2016年-世界发展银行全球_Scaling_Up_Rural_Sanitation_and_Hygiene_in_Indonesia_49页_1mb

Summary of Report No: ACS18642

Core Content

This report outlines the outcomes and lessons learned from the World Bank's Water and Sanitation Program (WSP) technical assistance (TA) project P132007: Scaling Up Rural Sanitation and Hygiene in Indonesia, which ran from 2013 to March 2016. The TA aimed to strengthen the implementation of the Community-Based Total Sanitation (STBM) strategy across five provinces in Indonesia. The report also discusses two complementary TAs: Rural Sanitation Market Creation (P143165) and Institutionalization of Rural Sanitation Capacity Building (P132118), both of which concluded in 2015.

The STBM strategy was launched in 2008 by the Ministry of Health (MoH) in response to the success of the Community-Led Total Sanitation (CLTS) approach in East Java. The strategy is based on three pillars: demand creation through CLTS and behavior change communication (BCC), supply chain improvement through local sanitation market development, and the creation of an enabling environment through policy advocacy and resource mobilization.

Main Objectives

• Strengthen the STBM Secretariat to guide nationwide implementation.
• Develop a nationwide performance benchmarking and monitoring system for STBM.
• Enhance provincial and district government capacity in STBM implementation.
• Build local government capacity and ownership in sanitation and handwashing promotion through evidence-based BCC.

Key Results and Achievements

Intermediate Outcome 1: Well-functioning STBM Secretariat

• The STBM Secretariat was established under the MoH in 2012 and now includes seven consultants and is co-ordinated by a government official.
• It has organized national reviews and coordination meetings, developed guidelines and training materials, and supported knowledge management and advocacy.
• The Secretariat is now largely funded by the MoH's regular budget, though some donor support is still needed for specific activities.

Intermediate Outcome 2: Enhanced Local Government Capacity

• A comprehensive STBM guideline was developed for all government levels, from national to village.
• Training modules were formally accredited by the MoH, and 28 health schools now offer the curriculum.
• Over 1,500 students completed the training by December 2015, and more than 500 people completed the e-learning course.
• The TA helped establish a 'district-wide approach' which was later adopted by other national and international programs.
• By 2015, 85 out of 514 districts and 19 out of 34 provinces had issued local regulations to support STBM.
• In East Java, three districts and one city achieved ODF status, demonstrating the effectiveness of the approach.

Intermediate Outcome 3: More Effective STBM Implementation

• A nationwide SMS-based monitoring system was established, covering 34 provinces.
• Access to improved sanitation in the five focal provinces increased by 2.57% annually from 2012 to 2015, surpassing the national average.
• Access to permanent improved sanitation (e.g., pour-flush toilets) increased by 1.68% annually, compared to a national average of 1.12%.
• An additional 8 million people gained access to improved sanitation between July 2012 and December 2015.

Key Lessons Learned

1. A capacity building framework is essential for scaling up in a decentralized environment.
2. Advocacy and communication are crucial for the adoption of tested approaches.
3. Collaboration with various institutions enhances campaign outreach.
4. An effective monitoring system should be integrated into routine government operations.
5. Local governments can develop the rural sanitation market through partnerships with micro-finance institutions.
6. Incorporating tested approaches into existing programs can significantly enhance progress.

Recommendations

For the Government

• Accelerate the relocation of the STBM Secretariat directly under the Director of Environmental Health.
• Enhance coordination with other parts of the Directorate General of Public Health, including the Health Promotion Unit, Public Communications, and PPSDM.
• Collaborate with social sector programs to ensure better inclusion of the poor and develop pro-poor support mechanisms.
• Strengthen the supply side of STBM by expanding capacity building for entrepreneurs and developing affordable sanitation technologies.
• Explore opportunities for rural sanitation development under the Village Law by making ODF status a key performance indicator.

For the Bank

• Develop an interactive, smartphone-based reporting system based on the experience of the SMS-based system and PAMSIMAS MIS.
• Create performance-based incentive schemes for STBM implementers at all levels to encourage quality and scale.
• Continue supporting innovative ideas and non-budgeted, nation-wide impact activities, including reaching the bottom 40%, and cross-sectoral collaboration.

Conclusion

The TA P132007 has been instrumental in scaling up the STBM strategy in Indonesia, improving local government capacity, and enhancing the national sanitation monitoring system. The project has demonstrated the importance of institutional support, capacity building, and effective advocacy in achieving sustainable rural sanitation improvements. The success of the initiative has also encouraged the adoption of the district-wide approach by other programs and international agencies, contributing to Indonesia's goal of universal access to sanitation by 2019.