Background
In response to the preventable threats posed by poor sanitation and hygiene, in December 2006 the Water and Sanitation Program (WSP) launched two related large-scale projects, Global Scaling Up Handwashing1 and Global Scaling Up Rural Sanitation. Th ese hygiene and sanitation interventions are designed to improve the health and welfare outcomes for millions of poor people. Local and national governments are implementing these projects with technical support from WSP. Th e goal of Global Scaling Up Rural Sanitation is to reduce
the risk of diarrhea and therefore increase household productivity by stimulating demand for sanitation in the lives of people in India, Indonesia, and Tanzania.
Th e project approach demands involvement from communities, local government, and the private sector. It aims to trigger the desire for an open-defecation free community by raising collective awareness of the open defecation problem.
Facilitators are sent to communities to initiate participatory analysis of the communities’ existing sanitation practices, and the consequences and implications of such practices for themselves. Th is process is designed to catalyze collective community desire and action to become open defecation free (ODF). Th e community must forge their own plan for
making this happen with only limited follow-up support and monitoring from the program. Communities claiming to have become ODF are verifi ed by local government agencies. ODF achievement by a community brings recognition and commendation from local and provincial governments. The project also seeks to stimulate the supply of appropriate sanitation products and services by conducting market research and training local artisans to build the relevant facilities.
To measure the magnitudes of the impacts, the project is implementing randomized-controlled trial impact evaluations (IE) study in order to establish causal linkages between the intervention (treatment) and the outcomes of interest. Th e IE uses household surveys to measure the levels of key outcomes. This report summarizes the likelihood of success because of favorable local conditions (strong leadership, existing water and sanitation infrastructure, highly educated populations, and so forth) or diff erences in terms of hygiene habits, lower motivation, or other factors that are diffi cult to observe. Th is is known as selection bias. A random control group avoids these diffi culties by ensuring that the communities that receive the program are no diff erent, on average, than those that do not. In Indonesia, the project is being implemented in 29 rural districts (kabupaten) in East Java. Eight of those 29 districts
are participants in the impact evaluation—a total of 2080 households in 160 sub-villages (dusun). Th e sample is geographically representative and representative of the households
in rural East Java.
Th e evaluation measures a broad range of health indicators, and intensively studies the developmental, social, and economic welfare impacts of these interventions. Th e indicators were collected via an extensive baseline survey in September 2008, monthly longitudinal surveys conducted over a 15-month period, and an extensive follow-up survey in mid-2010.