Impact Evaluation of a Large-scale Rural Sanitation Project in Indonesia

Lack of sanitation and poor hygiene behavior cause a tremendous disease burden among the poor. This paper evaluates the impact of the Total Sanitation and Sanitation Marketing project in Indonesia, where about 11 percent of children have diarrhea i...

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Main Authors:	Cameron, Lisa, Shah, Manisha, Olivia, Susan
Format:	Policy Research Working Paper
Language:	English en_US
Published:	World Bank, Washington, DC 2013
Subjects:	ABDOMINAL PAIN ACUTE RESPIRATORY INFECTION ACUTE RESPIRATORY INFECTIONS AGE GROUPS AGED AGING ANCYLOSTOMA ANCYLOSTOMA DUODENALE ANEMIA ARI ASCARIS LUMBRICOIDES ATTITUDINAL CHANGE BEHAVIOR CHANGE BEHAVIORAL CHANGE BEHAVIORAL CHANGES BETTER HYGIENE BOREHOLES BREASTFEEDING BURDEN OF DISEASE CAREGIVERS CAUSES OF DEATH CHEMOTHERAPY CHILD DEVELOPMENT CHILD GROWTH CHILD HEALTH CHILD HEALTH OUTCOMES COMMUNITIES COMMUNITY HEALTH DEFECATION DESCRIPTION DIAGNOSIS DIARRHEA DIARRHEAL DISEASES DISABILITY DISEASE BURDEN DISEASE RISK DISTRICTS DRINKING WATER DWELLING EPIDEMIOLOGY FECUNDITY FEMALE GENDER HANDWASHING HAZARD HEALTH EFFECTS HEALTH OUTCOMES HELMINTHES HELMINTHIASIS HOOKWORM HOOKWORMS HOUSEHOLDS HYGIENE HYGIENE BEHAVIOR HYGIENE HABITS HYGIENE ISSUES HYGIENE PRACTICE HYGIENE PRACTICES ILLNESSES IMMUNE DEFICIENCY IMPROVEMENTS IN HEALTH INADEQUATE SANITATION INADEQUATE WATER INADEQUATE WATER SUPPLY INFANTS INFECTION INFECTIONS INFECTIOUS DISEASE INTERVENTION INTERVENTIONS IRON LATRINE CONSTRUCTION LATRINES MALNUTRITION MARKETING MATERNAL HEALTH MOBILITY MORTALITY NASAL CONGESTION NECATOR NECATOR AMERICANUS NUTRITION NUTRITIONAL STATUS PARASITOLOGY PATHOGENS PEDIATRICS PHYSICAL ACTIVITY PHYSICAL FITNESS PHYSICAL GROWTH POLLUTION POOR HYGIENE PREVALENCE PREVENTABLE DISEASES PUBLIC HEALTH RANDOMIZED CONTROLLED TRIALS RISK FACTORS RURAL AREAS RURAL COMMUNITIES SANITATION SANITATION FACILITIES SANITATION PRACTICES SANITATION SERVICES SANITATION SITUATION SCHISTOSOMA SCHISTOSOMIASIS SOAP SOCIAL MARKETING SOURCES OF WATER STD STUNTING SYMPTOMS TENANCY TOILETS TREATMENT TROPICAL DISEASES TROPICAL MEDICINE TYPHOID VACCINES VILLAGE LEVEL VILLAGES WASHING HANDS WASTE WASTING WATER QUALITY WATER SOURCE
Online Access:	http://documents.worldbank.org/curated/en/2013/02/17288401/impact-evaluation-large-scale-rural-sanitation-project-indonesia http://hdl.handle.net/10986/13166

id	okr-10986-13166
recordtype	oai_dc
spelling	okr-10986-131662021-04-23T14:03:07Z Impact Evaluation of a Large-scale Rural Sanitation Project in Indonesia Cameron, Lisa Shah, Manisha Olivia, Susan ABDOMINAL PAIN ACUTE RESPIRATORY INFECTION ACUTE RESPIRATORY INFECTIONS AGE GROUPS AGED AGING ANCYLOSTOMA ANCYLOSTOMA DUODENALE ANEMIA ARI ASCARIS LUMBRICOIDES ATTITUDINAL CHANGE BEHAVIOR CHANGE BEHAVIORAL CHANGE BEHAVIORAL CHANGES BETTER HYGIENE BOREHOLES BREASTFEEDING BURDEN OF DISEASE CAREGIVERS CAUSES OF DEATH CHEMOTHERAPY CHILD DEVELOPMENT CHILD GROWTH CHILD HEALTH CHILD HEALTH OUTCOMES COMMUNITIES COMMUNITY HEALTH DEFECATION DESCRIPTION DIAGNOSIS DIARRHEA DIARRHEAL DISEASES DISABILITY DISEASE BURDEN DISEASE RISK DISTRICTS DRINKING WATER DWELLING EPIDEMIOLOGY FECUNDITY FEMALE GENDER HANDWASHING HAZARD HEALTH EFFECTS HEALTH OUTCOMES HELMINTHES HELMINTHIASIS HOOKWORM HOOKWORMS HOUSEHOLDS HYGIENE HYGIENE BEHAVIOR HYGIENE HABITS HYGIENE ISSUES HYGIENE PRACTICE HYGIENE PRACTICES ILLNESSES IMMUNE DEFICIENCY IMPROVEMENTS IN HEALTH INADEQUATE SANITATION INADEQUATE WATER INADEQUATE WATER SUPPLY INFANTS INFECTION INFECTIONS INFECTIOUS DISEASE INTERVENTION INTERVENTIONS IRON LATRINE CONSTRUCTION LATRINES MALNUTRITION MARKETING MATERNAL HEALTH MOBILITY MORTALITY NASAL CONGESTION NECATOR NECATOR AMERICANUS NUTRITION NUTRITIONAL STATUS PARASITOLOGY PATHOGENS PEDIATRICS PHYSICAL ACTIVITY PHYSICAL FITNESS PHYSICAL GROWTH POLLUTION POOR HYGIENE PREVALENCE PREVENTABLE DISEASES PUBLIC HEALTH RANDOMIZED CONTROLLED TRIALS RISK FACTORS RURAL AREAS RURAL COMMUNITIES SANITATION SANITATION FACILITIES SANITATION PRACTICES SANITATION SERVICES SANITATION SITUATION SCHISTOSOMA SCHISTOSOMIASIS SOAP SOCIAL MARKETING SOURCES OF WATER STD STUNTING SYMPTOMS TENANCY TOILETS TREATMENT TROPICAL DISEASES TROPICAL MEDICINE TYPHOID VACCINES VILLAGE LEVEL VILLAGES WASHING HANDS WASTE WASTING WATER QUALITY WATER SOURCE Lack of sanitation and poor hygiene behavior cause a tremendous disease burden among the poor. This paper evaluates the impact of the Total Sanitation and Sanitation Marketing project in Indonesia, where about 11 percent of children have diarrhea in any two-week period and more than 33,000 children die each year from diarrhea. The evaluation utilizes a randomized controlled trial but is unusual in that the program was evaluated when implemented at scale across the province of rural East Java in a way that was designed to strengthen the enabling environment and so be sustainable. One hundred and sixty communities across eight rural districts participated, and approximately 2,100 households were interviewed before and after the intervention. The authors found that the project increased toilet construction by approximately 3 percentage points (a 31 percent increase in the rate of toilet construction). The changes were primarily among non-poor households that did not have access to sanitation at baseline. Open defecation among these households decreased by 6 percentage points (or 17 percent). Diarrhea prevalence was 30 percent lower in treatment communities than in control communities at endline (3.3 versus 4.6 percent). The analysis cannot rule out that the differences in drinking water and handwashing behavior drove the decline in diarrhea. Reductions in parasitic infestations and improvements in height and weight were found for the non-poor sample with no sanitation at baseline. 2013-04-11T20:15:09Z 2013-04-11T20:15:09Z 2013-02 http://documents.worldbank.org/curated/en/2013/02/17288401/impact-evaluation-large-scale-rural-sanitation-project-indonesia http://hdl.handle.net/10986/13166 English en_US Policy Research Working Paper;No. 6360 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank World Bank, Washington, DC Publications & Research :: Policy Research Working Paper Publications & Research East Asia and Pacific Indonesia
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
language	English en_US
topic	ABDOMINAL PAIN ACUTE RESPIRATORY INFECTION ACUTE RESPIRATORY INFECTIONS AGE GROUPS AGED AGING ANCYLOSTOMA ANCYLOSTOMA DUODENALE ANEMIA ARI ASCARIS LUMBRICOIDES ATTITUDINAL CHANGE BEHAVIOR CHANGE BEHAVIORAL CHANGE BEHAVIORAL CHANGES BETTER HYGIENE BOREHOLES BREASTFEEDING BURDEN OF DISEASE CAREGIVERS CAUSES OF DEATH CHEMOTHERAPY CHILD DEVELOPMENT CHILD GROWTH CHILD HEALTH CHILD HEALTH OUTCOMES COMMUNITIES COMMUNITY HEALTH DEFECATION DESCRIPTION DIAGNOSIS DIARRHEA DIARRHEAL DISEASES DISABILITY DISEASE BURDEN DISEASE RISK DISTRICTS DRINKING WATER DWELLING EPIDEMIOLOGY FECUNDITY FEMALE GENDER HANDWASHING HAZARD HEALTH EFFECTS HEALTH OUTCOMES HELMINTHES HELMINTHIASIS HOOKWORM HOOKWORMS HOUSEHOLDS HYGIENE HYGIENE BEHAVIOR HYGIENE HABITS HYGIENE ISSUES HYGIENE PRACTICE HYGIENE PRACTICES ILLNESSES IMMUNE DEFICIENCY IMPROVEMENTS IN HEALTH INADEQUATE SANITATION INADEQUATE WATER INADEQUATE WATER SUPPLY INFANTS INFECTION INFECTIONS INFECTIOUS DISEASE INTERVENTION INTERVENTIONS IRON LATRINE CONSTRUCTION LATRINES MALNUTRITION MARKETING MATERNAL HEALTH MOBILITY MORTALITY NASAL CONGESTION NECATOR NECATOR AMERICANUS NUTRITION NUTRITIONAL STATUS PARASITOLOGY PATHOGENS PEDIATRICS PHYSICAL ACTIVITY PHYSICAL FITNESS PHYSICAL GROWTH POLLUTION POOR HYGIENE PREVALENCE PREVENTABLE DISEASES PUBLIC HEALTH RANDOMIZED CONTROLLED TRIALS RISK FACTORS RURAL AREAS RURAL COMMUNITIES SANITATION SANITATION FACILITIES SANITATION PRACTICES SANITATION SERVICES SANITATION SITUATION SCHISTOSOMA SCHISTOSOMIASIS SOAP SOCIAL MARKETING SOURCES OF WATER STD STUNTING SYMPTOMS TENANCY TOILETS TREATMENT TROPICAL DISEASES TROPICAL MEDICINE TYPHOID VACCINES VILLAGE LEVEL VILLAGES WASHING HANDS WASTE WASTING WATER QUALITY WATER SOURCE
spellingShingle	ABDOMINAL PAIN ACUTE RESPIRATORY INFECTION ACUTE RESPIRATORY INFECTIONS AGE GROUPS AGED AGING ANCYLOSTOMA ANCYLOSTOMA DUODENALE ANEMIA ARI ASCARIS LUMBRICOIDES ATTITUDINAL CHANGE BEHAVIOR CHANGE BEHAVIORAL CHANGE BEHAVIORAL CHANGES BETTER HYGIENE BOREHOLES BREASTFEEDING BURDEN OF DISEASE CAREGIVERS CAUSES OF DEATH CHEMOTHERAPY CHILD DEVELOPMENT CHILD GROWTH CHILD HEALTH CHILD HEALTH OUTCOMES COMMUNITIES COMMUNITY HEALTH DEFECATION DESCRIPTION DIAGNOSIS DIARRHEA DIARRHEAL DISEASES DISABILITY DISEASE BURDEN DISEASE RISK DISTRICTS DRINKING WATER DWELLING EPIDEMIOLOGY FECUNDITY FEMALE GENDER HANDWASHING HAZARD HEALTH EFFECTS HEALTH OUTCOMES HELMINTHES HELMINTHIASIS HOOKWORM HOOKWORMS HOUSEHOLDS HYGIENE HYGIENE BEHAVIOR HYGIENE HABITS HYGIENE ISSUES HYGIENE PRACTICE HYGIENE PRACTICES ILLNESSES IMMUNE DEFICIENCY IMPROVEMENTS IN HEALTH INADEQUATE SANITATION INADEQUATE WATER INADEQUATE WATER SUPPLY INFANTS INFECTION INFECTIONS INFECTIOUS DISEASE INTERVENTION INTERVENTIONS IRON LATRINE CONSTRUCTION LATRINES MALNUTRITION MARKETING MATERNAL HEALTH MOBILITY MORTALITY NASAL CONGESTION NECATOR NECATOR AMERICANUS NUTRITION NUTRITIONAL STATUS PARASITOLOGY PATHOGENS PEDIATRICS PHYSICAL ACTIVITY PHYSICAL FITNESS PHYSICAL GROWTH POLLUTION POOR HYGIENE PREVALENCE PREVENTABLE DISEASES PUBLIC HEALTH RANDOMIZED CONTROLLED TRIALS RISK FACTORS RURAL AREAS RURAL COMMUNITIES SANITATION SANITATION FACILITIES SANITATION PRACTICES SANITATION SERVICES SANITATION SITUATION SCHISTOSOMA SCHISTOSOMIASIS SOAP SOCIAL MARKETING SOURCES OF WATER STD STUNTING SYMPTOMS TENANCY TOILETS TREATMENT TROPICAL DISEASES TROPICAL MEDICINE TYPHOID VACCINES VILLAGE LEVEL VILLAGES WASHING HANDS WASTE WASTING WATER QUALITY WATER SOURCE Cameron, Lisa Shah, Manisha Olivia, Susan Impact Evaluation of a Large-scale Rural Sanitation Project in Indonesia
geographic_facet	East Asia and Pacific Indonesia
relation	Policy Research Working Paper;No. 6360
description	Lack of sanitation and poor hygiene behavior cause a tremendous disease burden among the poor. This paper evaluates the impact of the Total Sanitation and Sanitation Marketing project in Indonesia, where about 11 percent of children have diarrhea in any two-week period and more than 33,000 children die each year from diarrhea. The evaluation utilizes a randomized controlled trial but is unusual in that the program was evaluated when implemented at scale across the province of rural East Java in a way that was designed to strengthen the enabling environment and so be sustainable. One hundred and sixty communities across eight rural districts participated, and approximately 2,100 households were interviewed before and after the intervention. The authors found that the project increased toilet construction by approximately 3 percentage points (a 31 percent increase in the rate of toilet construction). The changes were primarily among non-poor households that did not have access to sanitation at baseline. Open defecation among these households decreased by 6 percentage points (or 17 percent). Diarrhea prevalence was 30 percent lower in treatment communities than in control communities at endline (3.3 versus 4.6 percent). The analysis cannot rule out that the differences in drinking water and handwashing behavior drove the decline in diarrhea. Reductions in parasitic infestations and improvements in height and weight were found for the non-poor sample with no sanitation at baseline.
format	Publications & Research :: Policy Research Working Paper
author	Cameron, Lisa Shah, Manisha Olivia, Susan
author_facet	Cameron, Lisa Shah, Manisha Olivia, Susan
author_sort	Cameron, Lisa
title	Impact Evaluation of a Large-scale Rural Sanitation Project in Indonesia
title_short	Impact Evaluation of a Large-scale Rural Sanitation Project in Indonesia
title_full	Impact Evaluation of a Large-scale Rural Sanitation Project in Indonesia
title_fullStr	Impact Evaluation of a Large-scale Rural Sanitation Project in Indonesia
title_full_unstemmed	Impact Evaluation of a Large-scale Rural Sanitation Project in Indonesia
title_sort	impact evaluation of a large-scale rural sanitation project in indonesia
publisher	World Bank, Washington, DC
publishDate	2013
url	http://documents.worldbank.org/curated/en/2013/02/17288401/impact-evaluation-large-scale-rural-sanitation-project-indonesia http://hdl.handle.net/10986/13166
_version_	1764422857511665664

Impact Evaluation of a Large-scale Rural Sanitation Project in Indonesia

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