In the 10 years to 2010, a World Bank project helped Indonesian communities to create the technical capacity to plan, manage and sustain improved water programs, sanitation, and community health services. It improved hygiene, health behavior, and community management of health services related to water-borne diseases, and provided safe options for waste disposal and clean water supply. Thanks to this project, Indonesia is now providing improved access to sanitation services in 2,294 villages across 37 districts in eight provinces and reaching over 5 million beneficiaries. The project also provided technical assistance to educate local communities about the importance of managing their own water and sanitation in a sustainable way.
As a growing middle-income country, Indonesia needed to substantially increase access to sanitation services. On a yearly basis, Indonesia lost approximately US$6.3 billion due to poor sanitation, including health care costs, lost productivity, premature deaths, water resource and fishery losses, declining land values and tourism losses. By improving sanitation in Indonesia, it could potentially contribute an estimated US$4.5 billion toward overall economic growth. The key challenge for Indonesia was for local governments to undertake important reforms, including improved governance, to implement sector programs.
Using a participatory approach, the Bank project worked with communities, schools and health centers to improve hygiene, health behavior, and community management of health services related to water-borne diseases. It was also aimed at providing safe options for waste disposal as needed by communities.
It worked with local communities to manage contracts with local firms, non-governmental organizations (NGOs) and academic institutions. By doing so, local communities could set up and run their own clean water supplies and sanitation facilities. Besides providing block grants, technical assistance was given to make sure that local communities could manage their own water and sanitation in a sustainable way. In addition, hygiene and sanitation was promoted through education and public information materials.
By the time of the project’s completion in 2010, it had:
- Assisted 2,291 villages with access to clean water, exceeding the appraisal target by 15%. The percentage increase of poor households with improved water supply and sanitation also exceeded the appraisal estimate.
- Assisted communities to organize and to obtain the technical capacity to plan, manage, and sustain water programs, sanitation and community health through service contracts with local firms, NGOs and academic institutions. Participatory methods at the community level were linked with hygiene and sanitation promotion. In addition, these methods also developed and produced information and education materials as well as public information activities.
- Improved hygiene, health behavior and community management of health services related to water-borne diseases through service contracts as well as to provide safe options for waste disposal as needed by the communities. Sub-components included a school health and hygiene program and a community health program.
- Provided clean water to the communities, through technical assistance service contracts to identify technology options and adequate levels of service. Furthermore, service contracts selected and planned the construction of health infrastructure according to the communities' needs. Financial and technical assistance supported the construction of infrastructure and its operation and maintenance.
This program expands the reach of the first Water Supply and Sanitation program for Low Income Communities. Beneficiaries have gained access to more convenient, higher quality, and more accessible water supply and improved community sanitation services.
The program also aimed to protect health services that are essential for the poor and public at large, while initiating key sector reforms and ensuring health sector financing. A second objective was to help the Ministry of Health carry out its new role in a decentralized system that encompassed the analysis of key issues, the advocacy of best practices and standards, and support for local initiative and innovation.
Reaching more than 2,000 villages across 37 districts in eight provinces over the ten years to 2010, the project was backed by a credit of US$77.4 million from the International Development Association (IDA), a grant of US$6.5 million from Australia’s AusAID, and funding from local beneficiaries of US$10.6 million. In response to public health concerns, the project aimed to improve health status, productivity, and quality of life in under-served rural villages in Indonesia through better provision of water and sanitation services.
The Project built on 10 years of Bank financial and technical experience in integrated water, sanitation and health programs in Indonesia implemented in six provinces through consultation with the Ministry of Health. The project supported demand-based improvements to water supply and to household and community sanitation and hygiene, with funds being channeled through block grants directly to the village level with separate budgets for district-level technical support.
Toward the Future
In supporting Indonesia to further strengthen the health system as a whole, the Bank focuses on the achievement of those Millennium Development Goals that will be most difficult for Indonesia to meet. The Bank will be continuously working with the Government to strengthen the health system as a whole, focusing on health financing, the health work-force and service delivery.