for more coherent plan- tarians with responsibility for sanitation promotion, service ning and policy. The 2010–2014 national development provision and outcome monitoring. plan contains provisions for financing STBM’s national strategy through PPSP, but there have been no firm fi- 7.5 Availability of Products, Tools, and nancial commitments and no mechanisms proposed for Information increased rural sanitation funds to be channeled to local There have been no significant changes in the availability, governments. As a result, it seems unlikely that sufficient affordability, and quality of sanitation goods and services in funding or resources have been allocated to reach either the Indonesia since the baseline assessment. However, sanita- rural sanitation MDG or the government’s 2014 target for tion promotion activities have been effective in increasing 100 percent ODF status. demand for sanitation, and this increased demand has led a few individuals to develop a range of more affordable and Local governments in East Java have increased public fi- attractive latrine options that are starting to shift spending nance of rural sanitation, but in most cases by little more preferences. than was previously allocated to WSLIC-2. As a result, the level of investment still remains some way short of that re- A small number of sanitation entrepreneurs, trained and quired to meet the rural sanitation MDG in East Java. A few supported by the project, are now offering one-stop services exceptions exist, including high-performing districts like for low-cost latrine construction in East Java based on the Lumajang that have increased investments and used highly model developed by Sumadi in Nganjuk district, but these cost-effective approaches to scale up implementation and activities are yet to have a significant or large-scale impact improve outcomes across the entire district. In many cases, upon service availability, price, or quality. increased district investments have been linked to strategic planning to achieve medium-term sanitation targets, which In the four months since the entrepreneur training was has highlighted previous under-investment and encouraged completed, it has become apparent that there is strong local more programmatic financing of activities. demand for the low-cost (US$20–120) latrine packages being offered by the trained sanitarian entrepreneurs. Ini- There is still no national award or incentive scheme for tial demand was largely from non-poor households able to rural sanitation, and several central stakeholders suggested finance their latrine purchase without credit, but the latrine that there was currently little support for this sort of in- customers are increasingly poor households that would centive mechanism due to the negative publicity associated like to pay in installments, generally over a four to twelve with India’s Nirmal Gram Puraskar. Despite this central month period. government unwillingness to consider incentives at this time, the JPIP sanitation award given to the elected head The main constraints on the availability of sanitation goods of the best performing sanitation district in East Java has and services appear to be a shortage of entrepreneurial ser- proved to be a powerful and effective incentive for increased vice providers willing to invest time, energy and capital political commitment to rural sanitation improvement, and into the development of latrine construction businesses and provides a useful model for the development of similar in- the lack of household credit to facilitate the purchase of centive schemes in other parts of Indonesia. latrines by low-income households. New sanitation market- ing models are being developed and implemented by the There is strong demand for sanitation credit from poor project, and a number of potential credit options are being households that would like to spread latrine payments over investigated, but no large-scale implementation was visible several months, and from sanitation entrepreneurs that re- at the time of this assessment. quire working capital to scale up latrine production and 44 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Conclusions sales. A number of informal and traditional credit mech- community and cost per improved latrine in use are both anisms are being used, but few of these are operating at lower than the endline targets, while program and local large scale. While there remains potential to interest com- government investment have leveraged five times more in- mercial lenders in developing micro-loans for household vestment by rural households. latrine construction, or possibly to finance a loan guarantee scheme that encourages micro-finance institutions to take 7.8 Monitoring and Evaluation on unsecured latrine loans, it appears that most of these The SUSENAS household surveys provide a biennial source commercial avenues have stringent requirements regarding of nationally representative latrine usage data, but there is household eligibility that may constrain the large-scale fi- no institutional system for more regular monitoring and nance of latrine loans to poor households. evaluation of national progress on rural sanitation improve- ment. In addition, the response categories in the SUSENAS 7.7 Cost-Effective Implementation surveys remain too broad to enable accurate classification of Cost-effectiveness remains an underused metric in the household latrines into improved and unimproved sanita- rural sanitation sub-sector in Indonesia. Few organizations tion facilities. compile cost or effectiveness data, and there was little cost- effectiveness data or future plans to collect these data at na- As a result, most monitoring and evaluation is conducted tional level. Despite limited attention in this area, there was through temporary project processes, with little evidence a general perception among national stakeholders that the that the data from these processes are being used to inform project “is a cost-effective program.� improved policy and programming. The project has devel- oped a province-wide monitoring system to collect monthly The decentralized nature of the project has encouraged bet- data on sanitation progress, but this system focuses on la- ter cost monitoring at provincial and district level in East trine construction rather than the sustainability of sanita- Java. Most districts were aware of the headline cost of im- tion outcomes, and has not yet been adopted or replicated plementing the total sanitation approach in a community, in any other provinces. The project is supporting a number and produced reasonably accurate annual development of interesting evaluations at the moment, but there is little budgets for rural sanitation activities. However, few dis- evidence that other stakeholders have been persuaded of the tricts have examined the effectiveness of these investments value of investing in evaluations of effectiveness and sus- in any detail, and very few have calculated or analyzed the tainability. The Environmental Health Directorate of the cost-effectiveness of their sanitation interventions. MoH has no budget for program evaluation and is conse- quently entirely dependent on externally derived effective- The WSP benchmarking tool, now incorporated into the ness data for its policy and investment decisions. JPIP award criteria, is the only mechanism that encourages the reporting and use of cost-effectiveness data in East Java. The SMS monitoring system currently being implemented Few districts compile the data themselves, but the inclu- in East Java seems likely to improve the reliability and cost- sion of three cost-effectiveness criteria in the JPIP award has effectiveness of rural sanitation monitoring, but has not yet heightened attention to the measures that influence these cri- been widely adopted even within some of the better per- teria, including household latrine investments, cost per ODF forming districts. Further efforts are required to promote community, and investment per improved sanitation facility. this system at both national and provincial levels. The cost-effectiveness data confirm the good performance The project has institutionalized cost-effective knowledge of the project to date, which in turn suggests that the en- management tools such as the annual stakeholder reviews abling environment has been working well. The 43 per- in East Java, but has failed to keep up with the strong sector cent ODF success rate has exceeded the target set and the and regional demand for regular and detailed information number of verified ODF communities is at 98 percent of on the TSSM approaches and the learning gained from the the project target. In addition, the program cost per ODF broad TSSM activities. www.wsp.org 45 VIII. Recommendations 8.1 Policy, Strategy, and Direction Generasi, which focuses on improving 12 health and educa- The project has been successful in scaling up rural sanita- tion indicators, to direct finance towards rural sanitation tion improvement in East Java, and in developing a sustain- improvement; and to use PNPM community block grants able, appropriate, and broadly replicable program model, to finance environmental sanitation improvements such as but has not yet found a vehicle for spreading this program drainage and solid waste management systems. In particular, model to other provinces. Therefore, it is recommended WSP has been examining the potential to include a com- that any future phase of the project should concentrate on munal sanitation indicator, such as ODF status, as a pre- three areas: condition for some of the conditional payments designed to improve health and nutrition, in the understanding that • Developing a support package and standard tools the effectiveness of some PNPM nutrition interventions is for implementation of a similar project in another limited by continuing diarrheal disease and tropical enter- province, opathy linked to inadequate sanitation and hygiene. • Identifying specific project elements that require specialist technical assistance and resources that are Discussions with key national stakeholders exposed con- not widely available in Indonesia, and cerns that the favorable enabling conditions in East Java • Developing partnerships with other stakeholders, might mean that the current project approaches cannot projects, and programs with the potential to scale up be transferred wholesale to more remote, low-income and and replicate the project approaches in other areas. subsistence parts of Indonesia. In particular, the different market conditions and consumer priorities in these areas In this regard, PPSP and its STBM component look likely recommend that separate market research and communica- to be the main government vehicle for scaling up rural sani- tions strategy development would be required. It was also tation improvement, so significant efforts are needed to en- noted that many other stakeholders would be unwilling or sure that the project approaches and learning are recognized unable to invest sufficient resources to obtain the special- in the design and implementation of the policies, strategies, ist technical assistance needed to undertake these activities. and processes under this program. Therefore, it is recommended that WSP should explore the potential to produce regional market research studies and PAMSIMAS still has the potential to be an important vehi- communication strategies that could be co-financed by a cle for scaling up the project approaches, subject to revital- group of interested stakeholders as a collective resource for ization of the sanitation component and stronger consensus future sanitation improvement activities. on the way to remedy previous program weaknesses. A multi-stakeholder evaluation should be used to identify the 8.1.1 Attracting Greater Political Support reason for the current problems, with careful efforts made The endline assessment makes clear the importance of to establish whether the approach has failed, or whether— gaining political support for rural sanitation improvement. as seems likely—the problems derive from poor implemen- While many elements of the political economy are beyond tation and institutional problems related to the different the influence of rural sanitation interventions, it is clear that priorities of the two main implementation agencies. more institutional approaches are required to attract politi- cal support, tackle succession problems, and to sequence PNPM provides another potential vehicle for scaling up interventions around election and budget cycles. rural sanitation. In the past, some PNPM components have provided household latrine subsidies that have been Lessons drawn from successful efforts to attract greater reported to undermine the project’s demand-driven ap- political support for urban sanitation suggest that regular proaches. However, there is considerable potential to uti- summits between interested and progressive leaders provide lize the conditional grant system incorporated in PNPM opportunities for incremental commitments, and generate 46 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Recommendations sufficient political capital to draw in previously disinter- private enterprises and local NGOs, should be encouraged ested elected representatives to future sector planning and to develop latrine businesses along the lines of the sanitation strategy processes. entrepreneur model currently being formulated by WSP. 8.2 Institutional Arrangements 8.2.1 WSP Role The rural component of the sanitation roadmap should be WSP lacks the manpower to manage implementation of used to highlight the important roles that the STBM sec- the project across several provinces, and has found it dif- retariat can play in the scaling up of the STBM strategy ficult to maintain its position as an independent reviewer across Indonesia. Without an effective secretariat, or at least while also being held responsible for project performance. some regional STBM centers, it will be difficult to plan Therefore, it is recommended that the WSP proposals the national strategy, monitor progress, and share learning. for the development of several resource centers in Indo- Predictable government finance will be required to develop nesia should be supported through the project, in order the STBM secretariat into a sustainable and effective insti- to develop a long-term institutional support mechanism tution capable of leading the sub-sector and directing the that can provide the back-stopping, technical assistance, growing PPSP resources in line with the national strategy. capacity building, and knowledge management services currently provided by WSP. Improved inter-project coordination will also be important to scaling up rural sanitation, both to leverage the large re- While it would be difficult to develop two or more of re- sources allocated to other programs for sanitation improve- source centers with the same caliber of staff as the WSP ment, and to ensure that their rural policies and practices do project office in Indonesia, it seems reasonable that WSP not undermine those promoted by other stakeholders in the could continue to innovate and undertake more special- sanitation sub-sector. As noted in the baseline assessment, ist tasks, while leaving the more day-to-day support to rural sanitation programs need to strengthen links with well-trained resource center staff. It is also possible that a other sanitation programs and with broader health, com- national version of the WSP multi-stakeholder financing munity development, and poverty alleviation programs. model, whereby a number of donors co-fund WSP based Many of the large-budget health and nutrition programs in on their assessment of the relevance and effectiveness of its Indonesia contain hygiene improvement and public health operations, may be relevant for sustainable long-term fi- components, often involving well-designed mass media nance of these resource centers. Several sector stakeholders campaigns. However, there is currently little coordination could club together to finance support in each region, thus or alignment of the hygiene messages and sanitation poli- ensuring that the centers remain responsive and account- cies promoted by the wide array of health, sanitation, and able to local demand for their services. community development programs being implemented in Indonesia. Improved linkages with long-term health and 8.3 Program Methodology community development programs will assist both the scal- The MoH reports that 252 of the 350 districts in Indo- ing up and replication of the project methodologies. nesia are now implementing the STBM strategy. In prac- tice, there are large variations between implementation The sanitarian is the key frontline government official for approaches within a single project, and across administra- sanitation improvement. In order to achieve functional sep- tive areas, due to the different contexts, personalities, and aration between service provision, monitoring of services, political economies found in each locality. Similarly, dis- and promotion of improved practices, it is recommended cussions with key sanitation stakeholders revealed a wide that sanitarians should not sell sanitation facilities, but disparity in understanding of the principles of an effective rather focus on the core health center functions of monitor- sanitation marketing approach, with some willing to learn ing sanitation status and public health along with support- from project experiences, others eager to start implement- ing the sanitation promotional activities implemented by ing immediately despite only limited awareness of supply local government. Alternative service providers, including and demand issues, and a few stakeholders eager to restart www.wsp.org 47 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Recommendations previous supply-driven approaches under the cover of a new model confirms that stronger incentives are required to re- name. tain trained personnel, that more careful selection processes are required before investing in capacity building, and that Given these wide variations in interpretation and imple- the outcomes of large-scale capacity building activities need mentation, WSP should produce some knowledge products to be carefully monitored and evaluated. Therefore, it is and implementation tools that clearly identify the key fea- recommended that all capacity building courses include an tures and indicators of effective total sanitation and sanita- initial selection process designed to identify individuals that tion marketing approaches, with a view to distinguishing are genuinely motivated, committed, and capable of uti- genuine implementation of these approaches from either lizing the additional capacities provided by the course. In poor implementation or implementation using lower qual- addition, these courses should always include some form of ity approaches. survey or evaluation to assess the performance of the capac- ity building program. 8.3.1 Evolution of Program Methodologies The achievement of open defecation free sub-districts in A number of different methods could be trialed for improv- East Java required development of a wide range of more de- ing selection prior to capacity building: applicants could liberate and institutional approaches to tackle the difficult be made aware that, for instance, only the top performing and resistant communities and households encountered 30 percent in the entrance tests will win places on the at this sort of scale. The ongoing action research into the course; that a non-refundable application fee would be behavior change process behind the achievement of ODF charged to individuals that are not selected for the course, communities should provide some useful information in or that the cost of the course would only be refunded to this regard, but it is also recommended that more specific individuals that meet specific performance criteria during research be undertaken to identify whether any particular the first six months after the course. The intention should processes or innovations were developed and improved in be to discourage non-interested individuals from taking up the pursuit of ODF sub-districts. This can be done with valuable places, to improve the quality and commitment a view to refining and documenting methodologies that of those that are trained, and to increase the proportion are responsive to the full range of conditions and contexts of trained personnel that go on to take advantage of their found during large-scale implementation. enlarged capacities to undertake new or improved activities. 8.3.2 Broader Methodologies Required Lumajang district introduced a budget line for annual The assessment suggested that current project method- sanitation training courses designed to refresh skills, dis- ologies fail to tackle the important areas of safe disposal seminate updated guidelines and approaches, and ensure of infant and child excreta, and handwashing with soap that learning and capacity are not lost when key sanitation after defecation. While these omissions reflect the project personnel are transferred. This capacity building approach origins from the total sanitation and sanitation marketing should be promoted across the province. approaches, and the fact that there is less consensus on cost- effective methodologies for safe child excreta disposal and 8.4.1 Technical Capacity improved handwashing with soap, these are critical sanita- Technical knowledge remains a weakness across the project. tion and hygiene behaviors for improved health, and it is Several trained sanitarians interviewed during the assess- therefore recommended that additional components should ment were unable to explain why vent pipes were included be added to the project methodology to address these areas. on pour-flush latrine designs with unlined pits, or how to enable hygienic emptying and disposal of the wet septage 8.4 Implementation Capacity from solid-lined latrine pits in rural areas. The conversion of recently built capacity into new or in- creased activities and improved outcomes remains a chal- Further investigation revealed that even some of the techni- lenge. The learning from the disappointing mason training cal trainers were either unsure or misinformed about these 48 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Recommendations issues. Few sector practitioners, including engineers and uptake of improved sanitation facilities in East Java. Little sanitation specialists, have a practical, rather than a theo- evidence of this effective use and contribution was evident retical, understanding of how and why toilets function. It from the fieldwork and discussions conducted for this is therefore recommended that additional technical materi- assessment. Consequently, a more comprehensive assess- als should be developed to identify practical shortcomings, ment should be made of the cost-effectiveness and sus- tackle common misconceptions, and share experiences with tainability of the strategic communications materials and innovative, effective, and sustainable technical options. sanitation marketing tools developed and implemented by the project in order to determine how best to use and 8.5 Availability of Tools, Products, and improve these important elements of the sanitation mar- Information keting approach. The preliminary findings from the sanitarian entrepreneur pilots suggest that the one-stop shop approach has resulted 8.5.2 Development of Pit Emptying and Disposal in viable and thriving latrine businesses for a small number Services of trained sanitarians. The next challenge is to open this It is also recommended that additional investment be model up to a wider selection of potential entrepreneurs in made in the development of viable latrine pit and septic order to promote competition and innovation, and to de- tank emptying services for rural areas. The ITS technical velop a system that monitors the performance of completed training and the local innovations developed by Sumadi43 latrines in order to identify any potential sustainability or in Nganjuk district have encouraged the promotion of twin public health problems associated with particular technol- pit latrine designs that operate like septic tanks, with lined ogy options or related sanitation services. pits connected in series to a soakaway. There is little recog- nition of the potential hazards associated with future emp- In the long term, the role of the sanitarian should be to pro- tying and disposal of the wet, pathogenic pit contents, with mote and monitor improved public health outcomes, with several stakeholders commenting that the tanks would take a particular focus on environmental sanitation. Given the 15–20 years to fill, or that some proprietary products could need for some form of public monitoring of sanitation out- be added to the pits to dissolve any sludge.44 comes, including the regulation of service providers when required, it is recommended that the sanitarian should not WSP experiences from the Philippines45 suggest that mech- become the sole commercial provider of latrine construc- anized septic tank emptying services are rarely an economic tion services in any area. This recommendation reflects the alternative in rural areas, and that safe disposal of septage potential conflict of interest between the commercial profit is difficult to regulate even when suitable disposal or treat- motive and the sanitarian’s public promotion and monitor- ment sites are available. Rapid installation and use of these ing role, as well as the need to ensure competitive and ac- “septic pit� latrines may be creating future long-term prob- countable service provision. lems that will require the development of appropriate man- ual desludging and disposal techniques, such as the use of 8.5.1 Effectiveness of Sanitation Marketing manual diaphragm pumps to desludge to disposal pits dug Communication Materials within 20m of the emptying site. Sanitarian involvement The project team remains confident that the communi- in the promotion, implementation, and regulation of safe cations strategy and branded marketing materials were pit-emptying and disposal services would be a useful long- used effectively and that they contributed to the increased term role. 43 The first sanitarian entrepreneur developed a number of twin-pit latrine designs that operate similarly to a septic tank (with in-line pits overflowing) that are likely to contain wet septage that will be difficult to empty and will require safe disposal to avoid re-contamination of the local environment. 44 The effectiveness of septic system additives in prolonging life and improving performance is highly questionable: inorganic additives tend to destroy the biological function of the tank; organic solvent additives kill bacteria and can contaminate groundwater; and biological additives do little to tanks already full of active bacteria. One study of 48 septic tanks found no difference in sludge level between tanks that used bacterial additives and those that did not (McKenzie 1999). 45 Robinson 2009. www.wsp.org 49 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Recommendations A related issue is the lack of knowledge management prod- along similar lines without further evidence of the benefits. ucts and events to share technical best practice and inno- Therefore it is recommended that award schemes similar to vation. It is recommended that more explicit mechanisms the JPIP should be identified in other provinces, and that should be introduced to collect, document and share tech- efforts should be made to introduce sanitation awards or nical best practice through annual competitions, local tech- criteria into these existing systems. When several provincial nology catalogues, learning events, and newsletters that awards are operational, it will become easier to push for promote cost-effective and innovative products, and high- national recognition of the best performing local govern- light technical issues that need careful attention, such as the ments, and to work towards the creation of a national sani- safe-disposal problem discussed above. tation award system. 8.6 Finance and Incentives 8.6.1 Local Election Cycles The current backlash against incentive schemes among na- The majority of districts in East Java have elections in 2010, tional stakeholders appears to be driven by the belief that which has had a negative impact on sanitation finance due one-time awards, such as those for the achievement of ODF to the diversion of previously allocated sanitation funds to status, may encourage short-term and coercive approaches election-related expenditures. This constraint highlights the with the risk of unsustainable outcomes. While a compre- importance of designing implementation, capacity building hensive system of sanitation incentives and awards with dif- and advocacy activities around the election cycle in order to ferent criteria and objectives should be the ultimate aim, recognize and counter the effects of these political processes. the JPIP model provides a high-profile alternative that has demonstrated the potential to include a sanitation prize 8.6.2 Availability of Credit Facilities into larger award schemes that generate greater incentives, It is recommended that WSP support and document the better information, and high political capital. informal credit mechanisms being developed to finance household latrine construction in East Java. A broad range The narrowly targeted JPIP sanitation award has shown of different approaches is being used, including traditional the value of outcome-based incentive schemes in generat- arisan savings schemes, community-based loans through ing political and bureaucratic support for rural sanitation in local philanthropists, and conventional money lending with East Java, which in turn are important in improving local interest charges. Further work is required to assess whether financial allocations to rural sanitation improvement. these informal credit systems can be improved and scaled up while WSP works with the IFC to examine more formal The JPIP sanitation award was incorporated into an ex- credit options for large-scale sanitation improvement in the isting award of some prestige, and thus gained from the longer term. prior infrastructure and profile of a tried and tested pro- vincial award system, which may not be available in other 8.7 Cost-Effective Implementation provinces. The JPIP sanitation award was also based on a The value of the cost-effectiveness data collected by the detailed benchmarking assessment, which requires annual project remains limited by the quality of the monitoring data collection across the province. This process was facili- data and, in particular, the lack of a reliable measure of la- tated in East Java by project investments in improved moni- trine usage and sustainability in the benchmarking frame- toring systems. Any larger award scheme would first require work. As a result, the effectiveness data is relatively weak, the establishment of a reliable data collection and outcome and there is a risk that these “cost-effectiveness� assessments verification system. remain dependent on supply-side monitoring systems and disconnected from the more reliable household survey data Given limited appetite in government for the national emerging from other instruments and evaluations. ranking of districts based on service provision, and some skepticism regarding outcome-based incentive systems, it Therefore, it is recommended that the annual benchmark- may prove difficult to establish a national award scheme ing and cost-effectiveness assessments include an additional 50 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Recommendations comparison against the latest household survey data in order Similarly, national monitoring systems should enable disag- to evaluate any sustainability losses that are not captured gregated reporting of shared sanitation facilities. At present, by routine monitoring. More routine use of the house- national reports count all users of shared sanitation facilities hold survey data should encourage greater recognition of as having access to improved sanitation, despite awareness the sustainability challenges, more realistic assessments of that there are large variations in the regularity of usage and cost-effectiveness, and more regular evaluation of sanitation hygienic condition of shared facilities. outcomes and program effectiveness. Following discussions during the endline enabling environ- In addition, further work is required to identify the signifi- ment assessment, the project monitoring system will be cant costs expended below district level. Leading districts adjusted so that only co-owning latrine sharers would be like Pacitan have allocated very little district development counted as having access to improved sanitation. This de- budget to rural sanitation, but have leveraged significant cision follows growing anecdotal evidence of partial usage sanitation improvements through effective use of lower and intermittent open defecation among latrine sharers that level resources. The current cost-effectiveness data include have not invested in the construction or maintenance of the only the officially declared district development budget al- shared facility. located to rural sanitation, thus exclude project expendi- tures (some of which may have direct benefits), and exclude 8.8.1 Process Quality Monitoring the increasingly significant expenditures and resource allo- It is recommended that WSP develop a set of process indi- cations made by sub-districts, health centers, other projects cators that enable monitoring of the quality of total sanita- and other stakeholders including future CSR contributions tion and sanitation marketing processes. The intention is by private companies and individuals. that these process monitoring indicators could be readily used to compare process quality against outcomes in order WSP is currently working with Mathematica Policy Re- to identify low quality approaches, and monitor process search to examine discrepancies between the monitoring quality as these approaches are more widely adopted and and impact evaluation data, including the anomaly of the scaled up by other stakeholders across Indonesia. lower ODF success rate found in Phase 2 project districts. It is hoped that this process evaluation will contribute to 8.8.2 Knowledge Management improved understanding of the factors that influence cost- The learning focus of the project argues for a stronger allo- effectiveness, and identify appropriate monitoring mecha- cation of resources for documentation and other forms of nisms and indicators. knowledge sharing. The project team holds huge amounts of learning in their heads, but since little of this knowl- 8.8 Monitoring and Evaluation edge is being documented or shared, there is a substantial The current dependence on the SUSENAS household sur- risk that much of this learning will be lost as the project vey as the main source of sanitation outcome data argues for winds up and key personnel move on to new roles and increased efforts to harmonize the indicators with interna- activities. tional response categories, and improve the disaggregation of these data. In particular, it is recommended that efforts This is particularly true for sanitation marketing, because should be made to elaborate the response categories cem- much of the work in this area has been innovative and plung/cubluk (pit/hole) and lubang tanah (dry pit) as these groundbreaking. Important learning can be gleaned from categories do not allow reliable differentiation between an the disappointing results of the mason training program, improved pit latrine with slab and an unimproved pit latrine the limited utilization of the impressive communications without slab. As a result, there remains some controversy strategy, and the eventual development of the more promis- over national progress reports that include all pit latrines as ing one-stop entrepreneur model. Without rapid dissemi- improved sanitation facilities, despite awareness that some nation of this learning, other stakeholders may follow the of these facilities are likely to be unimproved pit latrines. same route and make the same mistakes. www.wsp.org 51 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Recommendations Finally, it remains important to capture and share as much of the technical in- novation from the project as possible. The open and flexible approaches that are inherent in the project promote innovation, diversity, and cost-effectiveness, as witnessed during the short assessment period. At present, the main system designed to capture and document innovation and diversity, or to share these technical ideas, is the annual stakeholder reviews. Therefore, it is recommended that the project assist the provincial government to develop, among other things: • Annual latrine competition in each area (ceremonial awards for best de- sign, best innovation, best latrine in difficult circumstances) • Technology and product catalogues (updated annually with competition winners) • Annual workshops to share best production techniques and labor-saving devices • Latrine sales competition (awards for highest sales volume, most low-cost sales, most innovative promotional techniques) 52 Scaling Up Rural Sanitation References BAPPENAS (2007) National Operational Strategy for McKenzie (1999) “NC State Produces Landmark Re- Rural Sanitation and Hygiene Improvement in Indonesia search on Septic Tank Additives.� Small Flows news- (draft). Jakarta: Government of Indonesia. letter. Vol. 13. Colin, J. (2009) Urban Sanitation in Indonesia: Planning Nielsen Indonesia (2009) Total Sanitation and Sanitation for Progress. Field Note. Jakarta: The World Bank Marketing Research Report. World Bank Water and Water and Sanitation Program East Asia and the Sanitation Program. Pacific. Rajiv Gandhi National Drinking Water Mission (2005) Nir- Elledge, M., F. Rosensweig, D. Warner, J. Austin, and E. mal Gram Puraskar: A National Award under Total Sani- Perez (2002) Guidelines for the Assessment of National tation Campaign. New Delhi: Rajiv Gandhi National Sanitation Policies. Washington DC: United States Drinking Water Mission, Government of India website: Agency for International Development. Environmen- www.ddws.nic.in. Last accessed 18 August 2010. tal Health Project. Strategic Report 2. Robinson, A. (2005) Scaling Up Rural Sanitation in South Frias, J. (2007) Rural Sanitation Strategies to Meet the Asia: Lessons Learned from Bangladesh, India, and Paki- Sanitation MDGs: An Example from Rural Jawa stan. New Delhi: The World Bank, Water and Sanita- Timur. PowerPoint. Jakarta: Water and Sanitation tion Program South Asia. Program. Robinson, A. (2009) Mid-Term Review of the Sustainable Giltner, S. and A. Surianingrat (2010) Sanitation in In- Sanitation in East Asia—Philippines Component. Ma- donesia: A Market Assessment. Report. International nila: World Bank Water and Sanitation Program. Finance Corporation. United Nations (2009) World Population Prospects: The Government of Indonesia (2008) National Strategy for 2008 Revision. UN Population Division Community Led Total Sanitation Jakarta: Government UNDP (2007) Let’s Speak Out for MDGs: Achieving the of Indonesia, Ministry of Health. Millennium Development Goals in Indonesia. Jakarta: Hawkins, P. (2007) Mission Report 08 Jan–02 Feb 2007: United Nations Development Programme. Development of a National Enabling Framework for WSP (2007a) An Approach that Works: Community Led Sanitation. Indonesia Sanitation Sector Development Total Sanitation in Rural Areas. New Delhi: The World Project. Bank, Water and Sanitation Program South Asia. JMP (2006) Meeting the MDG Drinking Water and WSP (2007b) TSSM Total Sanitation & Sanitation Mar- Sanitation Target: The Urban and Rural Challenge keting: Scaling Up Community Led Approaches to Safe, of the Decade. Geneva: World Health Organisation. Healthy Sanitation and Improved Hygiene Behavior. Joint Monitoring Programme for Water Supply and Water and Sanitation Program East Asia and the Pacific. Sanitation. WSP (2007c) It’s Not a Private Matter Anymore! Urban JMP (2010) Progress on Sanitation and Drinking Water: Sanitation: Portaits, Expectations and Opportunities. 2010 Update. Geneva: World Health Organization, Jakarta: World Bank Water and Sanitation Pro- Joint Monitoring Programme for Water Supply and gram and National Development Planning Agency Sanitation. (BAPPENAS). Kar, K. (2005) Subsidy or Self-Respect? Community Led WSP (2009) Learning at Scale: Total Sanitation and Sanita- Total Sanitation. An update on Recent Developments. tion Marketing Project, Indonesia Country Update June. Brighton: University of Sussex, Institute of Develop- World Bank Water and Sanitation Program. ment Studies. www.wsp.org 53 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Annex 1: Activities in Indonesia Annex 1: Activities in Indonesia The following list details the stakeholders interviewed by Lumajang, 12–15 July the assessment team in Indonesia during 05 to 24 July 2010: 22. Budi Purwanto, District Health, Lumajang 12 July 23. As’at Malik, Vice Bupathi, Lumajang 12 July Jakarta, 05–06 July 24. Heads of Department, Lumajang 12 July 1. WSP Indonesia Team, Jakarta 05 July 25. Pak Nugraha, Chief of Social and Culture Dept. 2. Almud Weitz, Regional Team Leader, WSP Indone- BAPPEDA, Lumajang 12 July sia, Jakarta 05 July 26. Pahadi, District Public Works, Housing and Settle- 3. Djoko Wartono, WSP TSSM Project Manager, Ja- ments, Lumajang 12 July karta 05 July 27. Ibu Enda, District Public Works, Environment 4. Devi Setiawan, WSP Indonesia Co-Country Team Health, Lumajang 12 July Leader, Jakarta 06 July 28. Ibu Juli Haris, Radio Information Center, Luma- jang 12 July Surabaya, 07 July 29. Eva, Dian, and Lia, ex-consultants for Resource 5. Pak Saputra, WSP East Java Province Coordinator, Agency, Lumajang 12 July Surabaya 07 July 30. Dr. Tjahjo Bagus, Head of Puskesmas, Yosowilan- 6. Mohammed Iksan, Provincial Health Department, gun sub-district 13 July Surabaya 07 July 31. Ibu Endanani, Sanitarian, Yosowilangun sub-district 7. Bambang Harsoyo, Provincial BAPPEDA, Surabaya 13 July 07 July 32. Kepala Desa and health volunteer, Desa Karangan- 8. Edy Sudjono, Surabaya ITS, Surabaya 07 July yar 13 July 33. Budi Purwanto, District Health, Lumajang 13 July Jombang, 08–09 July 34. Retailer, Lumajang 13 July 9. Hery Priyanto, District Health, Jombang 08 July 35. Kepala Puskesmas and sanitarian, Senduro sub-district 10. Luna Agustin, District Health, Jombang 08 July 14 July 11. Camat, Peterongan sub-district, Jombang 08 July 36. Pak Harianto and team, and sanitarian, Gucialit 12. Kepala Puskesmas, Peterongan sub-district, Jom- sub-district 14 July bang 08 July 37. Chairman, local association of water CBOs, Guci- 13. Sri Suparmi, Sanitarian Peterongan sub-district, alit 14 July Jombang 08 July 38. Pak Kris, Chief Health Cooperative, Lumajang 15 July 14. Retailer, Jombang 08 July 39. Buntaran, Chief of District Health, Lumajang 15 July 15. Kepala Dinas, District Health, Jombang 09 July 16. Retailer, sub-district, Jombang 09 July Jakarta, 16–23 July 17. Budi Winarno, BAPPEDA, Jombang 09 July 40. Ir. Nugroho, BAPPENAS, Jakarta 16 July 18. Kepala Puskesmas, Sumowito sub-district, Jombang 41. Ibu Ita, BAPPENAS Jakarta 16 July 09 July 42. Nila Mukherjee, WSP Consultant, Jakarta 18 July 19. Sanitarian and mason, Sumowito sub-district, Jom- 43. Dr. Solahudin Imani, Director Environmental bang 09 July Health, MoH Jakarta 19 July 20. Kepala Desa, Sumowito sub-district, Jombang 09 July 44. Ibu Christine, Environmental Health MoH, Jakarta 21. Camat, Sumowito sub-district, Jombang 09 July 19 July www.wsp.org 55 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Annex 1: Activities in Indonesia 45. Begna Edo, UNICEF WES Specialist, Jakarta 21 July 46. Robby Kamarga, UNICEF WES Specialist, Jakarta 21 July 47. Fany Wedahuditama, UNICEF Consultant—WES Secretariat, Jakarta 21 July 48. Eka Setiawan, Plan Indonesia WES Adviser, Jakarta 21 July 49. Grace Retnowati, IFC, Jakarta 21 July National Enabling Environment Learning Event, Jakarta 20 July 50. Mike Ponsonby, WSLIC-2 Team Leader 51. Nina Shatifan, WLSIC-2 Participatory Development Specialist 52. Aldi, BAPPENAS 53. Budi, Plan Indonesia 54. Begna Edo, UNICEF Indonesia 55. Mercy Corps (ϫ3) 56. Arianto, Environmental Health MoH 57. Ari Kamasan, WSP 58. Amin, WSP 59. Wano, WSP 60. Nila Mukherjee, WSP Consultant 61. Devi Setiawan, WSP 62. Djoko Wartonon, WSP 56 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Annex 2: Interview Guide Annex 2: Interview Guide Total Sanitation-Sanitation Marketing (TSSM) Enabling Environment Assessment—Endline Interview Guide for Indonesia Introductions (5 minutes) Notes: • Introductions 1. Questions highlighted in bold type are considered • Appreciation for time “core questions� that should always be asked (if that • Purpose of interview dimension is relevant to the interviewee). • Confidential, won’t use name or other identifying 2. Questions marked with an asterisk “*� are consid- information ered suitable for use in FGDs. • Have series of questions, but not exclusive of other questions 1. Policy, Strategy, and Direction Establishing a shared vision and strategy and ensuring the po- NB—For TSSM, it will be essential to define “rural sanita- litical will to implement a program is the starting point for tion� and what is being promoted in the national/provincial scale up. Developing this shared vision and strategy in a col- context (in the purpose of interview). laborative manner is also the foundation for coordination and for creating motivation at all levels. Opening (10 minutes) • Tell me something about the importance of 1. To what extent is there political will and support Sanitation. to expand access to and use of sanitation facili- • Tell me something about your organization and ties, and at what levels (national, province, dis- briefly what your organization does to support trict, local)?* TSSM/sanitation work. And what you plan to do. 2. If not, what is needed to generate stronger political will and support? Who are the key decision-makers Dimensions Interview (50–60 minutes) whose political support is needed? Use attached interview guide. 3. What are the best channels for influencing policy relevant to the program?* How are sanitation pol- Closing (5 minutes) icy and decision-makers held accountable by rural • What do you see as the single most important suc- households? cess factor in the TSSM project?* 4. If there is a political will for sanitation in general, • And what would you recommend be done to im- to what extent is there political will to use: prove the environment in which this sort of project a. the total sanitation approach (focused on will be successful and sustainable?* ODF)? • Thanks for his/her time. b. the sanitation marketing (SM) approach? www.wsp.org 57 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Annex 2: Interview Guide 5. Evidence: what policy changes, budget allocations, TSSM project in terms of the following institutional or program activities have people or organizations functions: already made to follow up on that political will? Are a. setting policy more changes needed for the sanitation program to b. developing program methodology be successful? c. implementation (start-up, IEC, latrine construc- 6. What are the key policy barriers to scaling up the tion, institutional sanitation) program and how are they being addressed? (e.g., d. program coordination related to policy alignment, subsidies, availability e. training of products, policy on dry toilets etc.)* f. monitoring and evaluation (ODF status, in- 7. Are the overall goal and specific objectives of the centives, progress towards objectives, impact program clear and understood? Is there a shared vi- assessment) sion and direction among key stakeholders (at all 3. To what extent are these implementation arrange- levels)? What is this shared vision? ments (roles and responsibilities) clearly defined? 8. Has a detailed strategy (and investment plan) to Are existing institutional arrangements adequate meet these objectives been developed? Is there for effective large-scale implementation (to meet coordinated implementation by key stakehold- program objectives)? ers (at all levels)? What are the key elements of 4. Have reforms been required to support large-scale the strategy? Have targets been set to support the implementation? What implementation mecha- achievement of strategic objectives? nisms are already in place? If still being put in place, 9. What are the strengths and weaknesses of this strat- then what is the process? egy? What recommendations would you make to 5. What mechanisms have been established for coor- overcome these weaknesses? Who needs to act and dination among relevant partners (at national, pro- how? vincial and district levels)? How many “coordination 10. What are the institutional incentives, e.g., finan- points� are active? cial, recognition, training, at the national, province, 6. How well are coordination mechanisms working and local government levels, that support program (when was the last meeting)? Have any coordina- implementation? What additional incentives might tion bodies collapsed or proved redundant? How be needed? might they be improved?* 11. Which organizations, individuals, or agencies could 7. Has the program fully explored potential strate- act as champions or catalysts for the program? What gic alliances with public, private, and NGO sec- would it take to mobilize them successfully? Note: tor organizations? What has been done to explore these might include government units and programs, these potential strategic alliances? What/who has NGOs, CBOs, and for-profit companies. been considered (or excluded)? 8. Are partners fully aware of the overall goal and ob- 2. Institutional Arrangements jectives of the program? Do partners participate Institutions at all levels must clearly understand their roles, actively in planning decisions and discussions? responsibilities, and authorities. They must also have the re- 9. How would you describe the quality of the partner- sources to carry out their roles. In addition to clear roles and ships between district/municipal governments and im- responsibilities, institutional arrangements must include the plementing NGOs? How might they be improved?* mechanisms for actors at all levels to coordinate their activities. 10. How would you describe the working relationships be- tween the partners (e.g., NGOs) and the communities 1. What process has been/is being used to plan this with which they work? How might they be improved? program? Who is involved? 11. To what extent (and how) have partners integrated 2. How has the project/program been organized? the program into their ongoing activities and/or Please describe the institutional set-up for the budgets? To what extent do they plan to do so?* 58 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Annex 2: Interview Guide 3. Program Methodology 1. How would you rank capacity (financial, human The program methodology consists of the program rules, specific resources, training, technology, transport) to imple- activities and their timing and sequence. Each country will ment and monitor the main program components adapt and apply the program methodology making it specific at different levels: national, provincial, district, com- and appropriate to the country context. A workable program munity (1 lowest–5 highest): methodology that is clear and agreed upon by all key stakehold- • Total sanitation ers is a key programmatic condition. • Sanitation marketing • Enabling environment improvements 1. To what extent is there a defined and detailed meth- 2. What resources are in place to build, strengthen and odology for implementing the program?* support the required capacity? What is lacking? 2. Is the methodology achieving the desired out- a. Financial comes and objectives? Is it being implemented at b. In-kind large scale? If not, does the methodology need to c. Human resources be modified for large-scale implementation? d. Capacity building/training (skills development) 3. To what extent is the program methodology e. Technology widely understood and accepted by program 3. Are capacity building mechanisms effective? How is partners and implementers? Who has the main this effectiveness monitored? responsibility for implementation of the program 4. Where/what are the biggest capacity constraints methodology?* (barriers to progress)? What is/will be needed to 4. How fully/effectively has this program method- implement this program at larger scale (hiring ology been applied? What challenges have been staff, training, increased financial resources, in- experienced? What improvements would you centives etc.)? recommend?* 5. To what extent is there adequate capacity to plan 5. What kind of evaluation (if any) has there been of and implement behavior change activities in the this methodology? government sector? What about among NGOs? 6. How has the methodology been documented? How Among other major stakeholder groups (e.g., pri- complete is it? How useful and operational is the vate sector)?* documentation? 6. Describe a behavior change program you consider 7. How easy would it be for someone else (e.g., another successful (at national or provincial level). What agency) to implement the program methodology in made it successful?* another location (e.g., another province)? Would the 7. To what extent is there adequate capacity in the pri- methodology achieve similar outcomes in another vate sector to provide affordable goods and services location, or are the methodology and outcomes par- and respond to consumer preferences? Will the pri- ticular to East Java? vate sector be able to respond to increased demand as the program scales up? If not, what mechanisms 4. Implementation Capacity are in place to build private sector capacity and local Institutions at all levels must have the institutional capacity markets? to carry out their roles and responsibilities. Institutional ca- pacity includes adequate human resources with the full range 5. Availability of Sanitation Products, of skills required to carry out their functions, an “organiza- Services, and Information tional home� within the institution that has the assigned re- Target consumers ability to adopt improved behaviors is highly sponsibility, mastery of the agreed upon program methodology, dependent on the availability and affordability of appropri- systems and procedures required for implementation, and the ate products, services and information. Any and all products, ability to monitor program effectiveness and make continual services and information need to be considered, specific to each adjustments. country situation. www.wsp.org 59 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Annex 2: Interview Guide 1. How would you rank the availability and consistent and promotion activities. It also examines incentives for scaling supply of the following Sanitation product and ser- up, improving quality and meeting program targets. vices? [1 lowest to 5 highest] • Direct sanitation services (i.e., sanitation ma- 1. Are you aware of the costs of implementing the pro- sonry and construction) gram? Which costs (breakdown)? • Related sanitation services (i.e., provider financ- 2. To what extent is sustainable financing available to ing and transportation) meet the costs of implementing the program? (costs • Key sanitary products (i.e., ceramic pans and such as staff salaries, training, transport, etc.)* plastic slabs) 3. Do current arrangements for program financing en- 2. Have there been any improvements in the avail- sure adequate, timely and predictable payments to: ability, affordability or quality of sanitation goods • Districts and services since 2007? If so, what enabled these • Program partners (e.g., NGOs) improvements? • Communities/local governments 3. Are products/services reasonably priced for the poor 4. Who is responsible for financial planning? Could and of dependable quality? Is there a range of op- this process be improved? tions for other unserved groups (non-poor, tribal 5. What are the financing opportunities and willing- etc.)? ness to finance among public (or other) agencies at 4. Is information readily available on the quality and national, provincial, and local levels?* price of different product/service options? How can 6. To what extent have promotional activities been rural households access this information? included in provincial-, district-, and local-level 5. Do existing policies and guidelines influence or limit budgets? Are these budgets adequate for the re- the range of sanitation goods and services available quired promotional activities? to households (e.g., fixed ideas on technology)? 7. How are households mobilized to invest in sani- 6. What should the government start doing (or stop tation facilities? What schemes or mechanisms are doing) to facilitate increased availability and con- in place to mobilize households? Are any of these sistent supply of sanitation products and services? mechanisms aimed at the poorest households? 7. What should the government start doing (or 8. To what extent are there local opportunities to fund stop doing) to ensure affordability and depend- community and/or household investments (such able quality of the above sanitation product and as micro-financing, group savings/credit schemes, services? capital for initial investments)? Is credit available for 8. Are there any local institutions (government agen- toilet upgrades? cies or civil organizations—i.e., associations) in 9. Is credit available to local entrepreneurs/producers? place to facilitate the availability, affordability, or If so, who provides the credit and on what terms? quality of the above sanitation product and services? If not, does this lack of credit affect the availabil- If so, can you name them and detail their function ity, affordability or quality of sanitation goods and and responsibilities? How would you rank the ef- services? forts made by these institutions [1 lowest/worst to 10. To what extent will the national government be able 5 highest/best]? to sustain the costs of implementing the TSSM ap- proach after the program is over? What needs to be 6. Financing and Incentives done to ensure continued financial support (and on- This dimension assesses the adequacy of arrangements for fi- going monitoring and follow-up) from the national nancing the programmatic costs. These costs include training, government? staff salaries, transportation, office equipment and supplies, 11. Are there any incentives/rewards/benefits available and the development of communication and education materi- to high performers? Anything to encourage people als as well as programmatic line items in budgets for program to become actively involved in sanitation programs? 60 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Annex 2: Interview Guide 7. Cost-Effective Implementation Effective monitoring will identify strengths and weaknesses in While it will not be possible to assess the cost-effectiveness of the the program methodology, implementation arrangements, and approach and how best to achieve economies of scale until the cost efficiencies. Overall monitoring responsibility must be at end of the project, data must still be collected during imple- the highest level of the program, but must be based on informa- mentation to make this determination at the end of the project. tion collected at the local government or district-level. Therefore, the focus in this assessment is to ensure that infor- mation will be collected from the outset and that the capacity 1. What are the most important program monitor- to collect the information is in place—systems and procedures ing indicators? What is the main use of the moni- for collecting cost information and capacity to use and collect toring data? it exist. 2. Is there sufficient monitoring capacity at the na- tional/provincial/district levels? 1. How is “effective implementation� measured? Is 3. Is there a national monitoring process that mea- there any distinction between program outputs sures program effectiveness and outcomes (or col- (e.g., nr. toilets) and program outcomes (e.g., lects this data from the program)? toilets in use, improved sanitation behaviors and 4. Is there any performance benchmarking across health indicators)? program units (e.g., districts)? Has this bench- 2. What information do you collect on program marking had any impact on policies, activities, or costs (e.g., hardware, software, program, partner investments?* costs etc.)? 5. How will the monitoring (local and national) be 3. What assessments are made of cost-effectiveness?* sustained once the main program activities are What factors influence cost-effectiveness? Has complete? anything been done to improve cost-effectiveness? 6. What other sectors (whoever you are not interview- ing) have strong M&E components and which or- Note: It might be necessary to explain difference between ganizations facilitate the process at different levels? cost efficiency (cost per output) and cost effectiveness (cost per What other monitoring processes provide informa- outcome/impact). tion to the program (e.g., health data)? 7. To what extent is the (current or planned) pro- 4. How is the size of the targeted and affected (benefi- cess sufficient to monitor quality of services, ciary) program population assessed?* (give example outcomes, identify gaps and weaknesses, and de- if possible) termine lessons learned and best practices?* 5. Does the program depend on other non-permanent, 8. What is the most effective M&E tool for learn- supporting programs or resources (e.g., use of sala- ing, identifying weaknesses and driving improved ried local government staff )? Is any information col- performance? lected in order to measure these supporting costs? 9. What would be required to replicate the TSSM 6. To what extent does the capacity exist at the local M&E systems/processes in another location (e.g., government and provincial level to produce cost- province)? effectiveness data?* What needs to be done to ensure 10. What technical, administrative or financial im- that this information is collected and reported? provements or support are needed to ensure that the existing monitoring systems are adequate to support 8. Monitoring and Evaluation an expanded program? Large-scale sanitation programs require regular monitoring 11. What incentives exist to engage in and apply the re- and perhaps more importantly, the willingness and ability to sults of monitoring activities? What might encour- use the monitoring process to make adjustments in the program. age programs to value monitor? www.wsp.org 61 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Annex 3: Terms of Reference Annex 3: Terms of Reference Endline Assessments of the Enabling Environment water supply and sanitation services. Administered by the to Scale Up, Sustain, and Replicate Sanitation World Bank with financial support from several bi-lateral, Approaches in the Global Scaling Up Rural Sanitation multi-lateral, and private donors, WSP is a decentralized Project in Indonesia, India, and Tanzania partnership and operates through offices in Africa, East DRAFT Revised: February 25, 2010 Asia, Latin America and South Asia. A major thrust of the programs is to help its clients prepare for and implement 1. Overview of TOR actions towards meeting the water supply and sanitation The Water and Sanitation Program (WSP) is in the final (WSS) Millennium Development Goals (MDGs). In pur- phase of a project entitled “Total Sanitation and Sanitation suing their mission, WSP staff provides advisory support to Marketing: New Approaches to Stimulate and Scale up projects and policies to help identify and disseminate best Sanitation Demand and Supply.� The project has as one of practices and lessons from experience across countries, assist its central objectives to improve sanitation at a scale suffi- clients in the implementation of pilot projects to test out cient to meet the sanitation MDG targets by 2015 in Indo- new ideas, and facilitate informal networks of practition- nesia, Tanzania and the Indian states of Himachal Pradesh ers and sector stakeholders. Additional information about and Madhya Pradesh. WSP can be found on the program website (www.wsp.org). The purpose of this consultancy is to carry out an endline The Water and Sanitation Program is implementing the assessment of the programmatic conditions needed to scale “Total Sanitation and Sanitation Marketing (TSSM): New up, sustain and replicate the total sanitation and market- Approaches to Stimulate and Scale Up Sanitation Demand ing approaches. The programmatic conditions are the eight and Supply Project.� This project has the primary goal of dimensions that are defined in the conceptual framework learning about scaling up and about effective and efficient in Section 3 of this TOR. Scale up is defined as meeting sanitation interventions that improve health. The TSSM the 2015 MDG targets in each country. Sustainability is project is a large-scale effort to meet the basic sanitation needs defined as the ability to maintain programs after external of the rural poor who do not currently have access to safe and funding has ended. Replication is the eventual application hygienic sanitation. That aim will be accomplished by devel- of the TSSM approach in other countries at scale. oping the practical knowledge for designing sanitation and hygiene programs that are effective at improving health and The endline assessments will be carried out during the final are sustainable at large scale for rural areas. The project will phase of the overall project during late 2010 and early 2011. test proven and promising approaches to create demand for The endline assessments in each country will be carried out sanitation, and to use marketing techniques to improve the by two-person team consisting of an international special- supply of sanitation-related products and services. ists and a local consultant of country WSP staff member. The consultant teams will be hired as independent consul- The project is designed to achieve key milestones in each tants but will function as one overall team under the di- country at the end of four years of project implementa- rection of the WSP Country Task Manager for the TSSM tion (including the start up period) that will facilitate the project with support from the Global Task Team Leader. achievement of the MDG 2015 sanitation targets. These milestones should indicate if the key program elements 2. Background/General Description are in place by mid-2010 to meet the 2015 MDG targets. The Water and Sanitation Program (WSP) is an interna- The specific targets for scaling up in each country are in tional partnership to help the poor gain sustained access to Table 10. 62 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Annex 3: Terms of Reference TABLE 10: GEOGRAPHIC AREAS AND BENEFICIARIES Estimated Estimated Number Vision of Number of Number of People of People Who Will Additional People Who without Access to Gain Access to Will Get Access to Sanitation in Sanitation during Sanitation by 2015 to Geographic Areas Where the Project Will Take Place/Population 2006* Two-Year Pilot Phase Meet MDG Targets** Tanzania (rural)/26.7 million in 2006 14.25 million 750,000 6.5 million Indonesia (East Java province)/36.5 million 18.6 million 1.4 million 10 million Indian state of Himacahal Pradesh (rural)/5.5 million rural population 4.3 million 700,000 1.2 million Indian state of Madhya Pradesh (rural)/45 million rural population 43.6 million 1.1 million 20 million Totals 80.75 million 3.75 million 37.7 million * Best estimates given poor status of data. ** Accounts for population growth estimates. The purposes of this terms of reference are to 1) assess to ex- dissemination of lessons learned. This final programmatic tent to which the programmatic conditions for scale up and assessment will take place during Phase III. sustainability have improved by the end of the TSSM proj- ect and, 2) on the basis of the endline assessment findings In the larger sense, the assessment will answer the question and learnings, recommend what should be done to address whether there is an enabling environment in place in each the gaps during the remainder of the TSSM project imple- country that can continue after the end of this project and mentation period or for the future if a follow on project meet the MDG targets by 2015. is undertaken. Determine if the programmatic conditions are in place to meet the 2015 MDG targets and are likely 3. Conceptual Framework to be sustained over time. The fundamental question that In order to ensure consistency in the assessment findings, the assessment is intended to answer is whether the country WSP developed a conceptual framework for assessing scal- can continue to scale up after 2010 without assistance, with ability. This framework was developed based on a review of less assistance or with different assistance, from the TSSM relevant literature and discussions with key individuals. The Project and whether the TSSM project conditions are in- framework consists of eight dimensions that are considered stitutionalized to support scaling up in a sustainable man- essential to scaling up the total sanitation and sanitation ner. Strengthening the enabling environment is integral to marketing approaches in rural areas using on-site sanitation increasing demand at the household and community levels facilities. and improving the supply of affordable and appropriate sanitation products and services. • Policy, strategy, and direction • Institutional arrangements The overall TSSM project is four years in duration with • Program methodology three distinct phases. Phase I—December 2006 to August • Implementation capacity 2007—is the initial six to nine month start-up period for • Availability of products, tools and information detailed studies, planning, and procurement at the global • Financing and incentives and country level. Several assessments including the one for • Cost-effective implementation scalability, approaches for demand creation, sanitation mar- • Monitoring and evaluation keting, and the baseline for the impact evaluation will be carried out during this period. Phase II is the three-year im- In the rest of this section, each of these dimensions is de- plementation period and Phase III is the three to six month fined along with key questions to answer during the assess- wrap-up phase that will include the final evaluation and ment. These questions are not intended to be answered www.wsp.org 63 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Annex 3: Terms of Reference analytically. Rather the assessment should determine to 3.2 Institutional Arrangements what extent each aspect exists at the beginning of the TSSM In order for the total sanitation and sanitation marketing project and then measure the changes after the two years of approach to be scaled up, the right institutions must be in project implementation in the final assessment. place with all key roles and functions covered. The assess- ment must determine if the current institutional setup is Definition of Scale-up: Increase the scale, rate of provision, adequate to scale up the TSSM approach. Institutions at all and sustainability of sanitation services to reach the three- levels must clearly understand their roles, responsibilities, year 2010 targets in the TSSM project and the MDG targets and authorities and must also have the resources to carry for 2015. The specific targets are provided in Table 10. out these roles. In addition to clear roles and responsibili- ties, mechanisms should exist for actors at all levels to co- 3.1 Policy, Strategy, and Direction ordinate their activities and establish partnerships between Establishing a shared vision and strategy and ensuring the the public, private, and NGO sectors and between com- political will to implement it is the starting point for scale munities and local governments. up. Without political will and a shared vision and strat- egy among stakeholders at all levels, scale up will remain an • Is the current institutional setup adequate to scale elusive goal. Developing this shared vision and strategy in up the TSSM approach and reach the MDG targets? a collaborative manner is also the foundation for coordina- • Are there clear implementation arrangements includ- tion and for creating motivation all levels. ing well defined roles and responsibilities at all levels? • Have mechanisms been established for national Policy is defined as the “set of procedures, rules and al- level coordination (and in the case of India, state location mechanisms that provide the basis for programs level coordination) among relevant national or state and services. Policies set the priorities and often allo- agencies? cate resources for implementation. Policies are reflected • Have partnerships been developed between local in laws and regulations, economic incentives, and the government and NGOs that act as intermediaries assignment of rights and responsibilities for program with communities and the private sector that pro- implementation.�46 vides sanitation products and services? • Have sustainable institutional support mechanisms • Does political will to expand access to and use of to support the community after the initial phase of sanitation facilities through the total sanitation and implementation been established? sanitation marketing approaches exist at the na- tional, state/provincial, and local government level? 3.3 Program Methodology Is the level of political will adequate to achieve MDG Total sanitation and sanitation marketing are two comple- targets and objectives at scale? mentary approaches to scaling up sanitation, but they are • Have the key policy barriers essential to scale up not detailed program methodologies. A program methodol- been identified and are they being addressed? ogy consists of the program rules, specific activities and their • Are there institutional incentives at the national, timing and sequence. Each country must develop a program state/provincial, and local government levels that methodology based on these approaches that is specific and support program implementation? appropriate to the country context and covers all phases of • Do champions exist that act as catalysts for the program? project implementation including demand creation. A work- • Is there a shared vision and strategy among key able program methodology that is clear and agreed upon by stakeholders at all levels that will provide direction all key stakeholders is a key programmatic condition. Since and a basis for effective coordination? one of the objectives of the TSSM project is to establish a 46 Elledge M, Rosensweig F, and Warner D, Guidelines for the Assessment of National Sanitation Policies, EHP Strategic Report 2, July 2002. 64 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Annex 3: Terms of Reference workable program methodology, it is unlikely that a widely • Does the absorptive capacity exist to implement accepted program methodology will be in place at the time TSSM at scale? of the baseline assessment. Nevertheless, the extent to which there is a program methodology in place should be assessed. 3.5 Availability and Knowledge of Sanitation Products and Services • Is there a defined and detailed program methodol- The sanitation marketing approach is predicated on the ex- ogy for implementing the total sanitation and sani- istence of the sanitation services and products that respond tation marketing approaches? Has the methodology to consumer preferences and their willingness and ability been documented and disseminated? to pay for them. The focus of this scalability assessment as- • Is the program methodology widely understood and signment should be on the role of government in creating accepted by program implementers? an enabling environment for the private sector. The role • Has the methodology been applied in practice or it of government is not to contract directly with the private still awaiting application? If it has been applied, has sector, but rather to assist in creating a market for sanita- it been evaluated and adjustments made? tion products and services and build the capacity of private providers. The role of government in creating an enabling 3.4 Implementation Capacity environment for the local private sector should be assessed Clearly defined and workable institutional arrangements are in this enabling environment assessment. necessary but not sufficient for programs to operate at scale. In addition, institutions at all levels and including both gov- • Has the government (national or local) created con- ernment staff and contracted organizations must have the ditions that facilitate, enable, and provide the right capacity to carry out their roles and responsibilities. Insti- incentives to consumers and providers? tutional capacity includes adequate human resources with • Is the government playing a role in facilitating the the full range of skills required to carry out their functions; flow and access of information related to the avail- an “organizational home� within the institution that has the ability of sanitation products and services in the local assigned program responsibility; mastery of the agreed upon private sector? program methodology, systems and procedures required for • Is the government playing any kind of regulatory or implementation; and the ability to monitor program effec- related role (such as certifying providers) to protect tiveness and make continual adjustments. the consumers? • Is there adequate capacity (in terms of numbers and 3.6 Financing and Incentives skills) in social intermediation in order to create de- This dimension is aimed at assessing the adequacy of arrange- mand and facilitate community and household level ments for financing the programmatic costs of a scaled up pro- action at scale? gram. These costs include social mobilization such as training, • Is there adequate capacity in hygiene promotion? staff salaries, transportation, office equipment and supplies, • Are there adequate incentives in place to motivate and the development of communication and education ma- staff involved in social intermediation and hygiene terials. In addition, programs must establish the mechanisms promotion? that enable communities to achieve improved and total sani- • Has capacity been built in the private sector to tation and ensure that individual households have the means provide quality goods and services (i.e. training of to pay for on-site sanitation facilities. This is especially impor- plumbers and masons), supply affordable compo- tant to ensure that the poorest members of the community nents, market their services, and respond to con- are able to afford sanitation facilities and therefore help com- sumer preferences at different levels of service? munities achieve open defecation free status. • Has capacity been developed at national/state and local government levels to oversee and monitor pro- • Is there sustainable financing to pay for the ongo- gram implementation at the community level? ing programmatic costs including identification of www.wsp.org 65 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Annex 3: Terms of Reference the financing sources and mechanisms for long-term monitoring will identify strengths and weaknesses in the behavior change? program methodology, implementation arrangements, and • Is there a workable mechanism in place to mobilize cost efficiencies. Overall monitoring responsibility must be household investment in sanitation, especially for at the highest government level of the program but must be the poor? (e.g., microfinance schemes or community based on information collected at the local government or financial incentives.) district level. • If needed, are the financial mechanisms in place to • Does an M&E process at the macro level exist to enable the poor to move up the sanitation ladder? measure program effectiveness and outcomes? • Is there a clear understanding among stakeholders • Is there a commitment at the local government level regarding financial responsibilities? to monitor program implementation? • Are there incentives that support scaling up? • Does the capacity exist to implement the M&E • Are there incentives to communities and institutions process? that recognize their participation and achievements • Is the process sufficient and independent to monitor and also ensure long term sustainability for behavior quality of services, identify gaps and weaknesses, and change? determine lessons learned and best practices? • Has M&E been institutionalized so that evaluations 3.7 Cost-Effective Implementation and mid-course corrections are an ongoing compo- The potentially high costs of social intermediation at scale nent of the program? make cost-effective implementation a key element. It is es- sential to understand how the unit costs change as activities The conceptual framework above is the original framework are scaled up. While it will not be possible to assess the cost developed at the start of the global TSSM project. The effectiveness of the approach and how best to achieve econ- country teams have had significant experience and related omies of scale until the end of the project, data must still learnings over the past three years regarding the conceptual be collected during implementation in order to make this framework and conceptual thinking has evolved. determination at the end of the project. Therefore the focus in the scalability assessment is in ensuring that information 4. Scope of Work will be collected from the outset and that the capacity to International Specialist Consultant collect the information is in place. The tasks in the scope of work are divided into three over- all phases: preparation, endline assessment in the field and, • Do program implementers at all levels know what capturing and documenting learnings. The international information must be collected on program costs? consultant will carry out all of the tasks in these three • Does the capacity exist at the local government and phases, with assistance from the WSP country teams dur- state/provincial level to collect the information? The ing the main periods of fieldwork. capacity includes the systems and procedures to col- lect the information, a focal point of responsibility 4.1. Review key background and program documents including assigned staff, and the commitment to col- provided by WSP. Participate in a planning meet- lect the information on a regular basis. ing with the Global TSSM Task Team Leader. This • Does the applied strategy and approach have any may take place in WDC or in a mutually convenient economies of scale? meeting place in Europe. The objectives of the plan- ning meeting will be to ensure that the international 3.8 Monitoring and Evaluation consultant understands the background and objec- A large-scale sustainable sanitation program requires regular tives of the assessment; what expectations are in monitoring and perhaps more importantly, the willingness terms of deliverables, etc. and ability to use the monitoring process to make adjust- 4.2. Work with the respective WSP Country TSSM ments to improve and strengthen the program. Effective Task Managers via email and phone as needed to 66 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Annex 3: Terms of Reference develop a work plan and schedule for the endline determined by the consultant team, the assessment assessments, including agreement and arrangement is expected to include the following aspects: of preliminary meetings (in order to reduce the time • Review of key documents (assessment reports, spent in the capital on arrival). progress reports, sector strategies, laws, regula- 4.3. Travel to each country and participate in a planning tions, etc.) meeting in each of the countries with the TSSM • Meetings with key stakeholders including gov- country task manager, the WSP coordinator or ernment officials at the national, provincial, and STC consultant assignment to be part of the end- local government levels; private sector providers line assessment team in support of the international of sanitation products and supplies; NGOs; and specialist, and other TSSM team members as appro- donors priate. The purpose of the meeting will include pro- • Debriefing state, provincial, and national govern- viding the international consultant with an update ments as appropriate to test the validity of key on work done and related accomplishments in the findings enabling environment and also to include a review 4.6. Based on the results of the endline assessments, for- and discussion of the self-assessed “spider diagram� mulate recommendations for improved implemen- progress reports showing progress in strengthen- tation and for creation of the enabling environment ing the enabling environment. This initial meeting necessary to meet the 2015 MDG targets. should also allow the country team to share learn- 4.7. Debrief the WSP Country TSSM Task Manager, ings about the process of strengthening the enabling and as appropriate, other WSP country staff and key environment since the baseline with the consultant. government officials responsible for the program. Finally, as needed, the meeting should also confirm The consultant should discuss the recommendations any related administrative or travel related logistics and actions needed to strengthen those elements for the field assignment. that were found to be blockages to scaling up rural 4.4. Finalize the interview protocols for the respective sanitation. countries based on the baseline documents and any 4.8. Write a report with findings, recommendations for new information or revised analytical framework moving forward and filling remaining gaps in the en- provided by WSP-WDC or WSP-Countries either abling environment and, lessons learned by the WSP before or during the initial planning meeting (as per team, government partners and other stakeholders 4.3 above). For example, while the original concept as appropriate using the format that is agreed upon and related baseline focused on the enabling envi- in the team planning meeting. As a starting point, ronment at the national or state government level, the basic report will look like the baseline reports WSP countries have in many cases extended the (see WSP website to review each of the reports) and concept to local government levels. The conceptual revise and improve as appropriate and agreed to with framework is intended to provide a common ap- the Global TSSM Task Team leader. proach to the assessment so that the results are com- 4.9. When all the country reports are completed, the parable across countries. Each dimension has a set of consultant will then prepare a global report that syn- questions to be answered during the assessment. The thesizes the findings and recommendations from all consultant will be responsible for determining what three countries. Among other things, the synthesis information needs to be collected to answer these report should identify and discuss common cross- questions, how the information will be collected, global findings and recommendation. The starting and for developing interview protocols. point for the format of the approach should be the 4.5. Carry out the endline assessment of the program- synthesis report prepared on the baselines assess- matic elements required for scale up of the total san- ments (report can be found on WSP website). itation and sanitation marketing approaches. While 4.10. Based on this assignment, prepare a guidance the specific activities for each assessment will be document for carrying out enabling environment www.wsp.org 67 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Annex 3: Terms of Reference assessments for rural sanitation programs. This (India report to include both HP and MP in sepa- document will be similar to the guidance note de- rate sections). As a starting point, the outline for the veloped for carrying out a handwashing enabling en- report should be as below. Final revision of the out- vironment assessment that can be found of the WSP line should be carried out during the initial global website. planning meeting. 4.11. Based on the lessons from this assignment and the • Introduction. This section should explain the overall TSSM Global project experience, prepare a context and purpose of the assessment, summa- WSP Learning Note on the challenges and oppor- rize the TOR, and explain the methodology of tunities for strengthening the enabling environment the assessment. for large scale rural sanitation programs. • Summary of conceptual framework and assess- ment dimensions that guided the assessment WSP Coordinator • Summary of findings WSP should provide one experienced staff member (prefer- • Policy, strategy, and direction ably one of the TSSM project field coordinators) to assist • Institutional arrangements with the implementation of the endline assessments. • Program methodology • Implementation capacity • Availability of products and tools Preparation • Financing • Develop list of stakeholders (at central, provincial • Cost-effective implementation and district levels) • Monitoring and evaluation • Collect local policies, strategies, and other back- • Conclusions. Based on the specific findings, this ground documents section should summarize the overall conclusions • Collect and organize all enabling environment spi- of the assessment team, especially those that are der diagrams and related documentation cross-cutting and not captured in the findings for • Assist in review of background documents (arrange each assessment dimension. translation where appropriate) • Recommendations. These are specific recom- • Set up meetings and plan field visits for assessment mendations that may still be needed to fill any (with WSP assistance) remaining gaps in the conditions necessary for • Plan feedback/debrief sessions scale up and sustainability. • Organize logistics for assessment • Action plan directly based on the recommen- dations in the assessment report. This section Endline assessment should include the following: • Participate in team planning meeting a. Actions that need to be taken. Where possible, • Participate in finalizing (and translating if needed) these actions should be linked to existing pro- interview protocols and questionnaires grams that are seeking similar reforms. • Participate with international consultant in all field b. Sequence in which they should be addressed work related to the endline assessment and a timeline. • Assist with translation (if needed), processing and c. Skills and expertise and estimated LOE needed analysis of information from assessment to implement the actions. • Assist with debrief of WSP and government officials d. Expected implementation challenges, risks, and assumptions. 5. Expected Products/Outcomes • A final section in the report with lessons learned 5.1. The international consultant will be responsible for by the WSP team and government partners in the following deliverables: An Enabling Environ- strengthening the enabling environment for a ment Endline Assessment Report for each country large-scale rural sanitation program. 68 Scaling Up Rural Sanitation Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Annex 3: Terms of Reference 5.2. A global synthesis report. This should be a short (no enabling environment for large-scale rural sanita- more than 30 pages) synthesis of the findings, con- tion programs. Learning notes are 2–4 pages long clusions, and recommendations from the enabling and designed to be accessible for a wide audience. environment endline assessments in all three coun- Therefore, they should be written in a non-technical tries. The suggested draft outline is based on the syn- language and can incorporate graphics (maps, pho- thesis report for the baseline enabling environments tographs, charts, etc.). Each note includes the fol- and can be revised based on an agreement with the lowing sections: Introduction, Problem Statement, global task team leader: Action, Key Learnings, and What Else do We Need • Executive summary to Know? • Introduction with relevant background and context 6. Personnel and Estimated Level of Effort • Summary of country projects The assessment in each country will be carried out by a • Analysis by dimension two-person team consisting of an international consul- 1. Policy, strategy and direction tant and a WSP coordinator. The international consultant 2. Institutional arrangements should have the following qualifications: 3. Program methodology 4. Implementation capacity • 15 years of experience in the water supply and sani- 5. Availability and knowledge of sanitation tation sector, especially in project design and imple- products and services mentation and sector reform 6. Financing and incentives • Extensive consulting experience 7. Cost-effective implementation • Significant and in-depth experience in institutional 8. Monitoring and evaluation development • Overall conclusions • Knowledge of sanitation and the related institutional 5.3. A guidance document for carrying out enabling envi- and programmatic issues ronment assessments for rural sanitation programs that • Excellent communication and report writing skills are large scale and sustainable. The following draft out- in English line is based on a similar guideline developed for hand- washing and should be considered as a starting point: 7. Estimated Schedule • Purpose of the guideline A detailed schedule is suggested in the attached annex. Final • Background scheduling will depend on specific arrangements worked • Understanding what is meant by scalability and out with each WSP TSSM country team for the field mis- sustainability sions. The general timing should be as follows: • Assessment methodology including description of conceptual framework and related dimensions • Preparation: July 01–21, 2010 • Annexes (resources and tools to be used by assess- • India: late July 22 to late August ment team): • India final reports (HP & MP): mid-December • Sample TOR • Indonesia: late September to late October • Sample study protocol • Indonesia final report: mid-December • Sources by Dimensions Table (blank table used • Tanzania: mid-Jan to mid-Feb 2011 to identify the dimensions relevant to inter- • Tanzania final report: end March 2011 views with stakeholder organizations) • Synthesis final report: end April 2011 • Proposed report outline • Enabling Environment Assessment Guidance Note: • Interview guide May 2011 5.4. A WSP learning note on the experience, chal- • Enabling Environment Emergent Learning Note: To lenges, and opportunities for strengthening the be determined www.wsp.org 69 Scaling Up Rural Sanitation in Indonesia: Enabling Environment Endline Assessment Annex 3: Terms of Reference 8. Management and Logistical Support The consultants will report to the WSP Global TSSM Task Team Leader (Eddy Perez) with support as needed from the respective WSP TSSM Country Task Managers. All international travel logistics and administrative support will be provided by the WSP-WDC. All local travel and administrative support will be provided by the respective WSP country teams. 70 Scaling Up Rural Sanitation