Scaling up rural sanitation : factors associated with achieving and sustaining open defecation free communities : learning from East Java

What does it take to bring about sustainable sanitation behavior change, cost-effectively, and at scale? The search for answers has intensified in the rural sanitation sector in Indonesia, where access to improved sanitation has grown much too slowly from 22 percent in 1990 to just 36 percent in 2008, and the Millennium Development Goal target for rural sanitation seems well beyond reach. Meanwhile economic losses from poor sanitation and hygiene are costing Indonesia US$6.3 billion or 2.3 percent of its GDP per year. The Water and Sanitation Program’s (WSP) Global Scaling Up Rural Sanitation Project, a learning-by-doing initiative implemented in partnership with local and national governments in Indonesia, India, and Tanzania, sought answers by working at scale from the beginning and by  testing a combination of two relatively new and promising approaches: Community-Led Total Sanitation (CLTS) and sanitation marketing. [authors abstract]