Scaling access to sanitation across Indonesia (Story of Change)

Hands being sprayed by water.

Access to safe water, sanitation and hygiene (WASH) is crucial for ensuring the nutrition and development outcomes for children and is essential to protecting human health, not least during infectious disease outbreaks, such as the current COVID-19 pandemic.

This story summarises how the SNV Voice for Change Partnership (V4CP) programme worked with four civil society organisations (CSOs) between 2016 and 2020 to support the Government of Indonesia’s ambition to improve WASH conditions across the country. It explains how the V4CP CSOs increased their profile and credibility on the issue by supporting four districts in Sumatra as they became open defecation free (ODF), then drew on that experience to scale up progress across neighbouring districts and provinces.

Featured in the story are some of the fundamental approaches that have contributed towards the V4CP WASH programme’s success. These include capacity building, the use of robust evidence to enhance advocacy, consistent knowledge exchange and peer-to-peer learning, and the promotion of socially inclusive policies and practices. Key highlights are how the CSO’s applied on-the-ground experience to tailor their strategy and used a three-pronged approach to advocacy – personal, community and institutional – to help build a wide range of alliances across communities and governments.

Today, demand for better sanitation and hygiene is growing across the country and the critical gap between Indonesia’s national ambition and local implementation is closing. As the CSOs continue to garner support for the systemic changes required to sustain progress nationally, there is tangible hope that the government may reach its target of universal access to sanitation by 2024.

Although Indonesia is one of the world’s fastest-growing economies, many of its 250 million citizens still live in poverty. When V4CP started its WASH programme in 2016, over a third (37%) of children under five had stunted growth[1], a condition that is directly related to poor sanitation, hygiene and nutrition and affects physical and intellectual development. Furthermore, 51 million people still practiced open defecation, [2] which contaminates water and leads to diseases such as diarrhoea, an illness that accounts for a quarter (25%) of deaths amongst under-fives in the country.[3]

In order to address open defecation, the Indonesian government developed a Community-Led Total Sanitation Programme (STBM[4]) in 2006 to improve sanitation supply chains and stimulate consumer demand. However, implementing the programme across the country’s 17,000 islands proved challenging. Having failed to meet its 2015 sanitation target of 75% universal sanitation access, the government shifted it to 2019 and increased its goal to 100% universal access. It then shifted this goal to 2024 under its national-medium term planning document, the RPJMN.[5]

One reason why the government has struggled to meet its sanitation target has been the significant gap between national ambitions and local realities. Although tasked with implementing the national sanitation programme, district governments paid very little attention to WASH issues and the District Water and Sanitation Task Force (Pokja AMPL[6]) was largely inactive.

Ramadhaniati, Director of LP2M, at international learning event in June 2019.

Ramadhaniati, Director of LP2M, at international learning event in June 2019.

Sanitation entrepreneur, guided and supported by PKBI, producing toilets.

Sanitation entrepreneur, guided and supported by PKBI, producing toilets.

Pioneering evidence-based advocacy: a local context

From the outset, V4CP Indonesia’s WASH strategy was to bridge this gap by advocating STBM within, then across, districts and provinces. It began by focusing on the provinces of Lampung and West Sumatra where sanitation and hygiene was particularly poor and where very few organisations worked specifically on WASH issues. It identified four local CSOs working in four Sumatran districts – YKWS in Pringsewu, Mitra Bentala in Lampung Selatan, LP2M in Padang Pariaman, and PKBI West Sumatra in Sijunjungm.

As a first step, the V4CP programme worked with the CSOs to assess what evidence would be required to strengthen the legitimacy of their advocacy case. It provided support from renowned institutes with expertise in WASH to support the CSOs in the process, as they undertook nine evidence gathering projects, based on conducting new research or compilations of existing government data. Thanks to their work, by 2018, three of the districts had achieved ODF status, resulting in a better quality of life for up to two million citizens, while sanitation continues to improve on a village level in Padang Pariaman in West Sumatra (read more about this in the Story of Change, November 2018).

“We are very proud of our achievement as the first district in Sumatra Island who has achieved ODF district status. It is the effort from multi-stakeholder collaboration at all levels. Thank you also to YKWS as the partner who always reminds and advises us for the sanitation development,” said H. Sujadi Saddat, Bupati (Head of District) of Pringsewu.

Strategies for change

The V4CP programme used a number of approaches to scale up progress across the four districts. Peer-to-peer learning and collaboration among the CSOs strengthened capacity and the quality of advocacy, while knowledge exchange helped scale up progress. For example, the CSOs supported the growth of the supply chain by triggering entrepreneurs to produce and sell more affordable, appropriately designed sanitation facilities. Furthermore, Padang Pariaman and Sijunjung districts learned how Pringsewu and Lampung Selatan had managed to achieve universal access to sanitation through better regulation, institutional change and greater budget allocation.

Yet, ultimately, the CSOs’ success can be attributed to the way in which they used a blend of three approaches in their advocacy strategy: personal, community-based and institutional. This tailored approach accelerated the CSO’s influence and helped their local work evolve into a broader sanitation movement.

Personal: By using a personal approach and customising advocacy messages, the CSOs triggered a sense of ownership of WASH issues amongst stakeholders. This helped stimulate behavioural change and proved effective in engaging key champions.

Community based: By drawing upon their grassroots experience of working in communities, the CSOs significantly enhanced the desk research. Presenting the evidence in ways that were relevant to each local context helped mobilise community-based groups, including those representing marginalised sections of society. Once engaged, the CSOs built the capacity of these groups and enabled them to advance independently, which meant they did not need to lead on every initiative. For example, YKWS understood the value of involving religious leaders in Pringsewu and promoted better sanitation through the use of a religious song. In West Sumatra, PKBI and LP2M sought support from women’s groups because they have particular influence within the region’s matriarchal society.

Institutional: By advocating for institutional changes through formal mechanisms, the CSOs opened important avenues to reach influential stakeholders who could champion the need for increased political will to improve sanitation. For example, they revitalised Pokja AMPL by broadening the task force membership and facilitating meetings to work through problems together. This process enhanced the task force’s accountability and performance. It went on to establish inclusive sanitation policies, increase budget allocation, and to improve the implementation of the STBM programme. Ultimately, its support marked a key milestone in V4CP Indonesia’s WASH programme.

Embedding gender and social inclusion (GESI) issues into strategies is critical to achieve policies and practices that ‘leave no one behind’, in line with the mandate of the United Nation’s Sustainable Development Goals (SDGs). However, GESI issues were not consciously addressed in the WASH programme until 2018, when the CSOs started to push several initiatives. For example, they advocated that low-income communities and disadvantaged groups (including women and people with disabilities), should be given additional support in the financial mechanism to access healthy latrines within the Sustainable STBM regulation in Pringsewu and in the Sanitation Universal Access Acceleration regulation in the Sijunjung. In addition, LP2M strengthened the advocacy skills and sanitation knowledge among its women’s community organiser programme in Padang Pariaman. It then worked with the programme to engage the Head of District’s wife. As the leader of the family welfare movement (PKK), the largest women's group at district level in Indonesia, she has considerable influence.

Expanding progress: horizontal scaling

Having made substantive progress in the four districts, the CSOs set about scaling their advocacy to neighbouring districts and provinces, then nationally. YKWS and Mitra Bentala used their experiences in Pringsewu and Lampung Selatan to influence the other districts and cities in the province of Lampung. For example, YKWS successfully advocated for the establishment of the Mayor and Head of District’s regulation for STBM in Metro City and Lampung Tengah and provided an advisory role for STBM implementation in the Way Kanan district. Those efforts contributed to Metro City and Way Kanan being awarded ODF status. Furthermore, in 2019, Mitra Bentala started to advocate for better sanitation in another district, Pesawaran, and successfully pushed for the establishment of a Head of District’s regulation to accelerate universal access to sanitation.

“Evidence and experience sharing among districts is an effective advocacy strategy. It was conducted through visiting an ODF district (i.e., Pringsewu) and bringing that district’s Bupati to meet other regents in West Sumatra. It was also facilitated by horizontal learning workshops that resulted in increased motivation among other non-implementing districts to achieve ODF status”, said Firdaus Jamal, Director of PKBI West Sumatra.

On the provincial level, YKWS and Mitra Bentala organised an event to encourage learning and the exchange of best practices between cities and districts. They also inspired the province to play an active role in monitoring and evaluating progress. As a result, the province issued a target for its districts and cities to improve sanitation by 2024. In addition, LP2M and PKBI West Sumatra advocated for a governor regulation to be established, which is likely to prove an effective tool in encouraging other districts and cities to commit to accelerate universal sanitation access in the future.

Sustaining progress: vertical scaling

By extending their achievements to new areas, the CSOs are spurring a growing sanitation movement across Indonesia, awareness that is becoming more widespread by coverage of the issue in the regional and national media. “As the result of media coverage about our works, we are known as a capable organisation in the sanitation programme”, said Mashabi, Director of Mitra Bentala. Not only has media coverage strengthened the CSO’s reputations, their regular interactions and briefings with journalists means that the media is gearing up to be an influential advocacy route for WASH issues into the future.

Yet sustaining progress also requires systemic change to be stimulated at the top. The CSO’s decision to engage the national Alliance for Cities and Districts Concerned about Sanitation (AKKOPSI[1]) proved particularly effective and provides hope for lasting change, in part because some of its leaders, such as its Executive Director, grew up in Sumatra so have a personal interest and influence as elders of districts. When the V4CP WASH programme presented its best practices at the national City Sanitation Summit, the event was attended by AKKOPSI members from over 450 districts and cities.

Today, as the movement for better sanitation grows, the gap between national ambition and district implementation may, finally, be bridged. Transforming attitudes, behaviour and systems across all levels of government and society has not been easy yet, with the continued support of civil society, the government’s aim of better sanitation for all lies within reach.

Regular radio talkshow on Aired (Mitra Bentala & RRI Radio), on sanitation.

Regular radio talkshow on Aired (Mitra Bentala & RRI Radio), on sanitation.

Who we are

The Voice for Change Partnership (V4CP) strengthens the capacities of CSOs to foster collaboration among relevant stakeholders, influence agenda-setting and hold the government and private sector accountable for their promises and actions. It is funded by the Dutch Ministry of Foreign Affairs.

[1] UNICEF, 2015

[2] JMP, 2015

[3] UNICEF, 2020

[4] Sanitasi Total Berbasis Masyarakat

[5] Rencana Pembangunan Jangka Menengah Nasional, 2015-2019

[6] Air Minum dan Penyehatan Lingkungan

[7] Aliansi Kabupaten Kota Peduli Sanitasi . The alliance was established in 2011 as an initiative by the mayors of cities that had completed City Sanitation Strategies at that time.