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How to Scale Up Rural Sanitation Service Delivery in Indonesia

Global Delivery Initiative • September 2015 EN
Uploaded by Global Delivery Initiative • 27 June 2021

Authors: Sarah Glavey, Oliver Haas


How did Indonesia provide 25 million rural people with access to improved sanitation in the last decade? Was its paradigm shift—from subsidizing the purchase of latrines to changing people’s behavior—responsible for its success?

This case study tracks how the government and development partners introduced community-led total sanitation and developed total sanitation and sanitation marketing. It identifies key delivery challenges implementers faced and analyzes the decisions and actions they took to help overcome many of them.

Key contextual conditions: More than 100 million of Indonesia’s 250 million people lack access to improved sanitation, with some 54 million practicing open defecation. In rural areas, only 46 percent of the population has access to improved sanitation, and another 31 percent of rural residents defecate in the open.

Key stakeholders: Ministry of Health, Water and Sanitation Program, central government, provincial governments, local governments

Lessons Learned

  • The paradigm shift from supporting infrastructure to changing household behavior was key to achieving results.
  • Scaling up rural sanitation became a priority for local governments and the national government.
  • The program started with a field trial but planned for scale from the beginning. It used evidence at each juncture to discuss positives and negatives with stakeholders and collectively decide on the next step.
  • All stakeholders engaged in adaptive learning, in a relentless effort to improve citizen outcomes.
  • Champions were created through the process of witnessing the positive impact of first CLTS and then TSSM. The mantra “seeing is believing” held true throughout.

Development Challenges

  • More than 33,000 Indonesian children die from diarrhea every year, and another 11,000 die from typhoid. In 2008, just 37 percent of the country‘s rural population had access to sanitation—a level well below national and international targets for a country at its level of development.

Delivery Challenges

  • Existing policies, which centered on investment in infrastructure and subsidies, had failed to achieve results.
  • The government needed to increase private investment in sanitation and find new mechanisms for delivering services at scale, particularly to poor people living in a range of dispersed geographical locations across the country’s 17,000 islands.