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KEPUTUSAN MENTER! KESEHATAN REPUBLIK INDONESIA, NOMOR 8S2/MENKESISW/IX/2008. TENTANG. 'STRATEGI NASIONAL SANITASI TOTAL BERBASIS MASYARAKAT MENTERI KESEHATAN REPUBLIK INDONESIA, Menimbang : baa dalam rangka momperkuat upaya pernbudayaan hidup bersin dan sehat, mencegah penyebaran penyakitberbasis lingkungan, meningsatian Kemampuan masyarakat, Serta mengimplomentasikan komitmen Pemerintan untuk meningkatian akees air minum dan sanitasi daser yang Eerkesinamburgan dalam poncapaian Mlerusm Development Goais (MOGs) tahun 2015, perly clsusun Sirategi Nasional Sanitasi Total Borbasis Masyarakal yang dietapkan dengan Keputusan Mentor Kesehatan Mengingat : 1. ndong nda Nomar 4 Tepun 1084 texanaWasan 7k Menuiar(Lemooran Negara Republic Indonesia ‘ant 1904 Noror 20, Tambahan Lembaran Negara Republik nconesia Nomior 3273) 2. Undang Undang Nomor 4 Tahun 1982 tnlang Porumahan «dan Pemkiman (Lemberan Negara Repubik Indonesia ‘Thun 1982 Nomor 23, Tambanan Lembaran Negara Feepubik Indonesta Nomior 3468) 2. Undang-Undang Nomor 23 Tarun 1992 tentang Kesehatan (Lembsren Negara Repubik indonesia Tun $922 Nomoe {c0"Tambahan Lombaran Negara Repubik Inconesia Nomar 5488) 4. Undang-Undang Nomor 23 Tahun 1997 tontang Pongoloiaan Lingkungan Hidup (Lembaran Negara Repub Indonesia Tahun 1997 Noor 68, Tambanan embaran Negara Repubik Indonesia Nomor 3693): 5. Undang-Undang Nomor 7 Tahun 2004 tentang Sumber Daya Ai (Lebaran Negara Repudic Indonesia Tan 2004 Nomar 82, Tambahan Lermbaran Negara Republik ingonosia Nomor 4377), 8. Undang-Undang Nomor 32 Tahun 2004 tentang, Pemerinianan Daerah {Lembaran Negara Tahun 2004 [Nomar 125, Tambanan Lembaran Negara Nomor 4437) 10, 11 12, 13. 14. 18, sebagaimana diubah terakhi dengan Undang-Undang Nomar 12 Tahun 2008 tentang Porubahan Kedua Alas Undang-Undang Nomor 32 Tahun 2004 tentang Pemenintanan Daeran (Lembaran Negara Republik Indonesia Tahun 2008 Nomor 58, Tambahan Lembaran "Negara Republik Indonesia Nomer 4844), LUndang-Undang Nomor 33 Tahun 2006 tentang Perimbangan Keuangan antara Pusal dan Daerah (Combaran Nogara Republik indonosia Tahun 2004 Nomar 426, Tambahan Lembaran Negara Republik Indonesia Nomar 483) Poraturan Pemerintah Nomor 40 Tahun 1991 tentang Penanggulangan Wabah Penyakit (Lembaran Negara Repubik Indonesia Tahun 1081 Nomor 49 Tambahan ombaran Negara Republik Indonosia Nomor 3447); eraturan Pemerintah Nomor 16 Tahun 2005 tentang ‘Pengembangan Sistem Penyedaan Air Ninum (Lerbaran Negara Republik Indonesia Tahun 2005 Nomar 33 Tambahan Lembaran Negara Republik Indonesia Nomor 4420); eraturan Pemerintah Nomor 38 Tahun 2007 tentang Pombagian Urusan Pemerintalian Antara Pernerntal Pomerintah Daerah Propinsi dan Pemerinian Daerah Kabupaten/Kota (Lembaran Negara Repubik indonesia Nomar 82 Tahun 2007, Tambahan Lembaran Negara FRopubik Indonesia Nomtor 4737); eraluran Presiden Nomor7 tahun 2005 tentang Rencana Pombanguran Jangka Menengah Nasional tanun 2004 *2008: Koputusan Mentor Kesehatan Nomor 829/Monkos/SKNVIU 1999 tentang Persyaratan Kesehatan Perumanan; Keputusan Mentor Kesehatan Nomor 876.Menkes/SKMIWV 2001 tentang Pedoman Tokns Analisis Dampak Kesohatan Ungktingen Koputusan Mentor Kesohatan Nomor 288/MonkostSK/ 2003 tentang Pedeman Penyehatan Sarana dan Bangunan Umar Peraturan Menten Kesehatan Nomar 416/MenkesiSKID0 4890 tentang Syarai-Syarat dan Pengawasan Kuali Ai 16 1 18 19, Keoutusan Merter Kesehatan Nemo: 997/Menkes/SKVIU 2062 tentang Syara-syarat dan Pengawasan Kallas Ai Minar Peraturen Bersama Menteri Dalam Negeri dan Menteri Kesehatan Nomor 34 Tahun 2005 dan. Nomor ‘V138inderkes/PBIVII/2008 tentang Penyelenggaraan Kabupatenikota Sehat, Perauran Menter Kesehatan Nomor 1575IMenkes!PerXv 2005 fentang Organisas! dan’ Tata Kerja Departemen Kesehatan sebagaimana lelah iubeh dengan Peraturan Menteri Kesehatan Nomor 1296/MenkesiPer/xIV/2007, Keputusan Mentor Kesehatan Nomor 1468/MonkoS!SKKWV 2008 tentang Rencana Pemoangunan Kesonatan Tanun 2008-2008, MEMUTUSKAN Menetapkan Perama Kedua Ketiga Keempat KEPUTUSAN MENTERI KESEHATAN TENTANG STRATEGI NASIONAL SANITASI TOTAL SEREASIS MASYARAKAT, Strategi Nasional Sanitasi Total Berbasis Masyarakat Sebagaimana tercanium dalam Lampran Keputusan in Stratogl sebagaimana dimaksud dalam Diktum Kadua ‘manjadl aeuam 09gi potugas kosohatan dan instans yang {erkat dalam penyusunen perenoanaan, polaksanaan, Pemantauan, Gan ovaluesl rerkalt cengan saniaal total Bernasis masyarakat Keputusan ini mula berlaku pada tanggal ditetapkan Ditetapkan di Jakarta Lampiran Keputusan Menteri Kesehatan Nomor Tanggal 52/Menkes!SKIIX/2008 8 Soptomber 2008 STRATEGI NASIONAL SANITASI TOTAL BERBASIS. MASYARAKAT PENDAHULUAN A. Latar Belakang Tantangan yang dinadapl Indonesia terkait dengan masaioh ‘air minum, higiene dan sanitasi masin sangat besar. Has Studi Indonesia Sanitation Sector Development Program (15SDP) tahun 2006, menunjukkan 87% masyarakat masih Serpent bang sean singel, swan olam, kein an tempat terou Berdagarkan studi Basic Human Services (BHS) dl Indonesia tahun 2008, porlaky masyarakal dalam moncuc tangan acalah (0 Seteiah buang sir bosar 12%. (i) setolan mamborsinkan ty byl dan bala 92% (i) sdbckim makan 19%, (v) sebelum member! makan bayi 7%, dan (v) sebelum menyiapxan Takanan 6 8, Semertars such BHS tanya terhacap pena Pengelolaan air minum rumah tangga menunjkan 09,20% Frerebus air untuk menéapatkan aif minum, telap! 47.50 % Gar air fersebut masin mengandung Esenericla col: songs torcobut borkontbuslterhacep tngainya angie kojodian lao a Indonesia. Hal in teriat Gar angka keadon Glare nasional pada tanun 2008 sebesar 423 per se"ibU enduauk pada semua umuir dan 76 provinsl mengalam\ Kejadian Lar Basa (XLS) dare dengan Case Fateldy Role (CPR) sebesar 252, ond sepet in dapat dkondabkan melalui ietervensiterpacy ‘olalul pendekatan sari) total Hal nv cibutikan mail fgg sticl WHO tahun 2007. yay ojadian dare menurun 528. congan moningiatian auace raeyerakat thay sont daeorf88, dengan por mane fangan poke sabvn fan 30% penis penglaian a manu yang aman ch rumah fangga, Sasangkan dengan mengimogramia Keige pariaet Intervens ereebut, kejaran dare menuron setesar 4°. Pemerintah telah memberikan perhatian di bidang higiene «an santasi dengan menetapkan Open Defecation Free dan pponingkatan porlaku hidup borsih dan sohat pada tahun 2008 Salam Rencana Pembarguron Jangka Menongah Nasional {RPJIN) Tarun 2004-2008. Hal In soja dengan komten emerinfah dalam mencarai target Milenmum Development Goats (MDGs) tahun 2015, yatu meningkatkan akses air ‘minum an santas! dasar secara berkesinambungan kepada Separvh dari proporsi pendudck yang belum mendapalkan akses, Menyacar hal tersebut i atas, pemerinia t'ah melaksanakan Seneraza xogiazan, antara ain meakulkan Uf caba mplomortaet Communty Led Total Sanvation (CLTS) a Kabupaten pada tahun 2008, dlanjusan dengan pencanargan gerakan santas {otal oleh Menten! Kesehalan pada tahun 2008 di Sumatera Baral serla pencanangan kampanye cuci tangan secara nasional oh Menko Kesra bersama Mendiknas an hleneg Pemberdayaan Perempuan tahun 2007. Sebaga!tindak anjut, lakukan replica CLTS di borbagot Jokaa' leh beroaga’fombaga. balk pemerntan maupun ron femertah, yang menghesl kan perubanan periaks bong Siebesar 4 sembarang tempat, seningga paca tanun 2008 Sebanjak 160 cosa olan OOF dan thos 2607 mencapes SOD esa (Depkes, 207) Perlurya strategi nasional saritas total berbasis masyarakat berangiat dari pelaksanaan kegiaian dengan pendokatan ‘Soktoral dan subst perangkat koraseolama ini udak momen ‘daya ungkit toyadinya perudanan periiaku hygionis can Peningkalan akses santas. Sehingga Eiperukan satog yang Baru'dengan mesbakan irs sextorsetum gongentigas dan pokok dan ungsi masing-masing dengan leading sektor Depsrtemen Kesehatan karena sanitasi total berbasis mye marta hp ne] pron pie 'B. Maksud Dan Tujuan Strategl Nasional Santas! Total Berbasis Masyarakot int merupakan acuan dalam penyusunan perencanaan, pelaktansan, pemantauan seria eveluas| yang terkait dengar Sanitasi total berbasis masyarskat . Pengertian 1. Sanitasi Total Berbasis Masyarakat yang selanjuinya ‘dsebut sebagai STEM adalah perdexaran untuk meruban perlaku higiene dan santes! melalui pemberdayaan Imasyarakal dengan metode pemicuan. 2. Komunitas merupakan kolompck masyarakat yan: Dorntoraks soca'asosia|brdasarkan osamiaan > Nebutuhan dan tia unter tua 3. Open Defecation Free yang solanjuyadisobut sebagai ‘OOF dain kona ketia soap nad dalam Kornuritns tidak buang air besar sembarangan. 4. Cuci Tangan Pakai Sabun adalah periaku cus tangan sdongan'menggunakan Sabun dan at bersih yang mengalt 5. Pongololaan Air Minum Rumah Tangga yang solarjuya ‘isesta sobsga| PAMRT ads. suats proses pengolahan, onivmpanan dan pemartoatan air minum dan ot yang Sigunalan untuk produkt makanan dan Kepertian orl inionya sepert berkumur ska! gig persiepan makananvhinuman aye 6. ‘Sanitas total acaloh kondis kota suatu komuntas: ‘Tigak buang_air Doser (AB) sembarangan enc tangan paka sebun 2 Mengeiola air minum Gan makanan yang aman 2 Mengelo'ssampsh dengan benar. +) Mengeloi imben cai rumah tanaga dengan aman 7. damban sehat adalah fesilias pembuangan tina yang ‘tek Untuk memstus mata rata penuaran ponyakit 8. Sanitasidasar adalah sarana santasi mah tanggayang ‘melipull sarana Suang air besar, sarana pengelolaan Sampah dan iribah rumah tanga. ISU DAN TANTANGAN + Tantangan pembangunan santas Indonesia adalah masalah sosial budaya dan perlaku penduduk yang tetbiasa buang ai Desar (BAB) ci sambarang tempat, khususnya ke Dada’ air yang juga digunakan untuk mencuci, mandi dan kebutunan Figlenis tanya, + Burukrya konds sanitai merupakan salah satu peryebab Kematian anak oh bawah 3 tahun yaits eabesar 19% atau Setar 109.009 anak maringgl karo dire setap tah San karuglan kona Srtakan sobosar 23% a Prod Domest Brute (tud! Were Bank, 2007). + Berdasarkan Undang-Undang Nomar 32 Tahun 2004, Penanganan masslah sentasi merupakan kewenangan dserah, {etap! Sampal saat ini belum memperihatkan perkembangan Yang memada\ Oleh sebab ‘ty, pererintah dagrah peru Mempertihatkan dukungannya melalui Kebjakan Gan enganggaranaya Ii STRATEGI NASIONAL, ‘A. Penciptaan Lingkungan Yang Kondusit Menmgkatkan dukungan pemerni don, pomangky kepentingan anya daiem ceaingkalkan periaku Men's dan sander 2. Pokok Kesatan ‘Molson advokasi dan sositsast kepada pomoctah an pemangku Koporingan are socara befaniang + Mongemoangkan kapoataslembaga polakoarie ot Saoran + Moningkatkan kemitraan antara Pemerintan, PPemarstsh Daerah, Grganaos Masyarakat Lembsgs Swadaye Masyarakat dan Swast, BB. Peningkatan Kebutuhan 1 Princip eneptakan perlaku komuntas yang higions dan saniter Untuk mendukung terciptanya sanitast total Pokok kegiatan ‘Meniagkatian peran seluruh pemangku kepentingan alam perencanaan dan pelaksanaan sosiaisasi ppengemoangan kebutuhan + Mongombangkan kosadaran masyarakat tontang konsekuons dart kebiasaan buruk santas bang a Desay dan dlanjutkan dengan pemevan perubinar Periaky Komunias. + Menmgiatian kemampuan masyarakat dalam mein teknotog, material den Biya srana Santen yong seh + Mengembangkan kepemimpinan di masyarakat (natural leader) untuk menfasilitas! pericuan perubahan periaky masyarakat + Mengemoangkan sietom penghargaan Kopada masyarakat untuk. meningkatkan dan menjoga KReberlanutan santas! ota . Peningkatan Penyediaan 1 Prinsip eniagkatkan kotorcodiaan sarana saniasl yang sesual sdongar Kebutuhan masyarakal. 2 Poko egiatan alan kapasias produkt swasta loka! dalam enyediaan sarana santas! + Mengembangkan kemitraan dengan kelompok masyarakal, Koperas, lembaca kevangan dan Dengusatialokal dalam penyedizan sarana santas ++ Meningkatian Kerjasama dengan iembaga penelian pperguruan tingg| untuk pengembangan rancangan Sarana canta topat guna. Pengelolaan Pengetahuan (Knowledge Management) 1 Prinsip Melestarikan pengelahuan dan pembelajaran dalam Sarita foal 2. Pokok kogiatan +S" WongomBanskan dan mongooiepusat data dan ‘+ Meningkatken kemitraan antar program-program pemerintan, non pemerintan dan swasta Gaiam Eenngkata pengeancan can persedaran santas! + Menaupayakan masuknya pendekatan sanitas total dalam karkulum pencidika . Pomblayaan 1. Princip Heniadokan subi untuk penyediaan sila sates 2. Pokokkegiatan SE oem uk manta eee og a. + Menyeclaxan subst dperboiehkan untuk fasta ota Pemantauan Dan Evaluasi Prinsip Meibstkan masyarakat data kacatan pomartaven don Pokok kegatan ‘emia keaton dam ingkup Koruna oleh mmasyaraiat + Bemeriniah Oaerah mengembangkan sistem pomariauan dan pongo Gala. + Mengoptimumkat pomanfaatan Rasil pemantauan dark kogiatan-kegiaian.lain-yang. sojonis + Pomorith dan pomerinan doerah mongemagkon Stem pomsntauon Beneryang IV, PENGEMBANGAN RENCANA KERJA DAN INDIKATOR A. Rencana Kerja Stiap pola pemvangunen STBM mengembangkan rencana aks! corta pombiayaannya untuk poncapaian santas total yang disampaikan Kopada pomerintan daoran 8B Incikator TINGKAT | INSTITUSI_| PERAN DAN TANGGUNG JAWAB Output: 2 Mergenbargan pense ot rt lp inv dor homuras nempunya aes tethadop os dant nk sta monetar Ssrana senias! dasar sehingga dapal mewujuckah has antes Kemurtas yang bebas da buarg a cl sembarangtemeat 4 Mengevauns dan mernior bara oi Irina one ag + Sotop rumahtanage tlan monerapkan pengoiolaan a 4 Maman anaes estat rg minum can makanan yang aman ci rumah tangoa. (ft san ogp wea essa 9a + Sctap rimah tangga dar sorana pelnyanan uum 6am att womans (sepersekolah xa, rumah Makan, Tapsien | Pereiren | 1 Menpersptan can labapaon ut pustesris psa erin) ers ies cn angen Kebisen Imempreeshen sag’ yang ate sab, strana su nga, sehngga sma o8rg 2 fryemglanin meiienetasan meneud langen dengan boar {anges rman Cha Fabopatn + Setap umeh tangga mengelos imtahnya dengan bona. tmengenal pendetatanyarg Oats + Setap rumah tangs mongeisa sampahnya dengan bona 4 Menghoorstasan perdaraat unit Imports tog STEM Outcome 4. Mapurberion ol pl sone ct = Menurunnya tec penyakt re dan penyait deresis tegatana | Tingkungan taenya yng berkatan dengan sentes! dan 5: Naver Argon ancy rg peta Sipereian tase seman stan he ERAN DAN TANGGUNG JAWAB PEMANGKU KEPENTINGAN we ‘roi | Pareiran | 1 Berkoordinasi_ dengan werbapal reves ‘nansoroge wnat tare Sn TINGKAT | INSTITUSI_| PERAN DAN TANGGUNG JAWAB ‘eroerarstan pose pac rt Ribose | TrokejaSTBM | 4. Menpersaptan masyaraal oni servatepain ST roc | Geuthibuew | * bec gstrg rr) 2 Menpeeormastan seus sundae Kans 2 Memon stra a rela rast femblayean frat Senger STON 5c iiyalesa pernaralon an a tents peasterge seg nen ‘espa STOM dan marberten teteger yg + lenirgmancnas amar an, Sipeitan pas vw Kavusston eer cage taba ext 4. Meghan tgtn Nien dan 5 fee ins aon ds amass onc SN jongorganisit. pertukaran Beene ascarndan wean pense an orca ee es eens os i Rew | Foreman | 1 Berkoordinani_aongen_terbapai ‘ Pi instemtoga at rg Put Sn etgenbangtan pga pat Dee | Teakena STEW | 1. Menworwe tm fslaer dese yone Sera ogatn S00 one repays bral or asec Sa 2 Mengeeorinas ean semua sunter Ferd wth mntcian goals omtlayasn tra Senger SToM Fesyena Ven renentecpentrce 3 Memont prenboraan sg nore ic ranganan pene reat Gan STEM dan mantertan renee Yara ofan en eam pega oe Saenan encase Prov rreerhan Seg ar petites 4 Mengnuageraatankagatn Nigire din Heese ‘any ad ang ST his Deihyegeedrgtesain 5 Wengorganisit.pervekaran fon Pengethusijergaanan arbres «teatro sua pean Sarat provi seta anar nese nara incon ope Wearain | Beverneh | 1 cen inser Sodan soumesn Pareron gn nenberaucgan So Serpent Tau Vi. PENUTUP, STRATEGI NASIONAL si i ana ay ee SANITAS! TOTAL BERBASIS MASYARAKAT Cease naan easier aan Pedoman ini dinarapkan dapat digunakan sebagai acuan ‘alam perencanaan, pelaksanaan, pamsinaan, dan penn Upaya peningkalan akses sarias! bak oleh Pemennian Pusat maupun Pemerintah Daerah. Penetapan strategi dalam pedoman in eilakukan sedemikian rupa sehingga hasil Pencapaiannya dapat lebih terarah dan torukur, Sato! torsoout dharapkan dapat clgunakan sebagai bahan dalam menentuan kebyaxan yang sesvalspostk oko! sera mem penciptaan ingrungen yeng Kondstpenngksion Ccbutunen penungkatan Penyeotaan, can pengeolaan pengelarusn daar’ akees santas seria paraku masyarakat rghigens, yang pada aawnya dopa menngcatian peas sone mayer don emgiton aloes hap sara Sanias|khasusnya sorta moringkatian deraat kecohatan dan Kosojantoraan-masyarakat_ pada umumnya Dr. dr. SITI FADILAH SUPARI, Sp. JP(K) DEPARTEMEN KESEHATAN RI JAKARTA 2009 CHAPTER | INTRODUCTION A. BACKGROUND Inconesia sil faces great challenges in relation o water, hygiene ‘and sanitation. Study of the indonesian Senitation Sector evelopment Program (ISSDP) in 2006 showed that 47% of the populations sl cofecate at rors, eid, pools. gardens and other ‘open places. Based on a study of Basic Human Services (BHS) in Indonesia ‘in 2006, tne percontago of poopie washing thelr hands (i) ator selecaling was 12% (i) aller clearing feces of babies and children Lnder-fve 9%, (i) before taking meals 14%: (v) before feeding babies 75; and (v) before preparing meals 6% Anosher SHS study fn household water treatment shows that 99.20% of indonesian ‘people bol water to get drinking water but apparently 47.50% of {he water sill contains Escherichia co. ‘Such a condition contributes tothe high incidence of diarrhea in Indonesia, The 2006 national ciarhea incidence was reported to bbe 423 per one thousand people at all ages and 16 provinces had Extraordinary Incdences (KLB) of danhea witha Case Fatality Rate (CFR) of 2.52. Such a conation ean be contrlles tough an integrated intervention adopting total sanitation approach. This ‘was proved by a WHO study in 2007 which indicated that ciarrhea Incidence could be reduced by 32% through improving people's ‘ace266 o basi santation, 45% trough washing hands with soap, and 38% through safely treating water in houssholds. In addon By integrating the three penavioral interventions, the diarmer incidence can be reduced by 84%. 40 2009, the government has given attention to hygiene and sanitation by establishing Open Defecation Free (ODF) program and improvernent of heathy ané hygienic behavior io is National \Medium-Term Development Plan (RPUMN) 2004-2009. This isin line wih the government’ commitment io achieving the Milernium ‘Development Goals (MDGs) targets in 2018, \e. increasing access to crinking water and basic sanitation on a sustainable basis by {as much as haif of tne population who are without such access. Being aware of this, the government has taken some initatives such as Community-Led Total Sanitation (CLTS) that was Implemented in 6 Districts in 2005, followed by total sanitation ‘campaign that was launched by the Minister of Heath in 2008 in ‘est Sumatra ang National hand-washing with soap campaign that was launched by the Coordinating Minster of People’s Welfare together urn the National Edueation Miisor and the State Minister of Women Empowerment in 2007. {As a folow-up, CLTS has been replicate in various locations by mary government ané non-government instksons, leading 9 & bohavioral change so that 160 vilagos were dectared to be ODF in 2006 and 500 vilages were deciared io be ODF in 2007 (MoH 2007). (Old implementation of sector-based approach and hardware ‘subsidy were not success{ul Io increase people's access to ‘sanitation and change their hygienie behavior this regard, tis necessary to establish 9 NATIONAL STRATEGY FOR ‘COMMUNITY-BASED TOTAL SANITATION (CBTS/STBM) led by the Ministry of Health which involves cross-sectors with their ‘own ta, subject, an function by focusing on 5 (ive) plas for People’s hygiene and sanitation behavior changes. 5. AIM AND OBJECTIVES ‘This National Sirstegy for Community-Based Total Sanitation is used for reference in planning, implementing, monitoring and ‘evaluating the community-based tolal sanitation Program, DEFINITION 4. Community-Based Total Sanitation, which is later called BTS. is an approach to change people's hygiene and sanitation behavior through community empowerment by ‘employing a triggering method 2. Gommunity isa group of people interacting socaly onthe basis of the same needs and values to achieve 3 goal ‘3. Open Detecation Free, which slater calles ODF, isa canetion when every ndvidual in @ community does not defecate in pen space. 4. Washing Hands with Soap s the behavior of washing hands. using soap and clean flowing water. 5. Household Water Treatment, whichis later called PAMRT, Is a process of treatment, storage and use of crinking water and walor used in food production and othor oral purposos such as mouth rinse, teeth brushing, and baby food/drink preparation. 6. Stakeholders are individuals or a group of individuals, a community institutions exgarizations, andlor companies that have an interesUstake or have cortain issues/problome that are commen to all and they can either influence the ‘evelopment. change policies ancior can be affected by the consequences ofthat issu 7. Total sanitation is achieved when a community has met the following crt ‘+ Does not defecate in open space (open-detecation treo) + Washes hands wih soap 1 Manage drinking water and food safely + Manage garbage propery + Manage domeste liquid waste safely. 8. Improved latrines an effective sanitation fact to break a sisbase transmission lnk 9. Basic sanitation refers to household sanitation facilities inclucing latrines, garbage and domestic liquid waste management faites CHAPTER ISSUES AND CHALLENGES + The challenges of sanitation development in Indonesia are socio= cultural issues and practices of open defecation particulary in Wales bodies which are also used for washing, bathing and other hygienic purposes, + Poor santlalion is one ofthe causes for 19% or 100,000 deaths. ‘of children under 3 years old per annum associated with diarrhea land an economic loss representing 2.3% ofthe Gross Domestic Product (World Bank study, 2007) + Under Law Number 32 Year 2004, itis the authority of local ‘overments to adress santatin saues But no sigrvicant progress has been made so far Therefore, local governments should provide ‘Support through ther plicios and budgots. CHAPTER I NATIONAL STRATEGY 3.1 STRATEGY COMPONENTS SALT Create a conducive envronme a. Principle Increase support from the government and other stakeholders in improving hygiene and sanitation behavior thats based on communi paricipaton and empowerment b. Main Actviies +" Provide advocacy and dissemination ofirformation fo the government and other stakeholders in a (gradual manner (ay phases) ‘© Build the capacity of implementing agencies in local areas. + Increase partnership among Central Government, Local Governments, Communty Organizations, ‘Non-Governmental Organizations and the Privat Sector 3.1.2 Increase demand a. Principle (Create hygienic and sanitary community behavior to ‘achieve tal canitatin that Based on community parlcpalion and empowerment . Main activites ‘+ Increase the participation ofall stakeholders in planning and implementing tho socialization of heeds development + Raise tho community awarenoss on the consequences of poor sanilation behavior {@ofecating in tho opan)folowoc'by tiggoring tho ‘community for behavior change ‘+ Build tho community capaciy to choose specific technology, materials and costs of improved ‘sanitation facies ‘+ Develop natural leader inthe community to facitate community behavior change triggering + Develop a reward system for the community 10 improve and maintain the sustainacilty of total ‘sanitation. 3.1.3 Improve supply a. Prngple ‘crease the avalailly of appropriate saitaion faclities that meet the community's needs. Main Activities ‘+ Increase local private production capacity to provide sanitation facilities with appropriate Technology, affordable and of good quality (meet the requirement of “healthy laine”) ‘+ Develop parinership with community groups, cooperatives, financial institulions and local ‘entrepreneurs in providing sanitation facie. ‘+ Improve cooperation with universities’ research institutions to develop an effective design of ‘sarilation facies. 3.14 Knowledge management a. Prinaple ‘+ Maintain knowledge and disseminate leaning in total sanitation b. Main activites ‘© Develop and manage data and intrmaton canter. ‘+ Improve partnerships between government, non- ‘government and private sector programs in developing knowiedge and learning of sanitation in indonesia, = Integrate the {otal sanitation approach into Outcomes: fecueationsl curricula ‘+ Reduction of iarthea incidence and other environment-bomne diseases in elation to sartalon and behavior 3.18 Financing Prince Do not provide subsides for basic sanitation facies, CHAPTER V b. Main actities ROLE AND RESPONSIBILITY OF STAKEHOLDERS ‘Explor and encourage the community's potential {o build their own sanitation facilities. Level | Institutions | Functions and Responsibilities + Bevoiop social solidaty (community sol-nelp) tiie] STS Wong Prepate the connunly to patcpate + Subsidies may only be provided for communal pi Scam (Gonna seta sanitation facies, me | ane 2. Water wat connate Kango laves | 3. Resa pesensafasin te canary 4 Siprontmatae cer commantes set 244 Monona a evtoten fehlerag ta santa [OOF] ther InvoW¥ the community in monitoring and evaluation b. Main activities =" Monitor activities that are conducted within and by the community + Locai Governments together with the local fegtorced But the esc of runs nthe CTS Rate sctenec and nea demons IRrotseesony optow. Fave dear ingens ardent stateny communities develop monitoring and data vie | Vtage cars | tectaion tam wich management system Norra Tear of lage case eer + Optimize the use of monitecng results from other cbr commun mowers The Shia cies | ‘Sena eno age rs rh + The Cental Govemment and Local Governments ‘ok fee comecton wh aye develop 2 gradual monitoring systom. 2 eee wee cos vege exes brave nasser pads 2. Geloeraretoowen ad rareran CHAPTER IV (Gant ae be repost tos sae rau seu ma communi Iyer DEVELOPMENT OF WORK PLAN AND INDICATORS. Soo cout core 41 WRK PLAN PRACT development cor wildevlop an action pln a seine, | grams | Goan aasenstneaee Ke beopat he asp To esl government oer Recatin | Sty vote a pene en Sehiove lola sentation ow Government Ignoring cadres: 2 He Shremtoreca ne 42. piearors eee ey 4. Btineate ay tctosh Pie ndidainvammuniy has css bas an ete wd ry dul iy to base saniton ion facies o achieve an open defecation tree (ODF) community. ‘+ Every household has implemented safe household drinking i alabama water veatment and food management. 2. Bevel nd inane tintin 1+ Alouses and pubie facies in acommunity (suchas schools, Conpeigns about anew approach offices, restaurants, community health centers (puskesmas), ‘3 Goons fend for €B4S srategy markets and terminals) have provided hand washing facies 4 (water. soap, hand washing facies) s0 that every person are ‘able to wash ther hands propel 5. rose nozessny casey buf at + Every household manages their liquid waste oroperiy. Fetulorina at = Every household manages their garbage properly. Level institutions: Functions and Responsibilities Provnsat Dass Gowan Proinoa Goverment 1. Coordinate with variour related syeecesinttire ot Pech ova (eveop inyated poy fr al CBTS, 2, Crud sl CS TS fang aces 58. Montene progress fe CBTS Naso! ‘Siaegy and wove ress gudareeto ‘be Ds Tar 4, negate etn hygric ad sntaton sient CTS Sra 5. ganze exchange of Ahowledge! exereees betes atonal Netoal Goverment 1 Goordinate with various related sgencernsaons at Nr Lee =m vp nigral program fr al CBT. 2, Gensel CSTE fing saee 5. Manton props cme CBTS Nora) Staleg an rove reomsary guano (ee PodacaTam 4. erate est hygiric ard santaton ios no be COTS Satay 5. Oiganze exchange ef rowiedge! fewpoiones teinoun dhe andor provinces end betraen countries CHAPTER VI CLOSING. {With God's blessing and mercy, his National Strategy for Community- ‘Based Total Santaton (CBTSISTBM) can be completed. This sratogy Is based on and complements the National Policies on Water Supply and Community-Driven Environmental Sanitation (AMPL-BM), ‘This strategy fe expected to be used for reference in planning, implementation, guidance and assessment ofthe efforts in improving fccess to sanitation by both the central and local governments. Ths strategy Is prepared in such a way that the outputs wil be more appropiate and measurable and ican be used asthe basis for making localty-specific polices. We really appreciate the contributions from those involved in the preparation of ths strategy. Of course, this strategy will serve is Purpose if al stakeholders work hard to implement. This strategy is expected to vigger the creation of a conducive environment. increase in demand, increase in supply, knowledge management on access to sanitation and community's hygienic behavior. ‘This National Strategy for Community-Based Total Sanitation will hopefully improve the community's hygienic behavior and increase access fo sanitation facities in particular and community degree of health and welfare in general Etabiahed in hata O “Soptornber tt DR. dr. Sit! Fadiiah Supan, Sp.JP (K ‘CONTENTS NATIONAL STRATEGY FOR COMMUNITY-BASED TOTAL SANITATION (CBTS) CONTENTS... |. INTRODUCTION... ‘A. BACKGROUND, B. AIMAND OBJECTIVES. C. DEFINITIONS... |. ISSUES AND CHALLENGES. WL NATIONAL STRATEGY. A. Create a conducive environment. B. Increase demand C. Improve supply D. Knowledge Management E. Financing F Monitoring and Evaluation IV, DEVELOPMENT OF WORK PLAN AND INDICATORS... A. WORK PLAN, B, INDICATORS. ourputs ‘ouTcones. V. ROLE AND RESPONSIBILITY OF STAKEHOLDERS. VL. CLOSING. MINISTER OF HEALTH DECREE NUMBER 852/2008 JAKARTA, SEPTEMBER 9", 2008 CONTENTS... vw. ‘CONTENTS INTRODUCTION... ‘A. BACKGROUND, B. AIMAND OBJECTIVES. C. DEFINITIONS... ISSUES AND CHALLENGES. NATIONAL STRATEGY, A. Create a conducive environment. B. Increase demand C. Improve supply D. Knowledge Management E. Financing F Monitoring and Evaluation DEVELOPMENT OF WORK PLAN AND INDICATORS... 7 A. WORK PLAN, 7 B, INDICATORS. 8 ourputs 8 ‘ouTcones. 8 ROLE AND RESPONSIBILITY OF STAKEHOLDERS. CLOSING. NATIONAL STRATEGY FOR COMMUNITY-BASED TOTAL SANITATION (CBTS) MINISTER OF HEALTH DECREE NUMBER 852/2008 JAKARTA, SEPTEMBER 9", 2008