Safely Managed On-Site Sanitation: A National Assessment of Sanitation Services and Potential Fecal Exposure in Indonesia

Mitsunori Odagiri, Ann Thomas, Maraita Listyasari, Freya Mills, Robert E. S. Bain, Zainal Muhammad, Tom Slaymaker, Aldy Mardikanto, Anita Gultom, Asri Indiyani, Hasnani Rangkuti and Juliet Willetts
Additional contact information
Mitsunori Odagiri: United Nations Children’s Fund (UNICEF), Jakarta 12920, Indonesia
Ann Thomas: United Nations Children’s Fund (UNICEF), Jakarta 12920, Indonesia
Maraita Listyasari: United Nations Children’s Fund (UNICEF), Jakarta 12920, Indonesia
Freya Mills: Institute for Sustainable Futures, University of Technology Sydney, Ultimo, NSW 2007, Australia
Robert E. S. Bain: Division of Data, Analysis, Planning and Monitoring, United Nations Children’s Fund (UNICEF), New York, NY 10017, USA
Zainal Muhammad: United Nations Children’s Fund (UNICEF), Jakarta 12920, Indonesia
Tom Slaymaker: Division of Data, Analysis, Planning and Monitoring, United Nations Children’s Fund (UNICEF), New York, NY 10017, USA
Aldy Mardikanto: National Development Planning Agency (Bappenas), Government of Indonesia, Jakarta 12920, Indonesia
Anita Gultom: Ministry of Health, Government of Indonesia, Jakarta 12950, Indonesia
Asri Indiyani: Ministry of Public Work and Housing, Government of Indonesia, Jakarta 12110, Indonesia
Hasnani Rangkuti: National Bureau of Statistics (BPS), Government of Indonesia, Jakarta 10710, Indonesia
Juliet Willetts: Institute for Sustainable Futures, University of Technology Sydney, Ultimo, NSW 2007, Australia

IJERPH, 2021, vol. 18, issue 15, 1-16

Abstract: Sustainable Development Goal target 6.2 calls for universal access to adequate and equitable sanitation, setting a more ambitious standard for ‘safely managed sanitation services’. On-site sanitation systems (e.g., septic tanks) are widely used in low- and middle-income countries (LMICs). However, the lack of indicators for assessing fecal exposure risks presents a barrier to monitoring safely managed services. Furthermore, geographic diversity and frequency of disasters require a more nuanced approach to risk-informed decision-making. Taking Indonesia as an example, the purpose of this paper is to provide insights into current status and practices for on-site sanitation services in the contexts of LMICs. Using a dataset from a national socio-economic survey ( n = 295,155) coupled with village census ( n = 83,931), we assessed (1) household sanitation practices across Indonesia stratified by city-level population density and meteorological factors, (2) factors associated with septic tank emptying practice, and (3) inequalities in potential fecal exposure as measured by population density and WASH access by wealth quintile. We found a high reliance on on-site sanitation facilities (80.0%), almost half of which are assumed to be ‘uncontained’ septic tanks and one in ten facilities discharging untreated waste directly into the environment. The most densely populated areas had the highest rates of septic tank emptying, though emptying rates were just 17.0%, while in the lowest population density group, emptying was rarely reported. Multivariate regression analysis demonstrated an association between flooding and drought occurrence and septic tank emptying practice. Higher groundwater usage for drinking among poorer households suggests unsafe sanitation may disproportionally affect the poor. Our study underscores the urgent need to strengthen the monitoring of on-site sanitation in LMICs by developing contextualized standards. Furthermore, the inequalities in potential fecal exposure require greater attention and tailored support mechanisms to ensure the poorest gain access to safely managed sanitation services.

Keywords: on-site sanitation; safely managed services; inequalities; fecal exposure; Indonesia; sustainable development goals (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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