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No.

Kontrak
KU. 08.08/Kontrak/Pamsimas/47/IV/2011
Tanggal 11 April 2011

September 2011

Table of Contents

Baseline and Impact Evaluation Survey

2011

Table of Contents
Tabel Of Contents ...............................................................................................................................

Chapter I Introduction .....................................................................................................................

1.1 Background .....................................................................................................................

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

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

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

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

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

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

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

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

2.1 Design................................................................................................................................

2.2 Location ............................................................................................................................

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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Baseline and Impact Evaluation Survey

2011

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
ii

Baseline and Impact Evaluation Survey

2011

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

iii

1.1.

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

1.2.

The Flow of Thinking of Baseline 2011 ....................................................................................

1.3.

Organizational Structure ................................................................................................................

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

iii

Baseline and Impact Evaluation Survey

2011

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


3.1.

Governmental Status, Number of The Head of Family and Population


at 132 selected villages, Baseline Survey 2011 .................................................

3.2.

20

Socio-Demographic Characteristics of Respondents and Head of


Family at selected villages, Baseline Survey 2011 ...........................................

3.4.

20

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


Villages, Baseline survey 2011 ................................................................................

3.3.

iv

22

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 Respondents House, Baseline Survey 2011 ..................

24

3.6.

Household Distribution Based on Poverty Index and Family Income,


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

3.7.

26

Percentage Distribution According to People that Usually Take the


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

3.8.

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


- Baseline Survey 2011 ...............................................................................................

3.9.

36

Distribution of Minimum Drinking Water Need per Person/Day Based


on Travel Time in Getting the Water, Baseline Survey 2011 .......................

3.13.

35

Percentage Distribution According to the Minimum Need of Drinking


Water per person/day - Baseline Survey 2011 .................................................

3.12.

33

Distribution of Drinking Water Treatment Before Consumed Baseline


Survey 2011 ....................................................................................................................

3.11.

32

Percentage Distribution According to Chemical Test on Sources of


Drinking Water, Baseline Survey 2011 ................................................................

3.10.

29

36

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 ..................................................................................................

3.14.

Distribution of Defecation Place for Household members, Baseline


Survey 2011 ....................................................................................................................

3.15.

3.17.1.

39

Result of Observation on Waterwaste Disposal System and Distance of


Latrine at School Baseline Survey 2011 ...........................................................

3.16.

37

42

Distribution on the Availability of Water and Soap inside the Latrine


at Household Level - Baseline Survey 2011 .......................................................

43

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

44
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Baseline and Impact Evaluation Survey

2011

3.17.2.

Toilet Condition at Schools Baseline Survey 2011...........................................

3.18.

Data on Morbidity of Household Members in the Last 6 months

45

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 ...................................................................................................................................

3.21.

49

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 ....................................................................................................................

3.28.

63

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 ..................................................................................................

3.32.

Data on the Giving of Colostrum to Infants and Children under Five


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

3.33.

71
72

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

Baseline and Impact Evaluation Survey

2011

CHAPTER I
INTRODUCTION
1.1

BACKGROUND
The government of Indonesia is strongly committed in achieving MDGs 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 governments (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 (MDGs) target, with two considerations; (1) Adequate
number of data are available to measure the achievement of MDGs 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.

Baseline and Impact Evaluation Survey

1.2

2011

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 MDGs 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 MDGs 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

Baseline and Impact Evaluation Survey

1.5

2011

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

as follows:

Baseline and Impact Evaluation Survey

2011

Figure 1.1. Frame Work of Thingking, Baseline 2011

PURPOSE

Increase of Access for


Water Supply Facility

Increase of Access for


Sanitation Facility

The Percentage of ODF


Community

INDICATOR

The Proportion of
Household which Used
Water Supply Facilities

The Proportion of
Household which Use
Sanitation Facility

The Proportion of
Community that Use ODF

Household which used


Proper Sanitation

Community that Conduct


ODF

DATA

Household which use


Water Supply

The Percentage of Community


that Adopt the Hand Wash
With Soap Program

The Proportion of
Community of Hand Wash
With Soap Program

Community with Clean &


Healthy Behaviour

Design Development for


Regional Capacity

Expenditure Realization on
Water Supply & Sanitation
Sector of Regency/ City

Design for Pro Plan of


Water Supply & Sanitation

Promotion Expenditure of
Water Supply & Sanitation
in Regency/ City

Medium-term
development plan
area (RPJMD)

Local Budget
Realization (APBD)

Feed Back

PURPOSE OF
WSLIC3

Village Budget

Is obtained through
survey of Baseline
& Impact by using
questionnaire tool
for village,
household, school
and children school

Water Supply Facilities

LAKIP
Community with Water
Borne Dideases & Poor
of Sanitation

Local Regulation
Physical & Financial
Realization

Water Supply Quality


Providing Breastfeeding
& Food Presentation
Behavior for Family

Village Regulation
(Perdes)

Water Consumption

Affordability of Water
Supply Access

Knowledge concernig
Diarrhea

MONITORING AND EVALUATION

Baseline and Impact Evaluation Survey

1.6

2011

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.

Baseline and Impact Evaluation Survey

2011

Figure 1.2. The Flow of Thinking of Baseline 2011

1. Indicator
Clean Water
Sanitation
ODF
Hand Washing with
Soap
Morbiditas
Nutrisi
Consumsion

3. Data Colection
Baseline 2011
Develop manual
Develop Training
Modul
Training
Sampling
Organizing
Logistic
Data colection
Supervision

2. Measuring Instrument
quesioner
Household
Student,
Scholl
Village
Editing
Validation

Budgeting

Question Research

Data Colection Baseline


2011

6. Report
Basic Table
Draff Nasional
Report
Finall Nasional
Report

5. Statistik
Deskriptif
Bivariat
Uji Hipotesis

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

Baseline and Impact Evaluation Survey

1.7

2011

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

EXECUTING AGENCY
PAMSIMAS

WORLD
BANK

CPMU

MANAGEMENT OF
PT. INFRA TAMA YAKTI

DISTRICT
GOVERNMENT

PROVINCIAL
GOVERNMENT

TEAM LEADER

DPMU

PPMU

DMAC

CMAC

SUPPORTING
STAFF

DATABASE
PROGRAM
MANAGEMENT

ECONOMIST

WATER &
SANITATION
EXPERT

COMMUNITY
HEALTH EXPERT

MAC

LURAH

DATA
CLEANING
EDITOR

FIELD /
PROVINCIAL
COORDINATOR

SUPERVISOR
COMANDO LINE
COORDINATION LINE

ENUMERATOR

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.

Baseline and Impact Evaluation Survey

1.8

2011

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

Baseline and Impact Evaluation Survey

2011

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.

Baseline and Impact Evaluation Survey

2.3

2011

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.

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Baseline and Impact Evaluation Survey

2011

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

VILLAGE
Use systematic random sampling with
table random to select 2 dusun

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

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

11

Baseline and Impact Evaluation Survey

2.3.3

2011

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 Table of Random

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:

12

Baseline and Impact Evaluation Survey

2011

1. Household book that consists of:


AR : Household member;
SA : Source of water for the household;
PS : PHBS (Clean and Healthy Live Behavior);
ST : Sanitation;
MO : Morbidity;
IM : Immunization;
AS : Breast milk and Supplementary breastfeeding;
PM : Family Food Serving Behavior;
KP : Ownership of assets;
KS : Consumption;
PR : Household income;
MI : Information Media;
AK : Social activity;
OB : Observation results;
2. Student book
AM : Drinking water;
MK : Food;
CT : Hand-washing;
MD : Bath
GG : Brushing teeth;
BB : Defecation;
PT : Disease;
SL : Rubbish and Waste;
KI: Communication, Information and Education
3. School book
GM : Teachers and Student data;
OR : Observation of Room and Class
OL : Observation of school environment;
SP : Waste management at school
AM : Student attendance;
PK: Health check;

13

Baseline and Impact Evaluation Survey

2011

SK : Health socialization in School and information media;


PO : Participation of parents;
4. Village book
DP : Population data;
KD :Village organization;
PY : Disease
PK : Health Program;
MP : Health Promotion Media
BS : Drinking water and sanitation;
AG : Budget and Allocation of Fund of Health Facility;
PD : Village Map;
PP : Village Regulation;
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.
Respondents for the household book are head of the family or household couple
or any of the household members that can provide information.
To see the quality of water source chemical and bacteriologic test are done using
litmus paper and H 2 S
Student data collection represented by fifth grade students of elementary school
at each village using interview technique with student book and questionnaire
guideline.
School secondary data collection using student book and questionnaire guideline
with school principal or teachers as informant.

14

Baseline and Impact Evaluation Survey

2011

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

15

Baseline and Impact Evaluation Survey

interviewing

the

respondent.

Supervisor

and

regional

coordinator

2011

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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Baseline and Impact Evaluation Survey

2011

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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Baseline and Impact Evaluation Survey

2.7

2011

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.

18

3 SURVEY RESULTS

Baseline and Impact Evaluation Survei

2011

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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Baseline and Impact Evaluation Survei

2011

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

Kelurahan

17

12,9

Village

107

81,1

Nagari

6,1

Urban

13

9,8

Rural

119

90,2

Type of area

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

Mean

Median

936

619

Total Population

3.384

2.352

Men

1.739

1.157

Women

1.758

1.134

Head of the family

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

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.

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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Baseline and Impact Evaluation Survei

2011

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
persons

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.

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Baseline and Impact Evaluation Survei

2011

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

17.2

26.9

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

Dont know

0.0

0.1

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

1320

1320

Education (n=1320)

Occupation (n=1320)

Number of household

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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Baseline and Impact Evaluation Survei

2011

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

Head of the household


Male

1.159

87,8

161

12,2

44

3,3

157

11,9

295

22,3

357

27,0

228

17,3

127

9,6

7+

112

8,5

Female
Number of household member

Number of household
Average number of household member

1320

100.0

4,1

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Baseline and Impact Evaluation Survei

2011

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 Respondents House, Baseline Survey 2011

House Characteristic
Type of roof
Tile
Zinc
Others (concrete, sirap, asbestos, bamboo,
rumbia)
Type of floor
Granite/Ceramic/Marble
Plaster /Concrete /Brick
Ubin/Tegel
Wood
Bamboo
Dirt/earth
Type of wall
Plastered wall
Un-plastered wall
Metal/zinc
Wood
Bamboo/Rumbia
Others

622
510

47.1
38.6

14.2

259
464
94
243
35
225

19.6
35.2
7.1
18.4
2.7
17.0

511
109
14
549
134
3

38.7
8.3
1.1
41.6
10.2
0.2
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Baseline and Impact Evaluation Survei

House Characteristic

Ownership status of the house


Personal belonging
Rent/contract
Belong to parents/parents in law
Belong to family
Others
With electricity
Has adequate ventilation
Yes
No

2011

1148
16
93
40
9
1177

87.0
1.2
7.0
3.0
1.8
89.2

819
501

62.0
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 respondents household have electricity.

3.1.3 Wealth Index and Household Expenditure

Most of the head of the household work in

Wealth

index

is

background

informal sectors and half of the respondent

characteristic used in the report as

households are poor with expenditure less

approach to measure household living

than 2 US$ per day/person

standard for long term. This index is

based on approach for consumption in last month. In the MDGs agreement, it is stated
that Indonesias poverty indicator is population with income less than 2 USD.

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Baseline and Impact Evaluation Survei

2011

Table 3.6 Household Distribution Based on Poverty Index and Family Income,
Baseline Survey 2011
Characteristic

Poverty index based on MDGs


person /day
>2$
Number of household

791

62,9

467

37,1

1258

100.0

Family Income in last year


Mean
Median
5%tile
95%tile
Number of household

14.296.872
7.200.000
86.150
48.000.000
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 households access to decent
source of drinking water (WHO dan UNICEF, 2005). Source of drinking water is
26

Baseline and Impact Evaluation Survei

2011

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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Baseline and Impact Evaluation Survei

2011

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


respondents 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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Baseline and Impact Evaluation Survei

Table 3.7

2011

Percentage Distribution According to People that Usually Take the


Drinking Water as well as Decent of Drinking Water, Baseline Survey
2011
Characteristic

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

143

10,8

Closed public well

73

5,5

River/Stream/Canal

104

7,9

0,2

229

17,3

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

0,5

1320

100.0

Closed personal well

Dam/Lake/pond
Spring water
PAH

Others
Number of households

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.
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Baseline and Impact Evaluation Survei

2011

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
H 2 S solution to sources of drinking water of the households. The following Figure 3.2
shows access of drinking water for respondents 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.
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.

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Baseline and Impact Evaluation Survei

2011

Figure 3.2 Accesses to Protected, Decent and Safe Source of Water by Quintile
Baseline Survey 2011
90.0
80.0
70.0
60.0
50.0
40.0
30.0
20.0
10.0
0.0

77.7

73.8

80.9

77.8

72.6

76.6

36.3
20.3

18.7

0.4
1

21.4
0.8

0.4
2

23.4

20.6

4.4

0.0
5

1.2
Total

Quintile
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 respondentshousehold 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
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Baseline and Impact Evaluation Survei

2011

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 Baseline Survey 2011
Charateristic

Time needed to get water back and forth by foot


< 30 Minutes
30 - 60
> 1 Hour
Number of Households

1151

87,2

144

10,9

25

1,9

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, H 2 S solution, respondents 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.
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

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Baseline and Impact Evaluation Survei

2011

Pamsimas baseline survey 2011. While the result of test using H 2 S shows that almost
97% sources of water used by the household contained E-coli bacteria.

Table 3.9 Percentage Distribution According to Chemical Test on Sources of


Drinking Water, Baseline Survey 2011
Observational Result

Results of test using Litmus


Alkaline

672

50,9

75

5,7

Neutral

571

43,3

Missing

0,2

1279

96,9

41

3,1

1320

100.0

Acid

Results of test using H 2 S


Contained E.coli bacteria
Not contained E.coli bacteria
Number of household

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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Baseline and Impact Evaluation Survei

2011

Figure 3.3 Respondents Perception on the Characteristic of Source of Drinking


Water, Baseline Survey 2011
Persepsi terhadap karakteristik sumber air yang
digunakan (n=1320)
30.5
32.8

Ada Endapan
4.3

Berasa

9.0
4.8

Berbau Tidak Enak

9.7
6.9

Berwarna

11.6
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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Baseline and Impact Evaluation Survei

2011

Table 3.10 Distribution of Drinking Water Treatment Before Consumed


Baseline Survey 2011
Treatment for drinking water before consumed **
N= All household
Boiled

%
1.320
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

0,2

698

52,9

Disinfectant by sunlight
Precipitate

** 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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Baseline and Impact Evaluation Survei

2011

Table 3.11 Percentage Distribution According to the Minimum Need of Drinking


Water per person/day - Baseline Survey 2011
Water use/person/day **

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
Time (Back and Forth) needed to get water
(in minutes)
Amount of water
consumption in family

0 - 30
minutes
n

31 - 60
minutes
N

> 60
minutes
N

Total
n

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.

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Baseline and Impact Evaluation Survei

2011

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,
Baseline Survey 2011
Mean
Total cost spent in the initiation of
creating source of water
Total cost spent every month for the
water usage

Median

581.580,7 200.000,0
8.655,3

0,0

5%ilte

5%ilte

0,0 2.280.000,0
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 peoples feet. Defecation in a safe (healthy) will have high impact
on the reduction morbidity from deworming and diarrhea.

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Baseline and Impact Evaluation Survei

2011

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

38

Baseline and Impact Evaluation Survei

2011

3.3.1.2 Household Level


a. Place for Defecation
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

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 respondents household members.

Approximately 60.2% respondents

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

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

27

2,0

Ponds

b. Type of Latrine
Contrast to the results from interviews with the villages, the household survey
get 35.5% of respondents 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

39

Baseline and Impact Evaluation Survei

2011

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

Jenis Jamban berdasarkan Kuintil


30.0
25.0
20.0
15.0
10.0
5.0
-

Improved

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

40

Baseline and Impact Evaluation Survei

2011

3.3.2. Distance between Septic Tank with Source of Water


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
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

41

Baseline and Impact Evaluation Survei

2011

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

5,6

3.3.3. Latrine Condition


a. Household

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

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.
Latrine condition in Dist. TSS - NTT

Latrine condition above the lele-Pond


Gawang Kidul sub dist - Jawa Tengah

42

Baseline and Impact Evaluation Survei

2011

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

In the latrine/toilet is water available


Yes

745

75,3

No

245

24,7

Yes

536

54,1

No

454

45,9

In the latrine/toilet is soap available

b. School
A positive step to have the seperation of toilet facilities for girls and boys
although the percentage has not maximum
Needs on socialization about toilet cleanliness for students and the availability
of soap, water and trash can in students toilet

Most of the childrens 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.

43

Baseline and Impact Evaluation Survei

2011

Table 3.17.1 Source of Water, Toilet availability, at Schools Baseline Survey 2011
Facilities available in school

n= 149

Well (dug, pump, hand pum)

89

59,3

Spring

43

28,9

Lake /Pond

1,3

River /Stream

4,7

PAH

1,3

PDAM

19

12,8

Source of water use in school

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

44

Baseline and Impact Evaluation Survei

2011

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

4,4

Availability of hand wipes

4,8

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%.

45

Baseline and Impact Evaluation Survei

2011

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


Baseline Survey 2011
Morbidity of household members in the last 6
months

n= Total

%
5428

Diarrhea

320

5.9

Dysentry

49

0.9

128

2.4

0.1

Deworming

52

1.0

Scabies /ulceration

46

0.8

Malaria

77

1.4

Cough with rapid breathing


Hemorrhagic fever

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
sisters/bothers stool

Yes

295

38.0

No

479

61.6

0.4

Dont know

46

Baseline and Impact Evaluation Survei

2011

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

Interview process with respondent who has


children under five in Tanipah sub dist
South Kalimantan

difficult to be fed, take several hours for

47

Baseline and Impact Evaluation Survei

2011

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
Baseline Survey 2011
Menderita diare dalam 2 minggu terakhir (n=528)
Ya
7%

Tidak
93%

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%).
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.

This survey is also asked about mothers


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.

48

Baseline and Impact Evaluation Survei

2011

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, mothers 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
Baseline Survey 2011
n=39

Treatment facilities headed for the first time when having diarrhea
Private hospital

2.6

Health center/Pustu

13

33.3

GP practice/Clinic

5.1

Private practice midwives

Polindes/Village midwives

21

Buy drugs at stall

10

26

Traditional practice

7.7

Others

2.6

Head of the household

20.5

Couple of household

21

53.8

Head of the household and the couple

12.8

Parents/Parents in law

5.1

Others

7.7

Who is decided to take the child to health facility

Treatments that are done when the children having diarrhea


Solution from oral rehydration salt

15

38.5

Pills or syrup

22

56.4

Injected

5.1

Infused

2.6

Traditional medicine

10.3

Others

7.7
49

Baseline and Impact Evaluation Survei

n=39

2011

When children had diarrhea, is breast milk still be given


Less than usual

23.1

Same amount

13

33.3

More than usual

7.7

Not breastfed

7.7

Not applicable

11

28.2

Less than usual

10

25.6

Same amount

11

28.2

More than usual

15

38.5

Not given drink

5.1

Not applicable

2.6

Less than usual

21

53.8

Same amount

13

33.3

More than usual

7.7

Not given meal

5.1

When children had diarrhea, is beverage still be given

When children with diarrhea, is food still be given

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.

50

Baseline and Impact Evaluation Survei

2011

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
14.0

12.3

12.0
10.0
8.0

6.9

6.0

4.8

4.0
2.0
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

Balita diare dan Sumber Air


10.0

9.4

8.7

7.5

6.7
5.0

3.1
-

Tidak terlindungi

Terlindungi

Tidak Layak

Air Layak

Tidak Aman

Aman

51

Baseline and Impact Evaluation Survei

2011

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.

52

Baseline and Impact Evaluation Survei

2011

Figure 3.11 Respondents Knowledge about the Causes of


Diarrhea Baseline Survey 2011

Lainnya

17.8

Tidak Tahu

11.3

Perubahan Cuaca

9.2

Salah Makan

54.7

Makanan Tercermar

26.7

Air minum Tercermar

18.2

Kuman

7.9
0.0

10.0

20.0

30.0

40.0

50.0

60.0

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 babys
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.

53

Baseline and Impact Evaluation Survei

2011

Figure 3.12 Can Diarrhea Be Prevented Baseline Survey 2011

Figure 3.13 Respondents Knowledge on How to Prevent Diarrhea


Baseline Survey 2011

Menutup makanan

11.6

Mencuci tangan pakai sabun sesudah


BAB

3.7

Mecuci tangan pakai sabun sebelum


makan

17.5

Minum, minuman yang dimasak

35.6

Makan, makanan yang bersih

59.1
0.0

10.0 20.0 30.0 40.0 50.0 60.0 70.0

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.

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

54

Baseline and Impact Evaluation Survei

2011

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

Interview Process to Elementary


Students
Dist. TTU - NTT

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

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

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
55

Baseline and Impact Evaluation Survei

2011

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
ingredients

65

8.4

Shower

22

2.8

Healthy life behavior (wash hands/ cut nails)

33

4.2

DO NOT KNOW

216

27.8

Others

39

5.0

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

35

4.5

Microorganism (virus/bacteria/germ etc)

19

2.4

Disease/allergy

13

1.7

DO NOT KNOW

191

24.6

Others

60

7.7

helminth/vitamin/suplement/traditional

Causes of Skin disease

Because of animal
caterpillars, etc)

(insect

bites

/exposed

by

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

56

Baseline and Impact Evaluation Survei

2011

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

CTPS dalam 24 Jam terakhir


25.4

17.9

74.6

82.1

Responden RT

Responden Murid
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%.
57

Baseline and Impact Evaluation Survei

2011

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

3 Critical times

33

2.5

4 Critical times

0.2

5 Critical times

0.2
58

Baseline and Impact Evaluation Survei

2011

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 childrens 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%).
59

Baseline and Impact Evaluation Survei

2011

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= 133

Dental examination

104

78,2

Eye examination

64

48,1

Deworming

62

46,6

n= Health examination that conducted

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.
60

Baseline and Impact Evaluation Survei

2011

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
2 times a day
Never take a bath
3 times a day
Others

28
531
1
216
1

3.6
68.3
0.1
27.8
0.1

83

10.7

Own bathroom at home

519

66.9

River/stream

114

14.7

0.6

23

3.0

1.2

Well

53

6.8

Others

14

1.8

Where do you usually take a bath


Public bathroom

pool/pond
shower/spring
Neighbors bathroom

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

155

20.0

19

2.4

Dont know

0.3

Others

0.5

To have good scent


To prevent illness

BRUSHING TEETH
How many times do you usually brush your teeth in a day
Once a day
67
Twice a day
403
More than twice a day
303
Never
4
DEFECATION
Where do you usually defecate
Own toilet
555
Public/Neighbor toilet
122
River
67
Garden
20
Pond/Sea/Beach
8
Others
5

8.6
51.9
39.0
0.5

71.4
15.7
8.6
2.6
1.0
0.6
61

Baseline and Impact Evaluation Survei

2011

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%).

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

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

123

78,3

1,3

5,1

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

3,2

Thrown into sewers/drains/trenches

1,3

Sold

1,3

Others

3,2

There is not
Not applicable
Method on managing the waste that often done in school
Composted
Burned

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
62

Baseline and Impact Evaluation Survei

2011

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


and garbage from garden/yard.
Waste that stacked in the hole
Ds. Depok, Kec. Toroh, Kab. Grobogan
Central Java

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
Waste are derived from
Leaves
Plastic/Plastic bottles that no longer used
Garbage from kitchen
Cans that no longer used
Papers
Wood/branches
Glass
Human waste/animal
Leftover food /leftover snacks
DO NOT KNOW
Others
Where usually throw the waste
Thrown at the waste can
Thrown in a dug hole, and if already full will be burned
Thrown in a dug hole, and if already full will be covered
Dumped on the ground
Dumped on the drainase,/river
Dumped in the garden
Others

n=777

439
671
128
118
317
15
2
23
31
8
31

56.5
86.4
16.5
15.2
40.8
1.9
0.3
3.0
4.0
1.0
4.0

683
83
17
189
82
8
7

87.9
10.7
2.2
24.3
10.6
1.0
0.9

63

Baseline and Impact Evaluation Survei

2011

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
Source of water from spring at
Gunung Kidul

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
Cara pembuangan air limbah rumah tangga
Lainnya

1.0

Dibuang ke kolam Ikan


Dialirkan ke pembuangan tertutup

7.0
2.1

Dibuang ke luar rumah

26.6

Dialirkan ke sungai/kali

19.5

Dialirkan ke luar rumah/dapur


Dialirkan ke saluran lubang galian
Dialirkan ke SPAL

20.0
10.3
13.4

64

Baseline and Impact Evaluation Survei

2011

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
Baseline Survey 2011
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

Yes

861

65.2

No

459

34.8

Animal waste around the house

Smell of animal waste around the house


Yes

456

34.5

No

864

65.5

65

Baseline and Impact Evaluation Survei

2011

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
66

Baseline and Impact Evaluation Survei

2011

(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

3,8

Health promotion and general hygiene

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

112

71,3

Examination of deworming

47

29,9

Give supplementary feeding

27

17,2

4,5

15

9,6

Others

5,7

Not applicable

5,1

Other than UKS are there any other health program


Immunization month program (BIAS)

Student hygiene inspection


There are no

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%)).

67

Baseline and Impact Evaluation Survei

2011

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.

68

Baseline and Impact Evaluation Survei

2011

Table 3.30 the Giving of Immunization to Children Under Five Baseline 2011
n

Does this household have children under five


Yes
No

528
636

45.4
54.6

Has the children under five ever received immunization


Yes

498

No

30

94.3
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

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

Type of immunization received

69

Baseline and Impact Evaluation Survei

2011

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%).
One third of the respondents give breast milk within first one hour
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
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
70

Baseline and Impact Evaluation Survei

2011

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 4872 hours, due to the food reserves from mothers 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

0.2

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

Exclusive breastfeeding up to 6 months

108

20.5

Non exclusive breastfeeding

420

79.5

Do not know
FIRST TIME RECEIVED BREAST MILK

GIVING OF EXCLUSIVE BREASTFEEDING

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

0.1

Water

47

4.4

Sugar/sugar water

21

2.0

Starch water

0.0

Juice

0.1

Tea water

0.6

55

5.1

0.6

Other milks

Honey/honey water
Others

71

Baseline and Impact Evaluation Survei

2011

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 1324 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
Baseline Survey 2011
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

72

Baseline and Impact Evaluation Survei

2011

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

217
123
120

45.0
25.5
24.9

148
103
434
236

30.7
21.4
90.0
49.0

286
393

59.3
81.5

314

65.1

226
345
308

46.9
71.6
63.9

332
82

68.9
17.0

Milk
Breast milk
Infant/Formula mik
Other milk
Carbohydrates
All kinds of porridge
Instant food
Bread, Rice, Noodle and Biscuit
Potato or foods made from stolons
Vegetables
Carrots, sweet potato, orange
Green vegetables
Fruits
Mango, orange, other fruits rich in vitamin
Animal protein
Meat (beef, lamb), Poultry
Egg
Seafood
Vegetable protein
Foods from nuts
Offal (liver, kidney, heart, intestines, lungs, brain, etc.)

73

Baseline and Impact Evaluation Survei

2011

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
Condition of SD Mlale
di Kab. Sragen Central Java

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

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

How many times have snacks within last week

74

Baseline and Impact Evaluation Survei

2011

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

0.5

Others

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


Baseline Survey 2011
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

75

Baseline and Impact Evaluation Survei

2011

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
Drinking water and Sanitation

Mean

Median

55.426.328,5

12.617.500,0

% total village budget on expenditure for drinking water


21,5%
and sanitation
Environmental Health Program

13.360.000,0

% total village budget for environmental health program

5,2%

Health promotion inclusing socialization

3.033.333,3

% total village budget for health promotion

1,2%

2.500.000,0
2.950.000,0

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.

76

Baseline and Impact Evaluation Survei

2011

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

Is there Perdes or decree that manage water and sanitation


There is
There is not
Total Funds received

6,1

124

93,9

132

100.0

77

4 CONCLUSION

Baseline and Impact Evaluation Survei

2011

CHAPTER IV
CONCLUSION

1. More than 50% of respondents are educated

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 respondents households get clean
water from dug well (84,8%), pump well 46,2%, spring 52,3%, river/ stream 41,7%
and piping non

Not many get clean water from PDAM piping

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.

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.
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

Sample of water test using H2S


At. Manggarai District - NTT

that have landfill,


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
78

Baseline and Impact Evaluation Survei

2011

13. One third of respondents 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
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

.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.

79