Baseline Survey Report 2011

September 2011

No. Kontrak KU. 08.08/Kontrak/Pamsimas/47/IV/2011

Tanggal 11 April 2011

Table of Contents

Baseline and Impact Evaluation Survey 2011

i

Table of Contents

Tabel Of Contents ............................................................................................................................... i Chapter I Introduction ..................................................................................................................... 1

1.1 Background ..................................................................................................................... 1

1.2 Scope Of Baseline 2011 ............................................................................................. 2

1.3 Research Question ....................................................................................................... 2

1.4 Objectives Of Baseline 2011 ..................................................................................... 2

1.5 Framework Of Thinking ............................................................................................. 3

1.6 The Flow Of Thinking Of Baseline 2011 .............................................................. 5

1.7 Organization In Baseline 2011 ................................................................................ 7

1.8 Benefits Of The Study .................................................................................................. 8

Chapter II Methodology ................................................................................................................... 9

2.1 Design................................................................................................................................ 9

2.2 Location ............................................................................................................................ 9

2.3 Population and Semple .............................................................................................. 10

2.3.1 Determination of Village Sample .................................................................. 10

2.3.2 Determination of Household Sample .......................................................... 10

2.3.3 Determination of Sample, Schools and students at school ................. 12

2.4 Variables .......................................................................................................................... 12

2.5 Data Collection Tools And Method Of Data Collection ................................... 14

2.6 Data Management ....................................................................................................... 15

2.6.1 Editing ..................................................................................................................... 15

2.6.2 Entry ......................................................................................................................... 16

2.6.3 Data Merge ............................................................................................................. 16

2.6.4 Cleaning .................................................................................................................. 17

2.6.5 Imputation ............................................................................................................. 17

2.7 Data Management and Analisys ............................................................................. 18

Chapter III SURVEY RESULT .......................................................................................................... 19

3.1 Socio economic and demography characeristic .............................................. 19

3.1.1 Government and Village Population ............................................................ 19

3.1.2 Household Characteristics ............................................................................... 20

3.1.3 Wealth Index and Household Expenditure ............................................... 25


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3.2 Availability Of Drinking Water ............................................................................... 26

3.2.1 Availability of Drinking Water ..................................................................... 27

3.2.2 Access in Distance and Time to Source of Drinking Water ................. 31

3.2.3 Quality of Clean Water ...................................................................................... 32

3.2.4 Consumption of Drinking Water ................................................................... 35

3.2.5 Cost of Expenditure to Create Source of Drinking Water .................... 36

3.3 Sanitation ........................................................................................................................ 37

3.3.1 Sanitation Facility ............................................................................................... 38

3.3.1.1 Village level ........................................................................................... 38

3.3.1.2 Household Level ................................................................................. 39

3.3.2 Distance between Septic Tank with Source of Water ........................... 41

3.3.3 Latrine Condition ................................................................................................ 42

3.4 Morbidity ........................................................................................................................ 45

3.4.1 Description on Morbidity ................................................................................. 45

3.4.2 Seeking for Treatment....................................................................................... 47

3.4.3 Diarrhea in children under five ..................................................................... 47

3.4.4 Knowledge on Diarrhea .................................................................................... 52

3.4.5 Knowledge about Diarrhea, Skin and Deworming on Elementary

Students .............................................................................................................................. 54

3.5 Clean And Healthy Life Behavior (CHLB/PHBS) ............................................. 56

3.5.1 Hand Washing With Soap (HWWS) ............................................................. 57

3.5.2 Personal Hygiene among Elementary Students ...................................... 59

3.5.3 Waste Management in School ........................................................................ 62

3.5.4 Environment Condition .................................................................................... 64

3.5.5 Health Promotion Media .................................................................................. 66

3.6 Immunization ................................................................................................................ 68

3.7 Nutrition .......................................................................................................................... 70

3.7.1 Breast Milk (ASI) ................................................................................................. 70

3.7.2 colostrum ............................................................................................................... 72

3.7.3 Semi Solid and Solid Food as Supplementary Feeding for Breast Milk 73

3.7.4 Students Snack Pattern ..................................................................................... 74

3.8 Budget Allocation For Clean Water At Village Level ...................................... 75

Chapter IV CONCLUSION ................................................................................................................ 78


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List of Figure .............................................................................................................. iii

1.1. Frame Work of Thingking, Baseline 2011 ............................................................................. 4

1.2. The Flow of Thinking of Baseline 2011 .................................................................................... 6

1.3. Organizational Structure ................................................................................................................ 7

2.1. Flow Diagram on Selection of Respondent from Household ........................................... 11

3.1. Sources of Drinking Water at 132 Villages Baseline Survey 2011 ................................ 28

3.2. Accesses to Protected, Decent and Safe Source of Water by Quintile –

Baseline Survey 2011 ....................................................................................................................... 31

3.3. Respondents’ Perception on the Characteristic of Source of Drinking

Water, Baseline Survey 2011 ........................................................................................................ 34

3.4. Existing Sanitation Facility in 132 Villages,Baseline Survey 2011 ................................ 38

3.5. Types of Laterine, Baseline Survey 2011 ................................................................................. 40

3.6. Types of Latrines by Quintile Baseline Survey 2011 .......................................................... 40

3.7. Distributions on Distance of Septic Tank with Source of Water at

Household Level, Baseline Survey 2011 .................................................................................. 41

3.8. Children under Five with Diarrhea in the Last Two Weeks Baseline Survey

2011 ......................................................................................................................................................... 48

3.9. Percentage Distribution of Diarrhea Incidence among Children Under Five

in The Last Two Weeks Based on The Ownership and Type of Latrine

Baseline Survey 2011 ....................................................................................................................... 51

3.10. Percentage of Diarrhea among Children under Five with Source of Water

Baseline Survey 2011 ....................................................................................................................... 51

3.11. Respondents Knowledge about the Causes of Diarrhea Baseline Survey

2011 ......................................................................................................................................................... 53

3.12. Can Diarrhea Be Prevented Baseline Survey 2011 ............................................................. 54

3.13. Respondents Knowledge on How to Prevent Diarrhea Baseline Survey

2011 ......................................................................................................................................................... 54

3.14. HWWS in last 24 hours Baseline Survey 2011 ...................................................................... 57

3.15. HWWS among Elementary Students Baseline Survey 2011 ............................................ 59

3.16. Method on Wastewater Disposal from Bathing and Washing of Household

Baseline Survey 2011 ....................................................................................................................... 64

3.17. Information Media that Frequently Used by the Respondents from

Household - Baseline Survey 2011 ............................................................................................. 66

3.18. Health Media Availability at School Baseline Survey 2011 .............................................. 68


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List Of Table ................................................................................................................................ iv

3.1. Governmental Status, Number of The Head of Family and Population at 132 selected villages, Baseline Survey 2011 ................................................. 20

3.2. Number of the Head of Family and Population Based on Sexual in 132 Villages, Baseline survey 2011 ................................................................................ 20

3.3. Socio-Demographic Characteristics of Respondents and Head of Family at selected villages, Baseline Survey 2011 ........................................... 22

3.4. Percentage Distribution of Household Based on Sex of The Head of Family and Number of Family Member Baseline Survey 2011 ................... 23

3.5. Characteristics of Respondent’s House, Baseline Survey 2011 .................. 24 3.6. Household Distribution Based on Poverty Index and Family Income,

Baseline Survey 2011 .................................................................................................. 26 3.7. Percentage Distribution According to People that Usually Take the

Drinking Water as well as Decent of Drinking Water, Baseline Survey 2011 ................................................................................................................................... 29

3.8. Distribution of Travel Time to Get Drinking Water by Foot and Return - Baseline Survey 2011 ............................................................................................... 32

3.9. Percentage Distribution According to Chemical Test on Sources of Drinking Water, Baseline Survey 2011 ................................................................ 33

3.10. Distribution of Drinking Water Treatment Before Consumed Baseline Survey 2011 .................................................................................................................... 35

3.11. Percentage Distribution According to the Minimum Need of Drinking Water per person/day - Baseline Survey 2011 ................................................. 36

3.12. Distribution of Minimum Drinking Water Need per Person/Day Based on Travel Time in Getting the Water, Baseline Survey 2011 ....................... 36

3.13. Averages, Median of Cost Spent for the Making of Source of Drinking Water, and the Cost Spent Monthly to Get Source of Clean Water, Baseline Survey 2011 .................................................................................................. 37

3.14. Distribution of Defecation Place for Household members, Baseline Survey 2011 .................................................................................................................... 39

3.15. Result of Observation on Waterwaste Disposal System and Distance of Latrine at School – Baseline Survey 2011 ........................................................... 42

3.16. Distribution on the Availability of Water and Soap inside the Latrine at Household Level - Baseline Survey 2011 ....................................................... 43

3.17.1. Source of Water, Toilet availability, at Schools Baseline Survey 2011 .... 44


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3.17.2. Toilet Condition at Schools Baseline Survey 2011........................................... 45 3.18. Data on Morbidity of Household Members in the Last 6 months

Baseline Survey 2011 .................................................................................................. 46 3.19. Deworming at Elementary School Students Baseline Survey 2011 ......... 46 3.20. Seeking and Treating Diarrhea in Children under Five Baseline Survey

2011 ................................................................................................................................... 49 3.21. Distribution on Knowledge about Diarrhea and Deworming at

Elementary School Students, Baseline Survey 2011 ....................................... 55 3.22. Percentage of HWWS Practices at Household Baseline Survey 2011 ..... 58 3.23. Distribution on Practice of Five Critical Times Baseline Survey 2011 ... 58 3.24. Health Examination Program at School - Baseline Survey 2011 ................ 60 3.25. Distribution about Habits in Bathing, Brushing Teeth and Defecation

among Elementary School Students – Baseline Survey 2011 ...................... 61 3.26. Waste Management System at School Baseline Survey 2011..................... 62 3.27. Distribution on Waste Management at Household Level Baseline

Survey 2011 .................................................................................................................... 63 3.28. Result from Observation on Household and Environment Conditions

Baseline Survey 2011 .................................................................................................. 65 3.29. School Health Effort (UKS) Program Baseline Survey 2011 ....................... 67 3.30. The Giving of Immunization to Children Under Five Baseline 2011 ........ 69 3.31. Data on the Giving of Breast Milk to Infant and Children under Five,

Baseline Survey 2011 .................................................................................................. 71 3.32. Data on the Giving of Colostrum to Infants and Children under Five

Baseline Survey 2011 .................................................................................................. 72 3.33. Data on Nutrition of Infant and Children under Five Baseline Survey

2011 ................................................................................................................................... 73 3.34. Students Snack Pattern Baseline Survey 2011 ................................................. 74 3.35. Average Source of Fund Allocation Received by the Village Baseline

Survey 2011 .................................................................................................................... 75 3.36. Average Source of Fund Allocation Used Baseline Survey 2011 ................ 76 3.37. Frequency Distribution of Village that has Village Regulation

(PERDES) Baseline Survey 2011 ............................................................................. 77

1 INTRODUCTION


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CHAPTER I INTRODUCTION

1.1 BACKGROUND

The government of Indonesia is strongly committed in achieving MDG’s target

especially in water supply and sanitation which is to decrease number of people that

have not had access to drinking water and basic sanitation by 50% in 2015. The national

policy for development of community based Water Supply and Environmental

Sanitation (AMPL) stated that the general objective to be achieved in the development of

community based water supply and environmental sanitation is the realization of

community welfare through the continuous management of water supply and

environmental sanitation.

PAMSIMAS is one of the government’s (Central and Local) program with real

action supported by the World Bank aimed to increase the supply and community

access to clean water and sanitation and to improve community health; particularly in

reducing prevalence of diarrhea and other diseases that transmitted through water and

environment.

Conceptually, Pamsimas program has considered extended effort/program

(scalling up and also at the district/municipality government official (SKPD) to be able to

support program/extensive activities with village as mainstream, the sustainability of

Pamsimas will become the responsibility of community.

The second baseline of Pamsimas is conducted in 2011. The implementation of

this second baseline focused in collecting data to evaluate the success in achieving the

Millenium Development Goals (MDG’s) target, with two considerations; (1) Adequate

number of data are available to measure the achievement of MDG’s target indicators,

which until recently are facility based data. One of the weakness of this type of data is

its limitation in describing the real problem of clean water and sanitation at the

community.


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1.2 SCOPE OF BASELINE 2011

As previously described, the focus of Baseline 2011 is to collect community based

data that can be used to evaluate the Pamsimas program and MDGs indicators on

health. Data collection is done on sufficient number of households as sample to

represent the national figure.

1.3 RESEARCH QUESTION

The research question of the Baseline 2011 is to measure the achievement of poor

community in having access to drinking water and sanitation based on the Pamsimas

objective and MDG’s target.

1.4 OBJECTIVES OF BASELINE 2011

The general objective is to obtain description on the achievement of access to

drinking water and sanitation of poor community in rural and peri urban areas, in order

to achieve MDG’s target on drinking water and sanitation, and the achievement of

Pamsimas program.

The spesific objectives are

1. Increase number of community that continuously can improve acces to the

drinking water supply based on socio economic status;

2. Increase number of community that continuously can improve access to

sanitation facility based on socio-economic status.;

3. Percentage of community target that do not do open defecation (ODF) ;

4. Percentage of community that adopt the handwashing with soap program;

5. Planning on local capacity development to support the implementation and

mainstreaming the Pamsimas approach; and

6. Realization on percentage of expenditure for drinking water and sanitation

from district/municipality budget


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1.5 FRAMEWORK OF THINKING

Schematically, framework of thinking used to achieve the Pamsimas program are

as follows:


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Increase of Access for Water Supply Facility

Increase of Access for Sanitation Facility

The Percentage of ODF Community

The Percentage of Community that Adopt the Hand Wash

With Soap Program

Design Development for Regional Capacity

Expenditure Realization on Water Supply & Sanitation

Sector of Regency/ City

The Proportion of Household which UsedWater Supply Facilities

The Proportion of Household which Use

Sanitation Facility

The Proportion of Community that Use ODF

The Proportion of Community of Hand Wash

With Soap Program

Design for Pro Plan of Water Supply & Sanitation

Promotion Expenditure of Water Supply & Sanitation

in Regency/ City

Household which use Water Supply

Household which used Proper Sanitation

Community that Conduct ODF

Community with Clean & Healthy Behaviour

Medium-term development plan

area (RPJMD)

Local Budget Realization (APBD)

LAKIP

Physical & Financial Realization

Village Budget

Local Regulation

Village Regulation (Perdes)

Community with Water Borne Dideases & Poor

of Sanitation

Providing Breastfeeding & Food Presentation Behavior for Family

Knowledge concernig Diarrhea

Water Supply Facilities

Water Supply Quality

Water Consumption

Affordability of Water Supply Access

PURPOSE OF WSLIC3

PURPOSE

INDICATOR

DATA

Is obtained through survey of Baseline & Impact by using questionnaire tool

for village, household, school and children school

MONITORING AND EVALUATION

Feed

Bac

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Figure 1.1. Frame Work of Thingking, Baseline 2011


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1.6 THE FLOW OF THINKING OF BASELINE 2011

The flow of thinking (Figure 1.2) is schematically illustrate six key steps in

Baseline 2011. All of the steps are closely related with the data source of drinking water,

sanitation and health that valid, reliable, comparable and produce estimation that

represent households and individuals up to national level.

These steps describe a pattern that should be implemented continuously and

sustainable. Thus, the results of Baseline 2011 are not only be able to answer the policy

questions but also should provide direction for development of next policy questions.

To ensure the appropriateness and adequacy in providing valid, reliable and

comparable health data, at each step of Baseline 2011 a rigorous quality control is

conducted. The substance of questions, measurements and verifications in Baseline 2011

include data on drinking water, sanitation and health has adopted some of of the

questions from Knowledge Practice Coverage (KPC) developed by the World Health

Organization. As well as household expenditures both for food and non food from the

SUSENAS. Therefore, instruments developed for Baseline 2011 are referred to various

instruments that already exist and have widely used by many studies.


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Figure 1.2. The Flow of Thinking of Baseline 2011

1. Indicator x Clean Water x Sanitation x ODF x Hand Washing with

Soap x Morbiditas x Nutrisi x Consumsion

x Budgeting

2. Measuring Instrument x quesioner

x Household x Student, x Scholl x Village

x Editing x Validation

3. Data Colection Baseline 2011 x Develop manual x Develop Training

Modul x Training x Sampling x Organizing x Logistic x Data colection x Supervision

4. Manajemen Data x Editing x Entry data x Cleaning x data Outliers x Consistency check x Analisis x Dokumentasi/

pengarsipan

5. Statistik x Deskriptif x Bivariat x Uji Hipotesis

6. Report x Basic Table x Draff Nasional

Report x Finall Nasional

Report

Question Research Data Colection Baseline 2011


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EXECUTING AGENCY PAMSIMAS

CPMU

CMAC

MANAGEMENT OFPT. INFRA TAMA YAKTI

TEAM LEADER

DATABASE PROGRAM

MANAGEMENTECONOMIST

WATER & SANITATION

EXPERT

COMMUNITY HEALTH EXPERT

FIELD / PROVINCIAL

COORDINATOR

ENUMERATOR

SUPERVISOR

DATA CLEANING

EDITOR

SUPPORTING STAFF

COMANDO LINECOORDINATION LINE

LURAH

DPMU PPMU

DISTRICT GOVERNMENT

PROVINCIALGOVERNMENT

DMAC MAC

WORLD BANK

1.7 ORGANIZATION IN BASELINE 2011

In line with the framework of baseline survey, each step of work/activity

contained substances that are complementary, so that the successful of overall work

is depend on the achievement of the previous steps. To accomplish that requires an

organization. The organizational structure is as follows:

Figure 1.3. Organizational Structure

The figure above can briefly explained that in the implementation of work at central

level (Jakarta), the team is always coordinate with CPMU and CMAC as the

executing agency of Pamsimas and the World Bank. While at district/municipality

level, coordination with DPMU is conducted by regional coordinator and at the

village level is conducted by the supervisor.


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1.8 BENEFITS OF THE STUDY

1. Can be used to see the achievement status of Pamsimas program and develop

strategies for accelerating the clean water program at Pamsimas areas.

2. Can be used as advocacy materials for development community based clean water

and sanitation.

3. Can be used as the basis for following studies using community based data.

2 METHODOLOGY


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CHAPTER II METHODOLOGY

2.1 DESIGN

The Baseline survey is using case control design. Baseline 2011 is mainly aimed to

describe the problem of accessing clean water and sanitation as well as morbidity

related with environmental sanitation and to see the achievement of Pamsimas program

indicators.

2.2 LOCATION

Areas that received the Pamsimas program are in 15 provinces. Those areas are

as follows: West Sumatera, Riau, South Sumatera, Banten, West Jawa, Central Jawa,

South Kalimantan, East Nusa Tenggara, West Sulawesi, Central Sulawesi, South

Sulawesi, Gorontalo, Maluku, North Maluku and western part of Irian Jaya.

While the sample in Baseline 2011 represents national figure include 9 provinces,

66 districts/municipalities from the total 132 villages of Pamsimas areas in Indonesia.

Several notes related with the location are as follows:

a) In the data collection process, there are three changes of location (village) from

132 BS that have been set. These are because the selected villages are Pamsimas

replication villages.

b) Dusun selected in the village, if the number of household in that selected dusun

more than 500 head of family, means that the sample of household is going down

to the smallest unit bellow it (RW) with pre-defined criteria.


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2.3 POPULATION AND SAMPLE

Population in the Baseline 2011 is all ordinary household representing 15

provinces. The samples of household in the Baseline 2011 are selected based on

household listing at the dusun level. The process of selecting the household are

conducted by consultant using two stage sampling, similar with the sampling method

taken for Pamsimas Baseline in 2010.

2.3.1 Determination of Village Sample

The selections of 132 treatment or intervention villages are done with scoring

assisted by expert from the World Bank. Treatment villages are not selected randomly

but based on the matching score that is closest with the score of the control areas in 2010.

The score method of matching is done by measuring the prevalence of diarrhea and

poor data. The selected treatment villages have highest score on matching value in a

district/municipality. Determination of treatment and control villages in Baseline 2010 is

conducted by bridging consultant. The control villages in 2010 are also use as control

villages for Baseline 2011 with assumption that there are no significant changes in one

year. Consultant Baseline in 2011 does not perform such calculation.

2.3.2 Determination of Household Sample

Selection of household as sample is done by systematic random sampling. The

steps are as follows:

a) From the selected village

b) Determination 2 (two) dusun/RW/environment systematically. For the selection

of first dusun/RW/environment uses random table while for the second

dusun/RW/environment is done systematically/interval.

c) From the selected dusun/RW/environment then list of all households are made

(listing). From each of the dusun/RW/environment 5 households are selected.


11

d) From the list of households then divided into 2 (two) groups that are: households

with children under five and households without children under five. At each

dusun/RW/environment that has selected 5 households is divided into 2

households with children under five and 3 households without children under

five.

e) From the list of households within each group are then randomly selected

systematically. For the selection of first household/respondent uses random table

and for the next households are selected systematically/interval.

In simple way can be illustrated as follows: Within 1 (one) village is randomly

selected systematically 2 (two) dusun. From the selected dusun 5 (five) households are

interviewed, consist of 2 (two) households with children under five and 3 (three)

households without children under five. Thus, at each village 10 (ten) households from 2

(two) selected dusun are chosed as sample target. The survey for one

district/municipality is done in 3 – 4 days. Schematically can be seen in Figure 2.1.

Figure 2.1.

Flow Diagram on Selection of Respondent from Household

Use systematic random sampling with table random to select 2 dusun

Use systematic random sampling with table random to select 5 households for each dusun

VILLAGE

DUSUN

HOUSEHOLD

a) 2 Households with children <5 per dusun b) 3 Households RT that do not have children < 5 per

dusun


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sample Table of Random

2.3.3 Determination of Sample, Schools and students at school

The selected schools are the schools that are in the region of village selected as

samples. Schools sample consist of 1 (one) Government elementary school and 1 (one)

Private elementary schools. .

Sample of students are selected from the

population of 5th grade students. The selection

of students is using list of class attendance with

systematic random sampling. Selection of first

student is done using random table, and for the

next students selected systematically/interval. If

at the time of sampling is on school holiday then

enumerator will:

1) Ask for list of attendance to the school

2) Conduct the selection or sampling

3) Ask teachers or school principal to gather the selected students at school

so that the interview is easier to conduct.

These conditions experienced by several villages surveyed in the provinces: West

Sumatera, South Sumatera, Central Java2 , NTT, South Kalimantan, and Gorontalo.

2.4 VARIABLES

Various questions related to the Pamsimas indicators on drinking water. Sanitation and

health are operationalised into research questions and finally developed into variables

that collected in many ways. IN the Baseline 2011 there are approximately 580 variables

divided in 4 (four) types of book (see attachment), with details on main variables are as

follows:


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1. Household book that consists of:

x AR : Household member;

x SA : Source of water for the household;

x PS : PHBS (Clean and Healthy Live Behavior);

x ST : Sanitation;

x MO : Morbidity;

x IM : Immunization;

x AS : Breast milk and Supplementary breastfeeding;

x PM : Family Food Serving Behavior;

x KP : Ownership of assets;

x KS : Consumption;

x PR : Household income;

x MI : Information Media;

x AK : Social activity;

x OB : Observation results;

2. Student book

x AM : Drinking water;

x MK : Food;

x CT : Hand-washing;

x MD : Bath

x GG : Brushing teeth;

x BB : Defecation;

x PT : Disease;

x SL : Rubbish and Waste;

x KI: Communication, Information and Education

3. School book

x GM : Teachers and Student data;

x OR : Observation of Room and Class

x OL : Observation of school environment;

x SP : Waste management at school

x AM : Student attendance;

x PK: Health check;


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x SK : Health socialization in School and information media;

x PO : Participation of parents;

4. Village book

x DP : Population data;

x KD :Village organization;

x PY : Disease

x PK : Health Program;

x MP : Health Promotion Media

x BS : Drinking water and sanitation;

x AG : Budget and Allocation of Fund of Health Facility;

x PD : Village Map;

x PP : Village Regulation;

x PM : Pamsimas Program

2.5 DATA COLLECTION TOOLS AND METHOD OF DATA COLLECTION

Data collection in Baseline 2011 uses the following tools and method of data collection:

1) Household data collection is done by interview using household book and manual of

household book.

x Respondents for the household book are head of the family or household couple

or any of the household members that can provide information.

x To see the quality of water source chemical and bacteriologic test are done using

litmus paper and H2

x Student data collection represented by fifth grade students of elementary school

at each village using interview technique with student book and questionnaire

guideline.

S

x School secondary data collection using student book and questionnaire guideline

with school principal or teachers as informant.


15

x Village data collection using interview technique with village book and

questionnaire guideline, head of village or village staffs as informant.

2.6 DATA MANAGEMENT

Data management process of Baseline 2011 consist of, Edit, Entry, Merge of data,

cleaning and Input. Those activities take approximately two months. Data management

process is carried out at the location of data collection and also at central level in

Infratama Yakti Jakarta.

The processes that conducted at the location of data collection are Editing, Entry,

data submission, while other process are conducted by data management team at central

level. Data management team that concentrated in Jakarta coordinates overall data

management of Baseline 2011 both on the process and data source.

The breakthrough in data management of Baseline 2011 is the results of data

entry at the location send to data management team by email. Progress reports of data

collection and data management are always communicated via sms center. The sequence

of data management activities are as follows.

2.6.1 Editing

Data collection of Baseline 2011 is carried out by team which consist of two

interviewers and one data editor which concurrently as team leader (supervisor). The

team is accompanied by regional coordinator (Korwil) that responsibled and served as

representative from the central level and involved directly in the field for approximately

in one month.

In the implementation of Baseline data collection, editing is one of the chain that

pottentially can be use for data quality control. Editing begins to be done by

district/municipality data editor or supervisor since the enumerator finished


16

interviewing the respondent. Supervisor and regional coordinator of the

district/municipality should understand the meaning and flow of the question.

Supervisors/regional coordinators conduct the editing that include re-check the

completeness of the answer, and also consistency of the answer from each of the

respondent in each group of questions.

2.6.2 Entry

Data entry program in Baseline 2011 is developed using Epidata software. The

Data entry program includes household book, student book, school book and village

book.

Questions in the Baseline 2011 are addressed to respondents from different age

groups. The questionnaire also contains many skip questions (questions leap) which

technically requires precision to maintain consistency from one questions block to other

blocks. Therefore the data entry program was made with computerized entry restriction.

This prerequisite is become important to decrease error in data entry. Results of

data entry are one of the important parts in the data management process, especially

related with data cleaning.

Electronic data which result file of data entry is summitted by the data collectors

to regional coordinators at district/municipality. The regional coordinators receive the

electronic data and send it to the data management team via email. The submission is

done after finished the data entry for 1 village.

2.6.3 Data Merge

The files sent by the regional coordinators then merged by the data management

team. The data management team at central level is responsible for handling data from

the provinces. The data manager then merge the data and transfer them from *.rec into

*.dta.


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The next step is the temporary cleaning, with objective to immediately provide

feedback for interviewers to improve the data. Once all the data that have temporary

clean status merged, then followed by electronic data merging nationally. Results of the

data merging from 132 villages consist of household files, student files, school files,

village files and data listing of potential respondent.

2.6.4 Cleaning

Cleaning step in data management is an important process to support the quality.

This process is also carried out in Baseline 2011. Data management team at central level

is conduct initial cleaning to the electronic data on each of the district at the time receive

the electronic data from regional coordinator. If there are data that need to be confirmed

to the data collector team at district, then the central data management team will

coordinate with district data editor to do the re-entry if necessary and send back the

revised file by email.

Temporary cleaning is only done for certain variables that are considered have

high risk of errors. After the merged of data from all the provinces, overall data cleaning

is carried out.

Data management team provides specific guideline to conduct the cleaning data

of Baseline 2011. Treatment on missing values, no response, and outliers is highly

determined the accuracy and precision of the estimation produced.

2.6.5 Imputation

Imputation is the process for managing the missing data and outliers. Data

management team conducts imputation of electronic data nationally. In the Baseline

2011 data imputation carried out on outlier continuous data. While the missing data

only exist in the questions from knowledge and behavior block and maintain as missing

with notes not willing to answer.


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2.7 DATA MANAGEMENT AND ANALYSIS

Results of data management and analysis are presented in the chapter Results

and discussion of baseline that followed the questionnaire block. Number of households

sampled is 1320 households. In this report all analysis are done based on the number of

household sample and household member after excluding the missing values and

outliers.

Baseline survey at the analysis is carried out same procedure that is excluding

missing values and outliers as well as weighting in accordance to the number of each

sample.

3 SURVEY RESULTS

Baseline and Impact Evaluation Survei 2011

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CHAPTER III SURVEY RESULT

3.1 SOCIO ECONOMIC AND DEMOGRAPHY CHARACERISTIC

This section presents description on socio economic and demography characteristic

of villages and households in the survey area. At village level, data on governmental

status of selected villages, village category and population are presented. At household

level information of respondents on sex, age, education, occupation and sex of the head

of the family are described.

In this baseline survey, household is defined as a person or group of people,

regardless of whether thet have family relations or not, live together under one roof of

residential building and eat from one kitchen.

3.1.1 Government and Village Population

Results of data collection in baseline survey show that most of the area surveyed

are rural (90.2%) and the rest are in urban areas with the goverment status largely rural

(81.1%), kelurahan (12.9%), and the rest are nagari (6.1%). Villages that become survey

location are villages that established by The World Bank for the Pamsimas program

from Head of district decree by scoring on prevalence of diarrhea and poverty level.

Table 3.1 demonstrates number of village population. The population

demographic data are taken from the village office. Average number of population per

village out of 132 surveyed villages is 3.384 persons with 936 head of households.

Number of men and women in the population are almost equal, but numbers of women

are slighty more than men.


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Education level achieved by both of the repondents and head of the family are still low in accomplishing the wajib belajar program for 9 years.

Table 3.1 Governmental Status, Number of The Head of Family and Population at

132 selected villages, Baseline Survey 2011

Description n % Governmental Status

Kelurahan 17 12,9

Village 107 81,1

Nagari 8 6,1 Type of area

Urban 13 9,8

Rural 119 90,2

Table 3.2 Number of the Head of Family and Population Based on Sexual in 132

Villages, Baseline survey 2011

Number Mean Median Head of the family 936 619

Total Population 3.384 2.352

Men 1.739 1.157

Women 1.758 1.134

3.1.2 Household Characteristics

The characteristics of selected household are presented in table 3.5. The table

shows several data on socio-economic condition such as residential status, condition of

the house, and the ownership status of the household, as well as demographic data such

as age group, education, and type of occupation. To be more spesific, the characteristics

of respondent, mother with children under five, are presented in other section.

Table 3.3 shows the socio-demographic

characteristics of respondent and the head of

household. In majority, both respondents and

head of the family are under 45. There is

difference in age between head of the family and respondents, the percentage of age


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group 17-34 years at the respondents are higher 16% compared to the head of the family.

This is because most of the respondents are mother of children under five who are in

reproductive age.

Educational level is one of the determinant factors of the life style and status of a

person’s life in the community. Consistently researches had shown that

accomplishement of education level has strong influence to the decision making

behavior and also concern for family health. Education is also an important factor in

recepting and absorbing health information and life skills that can improve the welfare

of children and family.

Survey results show that in general education level achieved by the respondent

group is higher than the head of family. However the education levels achieved are still

low, because almost 70% have basic education or lower, and have not reached the level

of education for wajib belajar program for 9 years.

In general, respondents and head of the family work at informal sectors. Most

type work (34%) that occupied by the respondent and head of family are as laborers or

work in families. The manual of Pamsimas 2011 questionnaires defines a non-permanent

labor/ non paid labors as those who work or undertake on their own risk and only

receive payment based on the amount time of working or work load. While permanent

labor/ paid labor are those work with their risk and employed at least one permanent

labor/worker/employee that paid.

Percentage of respondents who do not work are higher than the head of family

(22.9% ; 8.6%), however on the other hand percentage of work as an employee and work

on their own is higher in the group head of family compared to the respondents.


22

Table.3.3 Socio-Demographic Characteristics of Respondents and Head of Family

at selected villages, Baseline Survey 2011

Characteristic Respondent Head of Family

Age (n=1320) % %

17 - 34 years 34.1 17.9

35 - 44 30.2 31.3

45 - 54 18.6 23.9

ǃȱśśȱ 17.2 26.9

Education (n=1320)

Do not finished Elementary school 28.3 32.5

Finished Elementary school 38.3 38.6

Finished Junior High school 16.6 14.3

Finished Senior High school 16.8 14.5

Don’t know 0.0 0.1

Occupation (n=1320)

Work by their own 20.1 23.7

Work assisted by unpaid worker, family worker 34.6 34.7

Work assisted by permanent workers/paid worker 2.7 5.7

Employee 10.8 14.2

Free worker in agriculture 4.2 5.5

Free worker non-agriculture 4.8 7.7

Not working 22.9 8.6

Number of household 1320 1320

The following Table 3.4. shows characteristics on sex of head of the family,

number of family member and average number of family member lived in the

household.

These characteristics are important because related with the household welfare.

Household with female as the head of household usualy poorer than household headed

by male, and also the households with more number of household members are


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generally more dense and usually related with poor health consition and the presence of

economic difficulties.

From Table 3.4 it can be explained that 12.2 percent of households have female as the

head of household, this proportion is almost the same as found in Indonesia

Demographic Health Survey in 2007 12.9 percent (BPS and ORC Macro, 2007).

Results from Pamsimas Baseline Survey in 2011 find that 3.3 percents of the

households have only one household member, though this percentage is higher than

household with more than or equal to seven person as family members. Tabke 3.2 also

shows that overall the average number of household member in Pamsimas Baseline

survey 2011 is 4,1 persons, the same pattern also found in the IDHS 2003, 2007 (BPS and

ORC Makro, 2007) that is 4,1 persons.

Table 3.4 Percentage Distribution of Household Based on Sex of The Head of Family

and Number of Family Member Baseline Survey 2011

Characteristic n %

Head of the household

Male 1.159 87,8

Female 161 12,2

Number of household member

1 44 3,3

2 157 11,9

3 295 22,3

4 357 27,0

5 228 17,3

6 127 9,6

7+ 112 8,5

Number of household 1320 100.0

Average number of household member 4,1


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House Characteristics

The physical characteristics of the house are important factors for the health

status that can also be used as indicators for socio-economic status of the household. In

this survey, some questions are asked on the characteristics of the house which include

access to electricity, condition of the house such as type of roof, floor, and wall.

Table 3.5 shows condition of the house inhabited by the respondents and

household members. Although most of the houses are in poor villages, but majority are

permanent and semi permanent. These can be seen from the types of roof which most of

them are tiles and zinc, most of the floors are from concrete and ceramic, and for the

wall most of them are from plastered walls. However the observation finds that 38% of

houses lived by the respondent do not have adequate ventilation.

Table 3.5 Characteristics of Respondent’s House, Baseline Survey 2011

House Characteristic n %

Type of roof Tile 622 47.1 Zinc 510 38.6 Others (concrete, sirap, asbestos, bamboo, rumbia) 5 14.2

Type of floor Granite/Ceramic/Marble 259 19.6 Plaster /Concrete /Brick 464 35.2 Ubin/Tegel 94 7.1 Wood 243 18.4 Bamboo 35 2.7 Dirt/earth 225 17.0

Type of wall Plastered wall 511 38.7 Un-plastered wall 109 8.3 Metal/zinc 14 1.1 Wood 549 41.6 Bamboo/Rumbia 134 10.2 Others 3 0.2


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Most of the head of the household work in informal sectors and half of the respondent households are poor with expenditure less than 2 US$ per day/person

House Characteristic n %

Ownership status of the house Personal belonging 1148 87.0 Rent/contract 16 1.2 Belong to parents/parents in law 93 7.0 Belong to family 40 3.0 Others 9 1.8

With electricity 1177 89.2 Has adequate ventilation

Yes 819 62.0 No 501 38.0

For ownership status, most of the houses inhabited by the respondents and

member of their family are personal belonging (87%), belong to parents/parents in law

(7%) or belong to family (3%), the rest are contract/rent and governmet houses with

percentage for each is less than 2%. This ownership status of the house can be used as

indicator of desire in get connection for clean water. Meanwhile, access to electricity is

quite good, because almost 90% of respondent’s household have electricity.

3.1.3 Wealth Index and Household Expenditure

Wealth index is a background

characteristic used in the report as

approach to measure household living

standard for long term. This index is

based on approach for consumption in last month. In the MDGs agreement, it is stated

that Indonesia’s poverty indicator is population with income less than 2 USD.


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Table 3.6 Household Distribution Based on Poverty Index and Family Income,

Baseline Survey 2011

Characteristic N %

Poverty index based on MDGs

ǂŘǞȱȦperson /day 791 62,9

>2$ 467 37,1


Family Income in last year

Mean 14.296.872

Median 7.200.000

5%tile 86.150

95%tile 48.000.000

Number of household 1320

The family income includes salary received in cash, as well as from selling plant

products or other goods. The family income is not limited to the head of the family but

also all family members lived in the household. The average amount of family income

per year is 14.292.872 IDR, with 5% tile 86.150 IDR and 95% tile 48.000.000 IDR.

From the Table 3.6 it is also known that 62.9% of the household have expenditure

less than 2 USD per day. Therefore, based on the above numbers, more than half of the

households in the intervention villages of the projects are poor household. It can be said

that villages included as project target villages are appropriate as area/village for

Pamsimas program.

3.2 AVAILABILITY OF DRINKING WATER

The increase access to decent sources of drinking water is one of the goals of

Millenium Development Goals, as adopted by Indonesia and other countries (United

General Assembly, 2001). Useful indicators to monitor household’s access to decent

source of drinking water (WHO dan UNICEF, 2005). Source of drinking water is


27

indicator whether the water is decent to be consumed, where the sources of decent

drinking water include piped water both piped into dwelling or yard, public tap,

protected well, protected spring, and rain water. This section presents the availabillity of

drinking water at village level, household and school. Sources of information about

source of drinking water at village are obtained from interview with the village leaders.

While for household level, the data are taken from observation done by enumerator at

each of the selected household, as well as data at school levels are taken from

observation.

3.2.1. Availability of Drinking Water

Access to sources of clean water from pipage are still low, therefore the Pamsimas Program is become decent solution to address problem on

clean water at the community

Village and its population will not be able to live continuously for long periods

when the source of life is not physically available. One of the sources of life is water,

because water is the primary source of daily needs such as for drinking, washing and

personal hygiene. The problem then is how the village can continuously have access to

water and provide the community needs. From the results of data collection in 132

villages, according to the village informant most of the respondent households get clean

water from dug well (84.8%), pump well (46.2%), spring water (52.3%), river /stream

(41.7%), and piping non PDAM (40.9%). Still few of the household get clean water

through pipage of PDAM 19,7%. Thus the villages of Pamsimas program have low

access to clean water, so this project is approriate to be implemented in those villages.


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Figure 3.1 Sources of Drinking Water at 132 Villages Baseline Survey 2011

Table 3.7 presents description on sources of drinking water accessed by

respondent’s households. Results from this survey show that sources of drinking water

used by the respondents are varied and mostly from protected source of drinking water.

Spring water is used by 17.5% of respondent households and piping non-PDAM have

almost the same amount (17.2%), followed by personal protected well and bore well

respectively (10.8% and 10.5%). Around 8% of the households still use river and pond as

source of water.


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Table 3.7 Percentage Distribution According to People that Usually Take the

Drinking Water as well as Decent of Drinking Water, Baseline Survey

2011

Characteristic N %

Source of Drinking Water

Piping from PDAM 92 7,0

Piping non-PDAM 227 17,2

Bore well 139 10,5

Open personal well 84 6,4

Open public well 68 5,2

Closed personal well 143 10,8

Closed public well 73 5,5

River/Stream/Canal 104 7,9

Dam/Lake/pond 3 0,2

Spring water 229 17,3

PAH 1 0,1

Gallon water /Refill water 35 2,7

Protected personal well 65 4,9

Protected public well 38 2,9

Buy from merchant 13 1,0

Others 6 0,5

Number of households 1320 100.0

Futher analysis sources of drinking water at the household level are categorized

into three groups that are protected and un-protected; decent and indecent; and also safe

and not safe. Protected source of drinking water is source of water that flowed through

the pipes into the dwelling or yard, or from taps and closed well inside or outside the

house.

Figure 3.2 presents sources of drinking water used by households that

differentiated into protected and unprotected wells. The survey results show that

protected wells are used by 76.2% of the households either inside the house or in the

yard or at public places which is used as main source of water for drinking and cooking.


30

Therefore it can be explained that out of 1.320 households surveyed in Pamsimas area in

2011, sources of water that categorized as unprotected are only have small part 23,8%,

however if using the categorization of source of drinking water by WHO and UNICEF,

2005 (WHO/UNICEF Joint Monitoring programme for Water Supply and Sanitation) it is

found that 76,5% sources of drinking water are not decent to be consumed. From 85,9%

sources of water that categorized as not decent to be consumned by community in those

villages at Pamsimas area, are come from opened and closed well, and mostly located in

West Java and Central Java provinces.

From the categorization of sources of water that is decent and not decent, it is

found that 98,8% of sources of drinking water are not safe for consumption because

contain bacteria Escherichia coli or often called E.coli after conducted water test using

H2

If seen based on the quintile of expenditure for food and non food (consumption)

in the last month, indicates that in the non poor group (quintile 4 – 5) protected and

decent source of water have higher percentage compared to poorer quintile (quintile 1 –

3). As for sources of water that safe to be consumed, highest percentage is found in the

richest quintile (quintile 5). This results show that although still in small number, the

non poor groups have better access to sources of water compared to poor group.

S solution to sources of drinking water of the households. The following Figure 3.2

shows access of drinking water for respondent’s households, the first is by seeing

whether the source of water is protected; second from the protected wells are they

decent to be consumed, and the last is out of the decent sources of water are they safe to

be used.


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Figure 3.2 Accesses to Protected, Decent and Safe Source of Water by Quintile –


77.7 73.8 72.677.8 80.9 76.6

20.3 18.7 21.4 20.6

36.3

23.4

0.4 0.4 0.8 0.0 4.4 1.20.0

10.020.030.040.050.060.070.080.090.0

1 2 3 4 5 TotalQuintile

Sumber air terlindungi Sumber air layak Sumber air aman

The figure above shows that access to water has been good, but has not

supported by the quality of water. And that community use clean water for daily use

these days put considerations more on its existence, that are easy to get, not far away

and with numerous amount. While quality has not been the main consideration.

Meanwhile surveys is also found that there is only small difference between dry

and rainy season (12.7% from 1320 household) which is in the use of source for drinking

water, sumber air minum, means that respondents’household access the same source of

water both for dry and rainy season.

3.2.2. Access in Distance and Time to Source of Drinking Water

This survey also asked question on time travel to the source of water.

Respondents are asked how long the time needed to reach source of clean water for go

and back on foot. Time spent to go from home to the source of water would be different

according to the geographical location.

Table 3.8 shows that time needed to obtain drinking water are relatively not long,

where most of the respondent (87.2%) stated that the travel time to reach the source if


32

water by foot is less than 30 minutes. The remaining 10.9% are reached in 30 – 60

minutes, and 1.9% is reached in more than 1 hour.

Table 3.8 Distribution of Travel Time to Get Drinking Water by Foot and Return -


Charateristic N %

Time needed to get water back and forth by foot

< 30 Minutes 1151 87,2

30 - 60 144 10,9

> 1 Hour 25 1,9

Number of Households 1320 100.0

3.2.3. Quality of Clean Water

Socialization and periodic lab test is needed to know the quality of water consumed by community in daily life, because it is found that many of the

sources of drinking water contained E. Coli bacteria

Quality of water can be obtained from several ways that is through litmus test

trial, H2

From Table 3.9 it is obtained that more than half of the water samples from

households tested with litmus is alkaline, while source of water that neutral is only

43,3%, but there is still 5.7% source of drinking water with acid in household in the

S solution, respondent’s perception on the condition of water they have, and

observation by enumerator. To test acidic or basic compound is by using indicator,

indicator is a subtance with different colors according to the hydrogen concentration.

Indicator generally is an acid or fatty alkaline organic that is used in a very dilute

solution, acid or basic that does not dissociate has different color with the result of their

cleavage, and make it easier to determine whether the water us acidic or alkaline.


33

Pamsimas baseline survey 2011. While the result of test using H2

Table 3.9 Percentage Distribution According to Chemical Test on Sources of

Drinking Water, Baseline Survey 2011

S shows that almost

97% sources of water used by the household contained E-coli bacteria.

Observational Result N %

Results of test using Litmus

Alkaline 672 50,9

Acid 75 5,7

Neutral 571 43,3

Missing 2 0,2

Results of test using H2 S

Contained E.coli bacteria 1279 96,9

Not contained E.coli bacteria 41 3,1


In the mean time, results from observation and perception of most of the

respondents on the charactristic condition of sources of water they had are shown in

Figure 3.3. From the results (observations and interviews) most of sources of water

respondents have contained sediment (respectively 30.5% and 32.8%). While overal all

percentage of respondents’ perception on the characteristics of water that are colored,

bad smell, and has taste, are higher compared to results from observation.


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Figure 3.3 Respondents’ Perception on the Characteristic of Source of Drinking

Water, Baseline Survey 2011

11.6

9.7

9.0

32.8

6.9

4.8

4.3

30.5

Berwarna

Berbau Tidak Enak

Berasa

Ada Endapan

Persepsi terhadap karakteristik sumber air yang digunakan (n=1320)

Hasil Observasi Persepsi responden

Water treatment before used

Clean water is obtained from various sources, in its utilization, according to the

comunity need to be tretated again in order to get safe water for consumption. This

effort is done as an inherited habitual activity, but there are people who get the

information on water treatment from health promotion, mass media, etc.

Table 3.10 also explains, to make the water suitable to be consumed, most of the

community do water treatment before drinking by boiling water 95.3%, although some

use chlorine or alum (2.0%) or filter it with fabric before. The survey result also found

that more than half (52.9%) of the community precipitate the water that has been

accomodated so that the water becomes clear and seperated from sediments.


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Table 3.10 Distribution of Drinking Water Treatment Before Consumed


Treatment for drinking water before consumed ** n %

N= All household 1.320

Boiled 1258 95,3

Added with chlorine 26 2,0

Added with alum 23 1,7

Added with other materials 10 0,8

Filtrated using filter 44 3,3

Filtrated using fabric 142 10,8

Disinfectant by sunlight 3 0,2

Precipitate 698 52,9

** Multiple Responses

3.2.4 Consumption of Drinking Water

One third of family members consume water less than 60 liters/day with access time in getting the water < 30 minutes

According to the WHO (Riskesdas, 2007), the amount of clean water used by

household per capita is strongly related with public health risk associated with hygiene.

Average individual use of clean water is the average amount of clean water use by the

household in a day divided by number of household members.

Table 3.11 shows that more than two-third of the respondent households use

water > 60 liters per day/person, while the remaining around 33% use water less than 60

liters /person /day. Some of the problems that often encountered with the amount of

water consumed are often have difficulties in getting the water (20.2 %) because of the

dryness/scarcity on source of drinking water.


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Table 3.11 Percentage Distribution According to the Minimum Need of Drinking

Water per person/day - Baseline Survey 2011

Water use/person/day ** N %

ǂȱŜŖȱ��s /Person / Day 422 32,6

> 60 Liters /Person / Day 871 67,4

When see the relationship between travel time and the amount of water usage,

Table 3.12 shows that 29.8% of the communities who get water less than 30 minutes use

water less than 60 liters/per capita. This means that almost one third of the community

with quick access is still use small amount of clean water.

Table 3.12 Distribution of Minimum Drinking Water Need per Person/Day Based

on Travel Time in Getting the Water, Baseline Survey 2011

Amount of water consumption in family

Time (Back and Forth) needed to get water (in minutes)

0 - 30 minutes

31 - 60 minutes

> 60 minutes

Total

n % N % N % n %

ǂȱŜŖȱ��s / Person / Day 336 29,8 72 50,7 14 56,0 422 32,6

> 60 Liters / Person / Day 790 70,2 70 49,3 11 44,0 871 67,4

3.2.5 Cost of Expenditure to Create Source of Drinking Water

Access to clean water can not be seperated from the affordability of the

community when the water must be accessed by paying or spending money. From the

survey result, it is obtained that the average cost for the initial creation to get source of

drinking water is 581.580,7,- IDR with median 200.000 IDR.


37

Table 3.13 Averages, Median of Cost Spent for the Making of Source of Drinking

Water, and the Cost Spent Monthly to Get Source of Clean Water,


Mean Median 5%ilte 5%ilte

Total cost spent in the initiation of creating source of water 581.580,7 200.000,0 0,0 2.280.000,0

Total cost spent every month for the water usage 8.655,3 0,0 0,0 50.000,0

Table 3.13 also explains that in order to get clean water, respondent household have to

pay or spend some money every month. The average cost that must be expended to get

the water per month is 8.655- IDR with the highest payment around 50.000,- IDR.

3.3 SANITATION

Ensuring the adequate sanitation facility is another goal of the Millennium

Development Goals. A household is categorized has adequate latrine/toilet if the latrine

is only used by family members (not shared with other household) and if the facility

used by household has sewage that seperated from human contact (WHO,UNICEF,

Joint Monitoring programme for Water Supply and Sanitation, 2004). While toilet is

considered sanitary if worked out with the toilet it self or together using septic tank.

Toilet with septic tank can isolate contaminant (feces), so it will not pollute ground

water, surface water or water around it, so the dirt can not be spreaded by wind, carried

by the water or from people’s feet. Defecation in a safe (healthy) will have high impact

on the reduction morbidity from deworming and diarrhea.


38

3.3.1. Sanitation Facility

Sanitation that is meant here is the sewage system or excretion eliminate by

human that included disposal plant (defecation), waste and disposal of wastewater or

dirt. One of the sanitation systems is the availability of sanitary landfill for waste

generated by household. The trash can that is meant here is the trash can that is put

inside the house.

3.3.1.1 Village level

Sanitation facilities that available in the village are still minimum

Figure 3.6 presents the existing sanitation facilities available at the village. Result from

this survey shows that according to the village informants, 18.9% of the households in

their village have disposal site. From 132 villages only 2.3% of the villagers that have

latrine/toilet with septic tank. While SPAL (Wastewater Disposal System) at household

level only had by 9.1% of the household. These results show that sanitation facility in

selected villages at household level in Pamsimas area are very minimal, therefore

require initiative on planning program for sanitation development such as Pamsimas

that has been rolled out in 2008 to develop source of drinking water in most of the

villages in Indonesia.

Figure 3.4 Existing Sanitation Facility in 132 Villages,Baseline Survey 2011


39

Require availability of safe and protected toilet and socialization to community about environmental health and the importance of hygiene, because more than a quarter of household member are still defecate at open places

3.3.1.2 Household Level

a. Place for Defecation

In general the households without

adequate toilet facilities, cause higher risk

for family members to have dysentery,

diarrhea and typhoid. Table 3.14 shows

distribution of places that usually use for

defecate for respondent’s household members. Approximately 60.2% respondent’s

household members use their own latrine for defecation. Of those who use their own

latrines 14,8% are used together with other families. Results from this survey found that

around 25% of the families are still defecate in the open places, at the river, sewers,

beaches, field, bush/garden, pool or pond.

Table 3.14 Distribution of Defecation Place for Household

members, Baseline Survey 2011

Where Usualy Household Member Defecate n %

Latrine / Shared toilet /Public 196 14,8

Latrine / Personal toilet 794 60,2

River / Sewers / Beaches 190 14,4

Field / Bushes / Garden 113 8,6

Ponds 27 2,0

b. Type of Latrine

Contrast to the results from interviews with the villages, the household survey

get 35.5% of respondent’s houses in Pamsimas region have use personal or public latrine

together with no holes (cubluk) or without septic tanks and flowed into the river or

sewer. Figure 3 shows that almost 40% of household using latrine/toilet personally or

together with waste water disposed to septic tank. The remain approximately 25% of the


40

community defecare at any places (Open Defecation Free) that will effected the raise of

diseases like diarrhea, disentry and typhoid.

Figure 3.5 Types of Laterine, Baseline Survey 2011

Figure 3.6 presents the type of latrines associated with consumption quintile of

the households. Result from analysis shows that the more non poor households, open

defecation is getting less percentage. Similarly, the more improve latrines shows the

reduction of poverty level.

Figure 3.6 Types of Latrines by Quintile Baseline Survey 2011

1 2 3 4 5Improved 13.5 17.7 18.7 22.3 27.9 Unimproved 22.3 18.7 20.9 21.2 16.9 Open Defecation 26.9 25.6 20.9 14.9 11.7

-5.0

10.0 15.0 20.0 25.0 30.0

Jenis Jamban berdasarkan Kuintil


41

3.3.2. Distance between Septic Tank with Source of Water

¾ One third of respondent household have less than 10 meters distance between source of water and septic tank that could have impact on health problem related with water

¾ Two third of observed schools do not have SPAL (waterwaste disposal system)

Centralized septic tank or wastewater treatment units are required to treat the

wastewater before discharge into a body of water. In addition to prevent pollutiin

including disease-causing organism, the wastewater treatment intended to reduce the

burden of pollution or sort out the contaminants in order to meet the standard quality

requirements when disposed to a body of water.

Out of 509 households that have septic tank, 29.5% of source of drinking water

and septic tank have distance <10 meters. This will impacted on the absorbtion of

waterwaste from cubluk or septic tank to the source of water, and cause contamination

on the source of water that could caused spreading of disease.

Figure 3.7 Distributions on Distance of Septic Tank with Source of Water at

Household Level, Baseline Survey 2011

Results from observation at 157 schools on distance from toilet to well,

information gained is that most have distance within 10 meters (64.4%). However,

almost the majority of the schools (64.3%) do not have Waterwaste Disposal System

(SPAL), whereas the unadequate sanitation facility is a risk factor for various health


42

Latrine condition in Dist. TSS - NTT Latrine condition above the lele-Pond Gawang Kidul sub dist - Jawa Tengah

problems including variety of environmental based disease such as diarrhea, DHF, ARI,

etc.

Table 3.15 Result of Observation on Waterwaste Disposal System and Distance of

Latrine at School – Baseline Survey 2011

Condition of Waste Channel n= 157 %

Wastewater Disposal System (SPAL)

Have 56 35,7

Not have 101 64,3

Is the distance between exctreta disposal and well at least in 10 meters

Yes 58 64,4

No 27 30,0

Not Applicable 5 5,6

3.3.3. Latrine Condition

a. Household

Criteria of latrine condition in this survey are to determine the availability of water and

soap in the latrine. At the household level, observation found that in 45.9% soap are not

available and a quater (24.7%) had no water that are supposed to be available as part od

the toilet equipments.

Quite apprehensive with the findings that only few of the household latrine provide soap and water


43

Table 3.16 Distribution on the Availability of Water and Soap inside the Latrine at

Household Level - Baseline Survey 2011

Availabilty inside the Latrine n %

In the latrine/toilet is water available

Yes 745 75,3

No 245 24,7

In the latrine/toilet is soap available

Yes 536 54,1

No 454 45,9

b. School

¾ A positive step to have the seperation of toilet facilities for girls and boys although the percentage has not maximum

¾ Needs on socialization about toilet cleanliness for students and the availability of soap, water and trash can in students’ toilet

Most of the children’s time spent in school environments, therefore school

environment should be in safe, comfortable, and healthy including the provision of

sanitation facilities.

School sanitation facilities are including clean water and toilet

(bathroom/WC/Latrine) in the school needs to get attention. Result from observation on

the condition of school sanitation shows that at most of the latrine in school has been

seperating the toilet for teachers and students (69.4% of 157 schools), and also between

toilet for girls and boys (45.6% of 114 schools). In general the sources of water that is use

are from well (59.3% of 149 schools). Latrine condition of teachers and students in

almost schools have very clear difference, where the toilet for teacher is look better than

toilet for students, especially in the availability of soap, clean floorm and trash can.


44

Table 3.17.1 Source of Water, Toilet availability, at Schools Baseline Survey 2011

Facilities available in school n= 149 %

Source of water use in school

Well (dug, pump, hand pum) 89 59,3

Spring 43 28,9

Lake /Pond 2 1,3

River /Stream 7 4,7

PAH 2 1,3

PDAM 19 12,8

Toilets for Teacher and Student are seperated (n=149)

Yes 109 69,4

No 37 23,6

Not Applicable 11 7,0

Toilets for boys and girls are seperated (n=114)

Yes 52 45,6

No 62 54,4

School condition and Bathroom at Pabelan Sub Dist Semarang District – Central Java


45

Table 3.17.2. Toilet Condition at Schools Baseline Survey 2011

Toilet Condition Teachers Toilet Students Toilet

n=146 % n=114 %

Availabilty of clean water 120 82,2 88 77,2

Toilet equiped with water container 134 91,8 104 91,2

Availability of soap 30 20,5 5 4,4

Availability of hand wipes 7 4,8 2 1,8

Clean floor 75 51,4 37 32,5

Ventilation 110 75,3 77 67,5

Availability of trash can 22 15,1 13 11,4

3.4 MORBIDITY

3.4.1 Description on Morbidity

Health status in this survey is depicted from morbidity of family and village

members in last year. Morbidity among children under five is illustrated by the

incidence of diarrhea in the last 2 weeks. As we know that diarrhea until now is still one

of the major causes of morbidity and mortality among children in the world especially in

developing countries. According to the Susenas data in 2004, the percentage of

community had diarrhea reached 5.2% or 11.53 million people from 220 million

population of Indonesia. Pamsimas as a program which one of its aims is to reduce the

incidence of diarrhea as well as water and sanitation related disease, will also see some

other diseases as health indicators related to sanitation and health behaviors. Type of

diseases that to be seen are: diarrhea, dysentry, cough with rapid breathing, DHF,

deworming, scabies and malaria.

Results from village secondary data collection related to 10 major diseases

obtained from health center, the two major diseases are ARI and diarrhea. The average

amount of each is 10.8% and 3.8%.


46

Morbidity of Household Member

In the Baseline survey 2011, morbidities are asked for all household members had the

illness in the last 6 months. From the seven types of diseases related to water and

sanitation, the largest percentages experienced by the household members are diarrhea

(5.9%), cough with rapid breathing (2.4%), malaria (1.4%), deworming (1.1%) and

dysentry (0.9%).

Table 3.18 Data on Morbidity of Household Members in the Last 6 months


Morbidity of household members in the last 6 months n %

n= Total 5428

Diarrhea 320 5.9

Dysentry 49 0.9

Cough with rapid breathing 128 2.4

Hemorrhagic fever 3 0.1

Deworming 52 1.0

Scabies /ulceration 46 0.8

Malaria 77 1.4

In contrast at the school level, elementary student of grade V experienced deworming at

38% of students by asking whether when they defecate are there worms come out with

the feces.

Table 3.19 Deworming at Elementary School Students Baseline Survey 2011

When defecation see worms come out from sister’s/bother’s stool n %

Yes 295 38.0

No 479 61.6

Don’t know 3 0.4


47

Interview process with respondent who has children under five in Tanipah sub dist –

South Kalimantan

3.4.2 Seeking for Treatment

At the household level, in handling sickness, of 545 people with illness 63.0% of

them had taken to health facilities. This indicates that before the disease continue

(severe) the community has conduct initial treatment to recover for example by taking

medicine at home before brought to health facilities (46%). Communities usually do

things that generally do such as for diarrhea given salt sugar sollution or bitter tea, for

cough-cold-fever (ARI) do the compressing or take paractetamol to reduce the body

temperature, while for malaria usually given water boiled with papaya leaves. If the

pain does not recover in one or two days, then usually the community took them to

health facilities.

In seeking for treatment, facilities that mostly used are health center/Pustu

(35.2%) and Polindes/Village midwive (10.6%). Both facilities are used because short of

time, affordable cost and relatively in short distance. The average distance from house to

health facilities is 3.7 Km.

3.4.3 Diarrhea in children under five

Diarrhea is a condition when someone

defecates three times or more in one day, and

the consistency of feces is liquid, which

sometimes also come out with blood. This

kind of illness is often experienced by children

because they often put their hand into the

mouth and easily contaminated by virus.

Similarly with the food, children generally are

difficult to be fed, take several hours for


48

Decision to bring children to health facilities is decision made by couple (53,8%), this shows that decision in health issues at the household has been equal.

children to finish their meal, and this will not protect the food from contamination from

virus or flies. This kind of transmission is better known as 3F, namely: Finger, Food, and

Fly (Dr. Luszy Arijanty, SpA, Mediastore.com).

Respondent who have children under five are asked, whether in the last to weeks

their children ever had diarrhea. Of the 528 households with its family members had

illnesses in the last 6 months, 7.4% of children under five had diarrhea in the last 2

weeks.

Figure 3.8 Children under Five with Diarrhea in the Last Two Weeks


Ya7%

Tidak93%

Menderita diare dalam 2 minggu terakhir (n=528)

For first treatment that is given to children with diarrhea shows two major things

that conducted by respondent that are directly taken to the health ceter/Pustu (33.3%)

and buy medicine at stall (26%). This is consistent with respondent answer to the

question of what treatment is given. The two major answers are to buy pills or syrup

(56.4%) and make solution of oral rehydration salt (38.5%).

This survey is also asked about mother’s

knowledge in giving food and beverage.

It is highly recommended that for

children with diarrhea feeding is still given, even for beverage and breast milk should be

given, even in large amount to replace the fluid came out.


49

Table 3.20 presents data on feeding habits to children with diarrhea in last 2

weeks preceeding the survey. 23.1% of respondents are actually reduced the

breastfeeding during the time children had diarrhea, and only 7.7% of respondents give

more liquid than usual. In term of giving fluid, mother’s knowledge in giving liquid

(drink) is the same on average, where the results obtained between giving more fluid,

equal and less than usual consecutively 38.5%, 28.2%, and 25.6%. While o the question

asking about feeding pattern, it turns out that in children with diarrhea the food intake

is tended to be reduced (53.8%).

Table 3.20 Seeking and Treating Diarrhea in Children under Five


n=39 %

Treatment facilities headed for the first time when having diarrhea

Private hospital 1 2.6

Health center/Pustu 13 33.3

GP practice/Clinic 2 5.1

Private practice midwives 1 3

Polindes/Village midwives 8 21

Buy drugs at stall 10 26

Traditional practice 3 7.7

Others 1 2.6

Who is decided to take the child to health facility

Head of the household 8 20.5

Couple of household 21 53.8

Head of the household and the couple 5 12.8

Parents/Parents in law 2 5.1

Others 3 7.7

Treatments that are done when the children having diarrhea

Solution from oral rehydration salt 15 38.5

Pills or syrup 22 56.4

Injected 2 5.1

Infused 1 2.6

Traditional medicine 4 10.3

Others 3 7.7


50

n=39 %

When children had diarrhea, is breast milk still be given

Less than usual 9 23.1

Same amount 13 33.3

More than usual 3 7.7

Not breastfed 3 7.7

Not applicable 11 28.2

When children had diarrhea, is beverage still be given


Same amount 11 28.2


Not given drink 2 5.1

Not applicable 1 2.6

When children with diarrhea, is food still be given


Same amount 13 33.3


Not given meal 2 5.1

Incidence of Diarrhea in Children under Five and Ownership on Type of Latrine

In this baseline survey is trying to see the relation between variable incidences of

diarrhea in the last two weeks among children under five with the latrine ownership.

The type of latrine is categorized into 3 that are improved, unimproved and open

defecation free. The following figure shows the relation between incidence of diarrhea

and types of latrine owned/used, where the incidence of diarrhea is lower in children

under five with parents have improved latrines. This means that to reduce the

indicidence of diarrhea by healthy behavior one of them is with the availability of

improved latrines.


51

Figure 3.9 Percentage Distribution of Diarrhea Incidence among Children Under

Five in The Last Two Weeks Based on The Ownership and Type of

Latrine Baseline Survey 2011

4.8

6.9

12.3

-

2.0

4.0

6.0

8.0

10.0

12.0

14.0

Improved Unimproved Open defecation

Balita mengalami diare

Incidence of Diarrhea in Children under Five and Source of Water

Figure 3.10 shows description on condition of source of water that protected, decent and

safe to be consumed associated with incidence of diarrhea in children under five. The

more protected, decent and safe then the incidence of diarrhea is lower than sources of

water that are not protected, undecent and not safe.

Figure 3.10 Percentage of Diarrhea among Children under Five with Source of

Water Baseline Survey 2011

9.4

6.7

8.7

3.1

7.5

--

5.0

10.0

Balita diare dan Sumber Air

Tidak terlindungi Terlindungi Tidak Layak

Air Layak Tidak Aman Aman


52

3.4.4 Knowledge on Diarrhea

Knowledge of mothers of children under five about causes of diarrhea

are not adequate, only a quarter answer spontaneously because of

contaminated foods and one-fifth because of contaminated beverages

The causes of diarrhea for children and adult are different. Among children

diarrhea is caused more by a virus of diarrhea/ rotavirus (around 90%), for example:

children are often put their fingers into the mouth and eat foods that have been more

than 2 hours, small part are because of bacterial infection, paracytes, and fungus. In

addition is due to the use of anti biotic (antibiotic induced diare), food poisoning,

allergies, and psychological factors that is stress (e.g. during exam). In adult, diarrhea is

mainly due to food and beverage contaminated by germs such as Eschericia coli

(pathogen), Salmonella sp, Shigella, virus, paracytes such as amoeba, several fungi such

like Candida sp. Drugs can also caused diarrhea, for example drugs that work by

increasing intestinal peristaltic or to dilute the feces as laxative.

Related with the knowledge about diarrhea, questions asked to respondents are

including two things which are whether the respondents know about the cause and how

to prevent the diarrhea. In these questions, respondents can give more than one

answers. For the question “What causes diarrhea” it is obtained three major answers

that are: missed feed, contaminated food and contaminated beverage. As it is known,

that foods and beverages are the main sources for transmission of diarrhea. Figure 3.11

shows that mothers’ knowldege about the causes of diarrhea is not adequate. This can

be seen from the respondents’ answers about the causes of diarrhea, less than a quater

answered for contaminated food and one-fifth for contaminated beverage.


53

Figure 3.11 Respondents Knowledge about the Causes of

Diarrhea Baseline Survey 2011

7.9

18.2

26.7

54.7

9.2

11.3

17.8

0.0 10.0 20.0 30.0 40.0 50.0 60.0

Kuman

Air minum Tercermar

Makanan Tercermar

Salah Makan

Perubahan Cuaca

Tidak Tahu

Lainnya

Penyebab Diare (n=1320)

According to Dr. Luszy Arijanty (Mediacastore.com), to prevent diarrhea in

children can be done by: teach the children to wash their hands with soap, wipes baby’s

hands often, keep the cleanliness of food and beverage, give exclusive breastfeeding at

least 6 months because breast milk contains immunoglobulin, and measles

immunization because measles can cause diarrhea by nesting in the mucosa. While for

adults, prevention can be done by preventing the main causes of diarrhea by put

attention to the hygiene quality of food and beverage.

Results from the survey find that 80.5% answered that diarrhea can be prevented,

while 12.3% of respondents’ answers do not know. However, the knowledge on how to

prevent is still low. The three highest answers given spontaneously on how to prevent

diarrhea are: (1) eat clean food (59.1%); (2) drink boiled water (35.6%); and (3) wash

hands with soap before eat (17.5%). Answers on wash hands after defecation is very

small (3.7%), as shown in Figure 3.13.


54

Students knowldege about the causes and prevention of diarrhea, skin and deworming is still low. For that, the appropriate KIE is required so that early practice on hygiene can be done

Figure 3.12 Can Diarrhea Be Prevented Baseline Survey 2011

Figure 3.13 Respondents Knowledge on How to Prevent Diarrhea


59.1

35.6

17.5

3.7

11.6

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0

Makan, makanan yang bersih

Minum, minuman yang dimasak

Mecuci tangan pakai sabun sebelum makan

Mencuci tangan pakai sabun sesudah BAB

Menutup makanan

Pengetahuan tentang Cara Mencegah Penyakit Diare (n=1320)

3.4.5 Knowledge about Diarrhea, Skin and Deworming on Elementary Students

In this section the 5th grade students are asked about the cause of diarrhea and skin, as

well as prevention of deworming. In this question, respondents can give more than one

answer.


55

Interview Process to Elementary Students

Dist. TTU - NTT

A total of 13.1% of the students do not know the cause of diarrhea. For those who

know the causes, generally answer because missed fed/digestive disorder (47.7%) and

contaminated food (22.9%). Similarly with the knowledge on cause of skin diseases,

24.6% of elementary students do not know the cause of the skin diseases. The two

highest answers are: play at any places/dirty (28.6%) and toys are not clean (24.3%).

Basically the way to prevent deworming is by

washing foods and eating equipments appropriately; do

shower at least 2 times a day; wash hand with clean

water and soap before eat, after playing and after

defecation; defecate at places that has provided (not at

any place); always use footwear/sandals when go out of

the house, and cut nails. From this survey, it is obstaines

that 29.9% of the students answer by washing their hand with soap, consumed

clean/healthy food/beverage (26.8%), and 18.5% answeres not play at any places. In this

part is also gained that 27.8% of students answer do not know how to prevent

deworming.

Table 3.21 Distribution on Knowledge about Diarrhea and Deworming at

Elementary School Students, Baseline Survey 2011

Causes of Diarrhea N %

Germs 95 12.2

Worms 39 5.0

Contaminated drinking water 71 9.1

Contaminated food 178 22.9

Food poisoning 27 3.5

Missed fed/digestive disorder 371 47.7

Weather changes 10 1.3

Food/Beverage that are not cooked 4 0.5

Food/Beverage from any places 26 3.3

Do not wash hands 47 6.0

DO NOT KNOW 102 13.1

Others 56 7.2


56

How to prevent transmission of deworming

Not defecate at any places (at latrine) 11 1.4

Wash hands with soap 232 29.9

Use footwear 15 1.9

Consumed clean/healthy food/beverage 208 26.8

Not play at any places/dirty 144 18.5

Take helminth/vitamin/suplement/traditional ingredients 65 8.4

Shower 22 2.8

Healthy life behavior (wash hands/ cut nails) 33 4.2


Others 39 5.0

Causes of Skin disease

Uncleaned bath 189 24.3

Bathing without soap 86 11.1

Bathing at sewers/dicth/river 91 11.7

Play outside in the middle of the day (direct sunlight) 41 5.3

Play at any place/dirty 222 28.6

Do not/Rarely take a bath 46 5.9

Because of animal (insect bites /exposed by caterpillars, etc) 35 4.5

Microorganism (virus/bacteria/germ etc) 19 2.4

Disease/allergy 13 1.7


Others 60 7.7

3.5 CLEAN AND HEALTHY LIFE BEHAVIOR (CHLB/PHBS)

CHLB promotion in Pamsimas aimed to all comunity levels, especially for

women and children of school age. In supporting that, in this survey CHLB is seen from

three sides that are household, school, and students. CHLB at household level includes

10 sections, five of them are exclusive breastfeeding, weighing children under five every

month, use clean water, wash hands with clean water and soap, as well as use healthy

latrine. While CHLB in school and student considered as one, which includes wash


57

hand and brush teeth cleanly, consumed nutritious food, and keep the school

environment, do regular exercise and good management of time for rest.

3.5.1 Hand Washing With Soap (HWWS)

Five critical times related with HWWS are still low among household respondents compared to elementary student, even when the options for answer are being read

One of the activities emphasized in CHLB is Hand Washing with Soap (HWWS)

that known as the five critical times. HWWS is one of important indicator related with

clean and healthy life behaviors which contribute to the high incidence of diarrhea in

Indonesia. The five critical times are: (1) before feeding the children under five, (2) after

defecation, (3) Before eating, (4) After cleaning out children under five, and (5) before

preparing meals.

Figure 3.14 HWWS in last 24 hours Baseline Survey 2011

74.6 82.1

25.4 17.9

Responden RT Responden Murid

CTPS dalam 24 Jam terakhir

Ya Tidak

Table 3.22 shows distribution of HWWS practice among respondents in the last 24

hours. Results from household survey shows that of 1.320 respondent, 74,6% do the

HWWS, the largest percentages are respectively; after work (32.3%), before eat (32%),

after defecation (13.2%), after cleaning the house (11.1%), and after eating (10.7%). Other

answers have percentage bellow 10%.


58

Table 3.22 Percentage of HWWS Practices at Household Baseline Survey 2011

HHWS Practice n= 1320 % After cleaning the house 146 11.1 After defecation 174 13.2 After cleaning out children 92 7.0 Before feeding the children 50 3.8 Before preparing the meal 123 9.3 Before eating 423 32.0 After handling animal 40 3.0 After working 426 32.3 After having meal 139 10.5 Before/after sleeping 93 7.0

The following table shows the distribution of HWWS practice related to the

practice of the five critical times, two of the highest answers on respondent HWWS

behavior are after working (32.3%) and before having meal (32%).

When the answers on five critical times are grouped then the percentage

decreased. From the table is also obtained that more than a quarter of respndents answer

HWWS practices are not related with one of the categories of five critical times.

Table 3.23 Distribution on Practice of Five Critical Times Baseline Survey 2011

Answer n=1320 % Washing hands with soap in the last 24 hours 985 74.6

Do not wash hands with soap 335 25.4

Not 5 critical times 343 26.0

1 Critical time 465 35.2

2 Critical times 140 10.6





59

HWWS among Elementary Students

In the survey to elementary school students, it is obtained that 82.1% of the

student in last 24 hours do the handwashing with soap. The three highest answers are

before having meal (79.2%), after having meal (43.4%), and after playing (24.0%). In

general the HWWS behaviors are conducted because suggested by mother (79.5%),

father (41.1%), and teachers (19.3%). Reasons why they should wash their hands with

soap are to make the hands clean (65.0%), to remove dirts/germs (56.4%), and to them

healthy (48.6%). The ways that recommended based on health are before eating, after

defecation, after handling pets, and after playing.

Figure 3.15 HWWS among Elementary Students Baseline Survey 2011

3.5.2 Personal Hygiene among Elementary Students

Early understanding about clean and healthy life among children is expected to

break the chain of spread of germs and to prevent them from various diseases. School as

a place for building the children’s character in this research has given good attention

where 84.7% of the schools do the health examination to every student. However the

examination related with water and sanitation health is only on one type of disease

which is deworming (46.6%).


60

Table 3.24 Health Examination Program at School - Baseline Survey 2011

Health Examination n= 157 %

Schoold ever conduct health examination to every student

Yes 133 84,7

No 24 15,3

n= Health examination that conducted n= 133 %

Dental examination 104 78,2

Eye examination 64 48,1

Deworming 62 46,6

Informations that obtained from elementary students related to their personal

hygiene are including behavior in bathing, brushing teeth and defecation. The healthy

life behavior suggests taking bath at least twice in a day, i.e. in the morning and

afternoon. 68.3% of the elementary school students have done that, there are even doing

it three times a day.

From the interview, it is known that they usually do the shower before and after

school, and in the afternoon when they are going to TPA (Religious Education Class).

This is highly done by the respondents 27.8%. The place where they can use for bathing,

generally is bathroom at their own house 66.9%, and when take a bath they use soap

(95.0%).

Health recommendation to use soap when take a bath is in order to: kill the

germs; be clean/healthy, not itchy. It is obtained two highest answers that are 88.8% of

the students stated that to be cleaned/healthy and other is to kill the germ (38.4%).

Brushing teeth behavior among students shows by 51.9% of the students, brush

their teeth twice a day, even there are more than twice (39.0%). In term of health, it is

suggested to brush the teeth using water from well, spring or PDAM pipes. It is found

that 56.0% of the students’ answers the sources for water they use are from well 16.7%

and others from spring. Related with defecation, most of the student have conducted it

at their own bathroom (71.4%) and 15.7% at public toilet/neighbors.


61

Table 3.25 Distribution about Habits in Bathing, Brushing Teeth and Defecation

among Elementary School Students – Baseline Survey 2011

BATHING n= 777 %

How many times usualy take a bath in a day

1 time a day 28 3.6 2 times a day 531 68.3 Never take a bath 1 0.1 3 times a day 216 27.8 Others 1 0.1

Where do you usually take a bath Public bathroom 83 10.7 Own bathroom at home 519 66.9 River/stream 114 14.7 pool/pond 5 0.6 shower/spring 23 3.0 Neighbor’s bathroom 9 1.2 Well 53 6.8 Others 14 1.8

What do you think the advantage using soap when take a bath To kill the germ 298 38.4 To be clean/healthy 689 88.8 Not be itchy 51 6.6 To be fresh 55 7.1 To have good scent 155 20.0 To prevent illness 19 2.4 Don’t know 2 0.3 Others 4 0.5

BRUSHING TEETH How many times do you usually brush your teeth in a day

Once a day 67 8.6 Twice a day 403 51.9 More than twice a day 303 39.0 Never 4 0.5

DEFECATION Where do you usually defecate

Own toilet 555 71.4 Public/Neighbor toilet 122 15.7 River 67 8.6 Garden 20 2.6 Pond/Sea/Beach 8 1.0 Others 5 0.6


62

Environment condition Location: SD Kembang, Desa Kembang, Kec. Todanan, Kab.Blora

Central Java

3.5.3 Waste Management in School

The waste management in school has not working

well, the seperation between organic and inorganic

waste, both at public and private school generally

have noot been done (78.3%). There are still many that

manage the waste by burned (87.3%) and thrown to

hole (17.8%).

Table 3.26 Waste Management System at School Baseline Survey 2011

Waste condition at school n=157 %

Trash can at school that seperated for organic and inorganic waste

There is 32 20,4

There is not 123 78,3

Not applicable 2 1,3

Method on managing the waste that often done in school

Composted 8 5,1

Burned 137 87,3

Collected and carried away by officer 15 9,6

Thrown into hole 28 17,8

Stacked 18 11,5

Thrown into stream/river/lake/pond 5 3,2

Thrown into sewers/drains/trenches 2 1,3

Sold 2 1,3

Others 5 3,2

According to the UU No.18 2008, waste is residue from daily human activities

and/or natural process in solid. Based on the source, they are divided into waste from

residential, agriculture and plantation, trash of building and construction, trade and

offices, and waste from industrial. Source of waste related in this study is waste from

residential, both from household and school in the form of residual from food


63

Waste that stacked in the hole Ds. Depok, Kec. Toroh, Kab. Grobogan

Central Java

processing, used equipments from household/school, paper, cardboard, glass, fabric,

and garbage from garden/yard.

From the household survey, it is obtained two

highest answers for source of waste that are

from plastic/plastic bottles that are not used any

more (86.4%) and leaves (56.5%). Related with

the landfills, usually the waste has dumped to

correct places (87.9%), but there is still thrown at

anly places (24.3%).

Table 3.27 Distribution on Waste Management at Household Level Baseline Survey

2011

Variable n=777 % Waste are derived from

Leaves 439 56.5 Plastic/Plastic bottles that no longer used 671 86.4 Garbage from kitchen 128 16.5 Cans that no longer used 118 15.2 Papers 317 40.8 Wood/branches 15 1.9 Glass 2 0.3 Human waste/animal 23 3.0 Leftover food /leftover snacks 31 4.0 DO NOT KNOW 8 1.0 Others 31 4.0

Where usually throw the waste Thrown at the waste can 683 87.9 Thrown in a dug hole, and if already full will be burned 83 10.7 Thrown in a dug hole, and if already full will be covered 17 2.2 Dumped on the ground 189 24.3 Dumped on the drainase,/river 82 10.6 Dumped in the garden 8 1.0 Others 7 0.9


64

Source of water from spring at Gunung Kidul

3.5.4 Environment Condition

Description of respondent related to disposal of wastewater from bathing and

washing depicted in Figure 3.16. It is obtaibed that

26.6% of respondents are still disposed wastewater

from bathing and washing outside the house. This

number is the highest compared to other answers.

There are also 19.5% of respondents throw them into

stream/river and 7.0% into fish pond. Both of the

ways certainly can disturb the ecosystem that exist

around the river/stream and fish pond, and it also

can cause skin disease for people who use the river.

It is suggested that community can dispose their wastewater from bathing and

washing in healthy way that is by flowing the wastewater from the sources (kitchen,

bathroom) to the wastewater shelter fluently without polluting the environment and can

not be reached by insects and rodents. For example, flow it to the Wastewater Disposal

System (SPAL) and closed disposal. However, results from this survey found that these

two methods are only done by few of respondents that are 13.4% and 2.1%.

Figure 3.16 Method on Wastewater Disposal from Bathing and Washing of

Household Baseline Survey 2011

13.4

10.3

20.0

19.5

26.6

2.1

7.0

1.0

Dialirkan ke SPAL

Dialirkan ke saluran lubang galian

Dialirkan ke luar rumah/dapur

Dialirkan ke sungai/kali

Dibuang ke luar rumah

Dialirkan ke pembuangan tertutup

Dibuang ke kolam Ikan

Lainnya

Cara pembuangan air limbah rumah tangga


65

Results from observation on the house condition of respondents including

whether there are animals around the house, animal waste and others are presented in

the following Table 3.29. It is found that there are animals at 85.2% around respondents’

houses. Animals that widely seen around respondents house are chicken (83.5%),

followed by ducks (15%), goats and cows (13.8% and 13.0%). Almost at 6% around

respondents’ house there are pigs can be seen. Other pets are dogs and cats (respectively

27.3% and 20.4%). Rambled livestocks are causing dirt (65.2%) and bad smell (34.5%)

around the house.

Table 3.28 Result from Observation on Household and Environment Conditions


Around the household and environment there are animals (n=1320)

Yes 1124 85.2

No 196 14.8

Animals that rambled around the house

Chicken 938 83.5

Dog 307 27.3

Cat 229 20.4

Duck/Goose/Swan 169 15.0

Goat/Sheep 155 13.8

Cow 146 13.0

Pig 63 5.6

Others 50 4.4

Animal waste around the house

Yes 861 65.2

No 459 34.8

Smell of animal waste around the house

Yes 456 34.5

No 864 65.5


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3.5.5 Health Promotion Media

Definition of health promotion media is all media, both print and electronic

media that are used to carry messages or information related to health. Of the 132

villages surveyed, mostly (59.1%) have had information media to support the health

program that is in form of posters (88.5%).

This household survey only asked information media that most frequently used

by the respondent, not related with health infomation. From the three media that asked,

which are newspaper/magazine, radio and television, it turns out that television is the

media that almost every day watched by the respondents (72.7%). So if Pamsimas

program want to use media as means for publication, television is the best alternative,

altough the cost for it is quite expensive compared to other mass media types.

Figure 3.17 Information Media that Frequently Used by the Respondents from

Household - Baseline Survey 2011

Other than househod, health promotion through the school community is most effective

among other public health efforts, particularly in development of healthy life behavior.

In relation to health, every school on average nearly half had a program called School

Health Effort (UKS). In the public school program that is often done is inspection on

students body hygiene (17.8%), whereas in private school is student health examination


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(14.3%). Beside the UKS, other health program at school is BIAS (School Children

Immunization Month) (71.3%).

Table 3.29 School Health Effort (UKS) Program Baseline Survey 2011

Variable n=157 %

School has UKS program

Yes 80 51,0

Programs that are done to improve health through UKS program Small physician-education program 23 14,6

Procurement of medicines for sick students 12 7,6

Examination on student body hygiene 26 16,6

Examination on students health 15 9,6

Promotion /socialization on CHLB 6 3,8

Health promotion and general hygiene 9 5,7

Activity to clean the school and sorrounding environment

14 8,9

Sports 10 6,4

Practice of body hygiene: brush teeth together/HWWS 14 8,9

Other than UKS are there any other health program Immunization month program (BIAS) 112 71,3

Examination of deworming 47 29,9

Give supplementary feeding 27 17,2

Student hygiene inspection 7 4,5

There are no 15 9,6

Others 9 5,7

Not applicable 8 5,1

In relation with the availability of health information media in school, it turns out that

there are 31.8% of schools that do not have means of health information media. In school

that already have the media, reading books about health (84.1%) and poster (72%) are

the most widely media owned by the schools, both at public and private schools. Both

types of media are also the media that most prefered by the respondents (health book

(37.4%) and poster (28.0%)).


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Figure 3.18 Health Media Availability at School Baseline Survey 2011

3.6 IMMUNIZATION

Immunization is the provision of body immunity to a certain disease by inserting

something to the body so that the body will resistant to the epidemic disease or harmful

for a person. Some diseases can be prevented by immunization, such as TBC, dysentry,

tetany, poliomyelitis (paralysis) and measles. This type of immunization is known as

basic immunization.

Based on the WHO guideline, infant stated to have complete immunization if

have been: get one BCG immunization, three times DPT immunization, three times polio

immunization, and one measles immunization. All of these immunization are

recommended and must be given before the child reached 12 month (Depkes, 2003). In

this survey, denominator of immunization coverage is the last children under five that

the mother/respondent has. Table 3.31. shows that 94.3% of 528 children under five have

ever received immunization. Among those, 70.9% have received complete

immunization.


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Table 3.30 the Giving of Immunization to Children Under Five Baseline 2011

n %

Does this household have children under five

Yes 528 45.4

No 636 54.6

Has the children under five ever received immunization

Yes 498 94.3

No 30 5.7

Age of children under five

<=11 months 121 24.3

12 - 23 months 116 23.3

24 - 35 months 116 23.3

36 - 47 months 78 15.7

48 - 59 months 67 13.5

Source of information about immunization to children under five

Based on KMS/MCH handbook 212 42.6

Verbal 286 57.4

Type of immunization received

BCG 447 89.8

DPT1 430 86.3

DPT2 410 82.3

DPT3 395 79.3

HB0 371 74.5

HB1 401 80.5

HB2 400 80.3

HB3 372 74.7

Polio 1 429 86.1

Polio 2 414 83.1

Polio 3 395 79.3

Polio 4 371 74.5

Measles 353 70.9


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3.7 NUTRITION

3.7.1 Breast milk

Breast milk is the best food and source of nutrition for infant, especially in the first 6

months of life. The digestive and immunity systems of the newborn are not yet perfect,

so any food other that breast milk will cause digestive disorders and illness. Awareness

regarding the giving of breast milk is good. Of the 528 respondent with children under

five, almost all received breast milk (97.3%).

¾ One third of the respondents give breast milk within first one hour

¾ 20.5% of respondent with children under five give exclusive breastfeeding 0-6

months and 50.8% of the mother give food/beverage other than breastmilk

when the breast milk has not fluent

¾ Need continuous socialization about the advantage of giving exclusive

breastfeeding and disadvantage of giving supplementary food so early

The Early Intiation of Breastfeedig (IBF) program is strongly recommended to put the

newborn next to the mother (skin-to-skin contact) after birth, this is an attempt to

accelerate the release of breast milk/colostrum, so the breastfeeding process can be more

fluent. The IBF practice in the surveyed area is still low, only 33.7% of the respondents

give breast milk within one hour, the remainings give breast milk over an hour. This

condition caused chance for the breast milk production to be decreased and give the

opportunities for the baby given any beverage other than breast milk.

The IBF is supporting the practice of exclusive breastfeeding that is the giving only

breast milk for the first 6 months of infants’ life. Exclusive breastfeeding will protect the

infant from infectious diseases, so the nutritional and health status are mantained well.

Various studies have shown that infants from mothers who conduct the IBF (get breast

milk within 1 hour after birth) grows better (weight and length) significantly and the

episodes of illness is shorter compared to the non-IBF. In this survey the giving of only


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breast milk for 0-6 months is also low that only 20.5%. Respondents that have gave food

or beverage when the breast milk has not come out/not fluent (50.8%). Generally

respondents in the surveyed area give special formula milk for infant (16.4%), honey

water (5.1%), and water (4.4%). Though in theory, infant afetr birth is still survive

without drinking for 48—72 hours, due to the food reserves from mother’s placenta.

Table 3.31 Data on the Giving of Breast Milk to Infant and Children under

Five, Baseline Survey 2011

n %

CHILDREN UNDER FIVE EVER RECEIVED BREAST MILK

Yes 514 97.3

No 13 2.5

Do not know 1 0.2

FIRST TIME RECEIVED BREAST MILK

Immediately < 1 hour 173 33.7

1 - 24 hour 215 41.8

25 - 48 hour 77 15.0

49 - 72 hour 24 4.7

> 72 hour 25 4.9

GIVING OF EXCLUSIVE BREASTFEEDING

Exclusive breastfeeding up to 6 months 108 20.5

Non exclusive breastfeeding 420 79.5

WHEN THE BREAST MILK HAS NOT FLUENT, THE INFANT GIVEN BEVERAGE OHER THAN BREAST MILK

Yes 261 50.8

No 253 49.2

KIND OF BEVERAGE GIVEN TO INFANT OTHER THAN BREAST MILK

Infant/formula milk 175 16.4

Other milks 1 0.1

Water 47 4.4

Sugar/sugar water 21 2.0

Starch water 0 0.0

Juice 1 0.1

Tea water 6 0.6

Honey/honey water 55 5.1

Others 6 0.6


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3.7.2 Colostrum

The practice of giving colostrum is good enough, 72% of respondent have gave

colostrum to their infants, but there are still about 28% of respondents who did not give

colostrum. The colostrum, yellowish fluid, should be given to the infant when the first

time breast milk came out as anti body. Colostrum is only available in the first to the

third or forth day in maximum.

WHO 2005 and the MOH also recommended that solid food should be given

after the child reached 6 months, and the given of breast milk should be continued until

the child reach two years. With breast milk, infant health will be more secured, less

susceptible to disease and gastrointestinal problem.

For infants, duration for receiving breast milk, given by the respondents, are

mostly at the age 13—24 months (63.3%), the remainings 23.7% of respondents have not

gave breast milk since their infants were less than or equal to 12 months. By not giving

breast milk, then the infants have chance to receive other other food, altough the given

of supplementary feeding at early age is the to open entry point for various kind of

germs, because the intestines and digestive system have not work perfectly and can

cause diarrhea, constipation to the infants.

Table 3.32 Data on the Giving of Colostrum to Infants and Children under Five


MOTHER GIVE THE COLOSTRUM TO THE INFANT

Yes 370 72.0

No 144 28.0

DURATION OF BREASTFEEDING FOR CHILDREN UNDER FIVE

<= 12 months 58 23.7

13 - 24 months 155 63.3

> 24 months 32 13.1


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3.7.3 Semi Solid and Solid Food as Supplementary Feeding for Breast Milk

When the infants age are more than six months, the digestive system have relatively

complete and ready to receive the supplementary feeding. Therefore, it is expected that

a mother can start to give the supplementary feeding slowly with semi solid food. The

Table 3.34 bellow shows that in the last one week infants have given food with good

variety of menu, consists of milk, carbohydrates, vegetables, fruits, animal protein, and

vegetable protein. For milk, the most widely administered is breast milk (45.0%);

carbohydrates are from bread, rice, noodle and biscuits (90.0%); for type of vegetable is

green vegetable (81.5%); and for fruits is mango and orange (65.1%); while for the

animal protein is from egg (71.6%), and for the vegetable is from nuts (68.9%).

Table 3.33 Data on Nutrition of Infant and Children under Five Baseline Survey 2011

THE GIVING OF FOOD WITHIN LAST WEEK n %

Milk Breast milk 217 45.0 Infant/Formula mik 123 25.5 Other milk 120 24.9

Carbohydrates All kinds of porridge 148 30.7 Instant food 103 21.4 Bread, Rice, Noodle and Biscuit 434 90.0 Potato or foods made from stolons 236 49.0

Vegetables Carrots, sweet potato, orange 286 59.3 Green vegetables 393 81.5

Fruits

Mango, orange, other fruits rich in vitamin 314 65.1

Animal protein Meat (beef, lamb), Poultry 226 46.9 Egg 345 71.6 Seafood 308 63.9

Vegetable protein Foods from nuts 332 68.9 Offal (liver, kidney, heart, intestines, lungs, brain, etc.) 82 17.0


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Condition of SD Mlale di Kab. Sragen – Central Java

3.7.4 Students Snack Pattern

Snacking habits among elementary students is quite high, both at home and at school.

Students need to provide with knowledge about balance nutrition inlcuding healthy

snacks, in order to fulfill their nutrition need

Snack pattern of the pupil/students is very high

(98.2%) and cost 70% of their pocket money

(70.0%). This snacking habit is done both at

home (83.9%) and also at stall near the school

(62.3%) or from itinerant food vendors (13.8%).

While students that buy it from the school

canteen are only 25.3%. Though most of the

snacks outside are included as non safe and

potentialy caused various diseases such as dizziness, nausea, vomitting, diarrhea, or

constipation. It is highly recommended that parents, especially mothers, provide the

children with food from home, so that the cleanliness and contents of the food/intake

can be ensure.

Table 3.34 Students Snack Pattern Baseline Survey 2011

SNACK PATTERN

Ever had snacks within the last week

Yes 763 98.2

No 14 1.8

How many times have snacks within last week

Every day 534 70.0

3 times a week 116 15.2

2 times a week 60 7.9

1 a week 16 2.1

Others 37 4.8


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SNACK PATTERN

Where do you usually buy the snacks

Stalls/kiosks near the house 640 83.9

School canteen 193 25.3

Stalls/Kiosks near the school 475 62.3

Itinerant food vendors 105 13.8

Market 43 5.6

Home (snack made at home) 109 14.3

Cooperation/Shop 4 0.5

Others 3 0.4

3.8 BUDGET ALLOCATION FOR CLEAN WATER AT VILLAGE LEVEL

Information on local budget is important, because by knowing and

understanding the source of funding and spending of the village then will know

development problems and local capability to over come them. Development fund for

village could come from many resources such as from the Central government,

provincial, district/municipality and from communities. The table bellow shows that

almost all villages (93.2%) receive funds from central, provincial, district/municipality

and community.

Table 3.35 Average Source of Fund Allocation Received by the Village


Source of fund Mean Median

Central Government 278.876.987,0 160.000.000,0

Provincial Government 37.307.426,5 7.000.000,0

District/Municipality Government 99.081.924,0 78.200.000,0

Community 62.573.169,4 14.400.000,0

The remaining from budget in 2009 10.768.149,5 0,0

PAD Village /Kelurahan 53.463.433,5 14.500.000,0

Others 75.112.011,6 5.673.000,0

Total funds received 257.422.401 124.724.597


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As seen in the above table, that the amount of funds from central level has the highest

average, that fund is fund balance from central. By that, village development is greatly

supported by funds from various sources. If we see the amount, the largest source of

fund is from the district/municipality in form of ADD (Village Allocation Funds). The

fund is use to help the village government in developing village infrastucture and

operational of village government. While funding from central level usually given as

stimulant funds in build structures and infrastructure of the village, that are manifested

in the village development projects.

Table 3.36 Average Source of Fund Allocation Used Baseline Survey 2011

Source of Fund Mean Median

Drinking water and Sanitation 55.426.328,5 12.617.500,0

% total village budget on expenditure for drinking water and sanitation 21,5%

Environmental Health Program 13.360.000,0 2.500.000,0

% total village budget for environmental health program 5,2%

Health promotion inclusing socialization 3.033.333,3 2.950.000,0

% total village budget for health promotion 1,2%

From the total of village income, average income is 257 million IDR in 2010. Of

that total, fund allocation for drinking water and sanitation programs is on average 55

million IDR (21.5%) a year. While for allocations that use for environmental health

development and disease prevention are still low with average 13.360.000 IDR (5.2%) in

2010 from direct cost.

However, for allocation on health promotion program is still low that in average 3

million IDR (1.2%) in 2010. The health promotion and provision of clean water has been

suppported by PAMSIMAS project where the region spent fund 6 billion IDR on

average.


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Village Regulation (PERDES)

Policy issued at the village level at this point could be head of village decree or village

regulation (Perdes). The village regulation arises because of village community

needs and facilitated by village government and subsequently issued a regulation.

Perdes is published as a legal umbrella to protect the community from various actions

that could harm the community so that the legal aspect can be implemented well for

community welfare.

So is the community demand for regulation or protection for clean water and

sanitation, this is very important and need to pay attention because it involves the

livelihood of the peoplw, and very vulnerable to create conflicts because the scarcity of

water resources. Of all 132 villages surveyed only 6.1% of the villages that have issued

village regulation contained regulation on clean water and sanitation.

Table 3.37 Frequency Distribution of Village that has Village Regulation

(PERDES) Baseline Survey 2011

PERDES n %

Is there Perdes or decree that manage water and sanitation

There is 8 6,1

There is not 124 93,9

Total Funds received 132 100.0

4 CONCLUSION


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Sample of water test using H2S At. Manggarai District - NTT

CHAPTER IV CONCLUSION

1. More than 50% of respondents are educated ǃȱ ş years, while for the head of the

family is less than 30%.

2. Most of the respondents work in informal sector, only 10% work as employee

(formal sector) and about half of respondents included as poor household with

expenditure less than 2 US$ per day/person.

3. There are 12.2% households headed by women.

4. The average number of family size is 4.1 persons.

5. According to village informants, majority of respondent’s households get clean

water from dug well (84,8%), pump well 46,2%, spring 52,3%, river/ stream 41,7%

and piping non ��ȱŚŖǰşƖǯȱNot many get clean water from PDAM piping ŗşǰŝƖ

6. At household level 23.8% have protected source of water and as much as 76,5% of

source of drinking water are not suitable for consumption.

7. şŞǰŞƖ sources of drinking water are not safe for consumption because contain E.coli

bacteria.

8. 87,2% of households have access to

drinking water < 30 minutes.

şǯ 33.3% of household members use water

less than 60 liters/day/person.

10. According to the village informants, the

available sanitation facilities in village at

household level are still minimal only

ŗŞǯşƖȱthat have landfill, ��ȱşǯŗƖǯ

11. About 25% of the families are still defecating at open land, at the river, sewer, beach,

field, bushes/garden, pond or pool.

12. Improved latrine ownership with lower diarrhea incidence in children under five


79

13. One third of respondent’s houses have less than 10 meters distance between water

source and septic tank which could impact on health problems associated with

water.

14. Two third of observed schools do not have SPAL.

15. 74.6% of the respondents state that within the last 24 hours do hand-washing with

soap. However, the five critical times related with HWWS are still low among

households compared with the elementary school students, even when the options

of answer have read.

16. The highest morbidities at village level from the result of secondary data is ARI

(10.8%) and diarrhea (3.8%).

17. In the last 3 months, 5.4% household members had diarrhea and cough with fast

breathing (2.4%).

18. Approximately 7.4% children under five had diarrhea in the last two weeks

ŗşǯ The health seeking behaviors for children under five with diarrhea are directly taken

to PHCs/Pustu (33.3%) and buy over-counter drugs (26%).

20. One third of the respondents give breastfeeding within one hour after delivery.

21. Coverage of exclusive breastfeeding for infant 0-6 months (20.5%) is still low and

quite high (50.8%) mothers of children under five have gave food/beverage other

than breast milk when her breast milk have not fluently came out.

22. Almost all villages ǻşř.2%) received funds from central, provincial,

district/municipality and community.

23. Budget allocation for drinking water and sanitation program in average is 55 million

IDR (21.5%) in 2010. While the allocation for development of environmental

sanitation and disease prevention is still low which in average around 13.360.000

IDR (5.2%) in 2010 from the direct cost.

Baseline Survey Report 2011

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