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Int. J. Environ. Res. Public Health 2017, 14(12), 1572; doi:10.3390/ijerph14121572

Enabling Factors for Sustaining Open Defecation-Free Communities in Rural Indonesia: A Cross-Sectional Study

1
UNICEF Indonesia, World Trade Center 6 (10th Floor), Jalan Jenderal Sudirman Kav. 31, Jakarta 12920, Indonesia
2
UNICEF Indonesia, Kupang Field Office, Gedung NTT Satu Data, Jl. Polisi Militer No. 2, Kupang 85111, Nusa Tenggara Timur, Indonesia
3
UNICEF, 3 UN Plaza, New York, NY 10017, USA
4
National Development Planning Agency (Bappenas), Government of Indonesia, Jl. Taman Suropati No. 2, Menteng, Jakarta 10310, Indonesia
5
Planning, Research and Development Agency (Bapelitbang), Government of District of Alor, Jl. Bukit Doa Ayalon, Petleng, Alor Tengah Utara, Kabupaten Alor 85871, Nusa Tenggara Timur, Indonesia
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Alor District Health Office, Government of District of Alor, Jl. Profesor W.Z. Yohannes, Subo, Alor Selatan, Kabupaten Alor 85871, Nusa Tenggara Timur, Indonesia
*
Author to whom correspondence should be addressed.
Received: 11 September 2017 / Revised: 14 November 2017 / Accepted: 8 December 2017 / Published: 14 December 2017
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Abstract

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 latrine ownership coverage in their community, (2) a lack of all-year round water access, and (3) wealth levels (i.e., not being in the richest quintile), were found to be significantly associated with slippage occurrence. These findings, together with qualitative analysis, concluded that CATS programmes, including a combination of demand creation, removal of perceived constraints through community support mechanisms, and continued encouragement to pursue higher levels of services with post-ODF follow-up, could stabilize social norms and help to sustain longer-term latrine usage in study communities. Further investigation and at a larger scale, would be important to strengthen these findings. View Full-Text
Keywords: Open Defecation Free (ODF) sustainability; latrine use; community approaches to total sanitation (CATS); social norms; Indonesia Open Defecation Free (ODF) sustainability; latrine use; community approaches to total sanitation (CATS); social norms; Indonesia
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MDPI and ACS Style

Odagiri, M.; Muhammad, Z.; Cronin, A.A.; Gnilo, M.E.; Mardikanto, A.K.; Umam, K.; Asamou, Y.T. Enabling Factors for Sustaining Open Defecation-Free Communities in Rural Indonesia: A Cross-Sectional Study. Int. J. Environ. Res. Public Health 2017, 14, 1572.

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