Shaming Techniques on CLTS in Indonesia

Sodality: Jurnal Sosiologi Pedesaan

This study is focused on the change in new behaviour and routines on the issues of safe water and sanitation in Indonesia. The aim of this study is to explain the deconstruction of people's consciousness and societal knowledge on wastewater treatment plant (IPAL) facilities and the resulting behavioural change. By positioning programmes of safe water, sanitation, and the local value of healthy living as the “life projects”, this article attempts to re-examine the position of local communities in this project. Life projects are programmes that adhere to the local histories of communities in perceiving ‘development’. Life projects are premised on densely and uniquely woven 'threads' of landscapes, memory, expectations, and desire. In this regard, this article tries to disclose the participation of local communities in planning, managing and integrating local values and global visions of proper sanitation development programs in their villages. This study was a micro one co...

BMC Public Health, 2021

Background There is increasing recognition of the complexity underlying WASH conditions in developing countries. This article explores the complexity by assessing the vulnerability of a specific area to poor WASH conditions using a qualitative approach. Methods We present our findings for the district of East Sumba in Indonesia. This area is known as one of the poorest regions in Indonesia with inadequate WASH services, indigenous belief that hinder the practice of WASH-related behaviours, and has a high rate of children malnutrition. All the factors that contribute to poor WASH conditions were discussed through the lens of the Financial, Institutional, Environmental, Technological, and Social (FIETS) framework. We then summarised the factors and visualized the “system” using a mind map which shows how factors are interconnected and helps to find the root causes of poor WASH conditions. Results There are three main challenges that inhibit the improvement of WASH conditions in this a...

Global Environmental Studies, 2022

This part discusses sanitation from the perspectives of health and well-being. In particular, we focus on the socio-cultural aspects of water, sanitation, and hygiene (WASH) in relation to health. First, we discuss the social determinants of health (SDH) with an in-depth focus on the gender, cultural, and economic disparities that impact access to quality sanitation. We also spotlight sanitation workers, who play a significant part in existing sanitation systems yet unquantified and ostracized. Furthermore, as theoretical underpinnings, we review methodologies to behavioral changes including information dissemination, education approach, and community-based approach. Subsequently, we introduce the three chapters that constitute this part. Chapter 10.1007/978-981-16-7711-3_7 examines relationships between child health (e.g., undernutrition and diarrhea) and its associated factors (e.g., water, sanitation, and hand hygiene) in Indonesia. In Chap. 10.1007/978-981-16-7711-3_8, we argue ...

International journal of environmental research and public health, 2017

Community Approaches to Total Sanitation (CATS) programmes, like the Sanitasi Total Berbasis Masyarakat (STBM) programme of the Government of Indonesia, have played a significant role in reducing open defecation though still little is known about the sustainability of the outcomes. We assessed the sustainability of verified Open Defecation Free (ODF) villages and explored the association between slippage occurrence and the strength of social norms through a government conducted cross-sectional data collection in rural Indonesia. The study surveyed 587 households and held focus group discussions (FGDs) in six ODF villages two years after the government's ODF verification. Overall, the slippage rate (i.e., a combination of sub-optimal use of a latrine and open defecation at respondent level) was estimated to be 14.5% (95% CI 11.6-17.3). Results of multivariate logistic regression analyses indicated that (1) weaker social norms, as measured by respondents' perceptions around la...

Bulletin of The World Health Organization, 2009

Objective To determine the effectiveness of a sanitation campaign that combines "shaming" (i.e. emotional motivators) with subsidies for poor households in rural Orissa, an Indian state with a disproportionately high share of India's child mortality. Methods Using a cluster-randomized design, we selected 20 treatment and 20 control villages in the coastal district of Bhadrak, rural Orissa, for a total sample of 1050 households. We collected sanitation and health data before and after a community-led sanitation project, and we used a difference-indifference estimator to determine the extent to which the campaign influenced the number of households building and using a latrine. Findings Latrine ownership did not increase in control villages, but in treatment villages it rose from 6% to 32% in the overall sample, from 5% to 36% in households below the poverty line (eligible for a government subsidy) and from 7% to 26% in households above the poverty line (not eligible for a government subsidy). Conclusion Subsidies can overcome serious budget constraints but are not necessary to spur action, for shaming can be very effective by harnessing the power of social pressure and peer monitoring. Through a combination of shaming and subsidies, social marketing can improve sanitation worldwide. Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se facilita una traducción al español. ‫املقالة.‬ ‫لهذه‬ ‫الكامل‬ ‫النص‬ ‫نهاية‬ ‫يف‬ ‫الخالصة‬ ‫لهذه‬ ‫العربية‬ ‫الرتجمة‬

The Guardian's Poverty Matters blog, 9 June 2011

The ends may justify the means, but let's be clear - in rural India, extremes of coercion are being used to encourage toilet use.

Wiley Interdisciplinary Reviews: Water, 2014

Community Led Total Sanitation (CLTS) is a new approach to sanitation that has been widely adopted by international and national development organizations and national governments and implemented in 56 countries in the global South. Using participatory methods, it forces primarily rural communities to recognize that their practice of open defecation causes sickness and disease in their area and ‘triggers’ them to take action, ensuring that every household builds at least a pit latrine so that the community becomes open defecation free (ODF). In contrast to past approaches, one of its main tenets is strictly no subsidies of finance or materials. In the absence of monitoring and evaluation systems, it is not clear whether its immediate achievements are sustainable. In addition to questioning its sustainability, it is essential to examine CLTS through the analytical lens of power dynamics and human rights. While there is a rich practitioner-focused literature, there are few critical studies of this nature. Drawing on literature from a range of disciplines, this article deliberates how CLTS can be understood in terms of the concepts of rights, agents, and community. It questions whether, in the case of conflicting rights, the communal right to sanitation may justify compromising an individual's right to dignity. It also asks how we balance the right to dignity against the socioeconomic right to sanitation. Finally it questions the community led nature of CLTS, and suggests that external agents retain a level of responsibility for responding to any human rights infringements.

Policy Research Working Papers, 2013

Bulletin of the World Health Organization, 2009

Objective To determine the effectiveness of a sanitation campaign that combines "shaming" (i.e. emotional motivators) with subsidies for poor households in rural Orissa, an Indian state with a disproportionately high share of India's child mortality. Methods Using a cluster-randomized design, we selected 20 treatment and 20 control villages in the coastal district of Bhadrak, rural Orissa, for a total sample of 1050 households. We collected sanitation and health data before and after a community-led sanitation project, and we used a difference-in-difference estimator to determine the extent to which the campaign influenced the number of households building and using a latrine. Findings Latrine ownership did not increase in control villages, but in treatment villages it rose from 6% to 32% in the overall sample, from 5% to 36% in households below the poverty line (eligible for a government subsidy) and from 7% to 26% in households above the poverty line (not eligible for a government subsidy). Conclusion Subsidies can overcome serious budget constraints but are not necessary to spur action, for shaming can be very effective by harnessing the power of social pressure and peer monitoring. Through a combination of shaming and subsidies, social marketing can improve sanitation worldwide.

Despite the swift development of Vietnam's water supply and sanitation (wat/san) sector, over the last ten years there have been 1.5 million annual documented cases of diarrhea. Western perspectives blame insufficient medical or economic advancement for failing to prevent diarrhea and its treatment, failing to grasp how disease is shaped in the cultural, moral and political domain. This article examines the nature and function of public health policy and discourse against the spread of the disease in Can Tho City, Mekong Delta. Some 94 qualitative interviews were conducted with government representatives, medical staff and water experts, and a survey of 131 households in urban and rural areas. Focusing only on improving the construction of wat/san 'hardware' does not improve 'cultural software', and ignores the needs of vulnerable minorities, compromising the control of diarrhea. I also show how state discourse follows neoliberal approaches in individualizing health responsibilities, and moralizing disease. Local (mis)perceptions and risky behaviors emerge as the result of structural constraints that include poverty, a lack of access to useful health information, and the cultivation of stigma around diarrhea. These types of health dispossessions serve a political purpose, where the state escapes responsibility for public health failures, and thus enhancing its efforts to maintain legitimacy as a good implementer and a 'caring head.' Malgré le développement rapide du secteur de l'approvisionnement en eau et de l'assainissement (wat / san) au Vietnam, il y a eu au cours des dix dernières années 1,5 million de cas annuels de diarrhée. Les perspectives occidentales accusent l'insuffisance de progrès médicaux ou économiques pour ne pas prévenir la diarrhée et son traitement, ne comprenant pas comment la maladie est façonnée dans le domaine culturel, moral et politique. Cet article examine la nature et la fonction de la politique de santé publique et le discours contre la propagation de la maladie dans la ville de Can Tho, dans le delta du Mékong. Quelque 94 entrevues qualitatives ont été menées auprès de représentants du gouvernement, du personnel médical et des experts en eau, et une enquête auprès de 131 ménages vivant en milieu urbain et rural. Se concentrer uniquement sur l'amélioration de la construction du «matériel» wat / san n'améliore pas les «logiciels culturels» et ignore les besoins des minorités vulnérables, compromettant ainsi le contrôle de la diarrhée. Je montre aussi comment le discours d'Etat suit les approches néolibérales en individualisant les responsabilités en matière de santé et en moralisant les maladies. Les perceptions locales et les comportements à risque sont le résultat de contraintes structurelles qui incluent la pauvreté, le manque d'accès à des informations utiles sur la santé et la propagation de la stigmatisation autour de la diarrhée. Ces types de dépossession de la santé servent un but politique, où l'État échappe à la responsabilité pour les échecs de santé publique, et ainsi renforcer ses efforts pour maintenir la légitimité en tant que bon exécutant et une «tête de soins». A pesar del rápido desarrollo de su sector de abastecimiento de agua y saneamiento en las últimas décadas, Vietnam ha tenido 1,5 millones de casos documentados anuales de diarrea en los últimos 10 años. Perspectivas occidentales en todo el mundo atribuyen las limitaciones en la prevención y el tratamiento de la diarrea en una insuficiencia del avance médico o económico, con lo cual no llegan a comprender cómo la enfermedad se forma en el ámbito cultural, moral y político. En este artículo se examina la naturaleza y la función de la política y del discurso alrededor de la salud pública contra la propagación de diarrea en Can Tho City, en el Delta del Mekong. Los resultados provienen de 94 entrevistas cualitativas con representantes del gobierno, personal médico y expertos en agua, y una encuesta de 131 hogares en zonas urbanas y rurales. Se demuestra, en primer lugar, por qué de-priorizar "software" y otros aspectos preventivos, y enfocarse sólo en la construcción de instalaciones "hardware" en agua y saneamiento, supone hacer caso omiso de las necesidades de minorías vulnerables y compromete el éxito en el control de la enfermedad. En segundo lugar, se muestra cómo el discurso del estado sigue tendencias neoliberales, individualizando responsabilidades de salud y moralizando la enfermedad. (Mal)percepciones y prácticas de riesgo surgen en nivel local como resultados de limitaciones estructurales que incluyen la pobreza, la falta de acceso a la información de salud útil, y el cultivo de estigma en torno a la diarrea. Estos tipos de desposesión de salud sirven a un propósito político, donde el estado se escapa su responsabilidad de los fracasos en la salud pública, mejorando así sus esfuerzos para mantener su legitimidad como un buen ejecutor y una "cabeza que cuida".

2010

Background Access to improved sanitation remains a huge challenge in Indonesia. Joint Monitoring Programme (JMP) 2010 data indicate that around 38% of the rural population has access to improved sanitation services and that open defecation remains a widespread practice for over 60 million Indonesians. The persistence of old habits and a lack of awareness form the basis of many challenges in the Indonesian sanitation sector. To change this situation there is a need to focus on changing sanitation and hygiene behavior within communities, in addition to increasing investment in sanitation services. The majority of Indonesians are Muslims (88%), and Islamic teachings provide instruction and guidance on sanitation habits and behaviors. The teaching requires that running water, if available, should be used for anal cleansing and certain materials, including human excreta and urine, are regarded as najis (ritually unclean). Apart from the 'natural' feelings of disgust that most people express towards human excreta which result in anal cleansing, Islam requires ritual cleansing after being in contact with materials that are considered to be najis. However, the use of water for anal cleansing also appears to be a cultural habit as non-Muslim Indonesians also use water for anal cleansing, a fact confi rmed by the study results. Objective of the Study The study objective was to identify the social, religious, cultural and gender-related factors which infl uence rural people's attitudes towards

2021

Though central to the human lives and relegated to 'invisibility' during most of the parts of human lives, sanitation in contemporary times has become a core area of social sciences across disciplines. The present has attempted to outline three distinct yet interconnected mappings of sanitation; i.e. in the fields of History, Sociology and social anthropology. The first one relates to how and why sanitation came into fore as a result of pandemics and advances in science and technology over a period of time. The sociological discourse on sanitation in the south Asian context gets interlinked with caste and occupation thesis deriving its strength from 'purity and pollution' praxis. Last but not the least, the socio-anthropological understandings of 'dirt' have much to offer to the sanitation discourse. The paper is a partial and situated attempt to provide an overview of the same.

IDS, 2009

The sanitation access rate was stagnant at 38 per cent of the Indonesian rural population for more than twenty years since 1985. Rural sanitation programs regularly funded by the government and donors had faied to improve access to sanitation, while poor sanitation continued to exact a heavy economic toll and the sanitation Millennium Development Goal targets seemed well beyond reach Within this sector environment a group of high level national government policymakers brought the Community-Led Total Sanitation (CLTS) movement into Indonesia, in the year 2005, after seeing its impact in rural communities of Bangladesh and India. A conducive national policy environment in Indonesia enabled rapid uptake of the idea and methodology of CLTS in national rural water supply and sanitation projects. Implementation experience from these projects began to change institutional mind-sets, dispelling myths about the need for household sanitation subsidies for the poor, and leading to the launch of a state-of-the-art Community-based Total Sanitation (CBTS) Strategy in August 2008, by the Ministry of Health.

Journal of Water Sanitation and Hygiene for Development, 2019

There is a wealth of literature indicating that socio-cultural understanding is crucial in the implementation of sanitation programmes. However, in Indonesia, the exploration and response to this understanding in regard to sanitation uptake and sustainability remain weak. This study aims to gain an understanding of the cultural determinants underpinning sanitation issues across all sanitation stages in one part of Indonesia in order to address both uptake and sustainability. A qualitative exploratory study in two rural communities in Bali identified some cultural values and traditional roles that can affect sanitation uptake and sustainability. A set of values relating to harmony and purity, and community and individual roles defined by culture appears to modify the perception of risks and barriers, and sets priorities for resources and commitment. The paper also discusses how to translate the understanding of local values and roles into action strategies in order to improve sanitation uptake and sustainability.

Shit' is a highly sensitive, almost taboo topic across all cultures. Circumventing this sensitivity has contributed to the failure of many programmes aiming to prevent the practice of Open Defecation (OD). OD is the practice of defecating in the open, be it common or private spaces and may include fields, forests, bushes or bodies of water. It is believed that it is a cause of diarrhoeal diseases, which are the leading cause of morbidity and mortality among children in the world. In 2010, an estimated 2.5 billion people in the world had no access to adequate sanitation and approximately 1.5 million children per year die from diarrheal diseases. Additionally, loss of earnings, because of ill health or needing to care for others, has considerable impact on the socio-economic situation of millions of people. Disappointingly, evidence suggests that programmes aiming to prevent OD have limited success. The Community-Led Total Sanitation (CLTS) approach is, however, more successful. This article asserts that this can be attributed to the emphasis placed on the 'power of shit' and more significantly the disciplinary action of the 'disgust' it elicits. The latter aspect is permissible as it is being orchestrated by people who are well acquainted with the targeted communities. To reflect on the mechanics at work in CLTS, data gathered during a visit to Nepal, which served as a case study, as well as various theories of disgust are used. The theories presented in this paper illustrate the contradictory nature of disgust, and address both the tension and the consensus between the various explanations. This reflection is based on the premise that the power inherent in disgust is a result of the web that exists to connect its cognitive, visceral and social aspects. CLTS has realized this and is capturing this power as a strategy to discourage and prevent the practice of OD and eventually reduce morbidity and mortality. [open defecation, disgust, shit, sensitivity, local views, sanitation, Nepal]. this article reflects on the notion that community-led total Sanitation (cltS) captures the 'power of shit' and draws on the disciplinary effect of the disgust that it elicits. theories of disgust help explain this disciplinary power and provide a useful lens to elucidate processes at work in the cltS approach. despite divergent theoretical