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The dream of replicating and scaling up a new sanitation and hygiene delivery model throughout Indonesia.

This news item is based on an interview with Erick Baetings, senior sanitation expert at IRC.

Indonesia's rural eastern regions house 50% of its population. This area is less developed and has some of the worst water, sanitation and hygiene (WASH) and health indicators of the country. Preventable diarrhoeal disease, which is related to a lack of safe water and poor sanitation and hygiene practice, is still the third biggest cause of neonatal deaths in Indonesia.

To address these problems, the Indonesian Government has launched multiple (national) programmes and strategies for water and sanitation, including the ambitious target of realising universal access to water and sanitation by 2019.

Handwashing

SEHATI: sanitation and hygiene in Indonesia

IRC's senior sanitation expert Erick Baetings is currently involved in the Simavi-led Sustainable Sanitation and Hygiene for Eastern Indonesia (SEHATI) programme. The programme is designed around a new Theory of Change and will be testing a new delivery model to roll out the Indonesian Government's rural community-based total sanitation (STBM) policy to improve sanitation and hygiene. The STBM policy focuses on five sanitation and hygiene behaviours and practices: use of toilets; access to hand washing with soap facilities; improved household drinking water treatment and safe storage practices; and improved household level solid and liquid waste management practices.

SEHATI is a three-and-a-half-year during programme covering seven districts in East Indonesia. It is a follow-up of the Sanitation, Hygiene and Water (SHAW) programme which was executed in nine districts in East Indonesia from May 2010 until June 2015. The SEHATI programme is being implemented in previous SHAW districts (Lombok Timur, Sumba Tengah, Sumba Barat Daya, and Biak Numfor) and in three new districts (Lombok Utara, Manggaria Barat, and Dompu). The three new districts were selected on the basis of a set of ten criteria, which include the level of interest and commitment expressed by the local government authorities and their willingness to allocate sufficient human and financial resources for replication and or scaling up of the programme throughout their jurisdiction.

IRC provides technical advice to Simavi and the local SEHATI partners: Yayasan Dian Desa, Yayasan Rumsram, PLAN Indonesia, CD-Bethesda, and Yayasan Masyarakat Peduli. IRC took the lead in developing the new Theory of Change and the performance monitoring framework for the programme and guiding the local partners during the inception phase.

Improved programme

SEHATI draws on the lessons learned from the SHAW programme. Both programmes involve the same five local partners. They were responsible for facilitating and driving change in the rural communities. Despite the fact they worked in coordination with the local government, these partners mainly worked by themselves. This created concerns about the sustainability of the programme. Who was going to continue to support the communities when the external actors left at the end of SHAW? There was another compelling factor to change the delivery model: although the SHAW programme was able to improve the sanitation and hygiene conditions for some 1.5 million people in Indonesia, this was still only 1% of the total rural population in Indonesia. This means that it would require 100 SHAW projects to reach full coverage across rural Indonesia!

Programme pillars

To be able to accelerate coverage and to increase the overall health impact of sanitation and hygiene programmes, they need to be faster, cheaper and more sustainable. To accomplish this, the NGOs involved have become catalysts, capacity builders and mentors instead of implementors. The NGOs will focus predominantly on building capacity - in the broadest sense - of local government in the districts, sub-districts and villages. Local authorities are expected to take the lead in implementing the programme and drive change throughout the district.

Empowering local government

When SEHATI is finished and the partners leave, the local government should be capable of continuing supporting the villages. This requires intense involvement of the local government during the programme. The first step local government needs to make is to take up sanitation and hygiene in their long-term strategy: their five-year village and district development plans and budgets. This means reserving funds for the implementation, and where necessary for the replication of the programme each year. While the Embassy of the Kingdom of the Netherlands (EKNI in Indonesia) financed the implementation of SHAW, the local governments are expected to finance a majority of SEHATI's STBM activities. This is expected to take away dependence on external donors. The second step is that the local governments - after their capacities have been strengthened - will execute the programme with support of the partners. Whereas the partners are responsible for increased levels of capacity, the local governments are directly responsible for the STBM achievements in the villages.

Success factors

The desired outcome of SEHATI is that the delivery model functions successfully in the seven districts. The result we want to see is that local government takes the lead and that it is capable of implementing STBM and sustaining the results independently from external partners. If the delivery model is proven to be successful it could be scaled up throughout Indonesia to support the government's efforts to realise universal coverage. In the end we all have the same dream: a healthier Indonesia.