Achieving sanitation for all through stbm percik special edition indonesia 2012

04 Main Report 22 Interview 37 Lessons Learned 1st edition, 2012
The spririt of STBM in Interview with East Java Lessons from Lumajang,
Indonesia sanitation Governor Probolinggo, and Soe

English edition

Water and Sanitation Magazine

STBM
special edition

ACHIEVING
SANITATION
FOR ALL
THROUGH STBM

Hari Cuci Tangan Pakai Sabun, 2012

From the Editor

Picturing the spirit of
STBM Program
Dear readers, once again you are holding our beloved Interviews with the Governor of East Java and the
magazine. This issue, we are presenting a special Regent of Bima show attempts to formulate and
edition on Community-Based Total Sanitation, or in implement policies and supporting environment for
Indonesian acronym, STBM (Sanitasi Total Berbasis the sustainability of sanitation development.
Masyarakat).
Tales of STBM leaders from Soe, Probolinggo, Lumajang
Since its launching as a national strategy through a and the roles of partners and private sector, and
Decision of the Minister of Health, STBM has succeeded innovations in raising demand and improving supply
as a platform for developing community-based at the community level are also expected to inspire all
sanitation to push changes in health behavior. STBM actors in all levels of the society.

STBM has created unsubsidized changes. The These tales become actual evidence that the changes
community becomes both teachers and subjects of in behavior stimulated by STBM are not merely
changes in health behavior. The changes in behavior project-based, but in fact have become contagious
include not defecating in arbitrary places, washing in disseminating the spirit to raise awareness among
hands using soap, managing safe drinking water society members to give more contributions to the
and food, managing waste properly and managing environment.
household waste in a safe manner.
All roads lead to Rome, so the saying goes. There are
All these behavior give actual contribution to the many roads to achieve success in the STBM program.
national achievement of Millenium Development Goals The key is to be alert of existing opportunities and
(MDGs) and the water and sanitation sector of national seizing them. Thus, it is not impossible that the targets
development targets, namely stopping the habit of that are challenging the nation be achieved.
open defecation by the end of 2014.
Have a good read!
In this STBM special edition of Percik, readers can draw
lessons and inspiration from various figures, champions
and main actors of STBM. Each article describes STBM Editor in chief
from three main elements, namely raising demand,
improving supply and enabling environment. Maraita Listyasari

02 Percik Magazine August 2012

Content
STBM:
04 Achieving Sanitation
for All
STBM brings a change in mindset in
the implementation of sanitations
programs. Besides putting community
development to the forefront, it targets
changes in the societal hygiene behavior
and cutting dependence from subsidies.

28


Published by : Kelompok Kerja Air Minum dan Penyehatan Lingkungan (Pokja AMPL) Nasional – National Water and Sanitation Working
Group Steering Committee: Director of Settlement and Housing, Ministry of National Development Planning/ National Development
Planning Agency, Director of Environmental Health, Ministry of Health, Director of Water Development, Ministry of Public Works,
Director of Natural Resources and Appropriate Technology, Ministry of Home Affairs, Director of Facilitation of Spatial Planning and the
Environment, Ministry of Home Affairs, Director of Urban Planning, Ministry of Home Affairs Supervisor: Nugroho Tri Utomo Editor in chief:
Maraita Listyasari Managing editor: Eko Wiji Purwanto, Nur Aisyah Nasution Editor: Aldy Mardikanto Writing Team: Nissa Cita Adinia,
Lisa Imrani, Kelly Ramadhanti, Indriany, Yusmaidy, Hendra Murtidjaja, Eko Budi Harsono Translator: Indra Krishnamurti Design: Endang
Sunandar Circulation/Secretariat: Agus Syuhada, Nur Aini

August 2012 Percik Magazine 03

33 Learning CLTS from Our
Neighboring Countries
As a participatory approach, CLTS has been applied in a num-
ber of our neighboring countries. Read the stories of Pakistan,
Laos and Vietnam

40 Albertus Fay,
FROM BONET TRADITION TO
INSTRUCTION OF THE DISTRICT
HEAD
Albertus Fay, the champion behind the success of Polen
district in Timor Tengah Selatan Regency. He tells us his steps
in applying STBM

19 Interview with the Director General
of PP & PL Ministry of Health

30 Strategic Choices in behavior
changing community
5 STBM Pillars,
Applications and 54 STBM Milestones
Challenges
With its 5 pillars, STBM has created a
significant boost in behavior change. 60 What they say about STBM


Contact us : Jl. RP Soeroso 50 Jakarta Pusat- Indonesia, Ph/Fax : +6221-31904113,
Website : http//www.ampl.or.id, Email: redaksipercik@yahoo.com, redaksi@ampl.or.id

Cover : E. Sunandar
Cover Photo : Nury Sybli


STBM :
Achieving Sanitation
for All

“For the sake of our descendants, and to improve the welfare of
the people of Maradesa Induk, with the nature as our witness, we
have to change into a healthy behavior.
Quit defecating in the open, wash hands properly, process
drinking water, manage household rubbish and waste at home...”

Doc. Plan Indonesia


Declaration of
7 ODF villages
in Serang
Regency

Doc. STBM Sect.
T
Community active movement community in their own ways.
he sentences above are part of the customary
oath stated by traditional leaders in the village One champion in Dompu, NTT, Salahuddin (13 years)
of Maradesa Induk, Sumba Tengah, NTB in with the Tahira Children Club, created “Polisi Tai Desa
December 2011. In order to encourage changes in Adu (Faeces Police of Adu Village)”. Along with village
hygiene behavior of its citizens, local traditional leaders cadres, these children actively trigger village residents
took the initiative to hold a customary oath witnessed not to defecate at arbitrary locations. They perform
by the whole community, even the district leader. routine surveillance to monitor the defecation habits of
The seriousmess of the customary oath is due to their citizens. When they find someone doing defecation in
having been triggered. the open, they shouted at the offender, blow whistles
so many people know the person’s behavior and
The condition of being “triggered” commonly shame him.
arises when people have gone through a process
called triggering. Triggering is a method aimed to Another champion in East Java, Hastatik, a sanitation
change hygienic and sanitation behavior through officer in Sampang, “provoke” citizens using messages
empowerment of community. A society is said to be that defecating in the open is immoral, as it creates
“triggered” when they become aware and committed suffering for others. For the Madurese, immorality
to change their behavior, and immediately implement and causing others to suffer is taboo and shameful.
follow-up actions. No doubt, the people are triggered and committed
to change their behavior. The commitment is
In Indonesia, triggering has been conducted in many evidenced by the amount of investment of the people
locations, even in the backwater regions. Many of those of the District of Sampang, reaching IDR 4.7 Billion
who were triggered spark are encouraged to trigger (approximately USD 520 thousand) to build latrine
other residents. They are known as “champions”. A facilities without subsidies from outside sources.
champion may be a citizen, a child, a local community
leader, a government official, etc. Champions actively “All these activity are the result of a process of
seek to change the behavior of the surrounding community empowerment. A program is said to


empower the community when the community acts However, can the results of the sanitation program be
as active subjects as well as decision makers in all sustainable only by empowering the community?
stages of the program, “said Oswar Mungkasa, former
Chairman of the Water and Sanitation Working Group This does not stop at empowering people, but also
(AMPL). changing the hygiene behavior of the society. “One
of the main supporters of the sustainability of the
Transforming mindset sanitation program is hygiene behavior change
For decades Indonesia has sanitation programs in the society,” said Zainal Nampira, Head of the
oriented towards development of physical Subdirectorate of Water and Sanitation, Ministry of
infrastructure. However, during this period, the Health.
coverage of sanitation has also shown no significant
changes. Various programs were introduced to the “The commitment of behavioral change can encourage
community supported by large amounts of fund, people to build their own sanitation facilities. Even the
providing various types of sanitation facilities. Yet the poorest communities will be capable. When triggered,
development of more sanitation facilities does not
increase coverage, and only result in unused facilities.
This condition shows that there is something wrong in
our thinking so far.

Changes
In recent years, a change of mindset is starting to of hygiene
appear in the current sanitation programs. People mindset and
are starting to be involved in the process, the level of behavior of
the targeted
involvement ranging from merely participants in the community
socialization, up to full engagement.

“The number of sanitation facilities built that are not
used or damaged due to the inability of the society to
maintain makes the government start thinking about
the importance of program sustainability,” said Imbang
Muryanto of the Makassar Public Works Office when
describing the Makassar sanitation program at the
National STBM Workshop on August 7-9 in Bogor, West
Java. “Sanitation without the empowerment of the
Doc. IUWASH

people will not succeed,” he added.


it turns out they were able to construct their own On the other hand, many people still persist in the
sanitation facilities, “said Zainal. old mindset that changes in the public hygiene
behavior require a lenghty, costly process and
Zainal’s claim is supported by a number of indisputable cannot be imposed. In fact, since 2005 Indonesia has
facts. Triggered communities, committed to change implemented a non-subsidized approach resulting in
behavior, will eventually be able to construct their own major changes to our sanitation achievement.
sanitation facilities. Sustainable sanitation program
not only requires the empowerment of communities, What is this unsubsidized approach?
however, more important is the emergence of This approach is known as Community-Led Total
behavioral changes in society. Without it, sanitation Sanitation (CLTS). Pioneered by Dr. Kamal Kar of
development is less likely to be sustainable. Bangladesh, CLTS has an innovative method to
mobilize community members to completely eliminate
Developing sanitation without subsidy the behavior of open defecation. The essence of CLTS
The emergence of public awareness for behavioral is a recognition that providing toilet facilities for the

“Even the poorest community will be empowered.
When triggered, they turn out to be able to
develop their own sanitation facilities”
change resulted in many communities declaring community does not guarantee their use, nor cause
themselves to have quit open defecation practices, behavioral changes or increase access to sanitation
termed Open Defecation Free (ODF) or “Stop BABS” in hygiene. Therefore, if the targets are behavioral change
Indonesian acronym. The ODF condition is achieved and sanitation access, the provision of latrines should
when all inhabitants in a community have quit be the community’s responsibility.
practices of open defecation and become used to
defecation in healthy toilet facilities. It began with emulating other countries
CLTS spread quickly in Bangladesh with the
Triggering activities in various locations have shown cooperation between the Bangladeshi government
results when many villages declared themselves to and international NGOs. WSP (Water and Sanitation
be ODF. ODF districts began to emerge across the Program) of the World Bank plays an important role
country, as many regencies declare to reach the status in the spread of this approach to India, Indonesia and
of ODF Regency. ODF is now a prestigious status being parts of Africa.
pursued by many local leaders.


In-country development
After the trial, the CLTS method continues to be
The CLTS applied in different regions by various sanitation actors,
method
both governmental and non-governmental. Starting
continues to
be applied in from the successful trials, a national strategy to expand
Doc. IUWASH

various regions the concept of improving access to rural sanitation
by a number
of sanitation tailored to the mission and character of the nation of
actors Indonesia is also developed.

The experiments in the six regencies are able to prove
Based on the success of CLTS in Bangladesh and India, that CLTS can be applied in Indonesia. Lessons learned
representatives from a number of ministries combined from these experiments are documented in the form
in the Water and Sanitation Working Group and several of a video, which acts as a communication tool for
sanitation actors went to both countries to learn more advocating various parties. Various agencies, both
about CLTS. The visit was followed by inviting Dr. Kamal government and non-government, are interested to
Kar to Indonesia, to make an assessment on whether replicate this approach, including WSLIC2 (Water and
the CLTS method can be applied in Indonesia. Sanitation for Low Income Communities), TSSM and
the program implemented by Plan Indonesia.
The government followed up this visit with the pilot
implementation of CLTS in six regenciesin six different WSLIC2 began to aggressively implement triggering
provinces, namely: Lumajang, East Java; Sumbawa, in different target regions of its projects in Indonesia.
NTB; Sambas, West Kalimantan; Muara Enim, South TSSM (Total Sanitation - Sanitation Marketing) in East
Sumatra; Muaro Jambi, Jambi, and Bogor, West Java. Java adds three components of total sanitation in
Dr. Kamal Kar himselft was asked to train this method implementation, namely:
in the national CLTS orientation in early May 2005 in
Lumajang, East Java. demand creation,
supply improvement, and
Evaluation conducted approximately 6 months later enabling environment.
in late November 2005 showed that the result is
considered to be very good. “The people of Indonesia The three components are innovations in the
can trigger quickly, since 8 months ago I came to replication of CLTS as CLTS focuses solely on demand
Indonesia while no one knows about CLTS. Within 6 creation. While Plan Indonesia has not yet fully
months, CLTS has developed well in Indonesia, “said Dr. implemented CLTS, it adopted the triggering method
Kamal Kar. in 9 regencies in 2007, and by 2009 it has fully adopted
the CLTS approach.


Enabling
Environment

Replication by various parties has resulted in
remarkable changes that in 2006 as many as 160
villages have reached ODF status, and in 2007 there
Institutionalisation
were 500 ODF villages. Even the government of
Pandeglang won an Indonesian Museum of Records
award in 2007, when the NGO PCI (Project Concern
International) succeeded in its triggering and Demand Supply
Creation Improvement
encouraged the construction of 1,719 toilets based on
public initiative without subsidies.
Components of Total Sanitation Diagram
“Since CLTS’ launch, there has been an extraordinary
Poor sanitary conditions and unsafe hygiene behavior
Doc. STBM Sect.

of people cause extraordinary outbreaks of diarrhea
in many provinces. Decreased incidence of diarrhea
is considered important because the disease is still
the leading cause of death of infants and toddlers in
Indonesia.

WHO states that there are three conditions that can
Various reduce the incidence of diarrhea, namely:
villages declare
themselves to be
open defecation 1. Increased public access to basic sanitation, reducing
free
incidence of diarrhea by 32%;
2. Washing hands with soap, reducing by 45%; and
3. Safe drinking water in households, reducing by 39%.
interest from various programs and projects. L
d j Leverage
at the community level is also high, “said Zainal. Each of these conditions, on its own, does not result in
major reduction. However, if the three conditions are
CLTS Implementation is Not Enough integrated, the incidence of diarrhea can be reduced
In 2007, the Indonesian sanitation world gained by as much as 94%.
valuable information from WHO (World Health
Organization) and World Bank studies. The WB Based on these two important studies, the government
study stated that the poor condition of sanitation in of Indonesia realizes that the implementation of CLTS
Indonesia caused economic losses amounting to 2.3% is not enough. A program large enough to integrate
of GDP or IDR 58 trillion per year. the above three conditions is required if it wants to be


Washing
serious in improving sanitary conditions and reducing hands with
the incidence of diarrhea. soap is proven
to reduce
incidence of
The success of CLTS trials, replication and development diarrhea by
of post-trial CLTS, as well as the WHO and World Bank 45%

studies, encourage the Government of Indonesia to
develop a program that targeted reduction in the
incidence of diarrhea by changing people’s behavior.
The result of these efforts is the Decree of the Minister
of Health No. 852/Menkes/SK/IX/2008 on the National
Strategy for Community-Based Total Sanitation.

Community-Based Total Sanitation adopted the CLTS
approach to change people’s behavior. The WHO study
results are reflected here as the 5 pillars of behavior
change, now known as the five pillars of STBM, namely:

Doc. Plan Indonesia
1. Stopping the practice of open defecation
2. Washing hands with soap
3. Managing household drinking water and food and supported by interdepartmentalinstitutions, the
4. Managing household waste National Water and Sanitation Working Group (Pokja
5. Managing household liquid sewage AMPL Nasional), STBM stakeholders from government
and non-government institutions initiate advocacy
Achievement of these five conditions in a community efforts and implementation of STBM at various levels,
is called as a Total Sanitation condition. starting from the national to the regional levels.
Successes began to appear, even in areas considered to
The creation of the ministerial decision on a national be very unlikely for the success of this program.
strategy of STBM, besides useful for advocacy, is also
beneficial to trigger more parties to implement the A series of changes and progresses accompany the
CLTS and develop into STBM. While there were initial implementation of STBM. “Many people have started to
doubts, like when CLTS was launched, STBM slowly implement triggering, not only for Stop BAB. There are
but surely gained support into the largest community- now villages achieving total sanitation in all 5 pillars of
based unsubsidized sanitation program in Indonesia. STBM,” said Zainal.

Under the coordination of the Ministry of Health STBM, while initially designed for the rural areas, is now


Doc. NWSWG

beginning to be tested in urban areas. WVI (World
Vision International) and USAID (United States Agency
”Many people have for International Development) are two of the donors
started to implement who initiated the pilot implementation of the STBM in
urban areas.
triggering, not only for
Stop BABS. There are “There is also an emergence of sanitation
businesspersons association at the community level.
now villages achieving All parties collaborate, again adding to the positive
leverage this program,” added Zainal.
total sanitation in all 5
pillars of STBM.” The same opinion was expressed by Nugroho Tri
Utomo, Director of Settlement and Housing of The
Ministry of National Development Planning (Bappenas).


According to Nugroho, STBM has evolved into a higher learning place of rural sanitation program for its
level of complexity, “STBM is the only program or neighbors. In the Southeast Asia-Pacific CLTS Regional
approach with a direct intervention to the household Workshop in 2009, Indonesia was known as a country
level, which is a major determinant e
experienced in a very comprehensive implementation
of the success of sanitation o
of CLTS, even compared to India.
program.”
I
It is said to be comprehensive because implementation
As a result, Indonesia o
of CLTS in Indonesia has reached the development
becomes a o
of the STBM concept. In addition, not only the
i
implementation of the 5 pillars, sms- and web-based
m
monitoring of STBM has already been applied. STBM
a
actors also become more varied, including the regional
g
government, local and international NGOs, donor
i
institutions and the private sector through Corporate

Map of CLTS Distribution in Asian Countries 2004-2010


Social Responsibility programs. most formidable challenge, for both the government
and society. Laos and Vietnam are examples of
There are many supporting factors in Indonesia such countries that sent their teams to Indonesia to
as existence of regulations, government’s commitment exchange knowledge on CLTS and STBM.
in the RPJMN, existence of AMPL/sanitation working
groups at the regency, city and province levels, In the Regional Workshop on Exchange Visits on
partnership with stakeholders and the presence of Scaling Up Sanitation in Solo (September 2011),
champions in communities. the Government of Indonesia was considered quite
successful in collaborating with donor agencies and
Serious Challenges partners to develop rural sanitation through the
In all countries implementing CLTS, transition of strengthening of three components of total sanitation.
the approach to development of sanitation from This activity was attended by donors such as Water Aid,
subsidized to non-subsidized is perceived to be the UNICEF, Plan, ADB, World Bank and the governments of

Enthusiasm
in ODF
declaration
activities
in various
regions Doc. Plan Indonesia


Demand Supply Enabling
Creation Improvement Environment

STBM triggering at the Evaluating sanitation markets Apply a local policy to
community level at provincial level to compare implement STBM in the regency
existing sanitation options through synergy of all rural
Formative research on hygiene and willingness and financial sanitation program/project
behavior and motivation of capability of consumers funding sources
community as consumers
Developing the range of Developing a specialised
Communications media sanitation options demanded financial framework in the
campaign based on formative and accessible to consumers government budget
research, using existing
motivation to change behavior Developing a catalog of suitable Providing development budget
sanitation options to help and improving local capacity (for
Offering options to consumers consumers select demand, supply, management,
when they are commited to knowledge, supervision and
change their hygiene behavior Monitoring of local program results of sanitation)
entrepreneurs and training of
construction workers to deliver Writing analysis of funding
technological choices with a effectiveness (input, output,
guarantee of quality results) of sanitation programs in
the progress report of regency
programs

Laos, Cambodia, Philippines, Timor Leste, Vietnam and Formulating strategic plans for
Papua New Guinea. STBM implementation in the
regency

With that performance and learning, there are still
so many challenges faced by STBM. The Indonesia
National Mid-Term Development Plan for 2010-2014
has set Indonesia Stop BABS as a goal in 2014, will it
be achieved? How to cope with the various programs/ As said by Nugroho Tri Utomo at the National STBM
projects in areas that are still subsidized? Achievement Workshop (7/9), “STBM still finding its way, still in the
of the MDGs for sanitation in Indonesia still relies on pilot stage. Whereas in the field we have known the
STBM because of its effectiveness in improving access to potential of STBM. Its success has been sufficiently
sanitation in rural areas. In the face of regional autonomy, tested. The challenge is no longer to advocate
how to make local leaders adopt this program? households but to advocate local governments


to support these activities. The challenge is the of “one health center, one ODF village “, the East Java
commitment of regional governments to allocate Provincial Health Office targets each health center to
funds to STBM. “ at least convert one village in the region each year to
ODF status. “Each district usually has one health center,
Towards Achieving STBM Targets some have more than one. With the strategy of “one
STBM moves from a simple learning, and increasingly health center, one ODF village “, this is an achievable
evolves, in line with increased learning. In the first target for the health centers,” said Edy Basuki, Section
quarter of 2012, we already have 6,457 villages Head of Environmental Health Office of East Java
implementing STBM. Our target is 20,000 villages by Province.
at least 2014. Will we use all the learning as a foothold

“Each district usually has one community health
centre. Thus the strategy of ‘one community
health centre, one ODF’ has a reachable target”
into achieving targets? This strategy is not impossible. If in each month a
sanitarian does a triggering event and monitoring, the
With regard to creativity to reach targets, STBM target of at least one ODF village can be accomplished
implementors have always shown a high level of in one year. Based on the funding that is available, the
creativity. In East Java, for example, using a strategy strategy of “one health center, one ODF village “ is an


On the achievement of STBM targets, Nugroho added
tha
that STBM emerges from much learning, results of
stu
studoes, creative work of champions and support of
ma
many parties. “STBM will also live and thrive from such
pas
passions. And do not forget, STBM can develop well,
wh
when it is integrated with other programs, such as
the Acceleration Program of Sanitation Development,
W
Water Safety Plan or School Sanitation, “said
Nugroho.
excellent strategy capable to be applied in other
regions. Synergy with other programs and breakthrough
in the STBM strategies of implementation. Imagine
Wilfried H. Purba, Director of Environmental Health, when all districts in Indonesia, which number about 6
Ministry of Health, added another potential. According thousand, implement the strategy. It is not impossible
to Wilfried, currently each health center obtains an that the target of achieving 20,000 STBM villages in
average of Rp. 100 million in BOK (Health Operational 2014 will be achieved, even exceeded. He invited us all
Assistance). “Here, the environmental health allocation to work together in achieving the target.
can be used for STBM. Now the question is, how we can
stimulate our colleagues to remember environmental Indriany, Nissa Cita

health through the STBM program,” he said.

All stakeholders
Doc. Plan Indonesia

synergize in
conducting
STBM promotion
to achieve the
national target.


Prof. dr. Tjandra Yoga Aditama SpP(K)
Director General of PP & PL Ministry of Health STBM

STBM, Driving Change
Without Subsidy
Community-Based Total Sanitation indicators of achievement being A number of community sanitation
(STBM) Program has been launched 20,000 villages implementing programs have been implemented
for four years. STBM is one of the Community-Based Total Sanitation for some time. The problem is
cross-sectoral national programs in (STBM) in 2014. that there are a number of issues
the area of sanitation. The program that need to be considered: first,
was launched in August 2008 by One of the attempts of hand clean and healthy behavior (PHBS)
the Minister of Health. STBM is an washing with soap campaign has not become a necessity
approach to changes of hygiene implemented by the Ministry of for most people. The society in
and sanitation change through Health. The following are excerpts general has the knowledge about
community empowerment using of an interview by Percik magazine the importance of clean and
the triggering method. journalist, Eko B Harsono with healthy behavior and influence
Director General of Desease Control of sanitary conditions to health.
In the 2010-2014 Strategic Plan of and Environmental Health (PP However, people still have
the Ministry of Health, eight priority & PL) Ministry of Health, Prof. Dr. not put priority on sanitation.
focus of health development are Tjandra Yoga Aditama in his office Therefore, inconsistencies in the
set. One is the control of infectious in Jakarta, recently. practice of clean living are still
diseases, non-communicable found in the community. Second,
diseases and environmental What are the fundamental issues there is a lack of commitment
sanitation; with one of the main in implementing STBM? from regional governments


Doc. STBM Sect.

regarding the importance of development. One of the obstacles still need to be developed to meet
sanitation development. Regional is the absence of blueprint and the requirements of the national
development is still focused on approach to manage sanitation program.
infrastructure development such development. Implementation of
as bridges or roads, while the sanitation development was carried Why does STBM have a non-
construction of sanitation is not out sporadically without clear subsidized principle?
a priority. Moreover, sanitation reference from the government. Previously we have applied
development has not been The government has launched traditional approaches to sanitation
integrated between relevant STBM as a national program, and programs, such as building latrines,
sectors and a shared responsibility. makes it a guide for implementing distributing family latrines for free
Third, there is no integrated and various sanitation programs/ or as stimulant packages in the
synergistic approach to sanitation projects. However, the program form of construction materials,


and distributing money to designated by the Decree of physical approach instead of
the community in the form of the Minister of Health No. 852/ behavioral change. To counter
revolving fund. Menkes/SK/IX/2008 dated 8 this, our step is to continue to
September 2008 conduct roadshows for advocacy
The three activities use a physical and outreach to decision
approach in which the focus and Is STBM a success? makers and stakeholders. We
success benchmarks are always We have not dared to declare also conduct media campaigns
on the physical approach. Such it as a success but the progress and learn from lessons from the
a physical approach does not is encouraging. This approach successful implementation STBM
provide adequate leverage to continues to be evaluated and in various regions.
improved sanitation because it accelerated while maintaining
is not sustainable (people always the quality of processes and How are non-government
rely on subsidies). outcomes. We have also began actors involved in the STBM
program?
This program requires the
The main obstacle is that not involvement and synergy of the
various parties (government,
all stakeholders understand private sector, NGOs, donors and

and adopt the STBM approach. the community). The synergy is
done in the form of partnership
and networking, such as through
In the absence of subsidies, to develop other STBM pillars Jejaring AMPL, Public-Private
what is the role of such as the Handwashing (CTPS), Partnerships for Handwashing
government? Household Water Management with Soap, synergies with donors
The role of government is to (PAM RT), waste and household and NGOs (UNICEF, ESP, Plan) in
facilitate in the form of norms, sewage/waste management adopting the STBM approach for
standards, guidelines, advocacy campaigns. sanitation development.
and outreach, campaigns,
monitoring, evaluation, and What obstacles are
learning. Regarding the role of encountered in the
the government, cross-sector implementation of STBM?
agencies and stakeholders has The main obstacle is that not all
developed a National Strategy stakeholders understand and
for Community-Based Total adopt this approach in sanitation
Sanitation (STBM) and has been development and retain a


Soekarwo
Governor of East Java

Disseminating learning
from East Java
What was it like when STBM people) and improving supply and and what efforts have been
program was introduced? What business networks involving the made to solve it?
was your impression when STBM private sector. In 2008 there was Not all regencies/municipalities
was introduced in East Java? a budget for STBM (Community- understand this approach,
STBM has been known since Based Total Sanitation) activities, sanitation is still not a priority in
2006, tested in Lumajang. At the and operational funding was development policy, and budget
beginning the Community Led provided by regency government allocations for sanitation is limited.
Total Sanitation (CLTS) method through the regional budget. To develop the program, the
was introduced, a method of provincial government pushes for
empowering the community with The first impression of STBM is access to resources such as CSR,
a focus on efforts to change the that this is a new approach to BOK funds (Fund for Operational
behavior of open defecation (BABS) empowerment. This approach cost in health services), PNPM
into using toilets. In 2007, the Total proved quite effective in increasing (National Program for Community
Sanitation and Sanitation Marketing access to toilets quickly. Empowering) or other national
(TSSM) approach was introduced projects. In addition, rewards
by WSP World Bank combining What constraints have appeared to successful regencies could
increased demand (triggered in the implementation of STBM also trigger other regencies, for


Pupils in
Tunjung Sekar
Elementary
School in Malang
enjoying hand
washing facilities

Doc. NWSWG Sect.
example, through JPIP Otonomi support and cooperation with reduce the risk of disease due to
Awards. Other efforts are also other agencies. These include the environmental conditions. People
shown in the form of a national private sector through CSR (eg, who already have a toilet from the
exhibition in the framework of Bank of East Java), Media (Jawa beginning will be comfortable
Unity Day of Village Women Post-Otonomi Award), NGOs (WSP- because surrounding communities
Organization and Community World Bank, USAID), PKK (Clean and who previously defecate openly will
Month in which STBM is able to Healthy Environment Competition), already have latrines.
mobilize community participation national projects (PNPM, SANIMAS,
and mutual assistance to build PAMSIMAS). Synergizing of efforts What are the local conditions
toilets in a broad scale. across programs is well established before and after the STBM
through the Healthy Cities, Alert program began to be
What is the role of various Village, Health Promotion, UKS and implemented?
stakeholders (government, other programs. The previous sanitation program
private/CSR/media, public, approach by providing subsidies
universities, donor/ NGOs, etc.) in What counts as STBM benefits to for latrine construction was very
the implementation of STBM? society? limited in scope, requiring relatively
At the very least, regional People can enjoy cleaner and large costs because people expect
governments provide policy healthier environment and help from the Government.


Additional access to latrines in What are the challenges getting closer, how is the
the community is very slow. With that must still be faced in the prospect of STBM in answering
STBM, the sanitation program implementation of STBM in East the challenges of the MDGs?
gives more attention to behavior Java? When STBM is implemented by
change through a method of STBM should be going at the all parties to the maximum and of
triggering and social control that speed of the implementation in course supported by all regents/
mechanisms in the community can Bojonegoro, Jombang, Pacitan, mayors, it is possible that MDGs
be sustainable, additional latrine Lumajang, Magetan, Ngawi, Goal 7 targets can be achieved. So
access grows faster and wider in and Nganjuk. To that end, the the keywords are strong support
scope and evenly in all walks of provincial government will and commitment, especially by
society. continue to provide motivation regents/mayors.

”With regard to exchanges of knowledge, East
Java has disseminated its learning to various
parties through field visits, inviting successful
regions as sources or becoming sources in other
regions”
In your opinion, what are the and advocacy to all regencies and What are the expectations,
factors that drive the success of municipalities by maximizing three feedback and evaluation for the
STBM in East Java? important components of STBM: improvement/acceleration of
The support of provincial 1. Continuing to create demand STBM program at the national
government policy in the field of with triggering; 2. Providing level?
sanitation, creation of synergy and solutions to the communities There should be support,
conducive stakeholder cooperation that have been triggered by consensus and a strong
and dissemination of information specifying healthy latrines, with commitment by all parties, from
through the media to all parties easier access to sanitation markets the top to bottom, it is the key to
concerned. In terms of the (closer supply); 3. The government the success of STBM in the national
exchange of knowledge, East Java and its stakeholders creating a level.
has spread its learning to various supportive environment (enabling
parties through field trips, using environment), at least by providing
local success stories as resources, or policy support.
becoming a source person in other
regions. The MDGs deadline date is


Ferry Zulkarnaen
Regent of Bima

“In 2015,
Bima will become an ODF regency”
What is the beginning of Year Development Plan to build and improved water supply and
the Community-Based Total sanitation with programs ranging sanitation coverage. What is
Sanitation program (STBM)? from Presidential Instruction interesting about this program is
What was your impression when Program of Water and Family Toilets the increased public awareness
STBM began to be introduced in Infrastructure (Inpres Samijaga), through triggering strategy. As a
Bima? Unicef, RWSS, Infrastructure result, in early 2012 there were 25
STBM was first introduced in the Development of Dissadvantages villages and 1 district that have
late stage of the Second Water Areas Program (P3DT), the been declared as ODF (Open
and Sanitation for Low Income Acceleration Development of Defecation Free) or free from
Communities (WSLIC 2) in 2005 Dissadvantages Areas Program indiscriminate defecation. And in
as CLTS (Community-Led Total (P2DT), etc. with a very large 2015, the regency of Bima plans to
Sanitation), then aggressively investment. These investments achieve status as an ODF regency.
adopted by other programs such as have not been able to increase the
WES Unicef, Alert Village Program, coverage and support behavior What are the obstacles that arise
Community Month, etc. change on increasing the health of in the implementation of STBM
society. to date, and what efforts have
The impression that arises when been made to solve it?
STBM began to be introduced The presence of five STBM pillars Some obstacles remain, such
in Bima is that we have has been able to provide significant people still considers construction
experienced since the first Five- leverage in behavior change of sanitation as the responsibility


Together
doing health
promotion
activities for
elementary
school
children.

of the government and is subsidy What are the efforts that have as a development priority in the
oriented. Moreover, there remain been made such by the regional Local Government’s Medium Term
a number of central government government? Development Plan (RPJMD).
policies on sanitation development In addition to issuing several
that are not aligned with the regulations, Bima regency The local government is also
Decision of the Minister of Health gives a big role to AMPL - BM seeking an increase in the
No.852/MENKES/SK IX/2008 on the working group to coordinate allocation of the regional budget
National Strategy for Community- implementation of water supply for STBM. Meanwhile, another effort
Based Total Sanitation. Another and sanitation development. Other done is by increasing the role of
constraint is the lack of capacity steps taken include facilitation informal leaders in the community
and understanding of The Regency’s and sustainable fostering of the to work together with technical
Offices in relation to STBM. society. It also sets the WSS sector officers in the field to conduct


triggering of CLTS (Community Led What do you think are the factors management of water supply and
Total Sanitation). behind the success of STBM in sanitation.
Bima? What have been done
What are the role of various to support the exchange of In your opinion, what are the
stakeholders (government, knowledge with other areas who challenges that are still faced in
private CSR, media, want to learn from Bima? the implementation of STBM in
communities, universities, The factors behind the success in Bima?
donors, INGOs, NGOs, etc.) in the Bima include leadership, where Challenges still to be faced are
implementation of STBM? there is a harmonious collaboration related to the limited ability of the
The regional government puts and communication, especially regency budget. In addition, there
NGOs, media, universities and between the executive and the needs to be improved synergy
of the role of different sectors/
stakeholders in the program.
” Several NGOs provide financial Another challenge to be faced is
support in the planning and the topography of the regency,

implementation of government which demands support facilities
and resources in facilitating the
programs” public.

others as partners in which legislature in formulating policies What are expectations, feedback
the government provides the that support STBM. In addition, and evaluation for increased
widest possible opportunity to the regent of Bima always heeds acceleration of STBM program at
contribute in compliance with the aspirations of the rural people the national level?
existing legislation. For example, through activities such as BBGRM National government support
in terms of promotion and in every village, Ramadan safari needs to be increased, both
dissemination of STBM, the role of activities, direct visits to the the allocation of funds and
the mass media (especially local community, etc., which also helped programs within the framework
media) is optimized. Some NGOs the success of STBM. of community-based STBM. At
provide financial support in the the policy level, synergy of STBM
planning and implementation In order to exchange knowledge promotion policy at the national
of government programs. with other areas, we have facilitated level needs to be increased, in the
Likewise academics are active as and shared our experience with framework of integration in the
government partners in assessment Dompu and Bima Municipality region.
and advocacy programs. AMPL working groups on
sustainable and community-based


5 Pillars of STBM, Doc. Plan Indonesia

Applications and Challenges
When Indonesia started implementing a variation of Management of household sewage. In particular, STBM
CLTS (Community Led Total Sanitation), namely STBM strategy is not made only to disseminate information,
(Community-Based Total Sanitation), the sanitation but with continuous encouragement and support
situation is still weak, in which public awareness about creating awareness on sanitation both in attitude and
the importance of sanitation is lacking. lifestyle. In other words, the expected effect is a change
in lifestyle, from “laissez faire” (let alone) to “care and
STBM itself is a strategy having 5 pillars including take care”.
five important aspects, namely: (1). Free from
open defecation, (2). Washing hands with soap, The Sanitation Hygiene and Water Program, commonly
(3). Management of drinking water and household abbreviated SHAW, is one of the consortia coordinated
food, (4). Household waste management, and (5). by the Dutch NGO SIMAVI, in introducing the five


pillars of STBM. This effort is done in participants, so triggering is done implement Pillar 1 only. The pride
collaboration with five local NGOs at the hamlet level, or even at a of reaching all 5 pillars is important
namely PLAN Indonesia (Kabupaten lower level. to a village, because the 5 pillars are
TTS and TTU in NTT), Yayasan Dian considered as a single package that
Desa (Kabupaten Sikka and Flotim Since 2010, it has been considered can encourage behavioral change.
in NTT), Rumsram Foundation (Biak important to involve various
Numfor and Supiori in Papua), CD groups. Not only local government Application of 5 STBM pillars is
Bethesda (Kab. Sumba Tengah staff, but also sanitarians, certainly not easy or without
and SBD in NTB) and Yayasan midwives, health office staff, task challenges altogether. Always there
Masyarakat Peduli (Kab. Lombok force members, village heads, is a risk of returning to original
Timur at NTB). hamlet heads, district heads, behavior. Dynamics in the village
and community leaders. The as well as the support of all parties,
The key to STBM is behaviour government as the stakeholder is both inside and outside the village,
change, not the number of facilities not the project manager, but acts are instrumental. Initiatives and
and activities. And as experienced as a supporter of organizations and joint efforts will be successful if all

Joint initiative and efforts will succeed when
everyone participates and cares about the
condition being experienced
in the field, the implementation of the community, and pay respect people want to come and care for
the five STBM pillars is divided into to successful villages and their the conditions experienced.
four stages, namely preparation, inhabitants.
triggering, follow-up support, and Knowledge of stages to achieve the
monitoring and stimulation of In relation to the five pillars, a five STBM pillars and alternatives to
interest made after the declaration. large number of actors want to achieve such status are important
In terms of dynamics, all partners concentrate on Pillar 1 (stopping to be encouraged. The available
begin by preparing themselves open defecation), because it is choices still needs to be further
and the community so that the easier and physically observable. In developed by the private sector in
triggering can be the highlight of fact, during roadshows by SHAW order to have economic value.
attention and the starting point for partners, there are districts and
Pam Minnigh, Yusmaidy/ Simavi
change. Often triggering cannot villages that already understand
be implemented at the village the importance of all five pillars,
level because there are too many and that they do not want to


Strategic Choices in
Changing Community Behavior

S ince 2008, STBM has become a national strategy to
accelerate the achievement of MDGs, for drinking
water and sanitation sector. Initially, STBM was more
characteristics of urban population with its density and
variation of livelihood, High Five develops a strategy
of holistic approach. The strategy of this approach
widely adopted in rural areas as most villagers do consists of three interrelated elements : Foster a sense
not have adequate access to water and sanitation. In of necessity and a sense of ownership of STBM; The
fact, in urban areas that are commonly understood to mechanism of dialogue and participative action for
have water and sanitation systems, there are still many sustainability program; Partnership to increase access
citizens who do not have adequate access and not and sanitation and hygiene behaviors.
practice hygienic behaviors and safe sanitation.
Opportunities and challenges
Given these conditions in April 2011, USAID in
collaboration with Yayasan Cipta Cara Padu Indonesia Challenges faced in implementing STBM in urban areas
rolled out the High Five program to implement STBM in are very complex, ranging from the regional diversity,
urban areas as an effort to improve sanitation practices varied livelihoods, population density, busy society, lack
and hygiene. In understanding that the approach of land, up to the materialistic and ego-centric attitude
taken should be able to provide space for public that focuses on personal gain. On the government
participation, as well as to accommodate the unique side, there are still many individuals holding key

1. Create a sense of need and ownership of STBM

2. Dialogue mechanism and community
participatory action for the sustainability of the
program.

3. Partnership for increasing access and sanitation
and hygienic behavior


positions who do not understand the introduction of the pillars their behavior to STBM must be
STBM and thus not understand and triggering are done at the accompanied by triggering the
the importance of STBM for their same time. From High Five’s city government, particularly
institutions. experience, people are invited to the local government’s offices
comprehensively observe their related to sanitation and hygiene
Instead of struggling with the sanitation conditions and discuss to implement STBM. The city
challenges that must be faced, which STBM pillar is considered the government is also encouraged
High Five looked at the situation most crucial and will be used as to connect the city system with
from a different angle and the entry point for the application community activities. Experience
turned it into an opportunity of STBM. Based on experience, in shows that the approach is

Challenges faced in implementing STBM
in urban areas are very complex

to implement the program. urban areas (especially Medan, successfulin creating synergy
The diversity of backgrounds of Surabaya and Makassar), people between government programs
the community of innovation see waste/garbage (STBM pillar 4) and community activities. For
spawned a unique approach as a crucial issue and provide an example, in the cities of Medan,
and a lack of understanding of entry point to carry out STBM. Surabaya and Makassar, the City
municipal government encourages Sanitation Departments are actively
the development of methods Second, the approach using involved in activities of community
and collaboration of different a positive perspective is more gotong royong activities by
approaches. effective to trigger the action taken. allocating garbage trucks.
High Five uses the VIC action tool
The learning is summarized in the (modified from VIC tool developed Fourth, the media is involved in
following several points: by JHU-CCP) to trigger people to the activity, and not just as news
get moving and carrying out joint coverers. High Five put the media/
First, participatory assessment actions. journalists as active participants in
is a tool for building awareness discussion and implementation. It
as well as triggering STBM. Here, Third, triggering people to change is effective to induce curiosity and


Doc. High Five
Suciati Lasiman
from Petemonan
Subdistrict in
Surabaya, a
local waste
bank activist.
Community
members can pay
for their loans
in the form of
waste

Given the lessons learned from the
implementation of the High Five program, it shows
that innovation in approach and implementation
strategy for STBM is much needed.

push to further engage in various implementation strategy for should be alert to opportunities
activities. STBM is much needed. Variations and development of innovation
of innovation depend on the to support the implementation of
Given the lessons learned from uniqueness of each region. This STBM.
the implementation of the High does not only apply to the
Ika Fransisca/ High Five
Five program for one year, it shows implementation of STBM in urban
that innovation in approach and areas but also in rural areas. We


Source: www.plan-international.org
Delivering the
CLTS approach to
the community in
Pakistan

Learning CLTS
from Our Neighboring Countries
As an unsubsidized participatory approach, Community Led Total
Sanitation (CLTS) is also applied in some of our neighboring coun-
tries. Plan International is one of the supporters of the implementa-
tion of CLTS in a number of Asian countries.
Starting CLTS in Vietnam sanitation facilities. A total of 27.7% of ethnic minorities

D iseases caused by water conditions and poor
sanitation is a major health problem in Vietnam.
According to the MICS (Multiple Indicator Cluster
still defecate in the open.

Through the implementation of CLTS in WASH
Survey) nationally conducted survey, in Vietnam PLAN VN Program for 2011 - 2012, some important
nearly 1 out of every 4 children under five (22.7%) are factors are identified in achieving the main goal of
malnourished. Malnutrition is also closely related to CLTS - free from open defecation, among which are:
sanitary conditions and poor health. involvement of local governments from the beginning,
involvement of the government health authorities in
On the other hand, the promotion and use of healthy all levels, involvement of individuals and community
latrines has not yet achieved satisfactory results when organizations, capacity building of local partners,
compared with the results achieved by the water follow-up of implementation and reporting.
supply sector within the 2000 to 2010 period. There is
also a large gap between the two sectors. According Total Sanitation approach in Pakistan
to MICS 2010-2011, 73.8% of households in Vietnam Pakistan’s 2006 National Sanitation Policy emphasizes
use healthy latrines, but among ethnic minorities, social movements as a major component in to
only 44.2% of households have access to improved tackle the problem of sanitation at the household


CLTS triggering
activity in
Vietnam

Doc. Plan Vietnam
level, especially in rural areas. dignity, self-esteem and pride. This methodology and the role they
The National Policy has a vision is also seen from the intervention play in maintaining the positive
to create an environment free from the supply side through the impact of the program to embed
from open defecation, disposal of creation of sanitation marketing. health promotion messages to
wastewater and solid waste and their students. As a result, a total of
promotion of hygienic behavior Development of rural sanitation in 3,279 schools have been triggered
and health. The purpose of this flood affected areas is implemented in the target area and 6,950 health
policy is to promote the CLTS through Community Resource promotion efforts have also been
approach and formalize the “Total Persons (CRPs) or community made in the same schools.
Sanitation Model”. In March 2011 activists. There is a total of 2,659
the Government of Pakistan has CRPs in 4 provinces and regions A sanitation marketing strategy has
approved a guidance document of Pakistan. During the training also been designed and a robust
entitled “Pakistan’s Approach in session, it is emphasized that framework developed carefully
Total Sanitation (PATS)”. CRPs should know about project through serious field research. A
activities, creation of action comprehensive guide has also
During March 2011, the plans and implementation of been developed to facilitate
Government of Pakistan through the project strategy. This training the training of the Sanitation
the Ministry of Environment has is also conducted on teachers. Entrepreneurs in both urban and
approved the preliminary stage of 10,000 school teachers attend two rural areas.
CLTS for Pakistan. Slightly different days of training related to health
from the CLTS approach, PATS care. They were given exposure Until now, 2,110 villages have been
emphasizes the importance of on the program objectives, certified ODF by the government,


Hand
washing with
soap, being
campaigned
in schools in
Vietnam

conditions in Laos have cost 5.6%
of Gross Domestic Product (GDP) or
at 193 million USD per year.

To increase the impact of ODF,
government WASH teams also
promote hand washing with soap,
drinking boiled water and storing
in sealed containers and keeping
Doc. Plan Vietnam the village environment free of litter
and water puddles.

At schools, where the residents
and more than 1,000 villages have Lamed in 8 villages in the districts are not able to build good toilet
achieved ODF status and are in the of Paktha, Phaoudom and Meung facilities, PLAN Laos provides
process of certification. celebrate their achievement of construction material for hand
100% toilet coverage in villages. washing facilities and toilet
Celebrating a Healthy Lifestyle This means, they no longer need construction. The villagers
in Laos to have to go to the bushes to contribute sand, wood and labor.
There is a fact that many people defecate. Eight elementary schools The joint initiative between PLAN
still do open defecation in remote and 1,400 students in the three and the residents have created a
villages in Laos. The condition of districts also celebrated their school sense of ownership for the villagers
poor sanitation behavior causes being ODF. More than 20 other and school children that is creating
many occurrences of disease villages and schools have made sustainability and maintenance for
and premature death. However, significant progress in achieving this facility.
this does not happen with the ODF status and hope that they
children and residents in Bokeo celebrate the same soon. The WASH program in Bokeo will
province, Laos. They no longer go continue to work with the local
to the bush, chase pigs, suffer from Having toilets only since the last government, schools and villages
mosquito bites, and hopefully, year, Maisang Houay villagers still with support from parties such as
suffer from diarrhea due to poor keep the memory of losing their the Water and Sanitation Program
sanitary conditions. children who died prematurely. (WSP) - The World Bank, SNV of
Not only causing health problems, the Netherlands and various other
In the last month, more than 2,000 according to a World Bank partners in Laos.
ethnic Leu, Hmong, Khamu, and study, poor water and sanitation Rewrite by: Yusmaidy


Learning STBM from the
experience in Lumajang
When the “Washing Hands” program is
combined
with the “Alert Husbands” program

I n the matters of developing STBM programs,
Lumajang may be the champion. Currently almost
7 districts have reached ODF status, namely: Gucialit,
centers. In 2012, Gucialit health center has received
BOK funding at IDR 81 million with 70% utilization
for health promotion activities or promkes (including
Senduro, Padang, Kedungjajang, Pasirjambe, STBM), 20% for Environmental Health activities and
Pronojiwo, and Klakah is soon to follow. the remainder allocated to maternal and child
health activities.
Various intensive efforts were
taken to achieve ODF and What is interesting in the utilization
develop STBM program, of the large BOK funds, Gucialit
including the following: health center initiates promotive and
preventive programs. The program
First, empowering small-scale CSR. facilitates and integrates all activities
The term is, “small, but effective to and programs under the Health Center.
help accelerating the achievement of Various programs were included in this program
targets”. This attempt is done through the supervision including Maternal and Child Health, Nutrition,
of the regency health office, district and village heads Environmental Health, Family Planning and Alert
who intensively submit proposals for assistance to large Village. All activities are also incorporated in Posyandu
stores, gas stations, factories and local businesses. The Gerbang Mas (Movement to Build a Healthy Society).
proceeds will be used to purchase materials for latrine,
communal ones in particular, while the labor needs will One form of the promotive, preventive and innovative
be pursued through community service. activity is the “Alert Husband” training. It is innovative
as the “Alert Husband” training was combined with a
Second, the use of Operational Health Support Fund number of CTPS (Handwashing with Soap) features
(BOK) to unify various existing programs in health campaigned in STBM.


One of the
teaching tools
in the Alert
Husbands
program. This
activity also
promotes STBM
efforts, such as
washing hands
using soap.

Synergy with Alert Husband The trainings used participatory
The Alert Husband program began methods, the active role of both
in early 2012 in Lumajang. Gucialit husband and wife are expected
is one of the districts that in this responsible in assisting the wife, as to bring a more comprehensive
year launched an Alert Husband well as meeting facilities/amenities understanding and ability to
training in all villages. Data showed of nutrition, sanitation and family practice in a real day-to-day
that there were about 500 pregnant hygiene in a sustainable manner. activities. Beginning with the
women in one year in Gucialit, who identification of the risks of
need intensive treatment during Every three months, opportunity pregnancy and childbirth, and
pregnancy and labor. is given for 10 young couples to benefits of nutrition for expecting

The active role of both husbands and wives
is to be developed to create comprehensive
understanding and ability to practice in real life
The objective of the Alert Husband receive training and knowledge and lactating mothers, benefits
training was to prepare husbands about pregnancy and childbirth. of family planning and healthy
during pregnancy, childbirth up to Participants exceeded the target environment for pregnant and
the care of infants up to 2 years of due to the high interest of young lactating women, the pairs are
age. This includes awareness to be couples. facilitated by cadres and midwives


Hariyanto,
PHBS promotor
and sanitation
entrepreneur from
Gucialit district,
Lumajang regency

who have prepared a check-list. observed whether pit toilets have
The check list becomes a tool for been converted to proper toilets,
monitoring the couples until after also whether CTPS facilities have
the birth. The understanding of the been provided either in the dining Another observed CTPS behavior
husband before and after training room or near pets cages. is that if not used to washing
were also compared and measured hands, children’s fingernails will
on a regular basis. It is customary that a mother who look black. It is recognized that
just gave birth be visited by many CTPS activity is still hard to do
Importance of CTPS facilities in people. Before looking at the baby, everyday, but citizens are aware
the Monitoring - Post-Childbirth every visitor must warm the feet that this is the practice that should
Phase and hands over the stove, thinking be done. In the end, each cadre
Through BOK funding, each Alert that the smoke and heat will kill has a role to monitor and survey
Husband training in one village germs. This is clearly not medically by visiting homes each month.
needs an average estimated cost justified. This habit is changed to The monitoring tool can be
of IDR 750,000 used for: allowance/ washing hands before visiting the downloaded from the internet, in
transport for trainees respectively infant. Thus in the check-list and the form of cards which is then
IDR 15,000, snack and lunch as campaigns, the importance of made in the form of stickers and
well as post-training monitoring providing CTPS means, especially affixed in every home to be an
activities. in the case of new mothers, is instrument of control.
stressed.
Wendy Sarasdyani / WSP
In the monitoring process, it is


ALBERTUS FAY

FROM BONET
TRADITION
TO
INSTRUCTION
OF THE
DISTRICT
HEAD
Notes from
the STBM Project (SHAW Program,
Cooperation of Plan Indonesia -
SIMAVI)

Kalu het aomin so tanaoba lais nono nim in
Lasi no nima ni, fun sin fani on ni ainaf/
Fani on ni ainaf, an bi monit lais aomina/
Kalu hit aomin fun hit aoke namep/
Hit aoke namep, fun hip mepu naomat,
fun hit mepu naomat, fun hit nekak an malin/
Hit neken malin, fun hit pules usi neno.
If you want to live a healthy life 5 things (STBM)
should be carried out /
The five pillars are the center/
The center of our health /
If we’re healthy, the body is strong,
Productivity increased, the heart rejoice /
If the heart rejoices, we can glorify God.

Achieving sanitation for all through stbm percik special edition indonesia 2012

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