Impact Evaluation of a Large-scale Rural Sanitation Project in Indonesia

Cameron, Lisa ; Shah, Manisha ; Olivia, Susan

World Bank, Washington, DC

关键词: ABDOMINAL PAIN;    ACUTE RESPIRATORY INFECTION;    ACUTE RESPIRATORY INFECTIONS;    AGE GROUPS;    AGED;   

DOI  :  10.1596/1813-9450-6360
RP-ID  :  WPS6360

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

Lack of sanitation and poor hygienebehavior cause a tremendous disease burden among the poor.This paper evaluates the impact of the Total Sanitation andSanitation Marketing project in Indonesia, where about 11percent of children have diarrhea in any two-week period andmore than 33,000 children die each year from diarrhea. Theevaluation utilizes a randomized controlled trial but isunusual in that the program was evaluated when implementedat scale across the province of rural East Java in a waythat was designed to strengthen the enabling environment andso be sustainable. One hundred and sixty communities acrosseight rural districts participated, and approximately 2,100households were interviewed before and after theintervention. The authors found that the project increasedtoilet construction by approximately 3 percentage points (a31 percent increase in the rate of toilet construction). Thechanges were primarily among non-poor households that didnot have access to sanitation at baseline. Open defecationamong these households decreased by 6 percentage points (or17 percent). Diarrhea prevalence was 30 percent lower intreatment communities than in control communities at endline(3.3 versus 4.6 percent). The analysis cannot rule out thatthe differences in drinking water and handwashing behaviordrove the decline in diarrhea. Reductions in parasiticinfestations and improvements in height and weight werefound for the non-poor sample with no sanitation at baseline.