Over the last three decades, Indonesia has enjoyed substantial achievements in poverty reduction, human development and improvements in service delivery. However, enormous challenges remain. Improving access to safe water and sanitation is a key priority, due to the severe consequences of poor sanitation infrastructure on public health, the economy, and the environment. Of the four most important causes of under-5 mortality in Indonesia, two—diarrhea and typhoid—are fecal-borne illnesses directly linked to inadequate water supply, sanitation and hygiene issues. Difficult access to improved water supply also means that poor households, particularly women and children, spend too much time fetching water. The 1998 financial crisis led to little to no investments in water infrastructure, and the government has struggled to maintain upkeep of existing facilities. PAMSIMAS strives to improve existing facilities and expand sanitation access, through a community-based approach.