Program Pengembangan Sanitasi

BAPPENAS

I n c e p t i o n R e p o r t August 2006

Indonesia Sanitation Sector Development Program

VOLUME 2 ANNEXES

DHV BV in association with:

PT Arkonin Engineering SP

IRC International Water & Sanitation

PT Mitra Lingkungan Dutaconsult

PEM Consult

Yayasan Indonesia Sejahtera


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CONTENTS PAGE

VOLUME 1 MAIN REPORT

VOLUME 2 ANNEXES

ANNEX 1 Sanitation Sector Assessment Kajian Sektor Sanitasi ANNEX 2 Sanitation Awareness and Hygiene Promotion Market Studies, Campaign and Communication Packages ANNEX 3 Quality Management and Assurance System

Annex 1 SANITATION SECTOR ASSESSMENT.................................................................................1

1 Introduction .................................................................................................................................1

1.1 Policies and Sanitation Strategy ......................................................................................1 1.2 Strategic approach ...........................................................................................................2 1.3 Legal Aspect and Regulation ...........................................................................................3

2 Institutional Aspects...................................................................................................................6

2.1 Stakeholders ....................................................................................................................6 2.2 Non-Governmental Organizations: ..................................................................................9 2.3 Vision and Mission (national level).................................................................................11 2.3.1 The Ministry of Environmental Affairs ............................................................................11 2.3.2 Health department..........................................................................................................11 2.3.3 Public Work Department ................................................................................................12 2.3.4 Department of Home Affairs...........................................................................................13

3 Existing Sanitation Condition ..................................................................................................14

4 Environmental condition ..........................................................................................................15

4.1 Water contamination ......................................................................................................15 4.2 Health affairs ..................................................................................................................15 4.3 Sanitation Services.........................................................................................................16

5 Investment and Financing........................................................................................................17

5.1 Existing Condition...........................................................................................................17 5.2 Medium and Long-Term Policy Objectives ....................................................................18 5.3 The Economics of Sanitation Infrastructure ...................................................................19 5.4 Investment Requirements and Financing Strategy........................................................21 5.5 Key Elements of an Implementation Strategy................................................................22 5.6 Conclusions and Recommendations .............................................................................23 5.6.1 Financing arrangements. ...............................................................................................23 5.6.2 Institutional arrangements..............................................................................................23

6 Summary ....................................................................................................................................23

6.1 Sanitation Findings.........................................................................................................23 6.2 Feedbacks from Workshop ............................................................................................25 6.2.1 Institution: .......................................................................................................................25 6.2.2 Regulation: .....................................................................................................................25 6.2.3 Financial .........................................................................................................................25 6.3 Action Plan for the next six months................................................................................25 6.3.1 Institutional Aspect ..........................................................................................................25 6.3.2 Advocacy.........................................................................................................................26 6.3.3 Policy and Regulation......................................................................................................26 6.3.4 Financial Aspect ..............................................................................................................26 6.3.5 Guideline for Local Government .....................................................................................26


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KAJIAN SEKTOR SANITASI...............................................................................................................27

1. Pendahuluan..............................................................................................................................27

1.1 Kebijakan dan Strategi Sanitasi .....................................................................................28 1.2 Kerangka pendekatan srategis ......................................................................................28 1.3 Aspek Hukum dan Regulasi...........................................................................................28

2 Aspek Kelembagaan .................................................................................................................32

2.1 Stakeholders ..................................................................................................................32 2.2 Lembaga non Permerintah.............................................................................................34 2.3 Visi dan Misi Stakeholders (tingkat nasional) ................................................................36 2.3.1 Kementrian Lingkungan Hidup.......................................................................................36 2.3.2 Departemen Kesehatan: ................................................................................................37 2.3.3 Departemen PU..............................................................................................................38 2.3.4 Departemen Dalam Negeri ............................................................................................39

3 Kondisi Sanitasi Saat Ini...........................................................................................................40

4 Kondisi Lingkungan..................................................................................................................42

4.1 Pencemaran Air..............................................................................................................42 4.2 Isu Kesehatan ................................................................................................................42 4.3 Pelayanan Sanitasi.........................................................................................................43

5 Investasi dan Pendanaan .........................................................................................................44

5.1 Kondisi Saat Ini ..............................................................................................................44 5.2 Tujuan Kebijakan Jangka Menengah dan Jangka Panjang ..........................................45 5.3 Aspek Ekonomi Prasarana Sanitasi...............................................................................46 5.4 Kebutuhan Investasi dan Strategi Pembiayaan .............................................................48 5.5 Unsur-Unsur Kunci dari Suatu Strategi Pelaksanaan....................................................50 5.6 Kesimpulan dan Rekomendasi ......................................................................................50 5.6.1 Sistem Pendanaan.........................................................................................................50 5.6.2 Pengaturan institusional. ................................................................................................51

6 Ringkasan.....................................................................................................................................51

6.1 Temuan Sanitasi ............................................................................................................51 6.2 Umpan Balik Pelaksanaan Workshop............................................................................52 6.2.1 Kelembagaan .................................................................................................................52 6.2.2 Regulasi: ........................................................................................................................53 6.2.3 Finansial .........................................................................................................................53 6.3 Action Plan untuk 6 bulan Mendatang ...........................................................................53 6.3.1 Aspek Kelembagaan ......................................................................................................53 6.3.2 Advokasi.........................................................................................................................53 6.3.3 Kebijakan dan Peraturan................................................................................................54 6.3.4 Aspek Keuangan............................................................................................................54 6.3.5 Panduan untuk Pemerintah Daerah...............................................................................54


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ANNEX 2 SANITATION AWARENESS AND HYGIENE PROMOTION .............................................55

1.1 Market Studies, Campaign and Communication Packages...........................................55 1.2 National Sanitation Awareness Campaigns...................................................................56 1.3 City level sanitation awareness campaigns ...................................................................58

ANNEX 3 Quality Management System ............................................................................................66

A. PROJECT MONITORING...........................................................................................................67

1. OBJECTIVE ................................................................................................................67 2. DEFINITIONS .............................................................................................................67 3. WORK METHOD ........................................................................................................68 3.1 Project monitoring by team members .........................................................................68 3.2 Project monitoring by the project manager .................................................................68 3.2.1 External progress report .............................................................................................68 3.2.2 Internal progress report...............................................................................................68 3.2.3 Documentation of results ............................................................................................69 3.3 Project monitoring by the project director ...................................................................69 3.4 Making adjustments ....................................................................................................69 3.4.1 Making adjustments for nonconformities ....................................................................69 3.4.2 Dealing with shortcomings, complaints and claims ....................................................69 4. ACTIVITIES/POSITION MATRIX................................................................................70 4.1 QUARTERLY PROJECT MONITORING FORM........................................................71 4.2 PROJECT COMPLETION ..........................................................................................74 4.2.1 OBJECTIVE ................................................................................................................74 4.2.2 WORK METHOD ........................................................................................................74 4.2.2.1 Draw up a draft final report .........................................................................................74 4.2.2.2 Sign and send draft final report...................................................................................74 4.2.2.3 Formulate comments and criticisms ...........................................................................74 4.2.2.4 Draw up final report.....................................................................................................74 4.2.2.5 Sign and send final report ...........................................................................................74 4.2.2.6 Employer satisfaction and certificate of completion....................................................74 4.2.2.7 Internal final discussion...............................................................................................74 4.2.2.8 Project Reference System (PRS) ..............................................................................75 4.2.2.9 Complete project.........................................................................................................75 4.2.2.10 After-care and follow-up..............................................................................................75

5. ACTIVITIES/POSITION MATRIX................................................................................................76

5.1 Handling of Project documents...................................................................................77


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LIST OF FIGURES Figure 5-1 Services delivered by a sanitation system ........................................................................20 LIST OF TABLES Table 1-1 Laws and Regulations Relating to Sanitation......................................................................5 Table 2-1 Agencies managing IPLT, IPAL and other sanitation facilities ...........................................7 Table 2-2 Government and non-governmental agencies related with Supplying Infrastructure for

Drinking Water and Sanitation.............................................................................................9 Table 5-1 Households with access to improved sanitation* ..............................................................18 Table 5-2 Service level targets for the sanitation sector ...................................................................18 Table 5-3 Estimated economic costs of public health .......................................................................19 Table 5-4 Classification of economic benefits of sanitation infrastructure ........................................20 Table 5-5 Financing responsibilities by sanitation service ................................................................21


Inception Report (Volume 2)_Annex 1 1

ANNEX 1 SANITATION SECTOR ASSESSMENT 1 INTRODUCTION Indonesia is so far still facing various types of sanitation problems. Management of sanitation elements such as drinking water, waste water, fresh air and solid waste is getting more demanded in line with a more modern life, but conditions in rural and urban areas in the country have yet to support its environmental sanitation, in terms of availability of resources, infrastructure, and facilities. From these elements, waste water is a complex element which is often abandoned, and untouched in terms of management and as a priority for the public and Government. It does not mean there is no attention and handling, but its management is still insufficient. Aiming at improving health condition, environmental conservation and social life through better environmental sanitation in selected urban areas Indonesia, this sanitation sector assessment discusses about better services for poor areas in cities by formulating policies, institutional reformation, and effective and coordinated planning strategy. Healthy environment is our dream. Unhealthy environment and poor sanitation will cause rare clean water, environmental contamination due to human feces, waste, trash, etc. which may cause diseases or even death. Generally, when a village or community is poor, it will have a poor drinking water and environment health, and poor access to sanitation. Therefore, better sanitation and environment health are developments which support the poor. Besides, it is also in line with human rights because everyone basically has the right for better environment. This study methodology is based on information and documents available, and our interviews with key officials in key agencies such as the Ministry of Environment, Department of Public Works, and the Department of Health focusing on the said topic of discussion. The condition of existing sanitation is apparently stagnant from time to time because development of sanitation cannot catch or even surpass high population growth. After performing 7 Pelita (five year development plan) and PROPENAS/RPJM until 2005, total population in Indonesia is about 2015 million, but the number of sanitation facility is equal or even lower compared with population growth, that there is no significant improvement in its sanitation. 1.1 Policies and Sanitation Strategy From 1999 to 2003, each agency related with sanitation prepared an RPJM, including sanitation based on existing condition and its purpose (tupoksi) but it has yet to be fully coordinated. Although its aim is similar i.e., to repair sanitation, but they are not synergized, that it does not produce any significant improvement.



6/17/2006 3

Strategic Framework

Where are we now

(present condition)

Where do we want to be

(Vision, Mission)

How do we get there

(Strategy and Action)

How to stay there

(Sustainability)

Demand drivenSupply driven

Dem

and responsive

Since 2004, by referring to RENSTRANAS/RPJMN and National AMPL Policies (agency and

community-based), each sector prepares RPJM, including sanitation based on existing condition specified in the National AMPL Policies. Each sector (agency) based on its TUPOKSI, prepares a strategic plan with the same aim i.e., to improve sanitation, synergize one another, only implement untested ones (but with the high expectation), except for handling community-based sanitation (SANIMAS) in certain promising cities. 1.2 Strategic approach As specified in the introduction, ISSDP approach does not start from the beginning, because this

activity is a follow up of activities performed earlier, not long from studies performed by WSP. Based on this latest study document, what have been obtained and are relevant with sanitation problem will be summarized. In studying sanitation problems, ISSDP refers to current condition by learning relevant and clear WSP, where sanitation services are supply driven. What to expect by referring to this vision and mission, sanitation then developed into demand driven, how to achieve it and how to maintain it so that demand responsive can

7/16/2006 2

IMPIAN :Demand Driven; Kota sehat & bersih; (masyarakat sehat & Kualitas Air Baku AM. baik)

Policy & Startegi, RPJM, RENSTRADA,AP; RPJP

????

PempropPemkab/Pemkot

Deliveri ? Desentralisasi!Rule? Regulasi?

RPJMN UPAYA MEMPERBAIKISANITASI (LAMPU MERAH)

Kondisisanitasi saatini

Akseske

Sanitasiterbatas, W

ater born diseases tinggi

KondisiA

ir Baku A

.M.

hususnyaair perm

ukaantercem

arbertaair lim

bah

Kebijakan AMPL Nasional Perencanaan

Startegis, Program, AP, NSPM

NPB +AP

Policy & StartegiLembaga terkait

MOH + AP

MOI + AP

MOHA + AP

MOF + AP

MPW + AP

MOE + AP

Kebijakan & Strategi belumterkoordinir denganbaik

Tidak/ belumberhasil

NDPA + AP


MOH + AP

MOI + AP

MOE + AP

MOHA + AP

MOF + AP

MPW + AP



be achieved and how to maintain what have been achieved continuously and sustainable. From approach viewpoint, there is a change from “supply driven” to “demand driven”. In terms of target, for example, its focus was to enable community to have their own latrine (“supply driven”). But now, it is no longer about having a latrine, but it is the community’s choice where they want to defecate, as long as they understand its consequence. One important thing is they do not defecate in the river, or public areas, etc. (“demand driven”). It is easy to say but difficult to perform. Change of mind needs high awareness and long time. 1.3 Legal Aspect and Regulation The effectiveness of sanitation services is highly influenced by government policy both at central and local levels. Legal and regulatory aspects were identified as a key element of the enabling environment for sanitation. To achieve better urban domestic wastewater management, it is necessary to analyse each element of the management process: (1) planning and programming, (2) design, (3) constructions, (4) operation and maintenance, and (5) monitoring. A clear framework should be designed to regulate these management processes smoothly. A thorough study is needed to evaluate existing conditions as follows: current regulation of all aspects of domestic wastewater management, identification of aspects of regulation which need strengthening, central and local government roles, and recommendations. At present, there is no specific law regulating urban domestic wastewater management; most relevant regulatory instruments are linked to environmental protection and environmental health rather than wastewater management. In other words, domestic wastewater management is seen as an important aspect in environmental protection and environmental health. Under decentralisation, environmental protection is the responsibility of local government at provincial and district levels (Law 32/2004, articles 13 and 14). Law 32/2004 regulates the responsibility of local government for environmental protection in: designing and monitoring construction, regional planning, providing facilities, and environmental management. The functions of local government are monitored and assisted by central government (Law 32/2004, article 217). Central government should deliver the norms, manuals and standards (NSPM), training and courses. Nationally, assistance and monitoring of local government functions is coordinated by the Ministry of Home Affairs (Law 32/2004, article 222). At regency and city level they are coordinated by the governor and at district level by the head of city. The functions of local government are monitored and assisted by central government (Law 32/2004, article 217). Central government should deliver the norms, manuals and standards (NSPM), training and courses. Nationally, assistance and monitoring of local government functions is coordinated by the Ministry of Home Affairs (Law 32/2004, article 222). At regency and city level they are coordinated by the governor and at district level by the head of city. The current conditions of domestic wastewater facilities in cities are poor. The concern of local government, which has responsibility in this area, are low and the consequence is that the development of domestic wastewater facilities is very slow. Possible reasons identified include1): o No clear institutional roles; o No specific/explicit central government regulation on domestic wastewater management, as a

reference for local government; o Ambiguous national role in assisting local government to develop domestic wastewater

management; o Inadequate local government resources; o Low awareness of domestic wastewater management in local government and communities; 1 )Partly based on workshop discussions, Gren Alia Hotel, June 27-28, 2006



o Lack of domestic wastewater management plans and strategies in local government; o Inadequate local and central government regulations to enforce domestic wastewater

management; o Lack of financial resources. The GOI is commited to the MDG targets in 2015, and this commitment is included in Rencana Pembangunan Jangka Menengah (RPJM) written in PP7, 2005. The RPJM target for domestic wastewater is to end open defecation in all cities by 2009; to increase the utiliisatiin rates of IPLT and IPAL to 60%; to decrease faecal pollution of surface water to 50% of 2004 values and to develop centralised sewerage systems in metropolitan cities. To achieve these targets, Bappenas, Ministry of Public Works and Ministry of Health have all developed strategies and plans. Bappenas is creating National Policies for Community Based Drinking Water Supply and Environmental Sanitation Development and Institution Based Drinking Water Supply and Environmental Sanitation Development. On the other hand, the Ministry of Public Works has made a National Action Plan for Wastewater and the Ministry of Health has made a National Environmental Health Plan for 2005-2009. Government decree (PP) 16/2005 regulates the Development of Drinking Water Supply Systems, protecting raw water, and the potential of solid and liquid waste to pollute the raw water. Law 23/1992 gives Ministry of Health responsibility for controlling solid and liquid wastes in relation to environmental health. It is stated in article 22 that “Environmental health is managed through creating a healthy environment in public places, settlements, the working environment, public transport and other environments, including efforts for improving water and air quality, control of solid waste, liquid waste, gas emissions, radiation, noise and disease vectors and other efforts or security on the above matters”. People’s rights to well being and environmental health are regulated by Law 23/1997 article 5, chapter V, which regulates environmental preservation, and chapter VI, requirements for environmental arrangement. In terms of financial arrangements, local government has autonomy in financial management, as stated in Law 33/2004 (Financial Balance between Central and Local Government) including the determination of health development priorities as appropriate to local capabilities, conditions and needs. Government decree (PP) 82/2001 regulates water quality management and water pollution control, including sanctions for any action polluting water and the authority of the Bupati/Walikota to issue wastewater discharge permits. Ministry of Health Decree (Kep. Menkes) 1457/2003 rules on the Minimum Standard of Health Services (MSHS) in Kabupaten/Kota, as follows: the prevention of diarrhoea and dengue fever; environmental health and hygiene services in public places; and responsibilities of the Bupati/Walikota for health services in accordance with MSHS. The strategic plan of the Ministry of Health is set out in Ministry of Health Decree (Kep. Menkes) 1274/2005, which states that the environment health program includes: clean water supply and basic sanitation; environmental quality management; environmental pollution control; and development of healthy areas. Technical guidelines and manuals have been developed by the Ministries of Public Works and Health. Some were developed in cooperation with other Ministries with financing from international institutions, including: CLTS (Community Led Total Sanitation) equipped with module and the team; MPA (Methodology for Participatory Assessment), and PHAST (Participatory Hygiene Transformation); Guidelines on Sanimas (Community Sanitation);



Technical Guideline (Juknis) on air and liquid waste quality assessment (By Dirjen P2MPLP in 1994); Guidelines on Installation of Hospital Liquid Waste Management (Dirjen Yanmedik, 1993).



The Draft law on regional planning (UU Tata Ruang) makes no explicit consideration of sanitation. It appears that at the moment, the current laws and regulations are not working properly in the various sectors responsible for the domestic wastewater management. Water quality degradation in surface and ground water is an indication of poor wastewater management in every management process, especially aspects of monitoring such as construction and the performance of built infrastructure (effluent standards, surface water standards, etc). Key Laws and regulations identified so far are described in Table 1.1.

Table 1-1 Laws and Regulations Relating to Sanitation

No Law / Regulation Stipulation 1 UUD 45:

Article 33 Alinea 3 ‘Land and water and the wealth beneath governed by state and utilized for the greatest benefit of people’s welfare’

2 UU No.23 Year 1992: Chapter IV, Article 9 Article 10 Chapter V, Fifth Part. Article 22 Article 38

Health Government has the task of mobilising community participation in administering and financing health Efforts to realize optimum health for community as a preventive approach Environmental health covers healthiness of water and air, protection against solid waste, liquid waste, gas emissions, radiation, noise, control of disease vectors, and other protection. Environmental health, disease abatement and health education represent part of health efforts. Health education is administered to improve knowledge, awareness, willingness, and capacity for healthy life

3 UU No. 23 Year 1997 Chapter III, Article 5 Clause 1 Chapter V, Article 14-17 Chapter VI

Environmental Management Each person has a right to well-being and a healthy environment Environmental preservation function Requirement for environmental arrangement

4 GBHN 1999-2004 Health development is directed to improve human resource and environment which support one with another with health paradigm, which providing priorities on health improvement, prevention, recovery and rehabilitation from the foetus to elder age.

5 UU No. 22 Year 1999 Local Government: Province, Kabupaten, and Kota have authority to govern and administer local community interest according to their own aspiration based on community aspiration.

6 UU No. 25 Year 2000 National Development Program (2000-2004) on healthy environment, healthy behaviour, and community empowerment. Settlement infrastructure and facilities development programme at local level.

7 UU No.7 Year 2004 Chapter III Article 23-25

Governance of water resources: community participation in management and fulfilment of water supply demands Water resource conservation Control of water pollution

8 UU No. 32 Year 2004 Local Autonomy 9 PP No.25 Year 2000 Government and provincial authority as autonomous district



No Law / Regulation Stipulation 10 PP No.7 Year 2005 Rural development

Acceleration of infrastructure development 11 PP No. 16 Year 2005 Development of SPAM integrated with sanitation infrastructure and

facilities development Wastewater infrastructure and facilities Solid waste infrastructure and facilities related to raw water source protection

13 KepMen Permukiman dan Prasarana Wilayah No. 409 Year 2002

Administration of KPS (Government-Private Sector Cooperation) in administration and/or management of water supply and sanitation

14 Kep Men LH No. 111 year 2003 Requirements and procedures for wastewater facilities discharge permit

15 Kep Men LH No. 112 Year 2003 Domestic wastewater quality standards 2 INSTITUTIONAL ASPECTS 2.1 Stakeholders Sanitation cannot be handled by many sectors because all should synergize to handle this issue. At the central level, in addition to Bappenas, Finance Department and Department of Home Affairs, the Health ministry, the Minister of Environment, the Department of industry, and the Department of public works shall also take part. At the regional level, local government offices at province level, and the regency and city administration shall take a part. In addition, NGOs, private sector and individuals shall also take part. When they are synergized one another toward the same final result, sanitation may be improved more significantly. Role sharing has yet been identified and the role of each agency (regulator, operator, provider, enabler, empowering body) has yet been clearly organized and who should be its beneficiaries. It is related with awareness about public services. Serving the community is placing community as beneficiaries, and if beneficiaries are project executors, as a number of previous developments did not involve the community from initial planning, work/project “waste” may occur again. Therefore, it is very important to share or clarify the role so that there won’t be any overlapping which will reduce each party’s performance. Who shall act as regulator, operator, provider and beneficiaries should be clear. The State Minister for Environmental Affairs shall play a major role in handling environment problems so as to enable development and to anticipate possible environmental contamination. Particularly for sanitation, it shall regulate requirements for all waste water which may be disposed of to irrigation, because it may affect our limited water resources; Health ministry shall play a major role as a regulator in managing the quality of potable water, and possible spread of disease through water; The Ministry of Industry shall deal with home industry of which liquid waste may contaminate water e.g., batik and tofu industry, etc. Similarly, other departments related with sanitation should also have a clear role. However, at the operational level within regional government, the role of agencies and local government offices concerning sub-sanitation sector is varied and apparently not properly coordinated. Agencies related with the management of sanitation facilities are available in the following Table 2.1.



Table 2-1 Agencies managing IPLT, IPAL and other sanitation facilities

OPERATOR. PAL IPLT MANY LATRINES

MCK SANIMAS/ COMMUNITY

Septic Tank, LATRINE

HOME INDUSTRY

PD.PAL + PDAM + + Dinas Kebersihan + DKP + RT/RW + + + Local Office for Environment Affairs

+ + +

Communal groups + + + LKMD + + BEST (NGO) + Individual + REGULATOR IPAL IPLT MANY

LATRINES MCK SANIMAS/

COMMUNITY Septic Tank, LATRINE

HOME INDUSTRY

HEALTH MINISTRY + + + + + + + Environmental Affairs

+ + + + + + +

Local Industry Office +



Decentralization should expedite development, including sanitation, but it is not the case now. Decentralization has handed over most tasks from the central to regional governments, bringing sanitation provider closer to those who need access to sanitation. Therefore, the development of sanitation should be better than pre-decentralization. Decentralization was firstly performed in 2001/2002. Now it has been performed for four to five years, but the development of sanitation is apparently stagnant. There are indeed many problems. Beside monetary crisis, the community has yet to need sanitation as a priority, and therefore the regional government probably considers sanitation is not a priority to develop. It is apparent from low budget for sanitation in the regional budget (APBD). Some regional governments have made plans from the bottom, starting from discussions on the need for its development at kelurahan and city level, which was attended by NGOs and local agencies/offices, but it has not been their priority based on their RPJM and activity plan in each local agency/office. It is recommended that capacity should be improved through facilitators at kelurahan forum so as to discuss the people’s actual need so as to improve health through better access for sanitation facility (preventive), so that real need for sanitation can be identified by related local agencies/offices and be made a basis to prepare regional program and its annual action plan. Since the relation between central and regional governments in handling sanitation is not clear, policies and strategies at the national level have yet been references for local government, because they have yet been supported by its regulations. Each agency and department related with sanitation has prepared policies, strategies, RPJM, Action Plan, and NSPM, but it is not clear if they have been implemented in the regions. A clear government regulation should be issued and local governments should have the same understanding so as to avoid confusion when it is applied at the operational level. At the regional government, it is necessary to clarify it in a local regulation so as to operate it well. At this level, it is necessary to have a clear relation between the national and local regulations. With the issuance of a local regulation concerning sanitation which refers to the national government, it is expected that national strategies and policies concerning sanitation can be in line with those prepared at local level and be part of RENSTRADA/ RPJM which explicitly and clearly describe about development of sanitation. For example, in achieving target sanitation related with MDGs commitment, the regional governments are generally aware of it, but their target achievements in every municipality/regency are varied proportionally depending on total population and resources (capacity).

Sanitation sector has yet become a priority, stakeholders in general, and the community in particular, has yet to consider sanitation their main requirement (they are more concerned about what to eat today). The development of sanitation is generally top down, except for several cases such as SANIMAS, CLTS, WSSLIC, and PAMSIMAS which have their own success-story. It is necessary to have a better understanding through an advocation program, so that all stakeholders will have the same understanding on how to improve priority for sanitation when it is not yet deemed necessary to develop. In Indonesia, a clear research has yet been performed (for example Making the Case) that with easy access to sanitation facility, people’s health can be improved. Better health can improve work productivity, and economy of the family and community in general. Investment in sanitation facility is so far deemed unable to obtain cost recovery, even less when it is related with off-site sanitation (sewerage). However, we should also consider its economic value due to better sanitation facility that we don’t have to apply for a sick leave, pay hospital cost, time lost and better performance. It is probably necessary for managers who develop sanitation to apply an entrepreneurship way of thinking.



Government agencies related with Sanitation: At the central level: Bappenas, Public Work Department, Health Department, Home Affairs Department, Finance Department, State Ministry for Environmental Affairs, and Department of Industry (particularly home industry) At local level: Local Offices/Agencies related with sanitation based on their TUPOKSI, and various levels, names and types from one region to another. 2.2 Non-Governmental Organizations:

NGO, Profession Associations, High learning institutions, Social Groups/Associations; Developers, Local Social Communities (RT, RW) etc. Following is a table on government and non-governmental agencies related with sanitation.

Table 2-2 Government and non-governmental agencies related with Supplying Infrastructure for Drinking Water and Sanitation

No Agency Tasks/Functions 1 Bappenas Bappenas shall be responsible for infrastructure plan, coordinating

policy reforms at the national level concerning water resources and supply of drinking water and community-based environmental health

2 Public works department: The directorate of Cipta Karya

Technical framework for developing rural infrastructure and facilities covers: promotion, arrangement, development, training and technical assistance. Participates in providing healthy settlement and houses including affordable basic infrastructure.

3 Health Department: The Directorate General of Environmental Health and Contiguous Disease Control The Directorate of Settlement Environmental Health The Directorate of Water Sanitation

Provider and developer of health information, maintenance of water quality and health education Conditions which may affect people’s health in settlement areas and disease contiguous places (Malaria, Dengue Fever) Monitoring water quality including waste water disposal areas.

4 Department of Home Affairs: The Directorate General of Regional Development The Directorate General of Village Community Development The Directorate General of General Affairs and Regional Autonomy

Managing development fund and improve administration plan, and environment including drinking water and sanitation services Developer at kelurahan level through Lembaga Ketahanan Masyarakat Desa (LKMD) so as to initiate bottom up plans and people’s self supports Supervisor for local companies (PDAM, PDAL, PD Kebersihan), has a Human Resource development program

5 Finance Department: The Directorate General of Development budget The Directorate General of Other Development Budget The Directorate General of Foreign Fund

Allocate sectoral development project fund which covers development in cities, regencies and province and national development, annual budget shall be distributed through related Departments and Regional government Manages other funds, other than development fund Manages bilateral and multilateral funds.

6 The Ministry of Environmental Affairs Developes policies and regulations concerning control over contamination and environmental issues Plans and performs environmental programs and supports people’s participation in managing their environment



No Agency Tasks/Functions 7 Provincial Government Planning

Board: Physical Field and Infrastructure and/or Socio-culture

Planning, coordination, monitoring program and development activities

8 Provincial Secretary (Setwilda): Financial and Development Bureau

Formulating development policies, monitoring and preparing commitment for development fund at province level

9 Provincial Bapedalda Performing and applying policies and governance in environmental management affairs at the region

10 Provincial Public Work Department Coordinating the development programs and projects at the province level

11 Village Community Empowerment Agency (province)

Development of Village community

12 Provincial Health Office 13 Regional Government Planning Board

at Regency/municipality: Physical Fields and Infrastructure and or Socio-Culture

Planning, coordination, monitoring of programs and development activities at Regency and/or Municipal Level

14 Regional Secretary (Setwilda) in Regency/municipality: Financial and Development Bureau

Formulating development policies, monitoring and preparing commitment for development fund at Regional level

15 Bapedalda at Regency/municipality Performing and applying policies and governance in environmental management affairs at the region

16 Public Work Department at Regency/municipality Kimtawil office (Bandung Regency) Public Work Department (Tasik Regency)

Be responsible for the implementation of the state budget (APBN). INPRES (Rural Clean Water and Environment Sanitation at Settlement Areas) and other development fund from APBD. Be responsible for planning and developing village drainage Be responsible for planning and developing village drainage

17 Local Office for Sanitation and Gardens

Operating and maintaining trash disposal system and drainage. Mostly at city level

18 Local Office for City and Regional Layout

Planning, layout and monitoring the city and regency layout. Authorized to grant the Building Establishment License (IMB) which contains requirement to establish waste water processing unit (cubluk or septic tanks)

19 Local Health Office at City or Region Coordinating and implementing health services at regency and/or city level, through People’s health centers

20 Regional-owned Corporations (BUMD): PDAM in several cities PDAL (Regional Corporation for Waste Water)

Supplying drinking water and managing domestic waste water Only available in Jakarta

21 Village Community Development Office

Community development

22 Kelurahan or Village Office It is a government unit under kecamatan which also has a functional relationship in community development. Village chief has the autonomy for village administration.

23 LKMD Semi governmental organization at village level which shall be responsible for planning and implementing village development

24 PKK Semi governmental organization which is responsible for social issues including health protection and environmental conservation and shall also be responsible for trash management in several sites



2.3 Vision and Mission (national level)

2.3.1 The Ministry of Environmental Affairs

Vision: To establish the State Ministry for Environmental Affairs as a reliable and proactive institution in materializing sustainable development through Good Environmental Governance (GEG), so as to improve the prosperity of Indonesian people. Explanation on program, among others PROKASIH which is aimed at reducing contamination due to liquid waste; ADIPURA Program which is aimed at establishing a clean and green city; and management of domestic waste and small-scale businesses which is aimed at reducing contamination from the source, and that program implementation based on the Decree of the Minister of Environmental Affairs No.93/ 2004 concerning Bangun Praja Program. Adipura award, for waste water aspect will only be included in the calculation/evaluation in 2008. Mission of Deputy II: To improve environment quality; to develop a professional performance in controlling environmental contamination; to encourage application of Good Environmental Governance principles KLH is of the opinion that one of its main tasks is to handle waste by considering that waste is a resource; it is still impeded by the meaning of other stakeholders/agencies as specified in Law no.7/2004 concerning water resources and Government Regulation no.16/2005 concerning Development of Supply of Drinking Water, Article 1 which says: “Solid wastes are wastes arising from settlement areas, not hazardous or toxic material, which is deemed useless”2). By understanding that waste is a resource, then handling or management of this resource will be optimal when it covers its amount in communal level than individual level. Although at individual level, it is motivated by the spirit to seriously perform it so as to produce a significant result. In this case, we may refer to Mexico where development of individual septic tank has been prohibited so as to conserve its environment. 2.3.2 Health department

Vision: People have a healthy behavior and life in a healthy environment. Mission: o To control environmental risks and behaviors; o To encourage the independence of health-oriented community; o To encourage network and partnership; o To develop technology and application of analysis on environmental health impacts; o To provide information concerning environmental health; o To improve HR professionalism concerning environmental health; and o To improve even, quality and affordable environmental health services. The central government has the authority to perform surveillances concerning epidemiology, eradication and elimination of epidemics/extraordinary events and application of policies to support macro development, preparation of national plan, development and supervision on regional autonomy which covers issuance guidance, guidelines, training, directions and supervision and eradication of epidemics and national disasters. Agencies within the environmental ministry which support healthy environment based on their respective tasks are: Directorate of Environmental sanitation, it is a leading unit. Health Promotion Center, Planning & Budgeting Bureau; Legal & Organization Bureau, Center for Health Facility, Infrastructure and Equipment, Directorate of Community Health etc., Local Health Offices at the Province and Regency/Municipality (DKK) levels.

2) Definition: Solid wastes are all the wastes arising from human and animal activities that are normally solid and are discarded as useless or unwanted. Because of their intrinsic properties, discarded waste materials are often reusable and maybe considered a resource in another setting. (G.Tchobanolous, Integrated solid waste management)



This DKK shall be authorized for decentralization of health affairs and providing assistance and determining types of levels of health services. Province Health Office has the authority for limited decentralization which covers health services which cannot be performed inter sectoral by the community or regional government at the regency/municipality level. Past five years experiences shows that the regional governments still require supports so that healthy environment priorities can be performed well. Limited fund sources and lack understanding about healthy environment cause poor commitment in this field. Environmental sanitation actually has a specific characteristic which does not recognize administrative boundaries. Their solutions require integrated and inter province/regency/ municipality handling. Otherwise, it may cause worse KLB/epidemic and environmental damages which may harm our health. In sanitation field, its targets are among others: to improve the percentage of families who live in healthy homes (75%); families who use clean water (85%); and families who use latrines which are of healthy standard (80%). However there is a slight change in its approach. In terms of target, for example, its focus was to enable the community to own latrines (which is “government driven”). But now, it is up to the community, they are free to defecate in locations of their choices, as long as they know the consequences of their choices. So long they do not do that in the river or in public areas, etc. (“community driven”). On the other hand, sanitation is also an investment. People have needs to develop. Its “return rate” is actually high. Many are interested in it. Its implementation is so far so good. Previously, some villages had no water/latrine, but now their homes have water (in 1,300 villages), serving for some 10 million people. WSSLIC project produces a good result. For example, in Lumajang it is reported that within three months only, no one in 16 villages within one kecamatan defecates in any place. Similarly, in Muara Enim, WSSLIC 2 has been developed in 2,500 villages. And WSSLIC 3 will be developed in 11 provinces, 70 regencies, 5,000 villages. It is planned for 2007-2012. Some 5,000 clean water facilities will be built with a better hygiene (washing hands with soap). 2.3.3 Public Work Department

Vision: To provide reliable, useful and sustainable Public Infrastructure so as to support safe, peaceful, justified, democratic and prosperous Indonesia. The Directorate General of Cipta Karya, Vision: o To establish regional independence in developing infrastructure and facilities so as to

materialize urban and rural areas which are convenient, fair, producctive and sustainable, and supports each other in developing the region.

o To supply public infrastructure in urban and rural areas in order to materialize convenient, productive and sustainable settlement areas, and to arrange buildings and environment, develop a standard safety of homes, settlement and private buildings.

Directorate of PPLP, Vision: To establish health environmental infrastructure and facilities in order to materialize convenient, healthy, safe and sustainable settlement areas through better quality of people’s health and environmental conservation.

Directorate general of CK, Mission: o To supply public infrastructure in urban and rural areas in order to materialize

convenient, productive and sustainable settlement areas. o To improve the capacity of regional government, community and businesses in

developing public infrastructure. o To arrange urban and rural areas and buildings which comply with standard safety and

building security of buildings. o To construct village roads, city streets and water infrastructure and facility (village

irrigation and water resources).



o To materialize efficient organization, effective performance and professional human resources by applying” Good Governance” principles.

Directorate of PPLP, Mission: o To provide services for waste water, trash and drainage infrastructure and facility, so as

to improve the quality of people’s health in urban and rural areas. o To establish and develop sanitation infrastructure and facility at settlement areas, to

prevent environmental contamination. o To improve the capacity of Regional Government and the community effectively,

efficiently and sustainable. o To encourage issuance of regulation which can be applied by the Government and

community in managing environmental sanitation in settlement areas. o To improve self-finance. o To promote people’s participation in development process. o To improve the roles of entrepreneurship, and high learning institutions by creating a

conducive climate for developing environmental sanitation infrastructure and facility in settlement areas.

Policies and Strategies (JAKSTRA) of the Directorate of PPLP in developing environment sanitation at settlement areas, including the management of domestic waste water in 2006 are still being considered for possible issuance of the Resolution of Public Works Minister. At present, there are draft regulations of the Public work Minister which shall be issued. When JAKTRA, regulation, standard, implementation procedure related with sanitation prepared at the national level can be integrated with RENSTRADA related with sanitation and prepared at Regency/City administration level, including local regulations, sanitation is assumed better than present one. Agencies within the Department of Public Works related with sanitation issues in addition to the Directorate of PPLP are the Directorate of Program Development, the Directorate General of CK which prepare budgets and the Secretary General of the Department of Public Works related with legal products/regulations.

2.3.4 Department of Home Affairs

Vision: To establish decentralistic governance, democratic political system, regional development and people’s empowerment within the Unitary State of the Republic of Indonesia. Mission: Missions of the Department of Home Affairs among others are: To issue a national policy and to facilitate governance, in order to: (3) improve effectiveness and efficiency of decentralistic government; (4) improve management of regional finance effectively, efficiently, accountably and auditable; (6) improve people’s economy, socio-culture, and politics; (7) develop harmony between central and regional governments, between regions and areas, and regional independence in managing sustainable and community based development.

When we see vision and mission of departments/agencies related with sanitation, it apparent that all of them have supported the development of sanitation, but in its operation in regions (based on decentralization system) it is in accordance with their vision and mission. Therefore, a more intensive coordination is required so that similar perception can be synergized so as to achieve sanitation targets and it should be coordinated with regional governments to be in line and the development of sanitation can be part of main activity of the regional government. People’s and Private Sector’s Participation o People’s awareness about the importance of sanitation is still poor o People have yet to have an optimum participation. It is due to low tariff/retribution o Development of waste water, particularly community-based ones is still limited



o Private companies are not interested to invest in waste water field Role sharing From these stakeholders above, role sharing between stakeholders or development executors has yet been identified or clearly organized, for example who shall be the regulator or operator, provider, enabler, empower body, and who shall be its beneficiaries. 3 EXISTING SANITATION CONDITION Studies about sanitation have been made in order to study conditions, main issues and efforts to handle them by preparing policies, strategies, short (annual), mid and long term plans, five year development plan (Pelita), RPJM and RPJP with possible different names depending on their periods. Therefore in preparing materials for Enabling Framework Sanitation workshop in this program (ISSDP), study on existing condition of sanitation, and identification of main issues are not performed. But it is based on results of past studies, particularly on what has been presented in the Waspola (2005) study and summarize them, except for finding new main issues based on current development. In special documents, particularly WASPOLA, it has explained why the development of sanitation in Indonesia did not run as it should be Main issues concerning sanitation are clearly documented in community-based and agency-based AMPL Policies and Strategies. Main topic of discussion, particularly for sanitation of WSP is: o Domestic wastewater and water supply management are not integrated. As we

understand, we use + 70% of water for daily requirement will turn into waste water. o Pollution of Bodies of Water as Sources of Raw Water. Total fresh water in the world

during hydrological cycle is relative the same, but total human who need water is increasing rapidly (for example in 1965, total population in Indonesia is 80 million and it becomes 215 million 40 years later (2006). Rapid population growth will surely increase the use of natural resources, particularly the limited fresh water, settlement which develops with all its implications due to limited lands for water catchments area including forest damages, that fresh water in the hydrological cycle which should be longer on lands (including ground water), at present, it flows fast into the sea and it is difficult to be used as fresh water for people’s needs (it will be very expensive to process seawater into fresh water). Limited water resources is further battered by contamination due to waste water which is not properly and correctly managed, that water for drinking water is getting more limited, or water which has been contaminated to be processed into clean water or drinking water will more expensive (additional treatment is required in its process such as more chemicals needed etc.).

o People’s access particularly urban-poor to waste water (sanitation) infrastructure and

facility (PS) is still low (Low Access to Wastewater Facilities). Up to present, urban-poor generally do not think they need sanitation. They are more concerned about what to eat today. They do not realize that sanitation is a tool which may cut the spread of diseases (preventive). They do not realize that such prevention can make them healthy, they do not need to spend money to stay healthy, work productivity remains high and therefore, will improve their income and prosperity.

o Institutions related with sanitation (at regions) are generally weak and their managements

are not professional (Weak Institutional Position and Poor Management Performance). Competent institutions cannot fulfill people’s need for sanitation, they have not been empowered (through hygiene sanitation marketing), that the community is of the opinion that sanitation is not a demand. Renstrada, RPJM, Action Plan have been prepared and approach has been developed starting from Kelurahan to city forums. However, the number of plans related with sanitation is still low. It is due to low priority to develop



sanitation compared to other sectors or sub-sectors and the economic benefits of a better sanitation, through higher human resource productivity, have yet been fully understood.

o Low Budget Allocation. It is understood that many city/regency administrations have low

source of fund due to poor exploration of existing potency. However, some administrations have high fund but low budget allocation for sanitation. If we study harder, we will find low awareness about sanitation that priority for development of sanitation is still low and this will eventually result in low supply of fund.

o Lack of Regulations at the Operational Level and Weak Law. At the national level,

number of regulations is still low that products to develop sanitation, such as policies and strategies have yet to have a clear legal basis. Therefore, delivery process will not run well because some regions would find difficulty to obey them. Regions tend to prepare their own local regulations by referring to existing limited national regulations (concerning sanitation) or prepare local regulations which are not in accordance with targets. In addition, there are multi-interpretations or different understandings between one government to another about the same problem. For example, there is a different understanding about trash between the Resolution of the Public Works Department No.16/2005 and Law no. 23/1997. Both regulations may be right. But it requires an explanation based on its context so as to avoid confusion among those who would read or apply them.

4 ENVIRONMENTAL CONDITION 4.1 Water contamination

In Indonesia, 50 % of its population has yet to manage their waste water (20.71 % in urban and 73.99 % in rural areas). Only 1.36% of the target for policies concerning water conservation can be achieved. Some 76.3 % of 53 rivers in Java, Sumatra, Bali and Sulawesi are severely contaminated by organic pollutants, and 11 major rivers are severely contaminated by Ammonium. Major rivers in urban areas are generally contaminated with high content of BOD (34.48 %), and COD (51.73 %); 33.34 % samples of pipe water and 54.16 % samples of non-pipe drinking water contain Coli bacteria. Supply of raw water in three provinces, namely DKI Jakarta, DIY Jogyakarta and East Java is critical (< 1000 m3/capita/annum). Many IPLT are not working well or utilized optimally. Local Waste Water Processing Unit (IPAL) service is not running optimally. 4.2 Health affairs

Lack of domestic liquid waste service result in many contiguous diseases in Indonesia. Result of SKRT (Survey on Family Health) in 1992 shows that diarrhea is the second most deadly disease for infants in the country. Based on Surkernas 2001 (Profil Kesehatan Indonesia, 2001), starting from 1995 to 2001, diarrhea went down to third spot. Increased infant mortality rate is 49 per 1000 births in 1998 and 50 per 1000 births in 2001. Infant mortality rate and types of diseases which cause the highest mortality are indicators that supply facility and infrastructure of drinking water and sanitation are very poor. Up to present, many contiguous diseases still spread among the community and they are deadly. Many of them are due to poor environment and sanitation. Unfortunately, on some 30% of them who know about this problem and able to resolve it by providing sufficient sanitation facilities. Some 50% don’t know but they can actually afford it, and 20 % don’t know and cannot afford it.



As we understand, contiguous disease is one of the most deadly diseases for infants and under five year old children. According to SKRT 1995, proportion of contiguous diseases which cause infants’ dead are: pneumonia (16.4%), diarrhea (11.4%), tetanus 4.7%), acute respiration infection (3.9%), encephalitis, bronchitis, emphysema and asthma (2.5% each). And proportion of contiguous diseases which cause the death of under five years old children are; pneumonia (22,5%), diarrhea (19,2%), acute respiration infection (7,5%), stomach typhus and malaria (7% each) and measles (5,2%). Some contiguous diseases identified as the causes for death are TB (9.2%), diarrhea (7,2%), pneumonia (6,9%), bronchitis, emphysema and asthma (6,1% each) and stomach typhus (5,2%). These contiguous diseases are due to among others, poor environmental health and people’s poor health In Southeast Asia, sanitation service in Indonesia in 2000 is ranked 6th among 9 (nine) countries. Indonesia is under Thailand, Philippine, Malaysia and Myanmar. Sanitation service in Indonesia is 8.85% lower than average rate of sanitation service in Southeast Asia (Depkimpraswil, 2003). This condition is certainly alarming because Indonesia gained her independence longer than Myanmar, but its sanitation services is still poor. It is important for the local government (Regional government) to manage (as regulator) and to facilitate any effort to over come this emerging problem. There are, however, found many local governments (Regional government) do not take any action due to lack of understanding to the problem, do not know the opportunity as well as how to handle the issue. In fact there is business opportunity at this aspect which may interest to the investor. 4.3 Sanitation Services

Coverage and service of liquid waste management in most cities in Indonesia are very small. Based on the result of a study performed by the Department of Public Works in 2005, up to 2003, waste water service using new septic tank covers 43,87%, while the rest of 20,12% throw (feces) into the river or lake, 23 % to holes while the rest thrown (feces) into beaches, gardens, ponds or rice fields. The worst condition is in Kalimantan, where only 37% of its population use of new septic tanks, 25% throw (their feces) into the river or lake and 31% throw (feces) into holes. In 1999, sanitation coverage reaches 77% in urban and 51% in rural areas. While clean water coverage reaches 92% in urban and 68% in rural areas. However, coverage of sanitation and clean water by provinces are varied. Coverage of clean water in rural areas in Central Kalimantan is 35% while in Bali 89%. There are some regions with above 90% sanitation coverage but some regency have 12 to 20% coverage. These figures have yet to indicate an effective use, and only 50% of existing clean water facility has complied with bacteriologic standards. Based on MDG agreement, Indonesia will reduce total population who do not have proper access to sanitation by half in 2015. In 2006, national program of Sanimas in 105 areas in 34 City/Regency administrations in 23 Provinces is launched. Socialization about this program and its pilot project in Regency/City administrations has been, and therefore, it is expected to run smoothly as it is a replication of the existing one. Regency/City administration which have yet to receive socialization about Sanimas, may find it difficult to implement it. They are expected to have a valuable lesson from their experiences in performing SANIMAS program in 2006. They could use it as an evaluation and recommendation for their next action plans. It is necessary to develop community-based sanitation (Sanimas) in other forms (by copying guidance samples for the community, existing building designs or other proper types). However, they are basically still a community-based sanitation, as a replacement for MCK which only prioritize physical building without considering its sustainability (its environment, social, operation and maintenance). It is necessary to study possible development of Sanimas for settlement within areas with sewerage piping system (off-site) such as in Surakarta, Denpasar, Banjarmasin etc.



Approach used to socialize a program like Sanimas needs to consider local sanitation culture such as using local language including profile/drawings/sketch of local inhabitants and eliminating behaviors which are no longer suitable for present condition. For example, Javanese jingle song of "Ee dayohe teko, ……, ee asune mati, ee buang ning kali", should be removed, because it does not respect river as a water resource for drinking water but as a place to throw trash/waste (dead dog is thrown into the river). Perhaps in the past, this song did not create any problem because of their high self purification. However, it is no longer suitable for present condition, where urban areas are highly populated, and lands and water resources are limited. In sanitation field, the Health Ministry has following targets: to improve percentage of families who live in healthy home (75%); families who use clean water (85%); and families who use standard latrine (80%). However there is a slight change in its approach. In terms of target, for example, its focus was to enable the community to own latrines (which is “government driven”). But now, it is up to the community, they are free to defecate in locations of their choices, as long as they know the consequences of their choices. So long they do not do that in the river or in public areas, etc. (“community driven”). On the other hand, sanitation is also an investment. People have needs to develop. Its “return rate” is actually high. Many are interested in it. Even the World Bank has indicated its interests to invest. Its implementation is so far so good. Previously, some villages had no water/latrine, but now their homes have water (in 1,300 villages), serving for some 10 million people. WSSLIC project produces a good result. For example, in Lumajang it is reported that within three months only, no one in 16 villages within one kecamatan defecates in any place. Similarly, in Muara Enim, WSSLIC 2 has been developed in 2,500 villages. And WSSLIC 3 will be developed in 11 provinces, 70 regencies, 5000 villages. It is planned for 2007-2012. Some 5000 clean water facilities will be built with a better hygiene (washing hands with soap). The Health Ministry’s data and experiences, for the past five years, show that regional governments still require support so that priorities in healthy environment can be performed well. Limited fund and unawareness about healthy environment result in poor commitment in this field. Environmental sanitation has a specific characteristic which does not recognize administrative boundaries. These solutions require integrated and inter province/regency/municipality handling. Otherwise, it may cause worse KLB/epidemic and environmental damages which may harm our health. Regional enthusiasm to open a sanitation clinic shows a better commitment to resolve environmental health problem. 5 INVESTMENT AND FINANCING 5.1 Existing Condition

The sanitation sector in Indonesia – now. Indonesia has one of the lowest rates of off-site sanitation services in the world. At present, less than 2% of the population is connected to piped sewerage networks, which served about 200,000 urban households in 2004. About 60% of population relies on septic tanks and pit latrines for human waste discharge. Over ten million households, or 25% of the total, are currently not served by some form of on-site sanitation (Table 1). A large portion of the rural population, as well as many low-income households in urban areas, discharge human waste directly into rivers, lakes and open space. The resulting contamination of surface and groundwater has led to high incidences of faecal-borne diseases and environmental degradation of water sources, especially in densely populated areas. In 1999, the ADB estimated the economic cost of wastewater pollution in Indonesia at almost US$ 4.7 billion per year.



The ‘do-nothing’ scenario. Since 1998, investment in new sanitation infrastructure has been negligible. Although the proportion of households with access to improved sanitation facilities (piped sewerage, septic tanks and pit latrines) has remained around 65% in recent years, over 90% of human waste remains untreated. Because population densities and environmental pressures continue to rise, the situation is likely to deteriorate without a radical change in government policy.

Table 5-1 Households with access to improved sanitation*

1998 1999 2000 2001 2002 Urban 80.4% 77.0% 77.4% 76.2% 77.5% Rural 55.6% 50.8% 52.3% 50.3% 52.2% Indonesia 64.9% 61.1% 62.7% 61.5% 63.5% Source: BPS * Defined as: off-site sanitation, septic tanks and pit latrines

5.2 Medium and Long-Term Policy Objectives

A vision for 2015. Ten years from now, 75% of the population will have access to improved sanitation services, up from 63% in 2000. Most of the increase has been financed by households themselves, who have been made aware of the economic benefits of reducing open defecation. Specialized local government agencies provide sludge treatment services to minimize wastewater pollution. The full cost of these services is financed from local service charges that are levied on the basis of ‘the-polluter-pays’ principle. Water utilities in large and metropolitan cities provide off-site sanitation services to almost four million households, a twenty-fold increase from the service level in 2004. Due to large improvements in the asset utilization rates, tariffs have not increased substantially in recent years, and off-site sanitation will soon become affordable to low-income groups. Medium and long-term policy objectives. In 2002, the Government of Indonesia (GOI) committed itself to achieving Millennium Development Goal (MDG) #7, known as ‘Ensuring Environmental Sustainability’. As a means to achieve this goal, GOI pledged to halve, by 2015, the proportion of people without sustainable access to basic sanitation. In 2004, the Ministry of Public Works (MPW) issued the National Action Plan on Sanitation, which contains a detailed proposal for operationalizing MDG #7. The National Medium-Term Development Plan (RPJM) for 2004-2009 prescribes an alternative to improving service levels in the sanitation sector. Instead of targeting a direct increase in the number of sanitation facilities, it plans for public information campaigns to encourage households to improve their own facilities. The RJPM also contains quantitative targets concerning an increased in the utilization rates of waste treatment facilities and a reduction in the proportion of wastewater that remains untreated (Table 2). To improve sanitation services in the country, it is likely that a combination of approaches is required.

Table 5-2 Service level targets for the sanitation sector Source Service level target Coverage* Millennium Develop-ment Goal #10

Halve, by 2015, the proportion of people without sustainable access to basic sanitation

75%

National Action Plan on Sanitation

Increase, by 2015, coverage of improved sanitation in urban areas to 80% and coverage in rural areas to 70%

75%

RPJM 2004-2009 No open defecation by 2009 100% Sources: UNDP, MPW (DG Cipta Karya), BAPPENAS * Percentage of total population with access to improved sanitation



Increase the number of households with access to improved sanitation. According to the National Action Plan on Sanitation, the number of persons with access to off-site sanitation, septic tanks or pit latrines needs to increase from 114 million in 2000 to 184 million in 2015, an increase of 60%. To achieve this objective, GOI would need to: i. Promote investment in off-site sanitation facilities (the construction of which is normally

co-financed by the central government). ii. Encourage the construction of on-site sanitation facilities. BAPPENAS is currently

supervising the implementation of a highly successful program to promote ‘open defecation free’ neighborhoods. This program demonstrates that households are willing to finance improved sanitation facilities from own sources if they are aware of the economic benefits of such facilities.

Increase the volume of wastewater treated. In 2000, the Ministry of Health conducted a survey that showed that human waste generated by over 96% of all households in the country is not treated in a specialized facility. The remainder is treated in sewage treatment plants (Instalasi Pengolahan Air Limbah or IPAL) or sludge treatment facilities (Instalasi Pengolahan Lumpur Tinja or IPLT). The actual volume of wastewater treated is even lower than these figures may suggest, as many IPALs and IPLTs are used at very low utilization rates (or are not used at all). Although the optimization of existing treatment facilities is needed, additional capacity is also required to reduce the share of untreated human waste from over 90% to 50%, as targeted in the RPJM. For these reasons, the National Development Plan prescribes that the Government should: iii. Optimize the capacity of existing treatment facilities. The RPJM stipulates that at least

60% of the capacity of an IPAL or IPLT should be in use by 2009. iv. Promote an increase in total treatment capacity. No quantitative targets given. 5.3 The Economics of Sanitation Infrastructure

Capturing economic benefits. The economic benefits of sanitation systems are significant (Table 5-3). However, most of these benefits do not accrue to households that are connected to the system, but to other households in the service area who benefit from, for example, an improvement in groundwater quality or a reduction in faecal-borne diseases that sanitation systems usually generate (Table 5-4). In other words, the public benefits of a sanitation system are much larger than the benefits of an individual user of that system.

Table 5-3 Estimated economic costs of public health

Proper sanitation infrastructure is an effective means to improve public health. In 1999, three surveys were undertaken in Indonesia to estimate the economic costs of public health systems and days lost due to illness. As shown in the table below, the average economic cost is in the order of IDR 128,000 per person per year. This amounts to a total cost of IDR 63 billion per year for a medium-sized town such as Surakarta (pop. 489,000).

Survey undertaken in Economic losses (IDR/capita/year)

Yogyakarta 104,100 Medan 95,900 Several medium-size cities (ADB) 185,100 Average 128,300 Source: National Action Plan on Clean Water, MPW (2003) Note: Economic losses were estimated as the sum of health expenditures (borne by the public and the government), and working days lost as a result of illness.



What does this mean for the financing of sanitation infrastructure? i. Users are unwilling to pay a full cost-recovery tariff for sanitation services, because a

significant portion of tariff revenues would be used to provide services that users do not wish to buy (e.g. sludge treatment at the other side of town).

ii. Sanitation services should be charged on the basis of ‘the-polluter-pays’ principle. This

means that a household is charged on the basis of waste generation –whether or not it is connected to the service – on the grounds that it automatically benefits from the presence of the sanitation system.

A sanitation system delivers several services (such as waste collection and sludge treatment). Users are able to capture the full economic benefits of some of these services. This means that ‘the-polluter-pays’ principle should not be applied indiscriminately.

Table 5-4 Classification of economic benefits of sanitation infrastructure

1. Improved public health. Reduction in health expenditures directly borne by the public (such as lower

expenditures on medicines, medical services and transportation to hospitals). Reduction in health expenditures borne by the government (these consist primarily in

reduced subsidies to health clinics and hospitals and lower expenditures on immunization and other preventive programmes).

Improvements in labor productivity. Improved sanitation has a significant positive impact on public health, thereby reducing the number of working days (and school days) lost.

2. Reduced water treatment costs. Improve sanitation reduces pollution in surface and groundwater sources, thereby lowering the cost of treating water for consumption. 3. Recycling potential. Some waste products can be converted into products with revenue-generating potential (such as compost and bio-gas). 4. Improved quality of life. Improved sanitary facilities normally result in a more pleasant living environment (such as a cleaner river or less odorous drains).

A typology of sanitation services. A sanitation system delivers three types of services: (i) disposal; (ii) collection and transportation; and (iii) treatment and storage. An off-site sanitation system is managed by a single service provider, who collects, transports, treats and stores waste. In an on-site sanitation system, several service providers play a role: (i) households construct their own septic tanks or pit latrines; (ii) vacuum trucks and hand carts periodically collect and transport waste; and (iii) local government agencies provide sludge treatment services. Most users are willing to pay a full-cost recovery tariff for on-site disposal and septic tank emptying, presumably because these benefits are immediately visible. This argument does not apply to waste treatment and off-site sanitation (where treatment accounts for a major share of the total cost of the service). Source: Consultant

Figure 5-1 Services delivered by a sanitation system

Toilet Vacuum truck, hand cart

Treatment facility (IPLT)

Toilet Pipe network Treatment facility (IPAL)

On-site

Off-site

Disposal Collection/transport Treatment/storage



5.4 Investment Requirements and Financing Strategy

Estimated investment requirements. The Ministry of Public Works (MPW) estimates that annual investments in the sanitation sector must increase to IDR 3.1 trillion (appr. US$ 350 million) to reach the objective stated in the National Action Plan on Sanitation of providing 75% of the population with improved sanitation facilities by 2015. The plan assumes that 70% of the investment requirements would be borne by households, presumably to finance septic tanks, pit latrines and transport vehicles (vacuum trucks and hand carts). The remainder would be financed by central, provincial and district governments, to finance off-site sanitation and treatment facilities. This amount, estimated at (30% x 3,100 =) IDR 930 billion, is far higher than current government investments in sanitation, which are believed not to exceed IDR 100 billion per year. Financing responsibilities. The Ministry of Home Affairs has recently completed a draft revision to PP25/2000, which allocates responsibilities to central, provincial and district governments. According to the revised PP, the National Action Plan on Sanitation and RPJM 2004-2009: i. Local governments are responsible for on-site sanitation. It is recommended that local

governments would only finance sludge treatment facilities, as the private sector can (and usually does) provide disposal and collection/transportation services.

ii. The central government is responsible for off-site sanitation in large and metropolitan cities. It is expected that, until 2015, no new off-site sanitation projects will be implemented in other cities.

Table 5-5 Financing responsibilities by sanitation service

Sanitation service Assumed responsibility % Cost recovery On-site sanitation (disposal and collection/transportation)

Private sector 100% of full cost at time of delivery

On-site sanitation (treatment/storage)

Public sector (local governments) 100% of full cost over economic lifetime

Off-site sanitation Public sector (central government) 70% of full cost over economic lifetime (2015)

Sources: Ministry of Home Affairs, MPW (DG Cipta Karya), BAPPENAS Options for closing the financing gap. To mobilize additional sources of funding for the sanitation sector, the following funding sources may be considered: i. central government grants; ii. private sector investments; iii. domestic commercial bank loans; iv. bilateral and multilateral bank loans; and v. user charges. Option 1: central government grants. Most sludge treatment facilities in Indonesia were financed by central government grants (many of these grants were, in turn, financed from multilateral loan proceeds). Because the central government has traditionally assigned a low priority to sanitation infrastructure, public investments in sanitation have remained at very low levels (estimated at appr. US$ 5 million in 2005). Although the Ministry of Public Works intends to increase investments in IPLTs and off-site sanitation, it is unlikely that central government grants can be relied upon to close the financing gap. At present, the channeling of central government grant was though Dana Dekonsentrasi, even though the provision of on-site sanitation is a local government responsibility. The appropriate mechanism for channeling such grants is the DAK (Dana Alokasi Khusus).



Option 2: private sector investment. Private investors are reluctant to invest in piped sewerage or sludge treatment facilities, the main reasons being: (i) no established demand for off-site sanitation and sludge treatment services; (ii) dependence on local government subsidies, as sanitation services at currently not provided at full-cost recovery tariffs; (iii) small size of investment projects; and (iv) limited access to long-term project financing. Option 3: domestic commercial bank loans. Most commercial banks (private or state-owned) are unwilling to lend long-term to local governments without guarantees. However, a kabupaten or Kota is by law not allowed to issue a guarantee or offer revenues or assets as collateral. In addition, few banks have experience in financing sanitation infrastructure and have difficulties in sourcing funds that match the economic lifetime of sanitation systems (15-20 years). Option 4: bilateral and multilateral bank loans. Virtually all off-site sanitation systems in Indonesia, as well as and many sludge treatment facilities, were financed by multilateral bank loans. The World Bank and ADB have repeatedly expressed interest in funding a large portion of the financing gap through long-term loans. Although GOI has established a mechanism to channel multilateral loan proceeds as sub-loans (SLA) to local governments through the Ministry of Finance, it has been reluctant to use this mechanism since the 1997/98 monetary crisis. In view of the limited availability of other funding sources, it is likely that multilateral bank loans will nevertheless play a major part in closing the financing gap in the sanitation sector. Option 5: user charges. Worldwide, few governments impose full cost-recovery tariffs for off-site sanitation or sludge treatment services, partly in recognition of substantial positive externalities (such as health and environmental benefits). In most local governments in Indonesia, revenues from sanitation fees are negligible and sanitation services are almost totally subsidized. In view of political and social implications, it is not realistic to expect local governments to introduce full cost-recovery tariffs any time soon. At best, they may be prepared to impose tariffs that cover O&M costs in the long run. This means that a local government would need to mobilize additional funding sources to cover the investment cost and, at least initially, part of the cost of operations and maintenance. 5.5 Key Elements of an Implementation Strategy

DAK, not Dekon. At present, most sludge treatment facilities in Indonesia continue to be financed by central government grants (usually as Dana Dekonsentrasi), even though the provision of on-site sanitation is a local government responsibility. The appropriate mechanism for channeling such grants is the DAK (Dana Alokasi Khusus). Implementation of ‘the-polluter-pays’ principle. At present, this principle is not applied anywhere in Indonesia. It is recommended that local governments will start charging ‘communal sanitation fees’ to finance: i. 100 percent of the full cost of sludge treatment; and ii. 30 percent of the full cost of off-site sanitation services (the remainder would be

financed from user charges paid by households connected to the service). It is proposed that local governments would to set the communal fees at a fixed percentage of the street lighting tax, and collect the fees together with this tax. This is transparent (simple fee structure), efficient (PT. PLN already collects the street lighting tax, which is a surcharge to the electricity bill), equitable (only households with an electricity connection pay), and likely to be politically acceptable (as the street lighting tax is a local tax). The implementation of the proposal requires the issuance of a local tax regulation (Regional government) and the cooperation of PT. PLN. It does not require a change to national legislation.



Clarification of responsibilities for sanitation at the local government level. In most local governments, in addition, the responsibility for sanitation is shared among the Department of Public Works, the Department of Health, the PDAM, the Local Cleaning Department (Dinas Kebersihan dan Pertamanan) and various other agencies. It is recommended that local governments assigns the responsibility for sanitation services to a single agency and ensures that the agency would have the funds at its disposal to properly implement its responsibilities. 5.6 Conclusions and Recommendations

5.6.1 Financing arrangements.

The Ministry of Public Works (MPW) estimates that public investments in the sanitation sector must increase from less than IDR 100b to over IDR 900b per year to reach the objective stated in the National Action Plan on Sanitation of providing 75% of the population with improved sanitation facilities by 2015. These investments would mainly be allocated to: (i) sludge treatment facilities; and (ii) off-site sanitation systems. The proposed financing arrangements can be summarized as follows: • Sludge treatment. Local governments would cover the full cost of sludge treatment

facilities from communal user charges (set as a fixed percentage of the electricity bill). Investments in IPLT would either be financed from: (i) central government grants channeled to local governments as DAK; (ii) sub-loans financed by multilateral and bilateral development banks.

• Off-site sanitation. In the long run, local governments would cover 30% of the full cost of the service from communal user charges. The remainder would be covered from user charges paid by households connected to the service. The central government would finance the construction of new systems from its budget, augmented with the proceeds of multilateral and bilateral development loans.

In the short and medium term, it is unlikely that private investors or domestic commercial banks will play a role in closing the financing gap. 5.6.2 Institutional arrangements.

These can be summarized as follows: • Central government grants for sludge treatment facilities will be fully channeled to local

governments as DAK (Dana Alokasi Khusus), and no longer as Dana Dekonsentrasi. • Local governments will start charging ‘communal sanitation fees’ to finance 100% of the

full cost of sludge treatment (and 30% of off-site sanitation, if any). The fees would be set as a fixed percentage of the street lighting tax, and collected together with this tax.

• Local governments will assign the responsibility for sanitation services to a single agency and properly fund that agency.

6 SUMMARY 6.1 Sanitation Findings

(i) Institutional organisation at the central level: It is considered necessary to strengthen coordination, so that all stakeholders agree to develop sanitation with the tools already prepared or now being prepared. These include the decentralisation of authority for sanitation, the existence of policies and strategies, RPJM, National Action Plan, NSPM, and increased funding for sanitation (e.g. Binpram CK-MPW will increase funds for the sanitation sub-sector up to 25% of the water supply sub-sector, starting 2007). What is still needed is to intensify coordination of sanitation development at the central level. At the local level, the roles and responsibilities of the institutions responsible for sanitation (wastewater) development need to be clarified and the roles of regulator and operator separated.



(ii) Institutional capacity: The institutions at central level tend to be more established, and understand very well the problems facing sanitation in Indonesia, including the targets and commitments of the MDGs. Their human resources are quite professional, but policy development, in particular at the operational level in local areas, still falls far short of what is expected. These conditions are highly influenced by many factors, such as (i) the diversity of the existing local institutions; (ii) the availability of human resources with the right qualifications and professions; (iii) the frequent rotation of duties or positions without consideration of the competences needed; (iv) human resources, or personnel trained in sanitation are not being posted to the relevant positions. Consideration could be given to establishing a BPPSPAM (regulatory body), or to the formation of special units at the Kabupaten or city levels, such as a Sanitation Management Unit (Unit Pelaksana Teknis Pengelola Sanitasi, UPTPS).

(iii) Capacity building for sanitation operation: Under decentralisation, sanitation is to

be managed within the community/local environment. Service providers and users are close to one another. The critical issue is the how local governments (kabupaten and kota) will implement sanitation development. It is therefore necessary to assess constraints at the operational level, the reasons for stagnation in the sanitation sector, the existing capacity of sanitation-related institutions, agencies and boards, capacity building needs for sanitation empowerment, and how capacities can be improved.

(iv) Advocacy: Advocacy is needed at city level to increase understanding and

awareness of the importance of sanitation and hygiene, to promote change from a supply-driven to a demand-responsive paradigm, and to promote sustainability. If there is a regulation stating that the development of public sanitation infrastructure is a government responsibility, and the communities consider that they need it, it would then be possible for a class action to be brought, if government sanitation services are below expectation.

(v) Regulation: At the central level there already are enough regulations. Regulations

related to sanitation already exist. What is needed is to add some clarification or revisions to ease delivery of national policy and strategy at the local level. However, there is no regulation to function as an umbrella for sanitation, covering matters such as community- and institution-based sanitation, NAP, policy, strategy, and the development of healthy cities. Other sanitation regulations are still in draft. Regulations, policy, strategy, RPJM, RPJP and annual activity plans related to sanitation at local level do not relate to the existing central regulations, due to the lack of the above-mentioned umbrella to constitute the point of reference.

(vi) Financial, one of the main issues is to improve sanitation so as to achieve MDG

targets for 2015. NAP said that to achieve MDG targets, a huge amount of fund is required. This amount is fantastic for current economic condition in the country. Similar to fund requirement at national level, regional governments face problems in increasing fund to develop sanitation. Besides, sanitation is not their priority to develop compared to other infrastructures. A certain breakthrough is required so as to obtain fund to develop sanitation. Obtaining fund from the community?; Domestic loan?; Loan?; Soft Loan?; Grant? ; NGO? Developing sanitation business with a clear business plan? Developing entrepreneurship?.



6.2 Feedbacks from Workshop

6.2.1 Institution:

o Agency should be supported with coordination and policies concerning community-based and Institution-based sanitation within one agency

o Agency shall be responsible for sanitation o Separation between regulator and operator o Technical assistance o Operator may be varied, but tend to be more independent, but IPAL (sewerage) and

IPLT operators should be under one agency o Advocacy/socialization from DPRD is necessary, because they play important role in

budgeting right, and local regulation concerning retribution should also be approved by DPRD

o Advocacy, and marketing concerning sanitation are required so as to improve awareness and to turn supply driven into demand driven

o Training for operators of IPLT, IPAL, SOP and Maintenance M&E, particularly for cities with IPAL, and Facilitators

6.2.2 Regulation:

o Policy concerning community-based sanitation (CBS) and institution-based sanitation (IBS) should be immediately issued by the Government, so that it can be a reference for issuing Local Regulations concerning sanitation (legal basis)

o Law concerning sanitation (special) at national level is required. o Standard substance of local regulations concerning sanitation is required, including

meaning of sanitation o The Government should provide access to sanitation facility for urban-poor despite

their illegal residence, for example by providing MCK Sanimas or MCK with a connection to waste water pipes (sewerage)

o More SNI related with sanitation such as norms, standards, guidance, implementation procedure (NSPM) as a reference for regions (implementation).

6.2.3 Financial

o The meaning of business plan (BP), preparation of BP and its supporting aspects (guidance, manuals etc.);

o Investment fund, operation and maintenance (O&M) for at least the first five years or other stimulants (pilot project).

6.3 Action Plan for the next six months

6.3.1 Institutional Aspect

Task: develop institutional framework at national level • To advocate GOI to approve WASPOLA policies; • Identify and assessment institutional options; • Initiate dialogue with national stakeholders & identify / recruit champions; • Develop institutional options: (Management guideline; Guideline for strengthening of

human resources; Guideline for intersection for planning and management; Preparing rules, responsibility and relation ships in sanitation);

• Sanitation Support Program: (education, certification, research, technical support, guideline).



6.3.2 Advocacy

Task: Develop capacity of key policy makers and stakeholders (advocacy) • Develop communication for change strategy (plan to advocate local leaders and talk

with woman); • Agree on key messages (Making the case of sanitation); • Make media plan; • Develop advocacy course outline & implementation; Engage allies; • Find communicators; • Find champion. 6.3.3 Policy and Regulation

Task: strengthen policy and regulation • Set framework for minimum service levels; • Suggest mechanism for agreeing & monitoring city targets insentives? Supervision /

sanctions; • Propose solutions to legal constrains to local action; • Prepare outline of sanitation regulation. 6.3.4 Financial Aspect

• Prepare guideline of Cost recovery and sustainability: • Substances for tax incentive for sanitation development; • Propose Funding Mechanism Policy; • Propose window for investment-criteria; • Identify actual source of funding; • Estimate capacity utilization rates of existing infrastructure; • Analyze funding requirements; • Analyze funding gap; • Estimate projected source of fund during 2007 and after. 6.3.5 Guideline for Local Government

Task: Develop strategies and action plan guidelines for local government • Set-up working group with PU to discus sourcebook; • Identify content for LG’s manual (sanitation sourcebook); • Prepare model of PERDA Sanitation; • Set framework for minimum service levels.



KAJIAN SEKTOR SANITASI

1. PENDAHULUAN

Kehidupan di Indonesia yang berlangsung selama ini masih menghadapi persoalan sanitasi dalam tingkat yang berbeda-beda. Unsur sanitasi seperti air minum, air limbah, udara segar dan limbah padat semakin berkembang tuntutan pengelolaannya sejalan dengan kehidupan yang semakin maju, sementara keadaan di Indonesia, baik di perdesaan maupun perkotaan masih pada taraf yang dapat dinilai tidak cukup memadai sanitasi lingkungannya, baik dilihat dari ketersediaan dari sumber daya, prasarana, maupun sarananya. Dari sekian unsur yang tersebutkan diatas, maka unsur yang complex, nyata terkesampingkan, dan tidak tersentuh secara managerial apalagi sebagai prioritas oleh banyak perhatian publik maupun Pemerintah adalah unsur air limbah. Bukanlah berarti tidak ada samasekali perhatian atau penanganan, namun pengelolaannya masih dapat teridentifikasi diselenggarakan dalam pencapaian yang tidak memadai. Dengan tujuan perbaikan kondisi kesehatan, kelestarian lingkungan dan kehidupan masyarakat melalui perbaikan sanitasi lingkungan di daerah perkotaan yang ditentukan di Indonesia, kajian sektor sanitasi ini membahas kerangka kemantapan pelayanan terhadap daerah-daerah miskin perkotaan dengan perumusan kebijakan, reformasi kelembagaan yang terlibat, dan strategi perencanaan yang efektif dan terkoordinasi. Lingkungan sehat merupakan dambaan kita semua. Lingkungan yang tidak sehat dan sanitasi yang jelek akan mengakibatkan: kelangkaan air bersih, pencemaran lingkungan dari kotoran manusia, limbah, sampah, dll yang kesemuanya itu dapat menyebabkan penyakit bahkan kematian. Pada umumnya apabila desa atau masyarakat itu miskin, keadaan air minum dan penyehatan lingkungannya juga jelek, sedangkan akses terhadap sanitasi juga rendah. Karenanya perbaikan sanitasi dan penyehatan lingkungan adalah pembangunan yang pro orang miskin. Selain itu upaya tersebut juga sesuai hak asasi, karena pada dasarnya semua orang berhak untuk memperoleh lingkungan yang baik. Methodologi kajian ini didasarkan pada pengumpulan informasi dan bahan bahan yang tersedia, selain melakukan wawancara dengan para pejabat kunci di Lembaga kunci antara lain Kementerian Lingkungan Hidup, Departemen Pekerjaan Umum, dan Departemen Kesehatan dengan fokus pokok bahasan tersebut diatas. Kondisi eksisting sanitasi dari waktu kewaktu seolah-olah stagnant (jalan ditempat) karena

relative pembangunan sanitasi tidak dapat mengejar dan melampaui perkembangan penduduk yang masih tinggi. Setelah melaksanakan 7 Pelita kemudian dilanjutkan dengan PROPENAS/RPJM sampai tahun 2005, penduduk Indonesia menjadi sekitar 2015 juta jiwa, namun pertambahan fasilitas sanitasi di indikasikan seimbang atau lebih rendah dibandingkan dengan perkembangan penduduk, sehingga sanitasi relative tidak ada perbaikan yang significant. 7/16/2006 2

IMPIAN :Demand Driven; Kota sehat & bersih; (masyarakat sehat & Kualitas Air Baku AM. baik)

Policy & Startegi, RPJM, RENSTRADA,AP; RPJP

????

PempropPemkab/Pemkot

Deliveri ? Desentralisasi!Rule? Regulasi?

RPJMN UPAYA MEMPERBAIKISANITASI (LAMPU MERAH)

Kondisisanitasi saatini

Akseske

Sanitasiterbatas, W

ater born diseases tinggi

KondisiA

ir Baku A

.M.

hususnyaair perm

ukaantercem

arbertaair lim

bah

Kebijakan AMPL Nasional Perencanaan

Startegis, Program, AP, NSPM

NPB +AP


MOH + AP

MOI + AP

MOHA + AP

MOF + AP

MPW + AP

MOE + AP

Kebijakan & Strategi belumterkoordinir denganbaik

Tidak/ belumberhasil

NDPA + AP


MOH + AP

MOI + AP

MOE + AP

MOHA + AP

MOF + AP

MPW + AP



6/17/2006 3

Strategic Framework

Where are we now

(present condition)

Where do we want to be

(Vision, Mission)

How do we get there

(Strategy and Action)

How to stay there

(Sustainability)

Demand drivenSupply driven

Dem

and responsive

1.1 Kebijakan dan Strategi Sanitasi

Dari tahun 1999 sampai dengan tahun 2003, masing-masing lembaga terkait dengan sanitasi menyusun RPJM termasuk sanitasi berdasarkan kondisi eksisting sesuai kepentingannya (tupoksi) namun belum/tidak terkoordiner. Sekalipun tujuannya sama yaitu untuk memperbaiki kondisi sanitasi, tetapi tidak saling bersinergi, sehingga relative tidak menghasilkan kemajuan yang signifikan. Sejak 2004, dengan mengacu RENSTRANAS/RPJMN dan Kebijakan AMPL Nasional (berbasis lembaga dan berbasis masyarakat), masing-masing sector menyusun RPJM termasuk sanitasi berdasarkan kondisi eksisting yang dibakukan dalam Kebijakan AMPL Nasional. Masing-masing sector (lembaga) sesuai dengan TUPOKSI-nya, menyusun rencana strategis dengan tujuan yang sama yakni untuk memperbaiki kondisi sanitasi, saling bersinergi, hanya implementasi belum teruji (namun mempunyai harapan tinggi), kecuali untuk penanganan sanitasi berbasis masyarakat (SANIMAS) pada beberapa kota cukup menjanjikan. 1.2 Kerangka pendekatan srategis

Seperti telah dikemukakan dalam butir pendahuluan, bahwa ISSDP pendekatannya tidak mulai dari awal, karena kegiatan ini merupakan penerus dari kegiatan-kegiatan yang telah dilakukan sebelumnya yang relative rentang waktunya tidak jauh seperti yang studi-studi yang telah dilakukan oleh WSP.

Berangkat dari dokumen studi terbaru tersebut, disini akan dirangkum apa yang telah diperoleh dan relevan untuk masalah sanitasi. ISSDP dalam mengkaji masalah sanitasi berangkat pada kondisi saat ini dengan mengambil dari studi WSP yang masih relevan dan cukup jelas, dimana pelayanan sanitasi masih pada tingkatan supply driven. Apa yang diharapkan dengan mengacu pada visi dan misi maka pengembangan sanitasi menjadi demand driven, bagaimana untuk mencapainya serta bagaimana

mempertahankannya agar terselenggara demand responsive dan apa yang telah diperoleh tersebut dapat dipertahankan terus secara kontinyu sehingga berkesinambungan (sustainability). Dari segi pendekatan ada pergeseran dari “supply driven” kepada “demand driven”. Misalnya dalam hal target, dulu fokusnya adalah agar masyarakat mempunyai jamban (yang merupakan “supply driven”). Sekarang tidak lagi menekankan harus ada jamban, melainkan terserah pada masyarakat, mereka bebas mau BAB di mana, sesuai pilihan mereka, asalkan mereka tahu konsekwensi dari pilihan-pilihan itu. Yang penting tidak BAB di sungai, di tempat umum, dll. (Ini merupakan “demand driven”). Cukup atraktif untuk dikemukakan tetapi cukup sulit untuk dilaksanakan. Perlu ada perubahan pola pikir, membutuhkan kesadaran tinggi dan waktu yang cukup panjang. 1.3 Aspek Hukum dan Regulasi

Keberhasilan jasa sanitasi sangat dipengaruhi oleh kebijakan pemerintah, baik di tingkat pusat maupun daerah. Aspek hukum dan peraturan diidentifikasi sebagai salah satu dari sejumlah aspek yang perlu didorong untuk menciptakan lingkungan yang mendukung. Untuk mencapai penatalaksanaan air limbah domestik perkotaan yang lebih baik diperlukan perhatian terhadap tiap-tiap bagian proses penatalaksanaannya: (1) perencanaan dan



pengembangan program, (2) perancangan, (3) pembangunan, (4) operasional dan pemeliharaan, dan (5) pemantauan. Kerangka perundangan dan peraturan yang jelas harus dirancang untuk mendorong bagaimana proses penatalaksanaan in dapat diatur dengan baik. Sebuah penelitian menyeluruh diperlukan untuk mengevaluasi kondisi yang ada sebagai berikut: bagaimana peraturan mengatur penatalaksanaan air limbah domestik secara keseluruhan, identifikasi aspek-aspek peraturan diperlukan untuk mencipatkan peran lebih banyak dari pemerintah dan pusat serta rekomendasi. Sejauh ini, tidak ada perundangan khusus yang mengatur penatalaksanaan limbah domestik kota karena sebagian besar peraturan ditetapkan untuk perlindungan lingkungan dan kesehatan lingkungan, bukan penatalaksanaan air limbah. Dengan cara lain, untuk mencapai perlindungan lingkungan dan kesehatan lingkungan, penatalaksanaan air limbah domestik menjadi bagian yang penting. Dalam periode desentralisasi, perlindungan lingkungan menjadi tanggung jawab pemerintah daerah di tingkat propinsi dan kota/kabupaten (UU 32 tahun 2004, ayat 13 dan 14). UU 32 tahun 2004 mengatur tanggung jawab pemerintah daerah untuk perlindungan lingkungan dalam: merancang dan memantau pembangunan, perencanaan regional, pemberian fasilitar dan penatalaksanaan lingkungan. Fungsi pemerintah daerah dipantau dan dibantu oleh pemerintah pusat seperti tertulis pada UU 32 tahun 2004 ayat 217. Pemerintah pusat harus memberikan norma, panduan dan standard (NSPM), pelatihan dan kursus. Secara nasional, fungsi pemerintah daerah dalam membantu dan memantau dikoordinasi oleh kementerian dalam negeri (ayat 222, UU 32 tahun 2004). Di tingkat kabupaten dan kota, fungsi ini dikoordinasi oleh gubernur dan di tingkat distrik dikoordinasi oleh walikota. UU 7 tahun 2004 yang memaparkan mengenai penatalaksanaan kualitas air dan perlindungan polusi air sehubungan dengan bertahannya dan dipulihkannya sumber air. Ayat 24 (UU 7 tahun 2004) mengatur bahwa orang dan organisasi bisnis dilarang untuk melakukan aktifitas apapun yang dapat merusak sumber air. Saat ini, kondisi fasilitas air limbah domestik di kota masih kurang. Perhatian pemerintah daerah yang bertanggung jawab untuk bisnis sangat rendah dan konsekuensinya pengembangan fasilitas air limbah domestik menjadi sangat lambat. Masalah-masalah yang telah diidentifikasi sebagai penyebab adalah *): *) berdasarkan pada diskusi lokakarya, Gren Alia Hotel, Juni, 27-28, 2006

o Tidak adanya institusi o Tidak ada peraturan spesifik/eksplisit dari pemerintah pusat untuk penatalaksanaan air

limbah domestik sebagai acuan untuk pemerintah daerah o Peran yang tidak jelas dalam mendampingi pemerintah daerah dalam mengembangkan

penatalaksanaan air limbah domestik o Sumber daya pemerintah daerah yang tidak memadai o Kurangnya kesadaran akan sanitasi air limbah domestik di kalangan pemerintah daerah

dan masyarakat o Tidak adanya rencana penatalaksanaan air limbah domestik dan strategi di pemerintah

daerah o Peraturan pemerintah daerah yang tidak memadai untuk mendorong penatalaksanaan air

limbah domestik o Kurangnya dana Pemerintah Indonesia telah berkomitment terhadap target MDG pada tahun 2015 dan komitmen ini diungkapkan dalam Rencana Pembangunan Jangka Menengah (RPJM) yang tertulis dalam PP 7 2005. Target RPJM untuk air limbah domestik adalah bebas BAB di tempat terbuka di semua kota pada tahun 2009, peningkatan pemakaian IPLT dan IPAL



hingga 60%, mengurangi polusi air sungai dari faeses sampai dengan 50% berdasarkan kondisi tahun 2004 dan pengembangan sistem pembuangan air/selokan terpusat di kota metropolitan. Untuk mencapai target-target tersebut, Bappenas, Kementerian Pekerjaan Umum dan Kementerian Kesehatan telah mengembangkan strategi dan rencana mereka. Bappenas membuat Kebijakan Nasional untuk Penyediaan Air Minum dan Sanitasi Lingkungan Berbasis Masyarakat dan Penyediaan Air Minum dan Sanitasi Lingkungan Berbasis Institusi. Di sisi lain, Kementerian Pekerjaan Umum menetapkan Rencana Aksi Nasional Air Limbah dan Kementerian Kesehatan menetapkan Rencana Nasional dalam Kesehatan Lingkungan 2005-2009. Sejauh ini, belum ada peraturan khusus yang mengatur pengelolaan air limbah domestik perkotaan. Peraturan Pemerintah No.16 tahun 2005 mengatur pengembangan sistem penyediaan Air Minum, khususnya melindungi air baku, potensi sampah padat dan limbah cair yang mencemari air baku. Di tingkat nasional ada seperangkat Undang-undang, Peraturan Pemerintah atau kebijakan nasional, a.l. : UU No. 23 Tahun 1992 tentang Kesehatan, yang a.l dalam pasal 22 menyebutkan bahwa: “Kesehatan lingkungan diselenggarakan untuk mewujudkan kualitas lingkungan yang sehat yang dilaksanakan terhadap tempat umum, lingkungan permukiman, lingkungan kerja, angkutan umum dan lingkungan lainnya yang meliputi penyehatan air dan udara, pengamanan limbah padat, limbah cair, limbah gas, radiasi dan kebisingan, pengendalian vektor penyakit dan penyehatan atau pengamanan lainnya”. Hak masyarakat terhadap kesejahteraan dan kesehatan lingkungan diatur dalam Undang-Undang 23 tahun 1997 ayat 5, bab V yang mengatur pelestarian fungsi lingkungan dan bab VI untuk persyaratan pengaturan lingkungan. Dalam hal pengaturan keuangan, pemerintah daerah memiliki kewenangan untuk menangani keuangannya sendiri seperti yang tercantum dalam UU 25 tahun 1999 Neraca Keuangan antara Pemerintah Pusat dan Daerah termasuk penentuan prioritas pengembangan kesehatan daerah tersebut sesuai dengan kemampuan, kondisi dan kebutuhan lokal. PP No. 82 Tahun 2001 tentang pengelolaan kualitas air dan pengendalian pencemaran air, yang a.l. menyebutkan ada sanksi terhadap pencemaran air dan kewenangan pemberian izin pemanfaatan air limbah ada pada Bupati/Walikota. Pada tataran departemen, terdapat sejumlah keputusan menteri yang telah diterbitkan, termasuk: Keputusan Meteri Kesehatan No. 907/2002 mengenai kualifikasi dan pengendalian kualitas/mutu air minum, yang memerlukan Perda untuk menindaklanjutinya. Kep.Menkes No. 1457/2003 tentang Standar Pelayanan Minimal Bidang Kesehatan di Kabupaten/Kota, yang a.l. mengatur tentang: Pencegahan dan pembrantasan penyakit diare, demam berdarah dengue, pelayanan kesehatan lingkungan dan pelayanan hygiene sanitasi di tempat umum, serta menempatkan bupati/walikota sebagai pihak yang bertanggung jawab dalam pelayanan kesehatan sesuai SPM ini. Kep.Menkes No. 1274/2005 tentang Rencana Strategis Depkes, yang menyebutkan adanya program lingkungan sehat, yang meliputi: penyediaan sarana air bersih dan sanitasi dasar, pemeliharaan dan pengawasan kualitas lingkungan, pengendalian dampak risiko pencemaran lingkungan dan pengembangan wilayah sehat. Selanjutnya juga telah dikembangkan Petunjuk Pelaksanaan/Teknis atau Manuals (beberapa di antaranya dikembangkan bersama departemen lain dan bantuan lembaga internasional), a.l.: CLTS: Community Lead Total Sanitation, dilengkapi dengan modul dan timnya. Gerakan MPA (Methodologi Participation Assessment), dan PHAST (Participatory Hygiene Transformation). Panduan Sanimas (Sanitasi Masyarakat). Juknis pengukuran kualitas udara dan limbah cair (Oleh Dirjen P2MPLP tahun 1994).



Pedoman Pemeliharaan Instalasi Pengelolaan limbah cair RS (Dirjen Yanmedik, 1993). UU Tata Ruang pada dewasa ini sedang dalam proses perubahan termasuk persiapan PP terkaitnya. RUU ataupun RPP tidak menyebutkan secara explisit aspek sanitasi; Pengaturan akan hal itu dicakup dalam pengaturan ruang untuk sirkulasi (orang, jasa, barang termasuk limbah). Diusulkan agar aspek perlimbahan dapat masuk sebagai bahan yang diterakan dan kesempatan untuk perubahan khususnya bagi RPP masih tersedia. Pada saat ini setiap sektor yang bertanggung jawab pada manajemen air limbah domestic kelihatannya sudah ada peraturan dan penundang-undangan yang mengaturnya namun tidak berjalan (operasional) dengan baik.

Table 1-1 Undang-undang & Peraturan Terkait dengan Penyediaan Air Minum & Sanitasi

No UU/Peraturan Pengaturan 1 UUD 45:

Pasal 33 Alinea 3 ‘Bumi dan air dan kekayaan alam yang terkandung didalamnya dikuasai oleh negara dan dipergunakan untuk sebesar-besarnya kemakmuran rakyat’

2 UU No.23 Tahun 1992: Bab IV, Pasal 9 Pasal 10 Bab V, Bag. Kelima, Pasal 22 Pasal 38

Kesehatan Pemerintah bertugas dalam menggerakkan peran serta masyarakat dalam menyelenggarakan dan pembiayaan kesehatan Upaya mewujudkan kesehatan yang optimal bagi masyarakat sebagai suatu pendekatan pencegahan penyakit (preventif) Kesehatan lingkungan meliputi penyehatan air dan udara, pengamanan limbah padat, limbah cair, limbah gas, radiasi dan kebisingan, pengendalian vektor penyakit, dan penyehatan atau pengamanan lainnya. Kesehatan lingkungan, pemberantasan penyakit dan penyuluhan kesehatan merupakan bagian dari upaya kesehatan. Penyuluhan kesehatan masyarakat diselenggarakan guna meningkatkan pengetahuan, kesadaran, kemauan, dan kemampuan untuk hidup sehat

3 UU No. 23 Tahun 1997 Bab III, Pasal 5 Ayat 1 Bab V, pasal 14-17 Bab VI

Pengelolaan Lingkungan Hidup Setiap orang mempunyai hak yang sama atas lingkungan hidup yang baik dan sehat Pelestarian fungsi lingkungan hidup Persyaratan Penataan Lingkungan Hidup

4 GBHN 1999-2004 Pembangunan kesehatan diarahkan untuk meningkatkan mutu sumber daya manusia dan lingkungan yang saling mendukung dengan paradigma sehat, yang memberikan prioritas pada upaya peningkatan kesehatan, pencegahan, penyembuhan, pemulihan dan rehabilitasi sejak dalam kandungan sampai usia lanjut.

5 UU No. 25 Tahun 2000 Program Pembangunan Nasional (2000-2004), tentang lingkungan sehat, perilaku sehat, pemberdayaan masyarakat. Program pengembangan prasarana dan sarana permukiman di daerah.

6 UU No.7 Tahun 2004 Bab III Pasal 23-25

Pengaturan Sumber Daya Air: Peran serta masyarakat dalam pengelolaan; Pemenuhan kebutuhan air minum masyarakat Konservasi Sumber Daya Air Pengendalian pencemaran air

7 UU No. 32 Tahun 2004 Otonomi Daerah 8 PP No.25 Tahun 2000 Kewenangan Pemerintah dan Kewenangan Propinsi sebagai daerah



otonom



No UU/Peraturan Pengaturan 9 PP No.7 Tahun 2005 Pembangunan Perdesaan

Percepatan Pembangunan Infra Struktur 10 PP No. 16 Tahun 2005 Pengembangan SPAM terpadu dengan pengembangan sarana dan

prasarana sanitasi Sarana dan prasarana air limbah Sarana dan prasarana sampah terkait dengan perlindungan sumber air baku

11 Kep Men Kesehatan No. 907 Tahun 2002

Persyaratan Kesehatan Air Minum Jenis air minum

12 Kep Men Permukiman dan Prasarana Wilayah No. 409 Tahun 2002

Penyelenggaraan KPS (Kerjasama Pemerintah-Swasta) dalam Penyelenggaraan dan atau pengelolaan air minum dan atau sanitasi

13 Kep Men LH No. 111 Tahun 2003

Syarat dan tatacara perijinan pembuangan sarana air limbah

14 Kep Men LH No. 112 Tahun 2003

Baku mutu air limbah domestik perumahan

2 ASPEK KELEMBAGAAN

2.1 Stakeholders

Sektor sanitasi tidak bisa ditangani oleh satu sektor saja, tetapi harus multi sektor, karena itu semua perlu bersinergi untuk menangani. Ditingkat pusat yang berperan disamping Bappenas, Dep.Keuangan dan Depdagri, juga DepKes, Men.LH, Dep. Perindustrian, Dep.PU. Di pemda ada lembaga, dinas ditingkat propinsi, pemkab dan pemkot. Disamping itu juga LSM/NGO, swasta dan perorangan. Bila mereka bersinergi satu terhadap lainnya dengan tujuan ahir yang sama kemajuan penanganan sanitasi akan lebih signifikan. Belum terindentifikasi role sharing (pembagian peran) dan belum terorganisasikan secara jelas peran masing-masing lembaga (regulator, operator, provider, enabler, empowering body) dan siapa berkedudukan sebagai beneficiaries. Hal ini terkait dengan pemahaman pelayanan masyarakat (public service). Melayani masyarakat menempatkan kedudukan masyarakat sebagai beneficiaries, akan tetapi apabila beneficiaries adalah pelaksana proyek sebagaimana sejumlah hasil pembangunan terdahulu yang tidak melibatkan masyarakat sejak awal perencanaannya, maka pengalaman ke’mubaziran’ kerja/proyek dapat berlangsung kembali. Oleh karena itu, pembagian atau kejelasan peran sangat penting agar tidak terjadi tumpang tindih dan perbenturan yang akan menurunkan kinerja masing-masing. Siapa yang akan berperan sebagai regulator, siapa yang menjadi operator, siapa berperan sebagai pemberi dan penerima manfaat haruslah jelas adanya. Meneg.LH sangat berperan dalam menyiapkan peraturan mengenai masalah lingkungan sebagai payung semua pembangunan dari kemungkinan terjadinya pencemaran lingkungan. Khususnya untuk sanitasi, tentunya dalam hal pengaturan persyaratan semua air limbah yang boleh dibuang ke perairan, karena kemungkinan dampaknya terhadap sumber air baku air minum yang jumlahnya terbatas. Depkes sangat berperan sebagai regulator berkaitan dengan kualitas air yang dapat dikonsumsi, kemungkinan penyebaran penyakit melalui media air. Dep.Perindustrian terkait dengan industri rumah (home industry) yang limbah cairnya dapat mencemari badan air, seperti industri batik, pembuatan tahu dll. Demikian pula dengan Departemen lainnya yang terkait dengan masalah sanitasi perannya cukup jelas. Namun ditingkat operasional di pemerintah daerah, peran lembaga dan dinas-dinas pada sub-sektor sanitasi sangat variatif dan terkesan tidak terkoordinasi dengan baik.



Lembaga-lembaga yang terkait dengan pengelolaan fasilitas sanitasi dapat dilihat pada tabel berikut ini.

Table 2-1 Lembaga yang mengelola IPLT, IPAL dan fasilitas sanitasi lainnya

OPERATOR. IPAL IPLT JAMBAN BANYAK

MCK SANIMAS/ KOMUNAL

SepticTank, LATRIN

HOME INDUSTRY

PD.PAL + PDAM + + Dinas Kebersihan + DKP + RT/RW + + + Dinas LH + + + Kelompok masyasarakat

+ + +

LKMD + + BEST (NGO) + Individu + REGULATOR IPAL IPLT JAMBAN

BANYAK MCK SANIMAS/

KOMUNAL SepticTank, LATRIN

HOME INDUSTRY

DEPKES + + + + + + + LH + + + + + + + Din.Perindustrian +

Desentralisasi seharusnya mempercepat pembangunan termasuk sanitasi, tapi sampai saat ini tidak demikian. Desentralisasi telah menyerahkan sebagian besar tugas-tugas pemerintah pusat kepada daerah, sehingga mendekatkan penyedia pelayanan sanitasi dengan masyarakat yang membutuhkan akses sanitasi, jadi seharusnya pengembangan sanitasi menjadi lebih baik daripada sebelum desentralisasi. Implementasi desentralisasi efektif mulai tahun 2001/2002, sekarang sudah berjalan 4 - 5 tahun, tetapi kelihatan seolah-olah pengembangan sanitasi masih berjalan ditempat. Memang kendala cukup banyak, disamping masalah ekonomi (krismon) belum pulih benar, masyarakat juga merasa belum membutuhkan sanitasi sebagai prioritas, sehingga kemudian pemda kemungkinan menganggap sanitasi juga belum menjadi prioritas untuk dikembangkan. Hal ini terlihat dari rendahnya anggaran sanitasi yang disediakan dalam APBD. Pemda yang telah menerapkan perencanaan dari bawah dimulai dari pembahasan kebutuhan pembangunan pada forum level kelurahan berjenjang sampai forum tingkat kota yang dihadiri oleh LSM maupun lembaga/dinas, namun kegiatan-kegiatan yang tercantum dalam RPJM maupun rencana kegiatan pada masing-masing lembaga/dinas kelihatan belum jadi prioritas. Direkomendasikan agar ada penguatan kapasitas melalui fasilitator di tingkat forum kelurahan untuk mengkaji kebutuhan dasar masyarakat yang sebenarnya harus ada dalam menunjang kesehatan melalui peningkatan akses ke fasilitas sanitasi (preventif), sehingga ada kebutuhan nyata sanitasi dari masyarakat kemudian untuk ditangkap lembaga/dinas terkait dan menjadi dasar penyusunan program daerah dan penyiapan action plan tahunannya. Belum jelasnya mekanisme kaitan pusat dan daerah dalam penanganan sanitasi, menjadikan kebijakan dan strategi di level nasional belum menjadi acuan daerah, karena belum didukung regulasi yang mengaturnya. Setiap lembaga dan departemen yang terkait dengan masalah sanitasi telah menyusun kebijakan, strategi, RPJM, Action Plan, dan NSPM, namun apakah hal itu sudah operasional di daerah, masih menjadi pertanyaan. Diperlukan peraturan/regulasi yang jelas dan peraturan-peraturan yang dibuat dipusat juga perlu mempunyai pemahaman arti yang sama (tidak bertentangan) sehingga tidak



membingungkan bila akan diterapkan di tingkat operasional. Ditingkat pemda, peraturan tersebut perlu dijabarkan dalam bentuk perda agar lebih bersifat operasional. Pada tataran ini perlu kejelasan hubungan antara peraturan yang dibuat secara nasional dan perda. Dengan adanya perda sanitasi yang mengacu pada peraturan nasional diharapkan deliveri kebijakan dan strategi sanitasi nasional juga sejalan dengan kebijakan dan strategi sanitasi yang disusun di daerah yang merupakan bagian dari RENSTRADA/ RPJM yang secara ekplisit pengembangan sanitasi disebutkan dengan jelas. Misalnya dalam upaya mencapai target sanitasi yang terkait dengan komitmen MDGs, pemda umumnya sudah mengetahui, namun target pencapaian tiap kota/kabupaten berbeda-beda secara proporsional disesuaikan dengan jumlah penduduk dan sumber daya (kemampuan) yang dimilikinya.

Sektor sanitasi belum menjadi prioritas, umumnya stakeholders, khususnya masyarakat belum menganggap sanitasi merupakan kebutuhan utama (urban-poor lebih memikirkan makan apa hari ini). Pengembangan sanitasi umumnya masih berlangsung top down, kecuali beberapa kasus seperti SANIMAS, CLTS, WSSLIC, PAMSIMAS yang mempunyai success-story tersendiri. Diperlukan perubahan kesadaran melalui suatu program advokasi, sehingga semua stakeholders mempunyai pemahaman yang sama. Bagaimana sanitasi akan meningkat prioritasnya bila masih menganggap sanitasi belum diperlukan untuk dikembangkan. Di Indonesia belum dilakukan penelitian yang jelas (perlu contoh Making the Case) bahwa dengan kemudahan akses ke fasilitas sanitasi akan meningkatkan kesehatan masyarakat, kesehatan yang baik akan meningkatkan produktifitas kerja, dan meningkatkan ekonomi yang bersangkutan, ekonomi keluarga dan masyarakat umumnya. Selama ini hanya dikatakan bahwa investasi fasilitas sanitasi tidak bisa cost recovery, apalagi bila dikaitkan dengan off-site sanitation (sewerage), tetapi belum dihitung berapa nilai ekonominya karena peningkatan fasilitas sanitasi yang baik sehingga tidak perlu cuti sakit, biaya berobat, kehilangan waktu dan peningkatan kinerja. Mungkin perlu dipikirkan bagi pengelola yang mengembangkan sanitasi untuk menerapkan pola pikir secara entrepreneurship. Lembaga Pemerintah terkait Sanitasi: Tingkat Pusat: Bapenas, Departemen PU, Departemen Kesehatan, Dep.Dalam Negeri, Departemen Keuangan, Kementerian Negara Lingkungan Hidup, dan Departemen Perindustrian (khususnya industri rumah tangga) Tingkat Daerah : Dinas/Badan di Daerah yang terkait sanitasi sesuai TUPOKSI-nya, dengan tingkat, variasi nama, yang beraneka ragam antar satu daerah dengan daerah lainnya. 2.2 Lembaga non Permerintah

LSM, Asosiasi Profesi, Perguruan Tinggi, Perhimpunan/Perkumpulan sosial; Pengembang (Developer), Komunitas sosial setempat (RT,RW) dll. Berikut ini adalah tabel lembaga-lembaga baik pemerintah maupun non pemerintah yang terkait dengan sanitasi.

Table 2-2 Lembaga Pemerintah dan non Pemerintah terkait Infrastruktur Penyediaan Air Minum dan Sanitasi

No Lembaga Tugas/Fungsi 1 Bappenas Bertanggung jawab pada perencanaan infrastruktur. Koordinasi

proses reformasi kebijakan pada tingkat nasional mengenai sumber daya air serta penyediaan air minum dan penyehatan lingkungan berbasis masyarakat

2 Departemen Pekerjaan Umum: - Direktorat Cipta Karya

Kerangka kerja teknis pembangunan prasaran dan sarana perdesaan meliputi: promosi, pengaturan, pembinaan, pelatihan dan bantuan teknis. Berperan dalam menyediakan perumahan dan permukiman yang sehat termasuk prasarana



dasar yang terjangkau.



No Lembaga Tugas/Fungsi 3 Departemen Kesehatan:

Direktorat Jenderal Kesehatan Lingkungan dan Pengendalian Penyakit Menular Direktorat Penyehatan Lingkungan Permukiman Direktorat Penyehatan Air

Penyedia dan pembina informasi kesehatan, pemeliharaan kualitas air dan pendidikan kesehatan Kondisi yang mempengaruhi kesehatan masyarakat di daerah permukiman serta tempat-tempat penularan penyakit (Malaria, Demam Berdarah) Monitoring kualitas air termasuk lokasi pembuangan air limbah

4 Departemen Dalam Negeri: Direktorat Jenderal Pembangunan Daerah Direktorat Jenderal Pembangunan Masyarakat Desa Direktorat Jenderal Umum dan Otonomi Daerah

Pengelola dana pembangunan dan memperbaiki perencanaan administrasi, lingkungan termasuk pelayanan air minum dan sanitasi Pembina kelurahan melalui Lembaga Ketahanan Masyarakat Desa (LKMD) untuk memprakarsai perencanaan dari bawah dan upaya-upaya swadaya masyarakat Pengawas perusahaan daerah (PDAM, PDAL, PD Kebersihan), memiliki program pengembangan SDM

5 Departemen Keuangan: Ditjen Pembinaan Anggaran Pembangunan Ditjen Pembangunan Anggaran lain Ditjen Dana Luar Negeri

Mengalokasikan dana proyek pembangunan sektoral yang mencakup pembangunan kota, kabupaten dan propinsi serta pembangunan nasional, anggaran tahunan disalurkan melalui Departemen terkait dan Pemda Mengelola dana lain selain dana pembangunan Mengelola dana bilateral maupun multilateral

6 Kementerian Lingkungan Hidup Mengembangkan kebijakan dan pengaturan tentang pengendalian pencemaran dan isu-isu lingkungan Merencanakan dan melaksanakan program-program lingkungan hidup serta mendukung partisipasi masyarakat di bidang pengelolaan lingkungan

7 Badan Perencanaan Pemerintah Daerah Propinsi: Bidang Fisik dan Prasarana dan atau Sosial Budaya

Perencanaan, koordinasi, monitoring program dan kegiatan-kegiatan pembangunan

8 Setwilda Propinsi: Biro Keuangan dan Pembangunan

Merumuskan kebijakan pembangunan propinsi, monitoring dan menyiapkan komitmen dana pembangunan propinsi

9 Bapedalda Propinsi Melaksanakan dan menegakkan kebijakan dan peraturan di bidang pengelolaan lingkungan hidup di daerah

10 Dinas Pekerjaan Umum Propinsi Mengkoordinasikan pelaksanaan program dan proyek-proyek pembangunan skala propinsi

11 Badan Pemberdayaan Masyarakat Desa (propinsi)

Pengembangan Masyarakat Desa

12 Dinas Kesehatan Propinsi 13 Badan Perencanaan Pemerintah

Daerah Kabupaten/Kota: Bidang Fisik dan Prasarana dan atau Sosial Budaya

Perencanaan, koordinasi, monitoring program dan kegiatan-kegiatan pembangunan di tingkat Kabupaten dan atau Kota



No Lembaga Tugas/Fungsi 14 Setwilda Kabupaten/Kota:

Biro Keuangan dan Pembangunan Merumuskan kebijakan pembangunan daerah, monitoring dan penyiapan komitmen dana pembangunan daerah

15 Bapedalda Kabupaten/Kota Melaksanakan dan menegakkan kebijakan dan peraturan di bidang pengelolaan lingkungan hidup di daerah

16 Dinas Pekerjaan Umum Kabupaten/Kota Dinas Kimtawil (Kab. Bandung) Dinas Pekerjaan Umum (Kab. Tasik)

Bertanggung jawab terhadap pelaksanaan APBN. INPRES (Air Bersih Perdesaan dan Penyehatan Lingkungan Permukiman) dan dana pembangunan lainnya yang bersumber dari APBD. Bertanggung jawab dalam perencanaan dan pembangunan drainase desa Bertanggung jawab dalam perencanaan dan pembangunan drainase desa

17 Dinas Kebersihan dan Pertamanan Pengoperasian dan pemeliharaan sistem pembuangan sampah dan drainase, kebanyakan masih ada pada tingkat perkotaan

18 Dinas Tata Kota dan Daerah Perencanaan dan penataan ruang serta monitoring pelaksanaan pengisian ruang kota maupun ruang kabupaten. Berwenang memberi Ijin Mendirikan Bangunan (IMB) yang di dalamnya terdapat persayaratan pembuatan bangunan pengolahan air limbah (cubluk atau tangki septik)

19 Dinas Kesehatan Kota atau Daerah

Koordinasi dan pelaksanaan pelayanan kesehatan kabupaten dan atau kota, melalui Pusat-pusat Kesehatan Masyarakat

20 Badan Usaha Milik Daerah (BUMD): PDAM pada beberapa kota PDAL (Perusahaan Daerah Air Limbah)

Penyediaan air minum dan pengelolaan air limbah domestik Baru tersedia di Jakarta

21 Kantor Pembangunan Masyarakat Desa

Pembangunan masyarakat

22 Kantor Kelurahan atau Desa Unit organisasi pemerintahan dibawah kecamatan yang juga mempunyai hubungan fungsional di bidang pembangunan masyarakat. Kepala desa mempunyai otonomi di bidang administrasi desa.

23 LKMD Organisasi semi pemerintah tingkat desa yang bertanggung jawab terhadap perencanaan dan pelaksanaan pembangunan perdesaan

24 PKK Organisasi semi pemerintahan yang bertanggung jawab terhadap isu-isu di masyarakat termasuk masalah kesehatan perlindungan dan pelestarian lingkungan, pada beberapa tempat bertanggung jawab pula terhadap pengelolaan sampah

2.3 Visi dan Misi Stakeholders (tingkat nasional)

2.3.1 Kementrian Lingkungan Hidup

Visi: Terwujudnya Kementerian Negara Lingkungan Hidup sebagai institusi yang handal dan proaktif dalam mewujudkan pembangunan berkelanjutan melalui Good Environmental Governance (GEG), guna meningkatkan kesejahteraan rakyat Indonesia. Penjabaran program, antara lain PROKASIH yang bertujuan untuk menurunkan beban pencemaran limbah cair; Program ADIPURA yang bertujuan untuk mewujudkan kota bersih dan teduh (clean and green city); serta pengelolaan limbah domestik dan usaha skala kecil yang bertujuan mengurangi pencemaran yang berasal dari sumber tersebut. Pelaksanaan program berdasarkan pada KepMen LH No.93/ 2004 tentang Pelaksanaan Program Bangun Praja.



Misi Deputi II: Meningkatkan kualitas lingkungan hidup; Membangun kinerja yang profesional di bidang pengendalian pencemaran lingkungan; Mendorong penerapan prinsip-prinsip Good Environmental Governance Penilaian Adipura, untuk aspek air limbah baru akan dimasukkan dalam perhitungan/ penilaian pada tahun 2008. KLH memandang bahwa salah satu inti tugasnya menangani limbah dengan pemahaman bahwa limbah adalah sebagai sumber daya; masih terkendala oleh pemahaman pemangku kepentingan/lembaga lainnya sebagaimana tertuang dalam UU no.7/2004 tentang Sumber Daya Air serta PP no.16/2005 tentang Pengembangan Sistem Penyediaan Air Minum pasal 1 yang menyebutkan bahwa : “Sampah (Limbah) adalah limbah padat yang berasal dari lingkungan permukiman, bukan bahan berbahaya dan berracun, yang dianggap tidak berguna lagi”3). Berkait dengan pemahaman bahwa limbah adalah sumber daya, maka penanganan atau pengelolaan sumber daya ini akan lebih optimal bila dicakup besarannya dalam skala komunal daripada skala individual, walaupun pada skala individual sejauh terdorong semangat melaksanakan dengan sesungguhnya dapat mempunyai hasil yang signifikan juga. Untuk hal ini dapat diacu informasi bahwa negara Mexico telah melarang pembangunan septik tank individual demi untuk capaian kelestarian lingkungannya. 2.3.2 Departemen Kesehatan:

Visi: Masyarakat berperilaku sehat dan hidup dalam lingkungan sehat. Misi: o Mengendalikan faktor risiko lingkungan dan perilaku; o Mendorong tumbuhnya kemandirian masyarakat yang berwawasan kesehatan; o Menggalang jejaring kerja dan kemitraan; o Mengembangkan teknologi dan penerapan analisis dampak kesehatan lingkungan; o Menyediakan informasi kesehatan lingkungan; o Meningkatkan profesionalisme SDM kesehatan lingkungan; dan o Meningkatkan pelayanan kesehatan lingkungan yang merata, bermutu dan terjangkau. Pemerintah pusat mempunyai wewenang untuk melaksanakan surveilans epidemiologi, pengaturan pemberantasan dan penanggulangan wabah/kejadian luar biasa serta penetapan kebijakan untuk mendukung pembangunan secara makro, penyusunan rencana nasional secara makro, pembinaan dan pengawasan atas penyelenggaraan otonomi daerah yang meliputi pemberian pedoman, bimbingan, pelatihan, arahan dan supervisi serta penanggulangan wabah dan bencana yang berskala nasional. Lembaga di lingkungan Depkes yang mendukung upaya penyehatan lingkungan sesuai dengan bidang tugas masing-masing: Dit. Penyehatan Lingkungan, merupakan leading unit. Pusat Promosi Kesehatan, Biro Perencanaan & Penganggaran; Biro Hukum & Organisasi, Pusat Sarana, Prasarana dan Peralatan Kesehatan, Dit. Kesehatan Komunitas, dll. Dinas Kesehatan propinsi dan Dinas Kesehatan Kabupaten/Kota (DKK). DKK ini memegang wewenang desentralisasi di bidang kesehatan dan tugas pembantuan serta menentukan jenis dan tingkat pelayanan kesehatan. Dinas Kesehatan Propinsi mempunyai wewenang desentralisasi secara terbatas yang mencakup upaya kesehatan yang belum mampu dilaksanakan secara lintas batas baik oleh masyarakat atau pemerintah daerah kabupaten/kota. 3) Definisi: Limbah padat (sampah) merupakan semua limbah yang dihasilkan oleh aktifitas manusia dan hewan yang biasanya berbentuk padat dan dibuang karena tidak digunakan lagi atau tidak diinginkan. Karena sifat-sifat intrinsiknya, bahan limbah yang telah dibuang seringkali dapat digunakan kembali dan dapat dianggap sebagai sumber daya di tempat lain. (G.Tchobanolous, Integrated solid waste management)



Pengalaman selama 5 tahun terakhir menunjukkan pemerintah daerah masih memerlukan dukungan sehingga prioritas-prioritas lingkungan sehat dapat dilaksanakan dengan baik. Keterbatasan sumber dana dan ketidak mengertian permasalahan lingkungan sehat menyebabkan lemahnya komitmen di bidang ini. Sebenarnya upaya penyehatan lingkungan memiliki karakteristik spesifik yang tidak mengenal batas wilayah administrasi. Penyelesaian masalahnya memerlukan penanganan secara terintegrasi dan lintas propinsi/kabupaten/kota. Apabila tidak, berpotensi terjadinya KLB/wabah dan kerusakan lingkungan yang semakin parah dan mengganggu kesehatan. Di bidang sanitasi, sasarannya a.l.: meningkatnya prosentase keluarga yang menghuni rumah sehat (75%); keluarga yang menggunakan air bersih (85%); dan keluarga yang menggunakan jamban memenuhi syarat kesehatan (80%). Namun dari segi pendekatan ada pergeseran. Misalnya dalam hal target, dulu fokusnya adalah agar masyarakat mempunyai jamban (yang merupakan “government driven”). Sekarang tidak lagi menekankan harus ada jamban. Tetapi terserah pada masyarakat, mereka bebas mau BAB (buang air besar) di mana, sesuai pilihan mereka. Mereka tahu konsekwensi dari pilihan-pilihan itu. Yang penting tidak di sungai, di tempat umum, dll. (Ini merupakan “community driven”). Di pihak Iain penanganan masalah sanitasi juga dapat merupakan investasi. Kebutuhan masyarakat ada, tetapi perlu ditumbuhkan. Sebenarnya “return rate” nya cukup tinggi. Melihat hal ini banyak yang tertarik Pelaksanaan sebegitu jauh, cukup baik. Di beberapa desa tadinya tidak ada air/jamban, tetapi sekarang air sudah mengalir di rumah-rumah (di 1.300 desa), mencakup sekitar 10 juta penduduk. Melalui proyek WSSLIC diperoleh hasil yang menggembirakan. Misalnya di Lumajang dilaporkan, dalam 3 bulan saja di 16 desa di satu kecamatan sudah tidak ada penduduk yang buang air besar sembarangan. Demikian pula berita menggembirakan di di Muara Enim. Hal seperti ini melalui WSSLIC 2 telah dikembangkan di 2500 desa. Kemudian nanti melalui WSSLIC 3 akan dikembangkan di 11 provinsi, 70 kabupaten, 5000 desa. Ini direncanakan pada 2007-2012. Maka akan dibangun l.k. 5000 sarana air bersih dan peningkatan hgiene nya (cuci tangan dengan sabun). 2.3.3 Departemen PU

Visi: Tersedianya Infrastruktur Pekerjaan Umum yang handal, bermanfaat dan berkelanjutan untuk mendukung terwujudnya Indonesia yang aman dan damai, adil dan demokratis, serta lebih sejahtera.

Dirjen Cipta Karya (Ditjen CK), Visi:

o Terwujudnya kemandirian daerah dalam penyelenggaraan pembangunan prasarana dan sarana guna mewujudkan kawasan perkotaan dan perdesaan yang layak huni, berkeadilan sosial, berbudaya, produktif dan berkelanjutan, serta saling memperkuat dalam mendukung pengembangan wilayah.

o Tersedianya infrastruktur Pekerjaan Umum (PU) di perkotaan dan perdesaan dalam rangka mewujudkan permukiman yang layak huni, produktif dan berkelanjutan, serta melaksanakan penataan bangunan dan lingkungan, pembinaan standar keselamatan bangunan perumahan dan permukiman dan gedung swasta.

Dit.PPLP, Visi:

Terwujudnya penyelenggaraan prasarana dan sarana penyehatan lingkungan permukiman dalam rangka mewujudkan kawasan permukiman yang layak huni, sehat, aman dan berkelanjutan melalui peningkatan kualitas kesehatan masyarakat dan menjaga kelestarian lingkungan.



Dirjen CK, Misi: o Fasilitasi penyediaan/mengembangkan infrastruktur Pekerjaan Umum (PU) di perkotaan

dan perdesaan dalam rangka mewujudkan permukiman yang layak huni, produktif, aman tentram dan berkelanjutan.

o Meningkatkan kapasitas Pemerintah daerah, masyarakat dan dunia usaha dalam penyelenggaraan pembangunan infrastruktur PU.

o Melaksanakan pembinaan penataan kawasan perkotaan dan kawasan perdesaan serta penataan bangunan gedung yang memenuhi standar keselamatan dan keamanan gedung.

o Melaksanakan pembinaan pengembangan jalan desa, jalan dalam kota dan pengembangan prasarana dan sarana sumber daya air (irigasi desa dan air baku).

o Mewujudkan organisasi yang efisien, tata laksana yang efektif dan SDM yang profesional dengan menerapkan prinsip ” Good Governance”.

Dit.PPLP, Misi: o Menyelenggarakan pelayanan prasarana dan sarana air limbah, persampahan dan

drainase untuk meningkatkan kualitas kesehatan masyarakat di perkotaan dan perdesaan.

o Membangun dan mengembangkan prasarana dan sarana penyehatan lingkungan permukiman, mendukung pencegahan pencemaran lingkungan.

o Membangun kapasitas kelembagaan Pemerintah Daerah dan masyarakat yang efektif dan efisien dan bertanggung jawab.

o Mendorong terciptanya pengaturan berdasarkan hukum yang dapat diterapkan Pemerintah dan masyarakat untuk membangun pengelolaan pembangunan penyehatan lingkungan permukiman.

o Meningkatkan kemampuan pembiayaan menuju kearah kemandirian. o Membangun peran masyarakat dalam proses pembangunan. o Meningkatkan peran dunia usaha, perguruan tinggi melalui penciptaan iklim kondusif bagi

pengembangan prasarana dan sarana penyehatan lingkungan permukiman.

Kebijakan dan Strategi (JAKSTRA) Dit.PPLP pengembangan penyehatan lingkungan permukiman termasuk pengembangan air limbah domestik tahun 2006 masih dalam proses untuk ditetapkan dalam Kepmen PU. Saat ini terdapat beberapa Rancangan Kepmen PU yang akan diterbitkan. Bila JAKTRA, Regulasi, standard, Juklak yang berkaitan dengan sanitasi yang disusun dilevel nasional dapat terintegrasi dengan RENSTRADA yang terkait dengan sanitasi dan yang disusun pada level Pemkab/Pemkot, termasuk regulasi (perda), rencana aksi dapat diasumsikan perkembangan sanitasi akan lebih baik dari saat ini. Lembaga di lingkungan Dep.PU yang terkait dengan masalah sanitasi disamping Dit.PPLP adalah Dit.Bina Program Ditjen CK yang menyiapkan anggaran dan Sekjen Dep.PU yang terkait dengan masalah produk hukum/ regulasi.

2.3.4 Departemen Dalam Negeri

Visi: Terwujudnya penyelenggaraan pemerintahan yang desentralistik, system politik yang demokratis, pembangunan daerah dan pemberdayaan masyarakat dalam wadah Negara Kesatuan Republik Indonesia. Misi: Misi Departemen Dalam Negeri antara lain: Menetapkan Kebijaksanaan Nasional dan Memfasilitasi Penyelenggaraan Pemerintahan, dalam upaya: (3)Memantapkan Efektifitas dan Efisiensi Penyelenggaraan Pemerintahan yang Desentralistik; (4)Memantapkan pengelolaan keuangan daerah yang efektif, efisien, akuntabel dan auditable; (6)Meningkatkan keberdayaan masyarakat dalam aspek ekonomi, sosial budaya, dan politik; (7)Mengembangkan keserasian hubungan pusat-daerah, antar daerah dan antar kawasan, serta kemandirian daerah dalam pengelolaan pembangunan secara berkelanjutan dan berbasis kependudukan.



Bila kita meninjau visi dan misi dari departemen/ lembaga yang terkait dengan sanitasi, kelihatannya semua telah mendukung pengembangan sanitasi, namun dalam operasionalisai di daerah (sesuai azas desentralisasi) masih belum sesuai harapan seperti tercantum dalam visi dan misi. Oleh karena itu masih diperlukan koordinasi lebih inten agar pandangan sama tersebut saling bersinergi untuk mencapai tujuan sanitasi bersama dan dikoordinasikan pula dengan pemda agar sejalan dan pengembangan sanitasi menjadi bagian dari kegiatan utama pemda. Peran serta Masyarakat dan Swasta o Kesadaran masyarakat tentang pentingnya sanitasi masih rendah o Bentuk partisipasi masyarakat belum optimal, terbatas pada tarif/retribusi yang rendah o Pembangunan di bidang air limbah terutama yang berbasis masyarakat masih terbatas o Badan usaha swasta tidak tertarik untuk investasi dalam bidang air limbah Role sharing Dari sejumlah stakeholders diatas, belum teridentifikasi bahwa role sharing (pembagian peran) antar stakeholders atau para pelaku pembangunan tersebut, dan belum terorganisasikan secara jelas peran masing-masing, misalnya sebagai regulator atau operator, sebagai provider, enabler, empower body (lembaga Pembina), belum pula siapa berkedudukan sebagai beneficiariesnya.

3 KONDISI SANITASI SAAT INI

Studi-studi mengenai sanitasi sudah banyak melakukan kajian kondisi, isue utama, dan upaya penanganan dengan menyusun kebijakan, strategi, Rencana Jangka Panjang, menengah dan pendek (tahunan), Pelita, RPJM dan RPJP dengan nama-nama yang dapat berbeda-beda sesuai dengan kurun waktu yang berlaku pada waktu pemerintahan berlangsung. Oleh karena itu dalam penyiapan bahan lokakarya Enabling Framework Sanitasi dalam program ini (ISSDP) tidak lagi melakukan kajian kondisi sanitasi eksisting, dan mengidentifikasi isu-isu utama yang dominan. Tetapi kita berangkat dari hasil studi-studi terdahulu, terutama apa yang telah dikemukakan dalam kajian Waspola (2005) dan merangkumnya. Keculai menemukan isu-isu utama baru sesuai perkembangan sampai saat ini. Dalam dokumen-dokumen khususnya WASPOLA, sudah menjelaskan mengapa pengembangan sanitasi di Indonesia tidak berjalan sebagai mana mestinya Isu-isu utama sanitasi didokumentasikan secara jelas dalam dokumen Kebijakan dan Strategi penanganan AMPL berbasis komunitas maupun yang berbasis kelembagaan. Pokok bahasan utama hususnya untuk sanitasi dari WSP tersebut adalah: o Tidak terintegrasinya penanganan air minum dan air limbah (Domestic wastewater and

water supply management are not integrated), yang telah kita ketahui bahwa + 70% dari air yang kita pergunakan untuk keperluan sehari-hari akan menjadi air limbah.

o Pencemaran badan air yang merupakan sumber air baku air minum (Pollution of Bodies

of Water as Sources of Raw Water). Jumlah air tawar di dunia dalam proses siklus hidrologi relative sama, namun jumlah masnusia yang membutuhkan air semakin bertambah dengan cepat (missal pada tahun 1965 penduduk Indonesia berjumlah 80 juta dan setelah 40 tahun menjadi 215 juta penduduk (2006).Pertambahan penduduk yang pesat sudah tentu akan meningkatkan menggunakan SDA, khususnya air tawar yang terbatas, pemukiman berkembang dengan segala implikasinya akibat makin terbatasnya lahan daerah tangkapan air termasuk perusakan hutan, sehingga air tawar dalam siklus hidrologi yang seharusnya lebih lama didaratan (termasuk air tanah), pada saat ini mengalir dengan cepat ke laut yang sulit untuk dapat dimanfaatkan sebagai air tawar bagi kebutuhan penduduk (akan sangat amat mahal untuk mengolah air laut menjadi air tawar).



Sumber daya air yang terbatas masih diperparah dengan pencemaran akibat masalah air limbah yang tidak dikelola secara baik dan benar, sehingga air yang layak sebagai bahan baku air minum juga menjadi semakin terbatas, atau air yang sudah tercemar tersebut untuk dilakukan pengolahan menjadikannya air bersih atau air minum juga menjadi mahal (dalam prosesnya perlu perlakuan tambahan seperti perlu bahan kimia yang lebih banyak dan sebagainya). o Akses masyarakat khususnya masyarakat miskin perkotaan (urban-poor) ke prasarana

dan sarana (PS) air limbah (sanitasi) masih rendah (Low Access to Wastewater Facilities). Masyarakat urban-poor sampai saat ini pada umumnya merasa belum membutuhkan sanitasi. Mereka masih berputar pada kebutuhan makan untuk hari ini. Mereka tidak menyadari bahwa sanitasi adalah salah satu perangkat yang dapat memutuskan mata rantai penyebaran penyakit (preventif). Belum menyadari bahwa dengan pencegahan tersebut, menjadikan dia sehat, tidak perlu mengeluarkan dana untuk kembali sehat, produktifitas kerja tetap tinggi dan dengan demikian akan meningkatkan pendapatan mereka menuju masyarakat yang lebih sejahtera.

o Institusi yang terkait dengan sanitasi (didaerah) umumnya masih lemah dan kinerja

manajemennya juga kurang professional (Weak Institutional Position and Poor Management Performance). Kelembagaan yang berkompeten belum dapat menangkap kebutuhan masyarakat atas sanitasi, belum memberdayakan (melalui pendekatan pemasaran sanitasi hygiene), sehingga masyarakat masih merasa sanitasi bukan suatu kebutuhan. Renstrada, RPJM, Action Plan sudah disusun dan penyusunannya ada yang sudah mengembangkan dengan pendekatan dari mulai tingkat forum Kelurahan berjenjang sampai ketingkat forum kota, namun bila dilihat rencana yang terkait dengan sanitasi masih sangat rendah. Hal ini tidak lepas dari prioritas pengembangan sanitasi yang masih rendah dibandingkan sektor atau sub-sektor lainnya dan belum disadari adanya potensi ekonomi yang besar bila sanitasi dapat lebih baik dari yang ada sekarang, karena produktifitas SDM yang tinggi

o Alokasi dana untuk keperluan sanitasi masih rendah (Low Budget Allocation). Disadari

banyak pemkot/pemkab mempunyai sumber dana yang rendah karena potensi yang ada belum tergali secara baik, namun tidak kurang juga yang mempunyai sumber dana cukup besar, tetapi alokasi budget untuk pengembangan sanitasi masih tetap rendah. Bila ditinjau lebih lanjut hal ini tidak lepas dari kesadaran akan sanitasi yang masih rendah, sehingga prioritas pembangunan sanitasi juga masih rendah dan ahirnya penyediaan dana untuk sanitasi juga masih akan tetap rendah.

o Regulasi untuk tingkat operasionalisasi yang terkait dengan sanitasi tidak atau belum ada

dan peraturannya lemah (Lack of Regulations at the Operational Level and Weak Law). Pada level nasional, regulasi masih sangat kurang sehingga produk-produk untuk pengembangan sanitasi, seperti kebijakan dan strategi ditingkat nasional yang belum mempunyai payung hukum yang jelas, dengan demikian proses deliveri akan tidak berjalan karena daerah merasa belum mengetahui atau sulit untuk dapat mengikuti karena ketiadaan payung hukum yang melandasi keharusan mengikuti kebijakan dan strategi nasional yang mungkin ada. Daerah cenderung menyusun Perda dengan mengacu pada regulasi nasional yang ada/yang masih terbatas (untuk sanitasi) atau kalau belum ada, akan menyusun perda yang kurang mengena pada sasaran karena ketiadaan acuan. Disamping itu masih adanya multi tafsir atau pengertian yang saling berbeda antara peraturan yang satu dengan yang lainnya untuk suatu masalah yang sama. Misalnya dalam Permen PU No.16/2005 dengan UU 23/1997 terdapat perbedaan dalam pengertian mengenai sampah. Bisa terjadi kedua-duanya benar, hanya diperlukan lembar penjelasan tambahan sesuai konteksnya sehingga tidak membingungkan bagi yang membaca atau akan menerapkannya.



4 KONDISI LINGKUNGAN

4.1 Pencemaran Air

Secara nasional 50 % penduduk belum mengolah air limbahnya (terdiri dari 20,71 % di perkotaan dan 73,99 % di perdesaan). Pencapaian sasaran kebijakan konservasi air secara nasional, baru mencapai 1,36 % Sebanyak 76,3 % dari 53 sungai di Jawa, Sumatera, Bali dan Sulawesi tercemar berat oleh cemaran organic, dan 11 sungai-sungai utama tercemar berat oleh unsur Amonium. Sungai-sungai utama di perkotaan umumnya sudah tercemar dimana rata-rata kadar BOD-nya telah melampaui ambang batas (34,48 %), dan juga kadar COD-nya (51,73 %). Dari 33,34 % sampel air minum perpipaan dan 54,16 % sample air minum non perpipaan ternyata mengandung bakteri Coli. Ketersediaan air baku di tiga propinsi, yaitu DKI, DIY dan Jatim telah memasuki ambang kritis (< 1000 m3/kapita/tahun). IPLT banyak yang tidak berfungsi dan termanfaatkan secara optimal. Pelayanan instalasi Pengolahan Air Limbah (IPAL) domestik yang ada, belum pada tingkatan optimum. 4.2 Isu Kesehatan

Minimnya pelayanan limbah cair domestik menyebabkan angka kejadian penyakit menular bawaan air di Indonesia selalu tinggi. Hasil SKRT (Survey Kesehatan Rumah Tangga) pada tahun 1992, menunjukkan bahwa diarhe merupakan penyebab kematian bayi kedua di Indonesia, peringkatnya menurun pada tahun 1995 menjadi penyebab kematian ketiga. Sampai dengan tahun 2001 diarhe masih merupakan penyebab kematian bayi ketiga sesuai dengan data Surkesnas 2001 (Profil Kesehatan Indonesia, 2001). Angka kematian bayi mengalami peningkatan dari tahun 1998 sebesar 49 per 1000 kelahiran dan 50 per 1000 kelahiran pada tahun 2001. Angka kematian bayi (AKB) dan jenis penyakit penyebab kematian bayi tertinggi merupakan indikator bahwa sarana dan prasarana penyediaan air minum dan sanitasi ini masih sangat minim. Sampai saat ini di tingkat masyarakat masih banyak penyakit menular yang dapat menyebabkan kematian. Banyak diantaranya yang disebabkan oleh lingkungan dan sanitasi yang kurang baik. Sayangnya hanya sekitar 30% masyarakat yang tahu masalah itu dan mampu mengatasinya, dengan mengadakan sarana sanitasi yang memadai. Diperkirakan 50% belum tahu tapi sebenarnya mampu, sedangkan yang 20 % belum tahu dan belum mampu. Sebagaimana diketahui, penyakit menular merupakan penyebab kematian yang tinggi pada bayi dan balita. Menurut SKRT 1995, proporsi penyakit menular penyebab kematian pada bayi, adalah: pnemonia (16,4%), diare (11,4%), tetanus 4,7%), infeksi saluran pernafasan akut (3,9%), ensephalitis, bronchitis, emfisema dan asthma (masing-masing 2,5%). Adapun proporsi penyakit menular penyebab kematian pada balita, yaitu; pneumonia (22,5%), diarhe (19,2%), infeksi saluran pernafasan akut (7,5%), tifus perut dan malaria (masing-masing 7%) serta campak (5,2%). Beberapa penyakit menular diidentifikasi sebagai penyebab kematian kasar, seperti; TB (9,2%), diare (7,2%), pneumonia (6,9%), bronchitis, emfisema dan asma (masing-masing 6,1%) serta tifus perut (5,2%). Penyakit menular tersebut diatas adalah sebagai akibat, antara lain, kesehatan lingkungan yang buruk dan perilaku kesehatan masyarakat yang belum memenuhi harapan Di kawasan Asia Tenggara, pelayanan sanitasi di Indonesia pada tahun 2000 menduduki peringkat ke-6 (enam) diantara 9 (sembilan) negara, dibawah Thailand, Philipina, Malaysia dan Myanmar. Tingkat pelayanan sanitasi Indonesia 8,85% lebih rendah dari tingkat pelayanan rata-rata di Asia Tenggara (Depkimpraswil, 2003). Kondisi ini tentunya sangat memprihatinkan, mengingat Indonesia telah merdeka lebih lama dari Myanmar, tetapi pelayanan sanitasinya masih sangat rendah.



Sangat penting bagi pemerintah daerah (Pemda) untuk mengatur (sebagai pengatur) dan memfasilitasi setiap upaya untuk mengatasi masalah yang muncul ini. Meskipun demikian, terdapat banyak pemerintah daerah (Pemda) yang tidak bertindak akibat kurangnya pemahaman terhadap masalah, tidak mengetahui kesempatan dan tidak mengetahui bagaimana cara menangani masalah tersebut. Bahkan, terdapat kesempatan bisnis dalam aspek ini yang mungkin menarik bagi investor. 4.3 Pelayanan Sanitasi

Cakupan dan pelayanan pengelolaan limbah cair di sebagian besar kota-kota di Indonesia masih sangat minim. Hasil studi yang dilakukan oleh Dep.PU, 2005 menunjukkan bahwa sampai dengan tahun 2003, pelayanan air limbah dengan menggunakan tangki septik baru mencakup 43,87%, sisanya sebanyak 20,12% membuang ke sungai atau danau, 23 % ke lobang tanah sementara sisanya dibuang di pantai, kebun, kolam atau sawah. Kondisi paling buruk adalah di pulau Kalimantan, dimana penggunaan tangki septik baru mencapai 37%, dan 25% dibuang ke sungai atau danau dan 31% dibuang ke lobang tanah. Pada tahun 1999, cakupan sanitasi mencapai 77% di perkotaan dan 51% di perdesaan. Adapun cakupan air bersih mencapai 92% di perkotaan dan 68% diperdesaan. Namun demikian cakupan sanitasi dan air bersih antar propinsi sangat bervariasi. Cakupan air bersih di perdesaan Kalimantan Tengah adalah 35% sementara di Bali 89%. Ada daerah yang sanitasinya sudah mencapai diatas 90% dan sejumlah kabupaten yang cakupannya masih sekitar 12–20%. Disamping itu angka-angka tersebut belum mengambarkan tingkat pemakaian yang efektif, dan hanya 50% dari sarana air bersih yang ada telah memenuhi standar bakteriologis. Sesuai kesepakatan MDG, Indonesia akan menurunkan jumlah penduduk yang tidak memperoleh akses terhadap sanitasi yang baik sampai separuhnya pada tahun 2015. Pada tahun 2006 terdapat program Sanimas secara nasional untuk 105 lokasi di 34 Pemkot/Pemkab dari 23 Propinsi. Pemkab/Pemkot yang sudah mendapat sosialisasi Sanimas atau telah melaksanakan percontohan SANIMAS, implementasi diperkirakan dapat berjalan lancar karena merupakan replikasi dari yang telah ada. Bagi Pemkab/Pemkot yang belum pernah mendapat sosialisasi mengenai Sanimas, mungkin pelaksanaannya mendapat kesulitan. Dari pengalaman pelaksanakaan program SANIMAS tahun 2006 akan mendapatkan suatu pembelajaran yang berharga, bisa menjadi bahan evaluasi dan rekomendasi untuk rencana aksi program selanjutnya. Perlu mengembangkan kegiatan sanitasi berbasis masyarakat (Sanimas) dalam bentuk-bentuk lain (dengan mengikuti contoh pendampingan kepada masyarakat, disain bangunan yang ada sekarang atau tipe lain yang tepat guna), tetapi pada prinsipnya tetap sebagai program pembangunan sanitasi berbasis masyarakat, sebagai pengganti MCK yang hanya mementingkan target pembangunan fisik tanpa memperhatikan keberlanjutannya (lingkungan, sosial, operasi dan pemeliharaannya). Perlu dikaji kemungkinan mengembangkan sanimas untuk pemukiman diwilayah yang sudah terdapat sistem perpipaan sewerage (off-site) seperti di Surakarta, Denpasar, Banjarmasin dll. Pendekatan dalam melakukan sosialisasi suatu program seperti Sanimas perlu memperhatikan budaya sanitasi setempat seperti menggunakan bahasa setempat termasuk profil/gambar/sket penduduk setempat serta menghilangkan kebiasaan-kebiasaan sanitasi yang bila diterapkan pada masa kini sudah tidak sesuai lagi . Sebagai contoh, misalnya lagu jingle dari etnis jawa "Ee dayohe teko, ……, ee asune mati, ee buang ning kali", perlu di dihilangkan, karena di situ digambarkan sejak kecil diberi masukan untuk kurang menghargai sungai sebagai sumber daya air/ sumber air baku air minum tetapi digunakan untuk tempat membuang sampah/ limbah (anjing mati buang di sungai). Mungkin pada masa lagu tersebut dibuat belum menimbulkan masalah karena kemampuan purification secara alamiah (self purification) masih tinggi. Namun hal itu sudah tidak tepat untuk masa kini, dimana penduduk perkotaan cukup padat, sedangkan lahan dan sumber daya air terbatas.



Dalam bidang sanitasi, Depkes mempunyai sasaran a.l.: meningkatnya prosentase keluarga yang menghuni rumah sehat (75%); keluarga yang menggunakan air bersih (85%); dan keluarga yang menggunakan jamban memenuhi syarat kesehatan (80%). Namun dari segi pendekatan ada pergeseran. Misalnya dalam hal target, dulu fokusnya adalah agar masyarakat mempunyai jamban ( “government driven” ). Sekarang terserah pada masyarakat, mereka bebas mau BAB (buang air besar) di mana, sesuai pilihan mereka. Mereka tahu konsekwensi dari pilihan-pilihan itu. Yang penting tidak di sungai, di tempat umum, dll. (Ini merupakan “community driven”). Pada sisi lain penanganan masalah sanitasi juga dapat merupakan investasi. Kebutuhan masyarakat ada, tetapi perlu ditumbuhkan. Sebenarnya “return rate” nya cukup tinggi. Melihat hal ini banyak yang tertarik. Juga World Bank sudah tertarik untuk investasi. Pelaksanaan sebegitu jauh, cukup baik. Di beberapa desa tadinya tidak ada air/jamban, tetapi sekarang air sudah mengalir di rumah-rumah (di 1.300 desa), mencakup sekitar 10 juta penduduk. Melalui proyek WSSLIC diperoleh hasil yang menggembirakan. Misalnya di Lumajang dilaporkan, dalam 3 bulan saja di 16 desa di satu kecamatan sudah tidak ada penduduk yang buang air besar sembarangan. Demikian pula berita menggembirakan di di Muara Enim. Hal seperti ini melalui WSSLIC 2 telah dikembangkan di 2500 desa. Kemudian nanti melalui WSSLIC 3 akan dikembangkan di 11 provinsi, 70 kabupaten, 5000 desa. Ini direncanakan pada 2007-2012. Maka akan dibangun l.k. 5000 sarana air bersih dan peningkatan hygiene-nya (cuci tangan dengan sabun). Berdasarkan data dan pengalaman Depkes, selama 5 tahun terakhir menunjukkan pemerintah daerah masih memerlukan dukungan sehingga prioritas-prioritas lingkungan sehat dapat dilaksanakan dengan baik. Keterbatasan sumber dana dan ketidak mengertian permasalahan lingkungan sehat menyebabkan lemahnya komitmen di bidang ini. Upaya penyehatan lingkungan memiliki karakteristik spesifik yang tidak mengenal batas wilayah administrasi. Penyelesaian masalahnya memerlukan penanganan secara terintegrasi dan lintas propinsi/kabupaten/kota. Apabila tidak, berpotensi terjadinya KLB/wabah dan kerusakan lingkungan yang semakin parah dan mengganggu kesehatan. Antusiame daerah untuk membuka klinik sanitasi menunjukkan perkembangan komitmen wilayah untuk menangani masalah kesehatan lingkungan.

5 INVESTASI DAN PENDANAAN 5.1 Kondisi Saat Ini

Sektor sanitasi di Indonesia – saat ini. Indonesia merupakan salah satu negara dengan palayanan sanitasi terpusat di antara paling rendah di dunia. Saat ini, kurang dari 2% dari populasi dihubungkan dengan jaringan selokan berpipa, yang melayani sekitar 200.000 rumah tangga di daerah perkotaan pada tahun 2004. Sekitar 60% dari populasi bergantung pada septik tank dan jamban untuk buangan air limbah. Lebih dari sepuluh juta rumah tangga, atau 25% dari jumlah, saat ini tidak dilayani oleh bentuk sanitasi on-site apapun (Tabel 1). Sebagian besar populasi pedesaan, serta sejumlah besar rumah tangga berpendapatan rendah di daerah perkotaan, buangan air limbah dibuang langsung ke sungai, danau dan ruang terbuka. Kontaminasi yang dihasilkan pada air permukaan dan air tanah telah mengarah ke insidensi penyakit yang ditularkan lewat faeses yang tinggi serta kerusakan sumber air di lingkungan, terutama di daerah yang berpopulasi padat. Pada tahun 1999, ADB memperkirakan biaya ekonomi dari polusi air limbah di Indonesia mencapai hampir US$ 4,7 milyar per tahun.

Skenario “tidak melakukan kegiatan apapun”: Sejak tahun 1998, investasi untuk prasarana sanitasi baru dapat diabaikan. Meskipun proporsi rumah tangga dengan akses terhadap fasilitas sanitasi yang ditingkatkan (selokan berpipa, septik tank dan jamban) masih berkisar pada 65% pada tahun-tahun belakangan ini, lebih dari 90% limbah manusia tetap tidak diberi pengelolaan apapun. Karena kepadatan populasi dan tekanan lingkungan terus meningkat, situasinya akan menjadi lebih parah tanpa adanya perubahan radikal dalam kebijakan pemerintah.



Table 5-1 RT dengan akses terhadap fasilitas sanitasi yang ditingkatkan*

1998 1999 2000 2001 2002

Perkotaan 80,4% 77,0% 77,4% 76,2% 77,5%

Pedesaan 55,6% 50,8% 52,3% 50,3% 52,2%

Indonesia 64,9% 61,1% 62,7% 61,5% 63,5%

Sumber: BPS * Didefinisikan sebagai: sanitasi terpusat, septik tank dan jamban

5.2 Tujuan Kebijakan Jangka Menengah dan Jangka Panjang

Visi untuk tahun 2015. Sepuluh tahun dari sekarang, 75% dari populasi akan memiliki akses untuk fasilitas sanitasi yang ditingkatkan, meningkat dari 63% pada tahun 2000. Sebagian besar dari peningkatan tersebut telah dibiayai oleh rumah tangga itu sendiri yang telah dibuat menyadari keuntungan ekonomi untuk menurunkan BAB di tempat terbuka. Badan pemerintah daerah khusus memberikan pelayanan pengelolaan lumpur untuk meminimalkan polusi air limbah. Biaya penuh dari pelayanan-pelayanan ini dibiayai dari pembayaran pelayanan daerah yang didasarkan pada prinsip “yang membuat polusi yang membayar”. Perusahaan air minum di kota-kota besar dan metropolitan menyediakan pelayanan sanitasi terpusat hingga hampir empat juta rumah tangga, suatu peningkatan duapuluh kali lipat dari tingkat pelayanan pada tahun 2004. Karena peningkatan besar-besaran dalam peningkatan pemakaian aset, tarif tidak banyak meningkat dalam tahun-tahun ini dan sanitasi terpusat akan segera menjadi terjangkau bagi kelompok berperndapatan rendah. Tujuan jangka menengah dan jangka panjang. Pada tahun 2002, Pemerintah Indonesia telah berkomitmen untuk mencapai Millennium Development Goal (MDG) #10, yang dikenal sebagai “Memastikan Kelestarian Lingkungan”. Sebagai cara untuk mencapai tujuan ini, Pemerintah menetapkan untuk menurunkan jumlah orang tanpa akses sanitasi dasar yang dapat dipertahankan menjadi setengah dari jumlahnya sekarang pada tahun 2015. Pada tahun 2004, Departemen Pekerjaan Umum (PU) menerbit Rencana Aksi Nasional untuk Sanitasi yang mencakup proposal rinci untuk mengoperasionalkan MDG #7. Rencana Pengembangan Jangka Menengah Nasional (RPJM) untuk tahun 2004-2009 memaparkan suatu alternatif untuk meningkatkan tingkat pelayanan di bidang sanitasi. Alternatif tersebut tidak menargetkan peningkatan langsung jumlah fasilitas sanitasi, tetapi merencanakan kampanye informasi masyarakat untuk mendorong rumah tangga meningkatkan fasilitas mereka sendiri. RJPM juga mengungkapkan target-target kuatitatif mengenai peningkatan tingkat pemakaian fasilitas proses limbah dan penurunan proporsi air limbah yang tetap tidak dikelola (Tabel 2). Untuk meningkatkan pelayanan sanitasi, kelihatannya kombinasi pendekatan diperlukan.

Table 5-2 Target tingkat pelayanan untuk sektor sanitasi

Sumber Target tingkat pelayanan Cakupan*Millennium Development Goal #10

Menurunkan hingga limapuluh persen proporsi orang tanpa akses berkesinambungan terhadap sanitasi dasar pada tahun 2015

75%

Rencana Tindakan Nasional untuk Sanitasi

Meningkatkan cakupan sanitasi yang ditingkatkan di daerah perkotaan hingga 80% dan di pedesaan hingga 70% pada tahun 2015

75%

RPJM 2004-2009 Tidak ada pembuangan faeses ke tempat terbuka pada tahun 2009

100%

Sumber: UNDP, MPW (DG Cipta Karya), BAPPENAS * persentase populasi total dengan akses terhadap sanitasi yang ditingkatkan



Meningkatkan jumlah rumah tangga dengan akses terhadap sanitasi yang ditingkatkan. Menurut Rencana Aksi Nasional terhadap Sanitasi, jumlah orang dengan akses terhadap sanitasi terpusat, septik tank atau jamban perlu ditingkatkan dari 114 juta pada tahun 2000 menjadi 184 juta pada tahun 2015, yaitu peningkatan sebanyak 60%. Untuk mencapai tujuan ini, Pemerintah Indonesia perlu untuk:

i. Mendorong investasi dalam bidang fasilitas sanitasi terpusat (Pembangunan biasanya dibiaya bersama dengan pemerintah pusat).\

ii. Mendorong pembangunan fasilitas sanitasi on-site. BAPPENAS saat ini tengah mengawasi penerapan program yang sangat berhasil untuk mendorong lingkungan “bebas dari BAB di tempat terbuka”. Program ini memperlihatkan bahwa rumah tangga bersedia untuk mendanai fasilitas sanitas dari sumber daya mereka sendiri jika mereka memahami keuntungan ekonomis dari fasilitas semacam itu.

Meningkatkan volume air limbah yang dikelola. Pada tahun 2000, Departemen Kesehatan melaksanakan survei yang memperlihatkan bahwa buangan air limbah yang dihasilkan oleh lebih dari 96% dari semua rumah tangga di negara ini tidak dikelola di fasilitas khusus. Sisanya dikelola di Instalasi Pengolahan Air Limbah (IPAL) atau fasilitas Instalasi Pengolahan Lumpur Tinja (IPLT). Volume sesungguhnya dari air limbah yang dikelola bahkan lebih rendah dari yang terungkap dalam angka ini karena banyak IPAL dan IPLT digunakan pada tingkat pemakaian yang sangat rendah (atau tidak digunakan sama sekali). Meskipun optimalisasi fasilitas pengelolaan limbah yang ada diperlukan, kapasitas tambahan juga diperlukan untuk menurunkan jumlah buangan air limbah yang tidak dikelola dari lebih dari 90% menjadi 50% seperti yang ditargetkan dalam RPJM. Berdasarkan alasan ini, Rencana Pengembangan Nasional menyarankan bahwa Pemerintah harus:

iii. Mengoptimalkan kapasitas fasilitas pengelolaan limbah yang ada. RPJM menetapkan bahwa setidaknya 60% dari kapasitas IPAL atau IPLT harus digunakan pada tahun 2009.

iv. Mendorong peningkatan dalam kapasitas pengelolaan limbah total. Tidak ada target kuantitatif yang telah ditetapkan.

5.3 Aspek Ekonomi Prasarana Sanitasi

Menangkap manfaat ekonomi. Manfaat ekonomi sistem sanitasi sangat jelas (Kotak 6.1). Meskipun demikian, sebagian besar manfaat ini tidak nyata bagi rumah tangga yang terhubung dalam sistem ini, tetapi untuk rumah tangga lain di wilayah pelayanan yang mengambil manfaat, misalnya, dari peningkatan kualitas air tanah atau penurunan penyakit yang ditularkan melalui faeses yang biasanya dihasilkan oleh sistem sanitasi (Kotak 6.2). Dengan kata lain, manfaat masyarakat dari sistem sanitasi lebih besar daripada manfaat individu dalam sistem tersebut.

Table 5-3 Estimasi biaya ekonomi kesehatan masyarakat Prasarana sanitasi yang baik merupakan cara efektif untuk meningkatkan kesehatan masyarakat. Pada tahun 1999, tiga survei dilakukan di Indonesia untuk memperkirakan biaya ekonomi sistem kesehatna masyarakat dan hari yang terlewat akibat sakit. Seperti yang terlihat dalam tabel di bawah ini, biaya ekonomi rata-rata adalah dalam kisaran 128.000 rupiah per orang per tahun. Jumlah ini mengarah ke jumlah total 63 milyar rupiah per tahun untuk kota berukuran sedang seperti Surakarta (populasi 489.000).

Survei yang dilakukan mengenai kerugian ekonomi (rupiah/kapita/tahun) Yogyakarta 104.100 Medan 95.900

Beberapa kota berukuran sedang (ADB) 185,100 Rata-rata 128.300 Sumber: National Action Plan on Clean Water, MPW (2003) Catatan: Kerugian ekonomi diperkirakan sebagai jumlah pengeluaran kesehatan (ditanggung oleh masyarakat dan pemerintah ) dan hari kerja yang hilang akibat sakit.



Apa artinya kondisi ini untuk pembiayaan prasarana sanitasi?

iii. Pengguna tidak mau membayar full-cost recovery tariff untuk pelayanan sanitasi, karena sebagian tarif akan digunakan untuk menyediakan pelayanan yang tidak ingin dibeli oleh pengguna (misalnya proses pengelolaan lumpur tinja di bagian lain kota tersebut).

iv. Pelayanan sanitasi harus dibebankan berdasarkan prinsip “yang membuat polusi yang membayar”. Ini berarti bahwa rumah tangga dikenai biaya berdasarkan limbah yang diproduksikan – baik ketika rumah tangga itu terkait ataupun tidak dengan palayanan – berdasarkan pendapat bahwa rumah tangga tersebut secara otomatis memperoleh manfaat dari keberadaan sistem sanitasi.

Suatu sistem sanitasi menghasilkan beberapa pelayanan (seperti pengumpulan limbah dan pengelolaan lumpur tinja). Pengguna dapat memperoleh manfaat ekonomi penuh dari beberapa pelayanan ini. Ini berarti bahwa sistem “yang membuat polusi yang membayar” tidak boleh digunakan untuk semua jenis pelayanan.

Table 5-4 Klasifikasi manfaat ekonomi fasilitas sanitasi

1. Peningkatan kesehatan masyarakat. Penurunan pengeluaran di bidang kesehatan yang secara langsung dibebankan pada

masyarakat (seperti pengeluaran yang lebih rendah untuk obat-obatan, pelaynan kesehatan dan transportasi ke rumah sakit).

Penurunan pengeluaran di bidang kesehatan yang ditanggung oleh pemerintah (biasanya terutama terdiri dari penurunan subsidi untuk klinik kesehatan dan rumah sakit serta pengeluaran yang lebih rendah untuk imunisasi dan program pencegahan lain).

Peningkatna produktifitas pekerja. Sanitasi yang ditingkatkan memiliki pengaruh positif bermakna terhadap kesehatna masyarakat sehingga menurunkan jumlah hari kerja (dan hari sekolah) yang hilang.

2. Penurunan biaya pengelolaan air. Sanitasi yang ditingkatkan menurunkan polusi pada sumber air permukaan, sehingga menurunkan biaya pengelolaan air untuk konsumsi.

3. Potensi daur ulang. Sejumlah produk limbah dapat diubah menjadi produk dengan potensi menghasilkan pendapatan (seperti kompos dan bio gas).

4. Meningkatkan kualitas hidup. Peningkatan fasilitas sanitasi biasanya menghasilkan lingkungan hidup yang lebih menyenangkan (seperti sungai yang lebih bersih atau selokan yang tidak terlalu bau).

Tipologi pelayanan sanitasi. Suatu sistem sanitasi menghasilkan tiga jenis pelayanan: (i) pembuangan; (ii) pengumpulan dan transportasi; dan (iii) pengelolaan dan penyimpanan. Suatu sistem sanitasi terpusat ditangani oleh suatu provider pelayanan tunggal yang mengumpulkan, membawa, memberi pengelolaan dan menyimpan limbah. Dalam suatu sistem sanitasi on-site, beberapa pihak pelayanan berperan: (i) rumah tangga membangung septik tank atau jambannya sendiri; (ii) truk tinja dan gerobak secara berkala mengumpulkan dan memindahkan limbah, dan (iii) badan pemerintah daerah menyediakan pelayanan pengelolaan lumpur tinja. Sebagian besar pengguna mau membayar tarif full cost recovery untuk pembuangan onsite dan pengosongan septik tank, mungkin karena manfaatnya langsung terlihat. Argumen ini tidak berlaku untuk pengelolaan limbah dan sanitasi terpusat (dimana biaya pengelolaan menjadi sebagian besar dalam biaya total pelayanan).



Sumber: Konsultan

Figure 5-1 Pelayanan yang diberikan oleh sistem sanitasi 5.4 Kebutuhan Investasi dan Strategi Pembiayaan

Estimasi kebutuhan investasi. Departemen Pekerjaan Umum memperkirakan bahwa investasi tahunan di sektor sanitasi harus meningkat hingga 3,1 triliun rupiah (sekitar US$ 350 juta) untuk mencapai tujuan yang diungkapkan dalam Rencana Aksi Nasional untuk memberikan fasilitas sanitasi yang ditingkatkan kepada 75% populasi pada tahun 2015. Rencana ini mengasumsikan bahwa 70% dari kebutuhan investasi akan ditanggung oleh rumah tangga, terutama untuk membiayai septik tank, jamban dan fasilitas transportasi (truk tinja dan gerobak). Sisanya akan dibiayai oleh pemerintah pusat, propinsi dan kota/kabupaten untuk membiayai sanitasi terpusat dan fasilitas pengelolaan. Jumlah ini diestimasi pada (30% x 3100 =) 930 milyar, jauh lebih besar dari investasi pemerintah saat ini di bidang sanitasi yang tidak melebihi 100 milyar rupiah per tahun. Tanggung jawab pembiayaan. Departemen Dalam Negeri baru-baru ini telah menyelesaikan draf revisi untuk PP25/2000, yang mengalokasi tanggung jawab pemerintah pusat, propinsi dan kota/kabupaten. Berdasarkan PP yang telah direvisi, Rencana Aksi Nasional mengenai Sanitasi dan RPJM 2004-2009:

i. Pemerintah daerah bertanggung jawab untuk sanitasi on-site. Direkomendasikan bahwa pemerintah daerah hanya akan membiayai fasilitas pengelolaan atau proses lumpur tinja karena sektor swasta dapat (dan biasanya memang melakukan) pelayanan pembuangan dan pengumpulan/transport.

ii. Pemerintah pusat bertanggung jawab untuk sanitasi terpusat di kota besar dan metropolitan. Diperkirakan bahwa, sampai tahun 2015, tidak ada proyek sanitasi terpusat baru yang akan diterapkan di kota-kota lain.

Table 5-5 Tanggung jawab pembiayaan pelayanan sanitasi

Pelayanan sanitasi Asumsi tanggung jawab % perolehan keuntungan

Sanitasi on-site (pembuangan dan pengumpulan/transportasi)

Sektor swasta 100% full-cost recovery pada saat jasa diberikan

Sanitasi on-site (pengelolaan/penyimpanan)

Sektor pemerintah (pemerintah lokal) 100% full-cost recovery selama masa hidup ekonomis

Sanitasi terpusat Sektor pemerintah (pemerintah pusat)

70% full-cost recovery selama masa hidup ekonomis (2015)

Sumber: Departemen Dalam Negeri, PU (DG Cipta Karya), BAPPENAS Pilihan-pilihan untuk menutup kesenjangan pembiayaan. Untuk memobilisasi sumber tambahan pendanaan bagi sektor sanitasi, sumber pendanaan berikut dapat dipertimbangkan:

Toilet Truk tinja, gerobak

Fasilitas pen-gelolaan (IPLT)

Toilet Jaringan pipa Fasilitas pen-gelolaan (IPAL)

On-site

Off-site

Pembuangan Pengumpulan/transport Perlakuan/penyimpanan



i. Bantuan pemerintah pusat;

ii. Investasi sektor swasta;

iii. Pinjaman bank komersial domestik;

iv. Pinjaman bank bilateral dan multilateral, dan

v. Retribusi. Pilihan 1: Bantuan pemerintah pusat. Sebagian besar fasilitas pengelolaan lumpur tinja di Indonesia dibiayai oleh bantuan pemerintah pusat (banyak bantuan ini berasal dari pinjaman multilateral). Karena pemerintah pusat secara historis menetapkan prioritas yang rendah untuk prasarana sanitasi, investasi pemerintah dalam sanitasi tetap berada di tingkat yang sangat rendah (diperkirakan sekitar (US$ 5 juta pada tahun 2005). Meskipun Departemen Pekerjaan Umum ingan meningkatkan investasi untuk IPLT dan sanitasi terpusat, kelitahannya tidak mungkin bahwa bantuan pemerintah dapat diandalkan untuk menutup kesenjangan pembiayaan. Saat ini, penyaluran bantuan pemerintah pusat dilakukan melalui Dana Dekonsentrasi meskipun penyediaan sanitasi on-site merupakan tanggung jawab pemerintah daerah. Mekanisme yang sesuai untuk penyaluran bantuan semacam ini adalah DAK (Dana Alokasi Khusus). Pilihan 2: Investasi sektor swasta. Investor swasta ragu-ragu untuk berinvestasi dalam sanitasi terpusat atau fasilitas pengelolaan lumpur tinja dengan alasan: (i) tidak ada kebutuhan tetap untuk sanitasi terpusat dan pelayanan pengelolaan lumpur tinja; (ii) ketergantungan pada subsidi pemerintah daerah, karena pelaynaan sanitasi saat ini tidak disediakan dengan tarif penuh; (iii) proyek investasi yang kecil; dan (iv) akses terbatas terhadap pembiayaan proyek jangka panjang. Pilihan 3: pinjaman bank komersial domestik. Sebagian besar bank komersial (swasta atau milik pemerintah) tidak mau memberikan pinjaman jangka panjang kepada pemerintah daerah tanpa jaminan. Meskipun demikian, kabupaten atau kota tidak diperbolehkan oleh undang-undang untuk memberikan jaminan atau menawarkan pendapatan atau aset daerah sebagai jaminan. Selain itu hanya sedikit bank berpengalaman dalam pembiayaan prasarana sanitasi dan memperoleh kesulitan untuk mencari dana yang sesuai dengan masa hidup ekonomis dari sistem sanitasi (15-20 tahun). Pilihan 4: pinjaman bank bilateral dan multilateral. Hampir semua sistem sanitasi terpusat di Indonesia, serta sejumlah besar fasilitas pengelolaan lumpur tinja, didanai oleh pinjaman bank multilateral. Bank Dunia dan ADP terus menerus menyatakan ketertarikan untuk mendanai sebagian besar kesenjangan pembiayaan melalui pinjaman jangka panjang. Meskipun pemerintah Indonesia telah menetapkan mekanisme untuk proses penyaluran pinjaman multilateral sebagai penerusan pinjaman (SLA) kepada pemerintah daerah melalui Departemen Keuangan, pemerintah ragu untuk menggunakan mekanisme ini sejak krisis moneter tahun 1997/98. Dalam sudaut pandang ketersediaan sumber pendanaan lain, mungkin saja bahwa pinjaman bank multilateral ini akan berperan besar dalam menutup kesenjangan pembiayaan di sektor sanitasi. Pilihan 5: retribusi. Di seluruh dunia, sedikit pemerintah menetapkan tarif full-cost recovery untuk sanitasi terpusat atau pelayanan pengelolaan lumpur tinja yang sebagian disebabkan oleh pemahaman terhadap eksternalitas positif yang besar (seperti manfaat kesehatan dan lingkungan). Pada sebagian besar pemerintah daerah di Indonesia, pendapatan dari retribusi sanitasi dapat diabaikan dan pelayanan sanitasi hampir seluruhnya disubsidi. Dari sudut pandang implikasi politik dan sosial, tidaklah realistis untuk mengharapkan pemerintah daerah menetapkan tarif full cost recovery dalam masa jangka pendek. Paling mungkin adalah bahwa mereka mungkin bersiap untuk menerapkan tarif yang dapat membiayai biaya O&M di masa jangka panjang. Ini berarti bahwa pemerintah daerah akan perlu memobilisasi sumber pendanaan tambahan untuk menangani biaya investasi dan, setidakny apada awalnya, sebagian dari biaya operasional dan pemeliharaan.



5.5 Unsur-Unsur Kunci dari Suatu Strategi Pelaksanaan

DAK, bukan Dekon. Saat ini, sebagian besar fasilitas pengelolaan lumpur tinja di Indonesia terus dibiayai oleh bantuan pemerintah pusat (biasanya sebagai Dana Dekonsentrasi), meskipun pemberian sanitasi on-site merupakan tanggung jawab pemerintah daerah. Mekanisme yang sesuai untuk menyalurkan dana semacam ini adalah Dana Alokasi Khusus. Implementasi prinsip “yang membuat polusi yang membayar”. Saat ini, prinsip ini tidak diterapkan di manapun di Indonesia. Direkomendasikan bahwa pemerintah mulai kena retribusi “sanitasi komunal” untuk membiayai:

i. 100 persen biaya pengelolaan lumpur tinja penuh; dan

ii. 30 persen dari biaya penuh pelayanan sanitasi terpusat (sisanya akan dibiayai dari retribusi rumah tangga yang terkait dengan pelayanan ini).

Diajukan bahwa pemerintah daerah harus menetapkan retribusi komunal dengan persentase tetap pada pajak penerangan jalan umum dan mengumpulkan pajaknya bersama dengan pajak ini. Ini merupakan pembayaran yang transparan (struktur pembayaran sederhana), efisien (PT. PLN sudah mengumpulkan pajak penerangan jalan umum yang merupakan tambahan dalam rekening listrik), setara (hanya rumah tangga dengan listrik yang membayar) dan dapat diterima secara politik (karena pajak penerangan jalan umum merupakan pajak daerah). Implementasi usulan ini memerlukan dikeluarkannya peraturan pajak daerah (Peraturan Daerah) dan kerjasama PT PLN. Tindakan ini tidak memerlukan perubahan peraturan nasional. Klarifikasi tanggung jawab untuk sanitasi pada tingkat pemerintah daerah. Pada sebagian besar pemerintah daerah, tanggung jawab sanitasi ditanggung bersama antara Departemen Pekerjaan Umum, Departeman Kesehatan, PDAM, Departemen Kebersihan Daerah (Dinas Kebersihan dan Pertamanan) dan berbagai badan lain. Direkomendasikan bahwa pemerintah daerah menetapkan tanggung jawab untuk pelayanan sanitasi pada suatu badan tunggal dan memastikan bahwa badan tersebut akan menerima dana yang cukup untuk pelaksanaan tanggungjawabnya. 5.6 Kesimpulan dan Rekomendasi

5.6.1 Sistem Pendanaan

Departemen Pekerjaan Umum memperkirakan bahwa investasi pemerintah di sektor sanitasi harus meningkat dari kurang dari 100 milyar rupiah menjadi lebih dari 900 milyar rupiah per tahun untuk mencapai tujuan yang ditetapkan dalam Rencana Aksi Nasional Sanitasi untuk peningkatan penyediaan fasilitas sanitasi untuk 75% dari populasi pada tahun 2015. Investasi ini terutama akan dialokasikan untuk: (i) fasilitas pengelolaan lumpur tinja, dan (ii) sistem sanitasi terpusat. Sistem pendanaan yang diajukan dapat dirangkum sebagai berikut ini:

• Pengelolaan limbah tinja. Pemerintah daerah akan menanggung biaya penuh fasilitas pengelolaan lumpur tinja dari retribusi komunal (ditetapkan sebagai persentase tetap dalam rekening listrik). Investasi dalam IPLT akan dibiayai dari: (i) bantuan pemerintah pusat yang disalurkan kepada pemerintah daerah sebagai DAK; (ii) penerusan pinjaman yang dibiayai oleh bank multilateral dan bilateral..

• Sanitasi Terpusat. Dalam jangka panjang, pemerintah daerah akan menanggung 30% dari biaya penuh pelayanan dari retribusi komunal. Sisanya akan ditanggung dari retribusi rumah tangga yang mendapatkan pelayanan ini. Pemerintah pusat akan membiayai pembangunan sistem-sistem baru dari anggarannya yang ditambah dengan pinjaman multilateral dan bilateral.

Dalam jangka pendek dan sedang, tidak mungkin bahwa investor swasta atau bank komersial domestik akan dapat berperan dalam penanggulangan kesenjangan pembiayaan tersebut.



5.6.2 Pengaturan institusional.

Pengaturan ini dapat dirangkum sebagai berikut:

• Pinjaman pemerintah pusat untuk fasilitas pengelolaan lumpur tinja akan disalurkan sepenuhnya ke pemerintah daerah dalam bentuk DAK (Dana Alokasi Khusus) dan tidak lagi sebagai Dana Dekonsentrasi.

• Pemerintah daerah akan mulai memungut “retribusi sanitasi komunal” untuk membiayai 100% dari biaya penuh pengelolaan lumpur tinja (dan 30% dari sanitasi terpusat, jika ada). Biaya ini akan ditetapkan sebagai persentase tetap dalam pajak penerangan jalan umum dan dikumpulkan bersama-sama dengan pajak ini.

• Pemerintah daerah akan memberikan tanggung jawab untuk pelayanan sanitasi ini kepada suatu badang tunggal dan mendanai badan tersebut sesuai dengan tanggungjawabnya.

6 RINGKASAN

6.1 Temuan Sanitasi

(i) Institusional (organisasi), untuk di level pusat yang sudah berjalan, dipandang perlu memperkuat kemampuan berkoordinasi; semua stakeholders sepakat untuk mengembangkan sanitasi dengan segala ‘tools’ yang telah disiapkan seperti pelimpahan wewenang sanitasi (desentralisasi), adanya kebijakan, strategi, RPJM, Action Plan, NSPM, peningkatan dana untuk sanitasi (contoh: Binpram CK mulai 2007 akan meningkatkan dana sub-sektor sanitasi menjadi 25% dari dana untuk sub-sektor air minum). Yang masih diperlukan adalah pelaksanaan koordinasi yang lebih intens dari institusi di tingkat pusat dalam mengembangkan sanitasi. Pada level di pemerintah daerah, lembaga yang menangani sanitasi (air limbah) mempunyai nomenklatur yang bervariasi dan perlu ditunjukkan pemeran yang berkewenangan dan dilakukan pemisahan yang jelas antara peran regulator dan peran operator.

(ii) Kapasitas Lembaga/ institusi ditingkat pusat cenderung lebih mantap, mereka

sangat memahami masalah sanitasi di Indonesia termasuk target komitmen MDGs, dan SDM professional, namun mengembangkan kebijakannya apalagi sampai tingkat operasionalisasi di Daerah masih jauh dari apa yang diharapkan. Keadaan ini dipengaruhi oleh berbagai faktor antara lain: (i) keberbagaian (variasi) lembaga Daerah yang ada; (ii) demikian pula dengan ketersediaan sumber daya manusia yang tepat kualifikasi dan profesinya; (iii) sering terjadi pergeseran jabatan SDM yang tidak sesuai dengan kompetensinya; (iv) SDM terlatih atau telah mendapat training sanitasi tetapi tidak ditempatkan pada posisi yang tarkait, (v) penugasan SDM untuk mengikuti pelatihan tetapi bukan berasal dari instansi terkait dengan sanitasi dan setelah selesai mengikuti training tidak ditempatkan pada instansi yang sesuai (sanitasi). Perlukah dibentuk institusi khusus atau badan otoritas yang menangani sanitasi, seperti halnya badan otoritas lain yang sudah ada atau seperti BPPSPAM?

(iii) Capacity Building. Operasionalisasi Sanitasi; Sesuai dengan dengan OTDA,

sanitasi sudah berada pada lingkungan masyarakat langsung. Penyedia dan pengguna sudah dekat. Selanjutnya tinggal bagaimana pemkab dan pemkot melaksanakan implementasi pengembangan sanitasi. Perlu pengkajian lebih lanjut apakah ada permasalahan di tingkat operasional, mengapa sanitasi jalan ditempat, apakah diperlukah capacity building untuk memberdayakan dalam pengembangan sanitasi, kemudian seberapa jauh kapasitas lembaga/instansi/dinas yang terkait dengan sanitasi dan bagaimana untuk meningkatkan kapasitas.



(iv) Advokasi; Diperlukan advokasi untuk level kota berkaitan dengan pemahaman dan penyadaran pentingnya sanitasi dan promosi hygiene. Untuk menggulirkan pemahaman supply driven menjadi demand driven, keberlanjutan dan demand responsive. Bila ada suatu peraturan yang menyatakan bahwa pengembangan sanitasi kota kecuali untuk individu adalah menjadi kewajiban pemerintah dan masyarakat sadar bahwa sanitasi kota sudah merupakan kebutuhan masyarakat, maka adalah sangat mungkin muncul class action bila masyarakat merasa pelayanan sanitasi umum tidak memadai/ buruk.

(v) Regulasi, pada level pusat, regulasi sudah cukup banyak. Peraturan yang berkaitan

dengan sanitasi sudah tersedia. Yang diperlukan adanya penjelasan tambahan atau revisi-revisi agar lebih jelas dan mempermudah proses deliveri kebijakan dan strategi nasional sektor sanitasi ke tingkat daerah. Namun demikian kebijakan, dan strategi nasional masih belum disiapkan payung hukumnya, seperti kebijakan sanitasi berbasis masyarakat dan yang berbasis lembaga, NAP, kebijakan dan strategi pengembangan penyehatan lingkungan pemukiman. Demikian juga beberapa rancangan perturan mengenai sanitasi juga masih dalam bentuk rancangan. Perda, kebijakan, strategi, RPJM, RPJP, kegiatan tahunan di pemkab/pemkot terkait dengan sanitasi masih belum mengacu pada regulasi ditingkat nasional atau belum mengacu pada kebijakan dan strategi naional karena belum mempunyai payung hukum untuk diambil sebagai referensi.

No. REGULASI 1 UU Kes. 23/92 2 UU 23/92 3 UU 23/97 4 UU25/00 5 UU 7/04 6 PP 16/05 7 PP 82/01 8 PERPRES 67/2005 9 Kep Menkes 1575/05 10 Kep.Menkes 1274/05 11 Kepmen LH 112/03

(vi) Finansial, untuk peningkatan sanitasi apalagi untuk mencapai target MDGs tahun

2015 menjadi salah satu masalah utama. Dokumen NAP menyampaikan untuk mencapai target MDGs perlu dana yang sangat besar. Dengan kondisi ekonomi seperti sekarang besarannya bisa cukup fantastis. Seperti halnya kebutuhan dana di tingkat nasional, pemda juga kesulitan dalam meningkatkan dana untuk pengembangan sanitasi, disamping sanitasi belum menjadi prioritas untuk dikembangkan dibandingkan pembangunan infrastruktur lainnya. Perlu terobosan khusus untuk menggali dana bagi pengembangan sanitasi. Menggali dari dana masyarakat?; Pinjaman dalam negeri?; Loan?; Soft Loan?; Grant? ; NGO? Mengembangkan bisnis sanitasi dengan bisnis plan yang jelas? Pengembangan entrepreneurship?. Mengembangkan bisnis sanitasi dengan bisnis plan yang jelas?

6.2 Umpan Balik Pelaksanaan Workshop

6.2.1 Kelembagaan

o Kalau lembaga tetap mengikuti tupoksi agar diperkuat koordinasi dan kebijakan sanitasi yang terintegrasi baik berbasis masyarakat maupun berbasis lembaga;

o Lembaga penanggung jawab sanitasi agar dalam satu instansi; o Pemisahan regulator dan operator; o Bantuan teknis;



o Operator dapat bervariasi, tetapi lebih cenderung yang independent, tetapi hendaknya operator IPAL (sewerage) dan IPLT dalam satu instansi;

o Perlu advokasi/sosialisasi DPRD, karena sangat berperan dalam hak budget, termasuk perda retribusi juga harus acc DPRD;

o Perlu bantuan advokasi, marketing sanitasi untuk peningkatan kesadaran agar terjadi perubahan dari suplay driven menjadi demand driven;

o Pelatihan operator IPLT, IPAL, SOP dan Maintenance M&E terutama yang kotanya terdapat IPAL, serta Fasilitator.

6.2.2 Regulasi:

o Kebijakan sanitasi berbasis masyarakat (CBS) dan sanitasi berbasis kelembagaan (IBS) agar segera dikeluarkan Peraturannya, sehingga dapat menjadi acuan Perda mengenai sanitasi (payung hukum);

o Perlu UU sanitasi (khusus) ditingkat nasional; o Perlu standarisasi substansi perda sanitasi termasuk pengertian dalam sanitasi; o Peraturan yang memungkinkan diberikan akses ke fasilitas sanitasi bagi urban-poor

sekalipun tempat tinggalnya ilegal, misalnya dengan menyediakan MCK Sanimas atau MCK dengan koneksi ke saluran air limbah perpipaan (sewerage);

o Perbanyak SNI yang berkaitan dengan sanitasi seperti norma, standar, pedoman, juklak (NSPM) sebagai referensi di daerah (implementasi).

6.2.3 Finansial

o Pengertian business plan (BP), bantuan penyusunan BP dengan segala aspek yang mendukungnya (pedoman, manual dll).

o Bantuan dana investasi, operasi dan pemeliharaan (O&M) minimal untuk 5 tahun pertama atau stimulan lainnya (pilot project)

6.3 Action Plan untuk 6 bulan Mendatang

6.3.1 Aspek Kelembagaan

Tugas: mengembangkan kerangka kerja kelembagaan di tingkat nasional • Mengadvokasi Pemerintah Indonesia untuk menyetujui kebijakan WASPOLA; • Mengidentifikasi dan menilai pilihan-pilihan kelembagaan; • Memulai dialog dengan pengampu kepentingan (stakeholder) nasional &

mengidentifikasi/merekrut pemenangnya; • Mengembangkan pilihan kelembagaan: (panduan penatalaksanaan, panduan untuk

memperkuat sumber daya manusia, panduan untuk perpaduan perencanaan dan penatalaksanaan, menyiapkan peraturan, tanggung jawab dan hubungan dalam sanitasi).

• Program Dukungan Sanitasi: (pedidikan, sertifikasi, penelitian, dukungan teknis, panduan)

6.3.2 Advokasi

Tugas: Mengembangkan kapasitas pembuat kebijakan kunci dan pengampu keputusan (advokasi)

• Mengembangkan komunikasi untuk perubahan strategi (merencanakan untuk advokasi pemimpin daerah dan berbicara dengan wanita);

• Sepakat untuk pesan-pesan kunci (membuat kasus sanitasi); • Membuat rencana media; • Mengembangkan outline & implementasi arah advokasi; • Mengumpulkan sekutu; • Mencari komunikator; • Mencari pemenang.



6.3.3 Kebijakan dan Peraturan

Tugas: memperkuat kebijakan dan peraturan • Menetapkan kerangka kerja untuk tingkat pelayanan minimal; • Menyarankan mekanisme untuk menyepakati & memantau insentif target kota,

supervisi/sanksi; • Mengajukan pemecahan untuk keterbatasan-keterbatasan hukum bagi tindakan

daerah; • Menyiapkan outline peraturan sanitasi.

6.3.4 Aspek Keuangan

• Menyiapkan panduan untuk Cost Recovery dan kesinambungan: • Substansi untuk insentif pajak bagi pengembangan sanitasi; • Mengajukan Kebijakan Mekanisme Pendanaan; • Mengajukan kerangka untuk kriteria investasi; • Mengidentifikasi sumber pendanaan sesungguhnya; • Mengestimasi tingkat pemakaian kapasitas infrastruktur yang telah ada; • Menganalisis persyaratan pendanaan; • Menganalisis kesenjangan pendanaan; • Mengestimasi proyeksi sumber dana selama tahun 2007 dan setelahnya.

6.3.5 Panduan untuk Pemerintah Daerah

Tugas: Mengembangkan strategi dan panduan rencana aksi untuk pemerintah daerah • Membentuk kelompok kerja dengan PU untuk membahas buku sumber; • Mengidentifikasi isi manual LG (buku sumber sanitasi); • Menyiapkan model sanitasi PERDA; • Menyiapkan kerangka kerja untuk tingkat pelayanan minimal.



ANNEX 2 SANITATION AWARENESS AND HYGIENE PROMOTION

1.1 Market Studies, Campaign and Communication Packages

The national, segmented sanitation awareness and hygiene promotion campaigns, (with related preparatory market studies), includes an array of smaller, self-contained packages. For each package, distinct target groups, objectives, media channels and communication materials apply. This break-down into smaller packages is a practical way to manage the potential C3 workload. The general purpose of each package in the process of change (awareness - change - sustenance of change) is indicated in Table 3-1, Volume I, Main Report, Chapter 3. Except for the priority campaigning in poor urban pilot areas, the Program does not envisage large scale roll-outs of campaign packages. The Program outputs are defined as campaign designs, pre-tested master materials and funding proposals for roll-out. In reality, the packages listed here will not be "preserved" until such time when funding sources are secured. Using own funding sources, several packages described here will be developed and implemented on a pilot basis in the course of 2006 and early 2007, including typical advocacy and community empowerment events. For immediate and future roll-outs, a campaign implementation strategy will be worked out in the coming months, in consultation with the SANWG, which addresses such issues as package sequencing, linkages, standardization etc., issues that do not per se alter the production contents of each package. Study package 1: KAM assessments The best opportunities to know KAM-related barriers among decision makers would be their response to milestone events in the sanitation planning process, both at National and City levels, including bilateral meetings, workshops etc. To make this work, meeting reviews will always include interpretive assessments on the deeper KAM reasons that explain why officials are interested or reserved about sanitation issues or proposed solutions. Findings will be specifically reported throughout the Program period. Study package 2: projected sanitation demand The type and volume of city sanitation demands will be extrapolated from secondary data that are available for Kelurahan level, including population data and socio-economic characteristics. These projections of potential sanitation demand will be published as part of the Sanitation White Books. Study package 3: real sanitation demand assessments at community level Real demand surveys will be implemented in problematic and poor city areas, as prioritised for improvement in the coming 3-5 years by the Kelurahan. These PSA based sessions will be the first in a series of events in related communities, as indicated in package 6.2, and will be followed up with demand raising campaigns and sosialisasi events at the time of implementation. Implementation: November 2006 - March 2007, starting in Blitar, Surakarta and Banjarmasin with the other cities to follow.



Study package 4: sanitation supply studies Supply study components 1-7 will be implemented as separate or combined activities. Study and survey findings will form the basis for general capacity conclusions and specific promotion, briefing or training packages recommended for each target group to increase their quality and quantity of supply, promote public-private partnerships, development of supportive regulations, credit facilities etc. Implementation: August - December 2006, international and local experts being mobilized. Study package 5: hygiene behavior As defined in package 10.1 and 10.2, the HWWS campaigns will be segmented for various mass media and target groups, each requiring specific styling and triggers. Concept master materials (posters, video clips, guidelines) will be extensively pre-tested prior to expensive roll-outs and duplication. Where campaigning is based on personal intermediates (teachers, office bosses, women groups, medical staff) it is assumed that they have sufficient feeling for their target group to determine additional convincing triggers for their audience, while maintaining the basic ingredients of the HWWS message. Close monitoring of the pilot campaigns should confirm the validity of this assumption (action research). 1.2 National Sanitation Awareness Campaigns

Sanitation Awareness Package 1.1: National sanitation mass media campaign Includes series interrelated messages in one or more mass media. Possible main theme: disgust, shock, enough-is-enough, shame, clean/healthy city. The main theme will be sequentially combined with sub-themes such as open defecation, human waste disposal, solid waste issues, drainage, school sanitation, washing hands with soap etc. Actions

o SANWG to articulate campaign ownership, strategy and concrete topics as per GOI policies o C3 to assist SANWG with exploring media interests and establishing campaign partnerships o C3 to subcontract national baseline and monitoring mechanism o C3 to pre-design and pre-test short media messages and materials

Sanitation Awareness Package 1.2: National newspaper coverage Free press coverage Invite major national newspapers and weeklies. Brief on the need to expose urban sanitation issues, seek official responses, explore role of private sector, the cost of doing nothing, provoke with pictures and statements, keep up the heat. Focus on journalists with demonstrated interest in ISSDP/development issues. Negotiate regular coverage. Ask journalists to act on their own initiative and follow-up on ISSDP hints. Regularity is key: e.g. at least twice a week for 6-12 months. Concept cartoons Subcontract cartoonist to publish a series of 3-4 picture cartoons, e.g. once every week, related to behaviors we wish to expose. Introduce anti-pollution “wise cracker”. Advertising Buy newspaper space for special announcements from Ministries, ISSDP etc on policies, new projects and, especially, solid work progress. Start-up by September 2006.



Sanitation Awareness Package 1.3: National TV and Radio Coverage For further exploration required: inserted messages in popular sitcoms, talk shows etc., reports, documentaries, news items. 1.3 City level sanitation awareness campaigns

Sanitation Awareness Package 2.1: city level campaigns Includes series of interventions with public displays in streets, coverage by local media etc. Possible main theme: disgust, shock, enough-is-enough, shame, clean/healthy city. The main theme will be sequentially combined with sub-themes such as open defecation, human waste disposal, solid waste issues, drainage, washing hands with soap. Actions

o Local contests e.g. to develop clean/healthy city logo, essay on creative solutions etc. o Establish local coalition for health improvement: Koalisi untuk <City name> Sehat, following the

example of Jakarta (KUJS). This would open the door for collaboration with KUIS. o Review existing experience with larger city campaigns, popular channels, production capacity o Establish working relation with INFOKOM Kota Madya and assess their interest o C3 to provide technical assistance and limited or no funding.

Sanitation Awareness package 2.2: local press coverage

1 Prepare city specific press briefings 2 Identify and mobilize local journalists with demonstrated interest. Brief on ISSDP, City

sanitation and role of the (free) press. 3 Repetition/regularity in publicity is key: e.g. at least twice a week for a whole year. 4 Monitor what happens. Maintain clipping dossier 5 Buy advertising space to make public statements, report on tangible progress, special

sanitation column. 6 Optional (nice but not critical): publication of nationally produced cartoon series, or

locally contracted version Start-up (1-2): August - September 2006. Implementation: continuous Sanitation Awareness package 2.3: local TV and radio coverage For further exploration: inserted messages in local popular programs, talk shows, news reports. Sanitation Awareness Package 2.4: local rules, regulations and adat Sanitation programs often include initiatives that can hardly be labeled as systematic “campaigns”. However, with proper follow-up these loose ideas can help to create awareness and demand. Examples:

o Open defecation, polluting sceptic tanks etc. are declared “illegal”, or “environmental offences”. As per current legislation this is already the case, but enforcement is not considered. Activation of these rules, even without immediate penalties for the time being, will make polluters wonder… and officials have some basis to issue official “warnings” or create embarrassment.

o Building permissions and as-build inspections are only issued if the minimum requirements for

sanitation are met.



o PUSKESMAS Sanitarians already have an official responsibility to check the location and

functioning of sceptic tanks and soak pits. As part of local campaigning they step up their supervision role.

o Couples registering their intended marriage are explained that their new responsibilities include

sanitation at home, as basis for a healthy family life.

o Candidate Hadj pilgrims, about to become respected religious and social role models, are required to have adequate sanitation at home or, alternatively, help to solve pollution issues in their direct living area.

o Authorities start to test groundwater samples in suspected problem areas and provide feedback

on the results to households, creating appropriate unrest and awareness.

o Public monitoring (by schools, students, volunteers) of restaurants, hotels, food stalls, polluted places, public toilets, using simple indicators. Immediate start possible.

Implementation / try-outs: continuous Sanitation Awareness Package: ISSDP visibility and public relation materials 1. House style for printed materials, including logo. 2. ISSDP brochure 3. Fact sheets one page topical leaflets e.g. urban sanitation strategy, newsletter, city profiles, etc. 4. Posters, as produced by PT Qipra Galang Kualita. For further adaptation, expansion, printing and

distribution. Office use. 5. Sector booklet Ini bukan lagi urusan pribadi! Produced by PT Qipra Galang Kualita and printed as

part of ISSDP Fast Track Studies. Additional copies and revised 2nd edition required. 6. Stock materials with collection of digital pictures for re-use in presentations, reports etc. Started

and still growing. 7. Promotion items (optional) 8. Calendar 2007, in co-production with WASPOLA. Distribution: December 2006. 9. Web site with downloadable documents, counter, chatbox, newsletter etc. 10. Who is who in ISSDP booklet, with staff photos and profiles 11. Sanitation Solutions. Several versions / adaptations will be required:

1. Very basic and large (flip chart) set of pictures/drawings to generate informed decisions during Participatory Sanitation Assessment and Planning sessions at community level. Production: August - September 2006.

2. Same set, adapted as posters. Production: August - September 2006. 3. Same set, adapted as pocket book for households: "People's catalogue of sanitation solutions".

Production: August - September 2006. 4. Loose leaf collection of sanitation solutions (technologies and approaches) for decision makers,

following Philippines example. Production: September 2006 - March 2007. 5. Same as 11.4, including decision flow charts etc. as manual for sanitation experts/planners,

following Philippines example. Production: September 2006 - March 2007. Also considered: Sanitation Development Partners: resource book / yellow pages with institutions, resource persons, programs, donors, sponsor profiles etc. Sanitation Champions & Initiatives : collection of example case histories and initiatives, covering the whole spectrum of sanitation solutions. Includes pictures, interviews etc. Mainly from ISSDP cities.



Advocacy Package 3.1: National milestone events 1. ISSDP's core management and SANWG members to recognize and prepare for their role as

advocates, lobbyists and negotiators in enabling framework. 2. Map enabling framework, including key positions, movers and shakers, champions. 3. Define key messages and outputs of ISSDP, including selling points and anticipated ambiguities. 4. Based on 1-3 above: Define advocacy communication plan as series of events and opportunities

linked to general ISSDP work plan: who says what to whom, when and how in workshops, bilateral and topical meetings, etc. This will probably result in new and adapted designs of advocacy materials.

5. Formalized training in personal advocacy and lobbying skills might be required. 6. Most advocacy events will require: (a) presentation rehearsals, (b) review of documents, handouts

and presentation materials with respect to clarity, solutions, house style, and (c) review of events and meetings with respect to barriers and motivators (=KAM assessments).

Start-up (1-5): August - November 2006. Implementation (6): continuous Advocacy package 3.2: City level milestone events 1. POKJAs and City Facilitators decide on milestone meetings in the sanitation strategy development

process and treat these as advocacy opportunities. 7. Formalized training in personal advocacy and lobbying skills might be required. For CFs a first

exposure session is scheduled on 16 August 2006 2. POKJAs and City Facilitators identify credible local facilitator/lobbyist for all crucial meetings and

related pre & post meeting lobbying. It is advised to use the same facilitator/lobbyist for all events to guarantee continuity and consistency.

3. For crucial meetings: invite Mayor, SEKDA or Kepala BAPPEDA to chair. Rehearse presentations with feedback from internal team. Review documents, handouts and presentation materials with respect to clarity, solution-orientation, consistent house styling.

4. Internally review each crucial meeting, keeping track of personal barriers and motivators, subjects to avoid or exploit with key decision makers (KAM assessment).

5. Production of standard support materials, including posters, booklets and brochures, pictures/slides for use in presentations, video programs and other materials that would be difficult or too expensive to produce locally. City Facilitators to personally distribute these materials, monitor actual usage and responses, and keep copies at hand in their office.

Start-up (1-2): August - September 2006. Implementation (6): continuous Advocacy package 3.3: Multi-city summits 1. Mayor+SEKDA+Kepala BAPPEDA+CFs = 6 x 4 persons. Rotate venue. Add external facilitator and

person to take minutes. 1.5 day (two nights) in conducive environment. 2. Who will issue the invitation: Minister of Home Affairs, DG, national ambassador for sanitation?

Avoid sending of delegated staff (how?). 3. If these summits pick up momentum, they could rotate, with each city hosting in turn. First summit in

Jakarta by November/December 2006. 4. Proceedings/topics: exchange urban planning visions and logical links with sanitation improvement,

compare notes on experiences in ISSDP and articulate expectations, introduce elements of peer pressure and competition.

5. Next meeting in 2007 could be used to meet directly with Donors and discuss funding criteria and mechanisms.

6. Lobby in advance with possible champions to play a key role. Include interesting site visits or guest speakers.

Note: City Facilitators to make their own arrangements for ad hoc local “twinning” such as Solo – Blitar (already happing), Payakumbuh - Jambi. Implementation: One meeting in 2006 + two in 2007



Participation and empowerment package 4.1: Kelurahan consultation and information sessions Basic agenda: Morning: 1. Overview of city dreams and urban planning (15 min) 2. Overview of sanitation issues in the city, seriousness, risks etc (15 min) 3. Summary of PEMDA planning cycle and position of Kelurahan (15 min) 4. Open inventory sanitation issues and possible solutions in the Kelurahan. Results of

previous PSAP among poor communities are tabled. (extensive) 5. Additional information on sanitation solutions: catalogue materials (15 min) Afternoon: 6. Priorities, plans, implementation modalities, willingness to pay etc. (extensive) 7. Summary sessions: potential demands, trends etc. as input for sanitation strategy, next

steps (30 minutes) Notes: 1. Opening by Mayor (c.s.) to confirm relevance of event and pave the way for sanitation

priorities. 2. All presentations to be checked for clarity and appeal to the audience 3. Requires good external facilitator 4. Mainly Lurah are invited, not other higher up dignitaries as they would dominate or inhibit

discussions with their presence. POKJA members as observers in the background. 5. Focus on participation of Kelurahan with poor areas and focus on sanitation for the poor 6. Compile findings and to make sure these are channeled to the right persons/agencies to

make the voice and choice of the kelurahan heard. 7. Plans and priorities for "total sanitation": human waste, solid waste and drainage 8. Seek coverage by local media Participation and empowerment package 4.2: Community sanitation assessments 1. Includes a series of events, in quick logical succession, including local awareness

campaigns as warming-up and practical information dissemination on sanitation solutions. Targets will be set in the range of 50-80% coverage.

2. Warming-up campaigns will include production of banners, music, contests, appearances of popular personalities etc. Usually, local organizers can be found to organise such happenings in a creative manner.

3. The main features of Participatory Sanitation Assessments (PSA) sessions include: guided self-discovery of the main issues, open-ended priority setting for human waste, drainage, solid waste solutions, extensive use of local knowledge and creativity, no promises of subsidies for households and stressing collective community participation as condition for LG involvement.

4. PSA sessions will include initial efforts to negotiate community tasks/contributions and the involvement of the private sector and the local government. It is important that facilitators know all the ins and outs of sanitation solutions (catalogue) that are on offer.

5. Protocols for PSA are available from other programs. Lack of local facilitators may limit the volume of PSA sessions in all prioritized areas.

6. Results of PSA sessions (mainly primary qualitative data) are fed into the existing annual planning cycle at Kelurahan level. Perhaps additional lobbying and promotion of results is required at higher planning levels (Kecamatan, City) and in the private sector.



Special issues package 5.1: hazardous sceptic tanks Mainly in better-off areas, where ground water pollution is a demonstrated public health issue. If there is no immediate health threat, neighborhoods may still be interested to improve dysfunctional or smelly tanks, resolve sludging issues etc. The package will include local awareness campaigns and public consultations with households in problem neighborhoods, including information, presentation of various options to improve tanks and negotiations / agreements with municipal or private service providers. Special issues package 5.2: optimization of sewer systems Standard campaigns include timely pre-, during and post construction information of what is happening, what it will mean (services, payments) and what the benefits are. Door-to-door & public hearings expected. Issues may include: o Number of house connection remains below expectations (Banjarmasin) o Many in-house toilets are not connected to the system. o Inconvenience/protest caused by delays, successive repairs, street break-ups (Denpasar) o Pockets of uncovered areas within the system o Industries drain hazardous waste water in the system o Services and payment issues, including lack of willingness to pay. Special issues package 5.3: Polluting small industries and medical wastes in living areas Campaign details to be worked out. Includes: promotion of on-site or nearby treatment tanks for the industry with enough capacity to link households in the same area. Schools Sanitation package 6.1: total school sanitation Campaign details to be worked out. Individual projects should include provisions for sceptic tank, hygiene promotion, solid waste management, "3-R" contests, curriculum inserts etc. Example school packages are available from other programs and will be compiled and translated for distribution. Sanitation Supply Promotion Package 7.1: NGOs, Universities and consulting firms. Studies and assessments may confirm the need stimulate capacity building and training in community facilitation, sanitation project management and other areas of assistance. The success and scale of ISSDP initiatives depend on sufficient capacity in these areas.



Sanitation Supply Promotion Package 7.2: Media and campaign resources, including local press, TV, radio, internet providers, material designers, publishers, printers etc. who might play an independent or subcontracted role in local campaigning and the public coverage of sanitation issues and developments. Sanitation Supply Promotion Package 7.3: Potential sponsors. Once the potential of CSR-based sponsoring (national and in the cities) is defined, a special package is required to stimulate interest of potential in ISSDP activities. This includes news letters, workshop, visits and, ultimately, the submission of funding proposals for long term commitments. At short term, selected candidate sponsors will be approached for the funding of HWWS and school campaigns. Sanitation Supply Promotion Package 7.4: Door-to-door service providers, including latrine and sceptic tank builders, plumbers for installation and unblocking services. Studies and assessments may show a need to inform door-to-door providers on potential sanitation markets and to arrange for training on skills, technical standards etc. Sanitation Supply Promotion Package 7.5: Public services and businesses, including shared toilet facility operators in neigborhoods and busy public places, private carriers, solid waste recyclers and middle men. Where studies and assessments confirm a potential market and entrepreneurial interest, information campaigns and coaching support will be defined. Sanitation Supply Promotion Package 7.6: Shops and manufacturers of components. Studies may confirm the need to stimulate commercial interest in the growing urban sanitation markets. Sanitation Supply Promotion Package 7.7: Learning, research and information centres. Based on study and assessment findings, recommendations for institution, professional networking and capacity building will be drafted and promoted. The actual implementation of capacity building plans for sanitation knowledge management will be outside the scope of ISSDP. For immediate use, City Facilitators establish local libraries of printed and electronic documents.



Hygiene Promotion Package 8.1: National HWWS initiatives and media campaign Still open for debate and decisions: 1. Positioning of GOI or non-government coalitions (KUIS) as national HWWS campaigner. 2. Public Private Partnerships 3. Recruitment of a national HWWS Coordinator 4. Direct involvement of national agencies in local City campaigns (Package 8.2) 5. By April - August 2007: proposals for continued mass media campaigning and scaling-up

of campaigns based on direct consumer contacts whereby HWWS coalition partners dispatch tested guidelines and materials to all schools, all mosques, all PUSKESMAS, all GOI offices, all PKK units in the country etc.

National mass media: 1. Newspapers/magazines: continuous ads, articles and local campaign reports 2. Radio and TV: repeated commercials, talk shows, demonstrations 3. Stickers/inlays with HWWS details provided with soap, as constant reminder at a national

scale. Soap is the only single medium that will repeatedly reach all target groups at national scale with very low cost.

Hygiene Promotion Package 8.2: hand-washing with soap - city level Objective: Reduced incidence of sanitation related diarrhoea and mortality among children between 0 - 5 years in selected problem zones of six ISSDP pilot cities. Main events in the cities With personal intermediates:

1. PKK (Pendidikan Kesejahteraan Keluarga) with topical sessions in selected poor/problem areas.

2. Mosques/Imams providing HWWS and cleanliness messages during Friday prayers as part of the existing Clean Friday Movement.

3. PUSKESMAS & POSYANDU with personal advise, demos, practice and display points, focusing on mothers with children in the critical age range.

4. GOI / PEMDA to ensure availability of soap and HWWS reminders in toilets of offices. 5. Schools to ensure availability of soap, HWWS reminders and educational activities to

change pupils' behaviour. 6. (Self-)monitoring and evaluation.

Optional simultaneous local media coverage:

1. Local newspapers: including adverts, cartoon series, news coverage 2. Local TV: adverts, inserted messages in talk shows, interviews 3. Local radio: adverts, talk shows, news and event coverage 4. Street displays: busses, public buildings, active city areas

Detailed activities: August 2006 - March 2007

a) Prepare HWWS campaign write-up and inform POKJAs and local intermediates. Explore interest and decide on the basics: priority areas, strategy, funding, indicators.

b) Meetings with potential local sponsors, secure commitments c) Undertake preparatory base line studies in selected city zones: health situation, media

channels, local styling. Some, but not all, data collection takes place as part of preparation of the Sanitation White Book

d) Local launches and implementation e) Prepare end-of-campaign reports and evaluations



Materials for central ISSDP production and pre-testing

1. Summary of HWWS research evidence (fact sheet) 2. Reader with collected short articles providing more evidence 3. Sticker "How to wash your hands with soap", for inclusion and distribution with soap 4. Booklet with quotes on cleanliness from the Quran, as available from the Council of

Ulamas 5. Commercials (30/60 seconds) for TV and Radio, newspaper ads etc.



ANNEX 3 QUALITY MANAGEMENT SYSTEM

These quality management procedures are referred to DHV Quality Management System

conform to ISO 90001:2000 and other documents. The procedures related to the consultants

work on ISSDP include:

A. Project Monitoring

B. Project Completion

C. Handling of Project Document

However, further consultant’s specific quality management and quality assurance plan will be developed after the inception report. This being a first draft only.



A. PROJECT MONITORING 1. OBJECTIVE

This procedure describes the activities and associated responsibilities involved in managing, monitoring and adjusting the implementation of the project in relation to the project plan. In cases where DHV acts as the leading partner or the sole consultant, the reference framework consists of the ToR and the project plan from the inception (reporting) phase, while for small assignments it is the ToR and the plan from the proposal. 2. DEFINITIONS

Project monitoring Managing the project development on the basis of the project plan and internal and external progress reports.

Project control Managing the financial and economic aspects of project

development on the basis of the internal task-setting project budget, current financial reports and bookings.

External progress report Progress reports made for the employer. Internal progress report Progress reporting between the project manager and

project director. Documentation of results Studies, specifications, etc., for the employer that are

specified in the project plan as an output/result of the project.

Adjustment within the margins Adjustment of a project (activity) while no changes are

being made to the contract and/or budget/profits. Adjustment outside the margins Adjustment of a project (activity) that cause changes to be

made to the contract and/or budget/profits. Project progress review A systematic, documented and periodic review of the

progress of the project by the project director, carried out if possible during his/her visit to the project location or otherwise based on reports and contacts with the project manager, in order to:

- simplify management control over the activities that affect any changes made to the project plan and/or the contract.

- determine the activities required and responsibilities for any adjustments that may be made.

Shortcoming A shortcoming is an undesired, incomplete or missing

project result—reported by an employee of DHV —which has far-reaching consequences for the profit margin and/or contract/project plan, and which can be traced back to internal activities/procedures.

Internal complaint A complaint submitted in writing by an employee of DHV. External complaint A complaint submitted in writing by an external party.



3. WORK METHOD

3.1 Project monitoring by team members

Each team member is responsible for carrying out input checks, and for monitoring the progress of the project plan in relation to his/her contribution to the project concerned. He/she reports on the findings periodically to the project manager. DHV team member may request for an internal progress review if he/she thinks this is necessary. 3.2 Project monitoring by the project manager

The project manager is responsible for collecting, measuring, systematizing and analyzing progress. This periodic review of the state of affairs is carried out at evaluation points specified before and in the project plan. The monitoring can be based on the quarterly project monitoring form. The progress achieved is systematized and compared with the project plan. The causes and effects of good and poor results and of delays or advances on the time schedule are analyzed, and corrective activities are formulated if necessary. External and internal progress reports are written based on the before mentioned information. 3.2.1 External progress report In consultation with the project director, the project manager is responsible for external progress reporting in accordance with the ToR/project plan/contract. The project manager is responsible for ensuring that at least one copy of each progress report that has been authorized and sent to the employer is available in the relevant sector of DHV. 3.2.2 Internal progress report The project manager is responsible for producing short written progress reports to the Project Director periodically (monthly, or at least quarterly) with the he frequency of such reports is determined and recorded for each project at the point when responsibilities and powers of the Project Director are delegated to the project manager.

externalprogress reporting

measure

periodicproject

planning

team member activities analysis

contract

project plan

internalprogress reporting

internal progress review

projectmanager

projectdirector



The styles of the reports have to follow the house style standard of the project approved by employer. These reports must contain at least the following details: - Financial accounts as laid down in the financial and administrational procedures of DHV

(including a budget update, cash/bank details and copies of invoices sent to the employer)

- Progress report (between one and a maximum of three pages long). This report supplements the progress report to the employer. The points to be covered in this report include working with third parties, and risks and problems that may potentially be expected

- Copy of any letters that are relevant to risk management; i.e. letters which can give rise to (substantial) changes which cannot be agreed to without further consultation with the employer.

The Project Director is responsible for providing written feedback in response to these reports. This must comprise at least the following: - Financial feedback as laid down in the Financial Manual (including a budget update and

payments of invoices sent to the employer) - Feedback in response to internal progress reports. 3.2.3 Documentation of results The project manager is responsible for ensuring that at least one copy of each ‘results document’ that has been authorized and sent to the employer is available in the relevant sector of DHV. 3.3 Project monitoring by the project director

The project director is responsible for project monitoring based on the written communication recorded in the external and internal progress reports and the monthly financial summaries generated by project control (refer to financial/administrational procedures DHV). In addition to this, a systematic, documented periodic review of the project's progress is carried out at least once a year. 3.4 Making adjustments

3.4.1 Making adjustments for nonconformities A distinction can be drawn between the following four control measures for carrying out adjustments: - change nothing because the nonconformity is negligible (project manager's

responsibility). - make adjustments within the margins (project manager's responsibility). Improvements

are formulated, in consultation with the project team, until the (sub-)project is found to be closer to, or completely in accordance with, the project plan when the next check on the state of affairs is carried out.

- make adjustments outside the margins (Project Director responsibility). The contract, subcontract, joint venture agreement or service agreement is changed, in consultation with the employer/partner, in accordance with the Contract Changes sections of the Concluding a Contract Procedure, Working with Third Parties Procedure, and the Buying in Expertise Procedure. Changes to budgets/profit margins are carried out in accordance with the Financial Manual.

- stop a sub-project/activity in cases where it appears to be pointless or impossible to continue the activity in its present form. If this falls within the margins of the project plan, it is the responsibility of the project manager, while if it falls outside the margins, it is the Project Director’s responsibility.

3.4.2 Dealing with shortcomings, complaints and claims Any shortcomings, complaints or claims that may be observed and/or reported are notified.





4. ACTIVITIES/POSITION MATRIX

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Project monitoring by team members �

Project monitoring by project manager � � �

Project monitoring by project director � � �

External progress reports � �

Internal progress reports � � �

Feedback on internal progress reports �

Documentation of results � � � � �

Adjustments within the margin � � �

Adjustment outside the margin � � � �



4.1 QUARTERLY PROJECT MONITORING FORM

GENERAL DATA OF THE PROJECT

Project Name/Country

Reference Number

Project Director

Project Manager

Reporting Period

PROJECT PROGRESS PERIOD 01 Progress of the project 1 General progress of the consultancy services:

Bottlenecks in the implementation:

Bar chart of activities, progress line (to be annexed):

Copy of progress report made for the client (to be annexed):

Copy of important correspondence with client/financier; minutes of meetings, etc. (to be annexed if not yet sent separately):

02 Personnel 2 Personnel engaged in the project (bar charts and time sheets to be annexed, if not yet sent separately):

Bottlenecks:

Personnel approved/disapproved by the client:

Personnel from the partners, local consultants:

Miscellaneous matters (salaries, insurance, accommodation, education, vehicles, etc.):



03 Finance 3 Status of invoices and payments (status report/chart to be annexed, if not yet sent separately):

Need for change in established transfers from DHV/HQ and local transfer schedules:

Specific problems in running costs, budget and expenditures:

Cash/Bank statements (to be annexed if not sent separately):

04 Contractual matters 4 Claims:

Litigation matters (if any):

End of contract:

Proposals for contract extension:

Contract of local partner(s)/local (sub)consultant(s):



05 Miscellaneous 5 Study tours for client’s representatives/others:

Political developments in country of project:

Conferences/Workshops:

Project possibilities in country of project (copies of announcements to be annexed):

Information on project in local media:

06 Actions required by DHV HQ/Project Director 6 Personnel:

Finance:

Contractual matters:

Miscellaneous:



4.2 PROJECT COMPLETION

4.2.1 OBJECTIVE This procedure describes the activities and responsibilities related to completing a project. 4.2.2 WORK METHOD 4.2.2.1 Draw up a draft final report In consultation with the team members and the project director, the project manager is responsible for drawing up the draft final report in accordance with the project plan and contract. 4.2.2.2 Sign and send draft final report The project manager signs the draft final report, sends it to the principal, the partner(s) and the project director for comments and approval. 4.2.2.3 Formulate comments and criticisms The project director is responsible for ensuring that the draft final report is drawn up in accordance with the agreements laid down in the contract. If necessary, a short report (action list with comments and criticisms) is sent to the project manager. 4.2.2.4 Draw up final report In consultation with the project director, the project manager is responsible for ensuring that the comments and criticisms of both the principal and the project director are incorporated in the final report. 4.2.2.5 Sign and send final report Unless the project director decides otherwise, the project manager signs and sends the final report to the principal, the partner(s) and to the sector of DHV concerned. 4.2.2.6 Employer satisfaction and certificate of

completion For each project an evaluation of the satisfaction of the employer will be carried out, and using one of the following scenarios:

- on the basis of an interview by the project manager with the Employer and/or the beneficiary (if different);

- by the project director him/herself, in DHV head office The approach will preferably be to visit and interview representatives of the employer and the beneficiary party. Employer’s pertinent questions can be responded to during the interview and the project manager can react to the responses given on the questionnaire. 4.2.2.7 Internal final discussion After completion of projects with a value over and above EU 250,000 or project duration longer than 6 months, a final evaluation takes place between at least the project director and

reports

sign andsend draft

final report

draw updraft final report

draw upfinal report

internal comments and

criticisms

sign and send

final report

client'scomments and

criticisms

Clientsatisfaction

Certificate ofCompletion of

Services



project manager. This discussion is based on the Internal Final Discussion Checklist and will also take into account the findings from the principal satisfaction interview. Any relevant issues are recorded in writing. Evaluations of partners and of procured services are handled in accordance with the Working with Third Parties Procedure including filling of form CONS 14f2) and the Buying in Expertise Procedure. 4.2.2.8 Project Reference System (PRS) The project manager ensures that the project description data are in a suitable form to serve as input data for PRS. A project description is written at the start of a project and brought into the PRS; if necessary, this description should be adjusted by the project director during the project and in any case by the project manager at project completion, including roles of partners, achievements and results. 4.2.2.9 Complete project Preferably, the project should be finished and closed by the project manager or, if this can only be done at a later stage, by the project director. The decentralized project file is closed in accordance with the Archiving Procedure no earlier than after final payment has been received. 4.2.2.10 After-care and follow-up The project director is responsible for the after-care and follow-up towards the principal in case this is specified in the contract. If relevant (for the Institutional Memory), after some time has elapsed, the project director or his/her representative inquires into the employer’s experiences with the project in question. The employer is entitled to request copies of the results reports for at least ten years after completion of the project.

end

after-carefollow-up

close projectadministration

fin/adm.procedures

archiving

PRS

Internal finaldiscussion



5. ACTIVITIES/POSITION MATRIX

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Draw up draft final report � �

Sign and send draft final report �

Formulate comments and criticism � �

Draw up final report � �

Sign and send final report �

PRS data � �

Certificate of Completion of Services � �

Principal satisfaction � �

Internal final discussion � � � � �

Complete and close the project � � � �

After-care and follow-up �



5.1 HANDLING OF PROJECT DOCUMENTS

• INTRODUCTION During the project, project documents are received, produced and mailed. Rules exist for this process, aiming at a correct distribution and that guarantee the recovering of project documents.

• PROJECT DEFINITION AND FILE NUMBERS

There is a distinction between contract-related and non contract-related projects. 1. Contract-related project

A contract-related project is a set of activities resulting from acquisition or from a contract with a customer.

2. Non contract-related project

A non contract-related project (NOW) is a set of activities that are performed on DHV own costs.

3. Special non contract-related project

A special non contract-related project is an activity (i.e. for: structural co-operations, alliances, V.O.F.’s, etc.) which for filing and archiving is treated as a contract-related project (see 2.1).

4. File number

Each project is identified by a unique and permanent file number. Under the file numbers of NOW activities no (parts of) projects as mentionned in 2.1 and 2.3 are archived.

• ELECTRONIC MAIL REGISTRATION

Registration of incoming and outgoing mail on project locations that are not connected to DHV-LAN, is performed on the guidelines/instruction of the project leader or team leader.

• HANDLING OF INCOMING PROJECT DOCUMENTS

Project documents arriving in the central mail room, are sorted by the mail department, after which it is distributed to the secretaries, who register and distribute the documents within their own sector/department. Depending on the contents and the nature of the documents, it is distributed to the different employees. There is a distinction between class A and class B documents. At project locations outside the central accommodation, handling takes place on instruction of the project leader or team leader.



1. Class A documents (financial/legal) Class A documents concern financial and legal aspects of a project. The project manager is responsible for these aspects. After registration, the project manager receives a copy of the documents. He determines the subsequent actions. The original documents are transferred to the company archivist for inclusion in the Central Project File (CPF) or for keeping in the safe.

2. Class B documents (technical)

Class B documents concern the technical aspects of the project. These documents are handed over to the team members to deal with. Subsequent treatment depends on the guidelines/indications given by the project leader or team leader.

3. E-mail, fax

The recipients are responsible for the registration and distribution (refer to 4.1 and 4.2) of mail which is sent to the organisation in other ways (e-mail, fax) and which is received by DHV in external meetings.

• IDENTIFICATION OF PROJECT DOCUMENTS

The identification of produced project documents is very important. Refer to the relevant procedure(s).

• DISTRIBUTION OF PROJECT DOCUMENTS When distributing project documents, a distinction is made between project documents that are for internal use only and documents that are sent to third parties.

1. Project documents for internal use only

The distribution of these documents depends on the guidelines/directions, given by the project leader or the team leader. In most cases, the distribution is performed by the team members, who also take care of the filing in the Local Project File (LPF). In case of a discipline integrated Local Project File, a secretary may perform this task.

2. Project documents destined for third parties

The author takes care of the signing by an authorised employee . The author also decides which persons within the organisation receive a copy. The secretary registers the documents, performs the internal distribution and the dispatch to the post department. A copy of each document is included in the Local Project File (LPF), or if applicable in the discipline integrated Local Project File. The original of class A documents is sent to the company archivist for inclusion in the Central Project Files (CPF) or for keeping in the safe, a copy is sent to the project administration. It is not necessary to submit copies of class B documents to the Information Management Department or to the project administration.

• E-MAIL

After sending a class A document by e-mail, a signed analogue document is forwarded also. A copy of the signed analogue document is submitted to company archivist for inclusion in the Central Project File (CPF) or for keeping in the safe.

Date post:	14-Apr-2015
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Program Pengembangan Sanitasi

Documents