Report Qualitative Sanitation Study in East Java

Understanding Sanitation Habits
A Qualitative Study in East Java Indonesia

(Probolinggo & Pacitan)
March 13, 2008
Prepared for :
WSP
Prepared by:
Nielsen | Qualitative
Mayapada Tower 15/F
Jl. Jend. Sudirman Kav. 28
Jakarta 12920
Confidential & Proprietary Copyright 2008 The Nielsen Company

Agenda
1 Business Needs Assessment

Research Objectives
2
1 Research Design
Detailed Findings
3
1
Household Expenditure
Defecation Behavior
Sanitation Shopping Process
Concept Evaluation
4
1 Conclusions and Proposed Actions
Confidential & Proprietary

Sanitation Marketing Program Copyright 2008 The Nielsen Company
Business Needs Assessment
Research Objectives
To understand decision making of major household expenditure (in
general and for sanitation in particular)
Prioritization
Role of father vs. mother
To identify most important values relevant to sanitation
To understand drivers and barriers including satisfaction level of current
defecation place
To understand shopping process for sanitation facilities
To explore customer evaluation toward communication concepts:
Understanding
Likes/dislikes
Relevancy

Research Design
Research Design
FGD (N = 6 groups per Father Mother
city, total 12 groups) Criteria
Probolinggo & Pacitan
User of Open Defecator 1 group 1 group Married male & female, 25 45 years
With or without children
Owner of Unimproved Owner of improved defecator:
Defecator 1 group 1 group should understand the process of
decision making of current improved
Owner of Improved sanitation
Defecator 1 group 1 group
FGDs were conducted on February 20 - 22 at:

Pacitan : Desa Jatimalang, Kec. Arjosari, Kab. Pacitan
Probolinggo : Desa Curah Sawo, Kec. Gending, Kab. Probolinggo

Probolinggo & Pacitan Overview
Both districts were selected representing different land type:
Pacitan for hill area
Probolinggo for coastal area
Probolinggo
4 villages in 2
sub-districts
Pacitan
3 villages in 2 sub-districts

Overview of Pacitan
Pacitan District
Area : 1.389,87 km
Population : 538.000 (2003)
Number of sub-districts : 12
Geographic Situation:
Much of Pacitan is chalk hills, part of Kidul Mountain range. This therefore makes
the land not suitable for paddy fields. As an alternative, people here plant
cassava, cloves, coconut or cocoa

Overview of Probolinggo
Probolinggo District
Area : 1.696,166 km
Population : 1.004.967 (2005)
Number of sub-districts : 24
Geographic Situation:
The bigger part of Probolinggo is coastal are with many small or big rivers running
through the area. The majority of people in Probolinggo are either Javanese or
from Madura.

Detailed Findings
Household Expenditure Management
Sources of Income
Additional income:
Harvest time or when husband
finishes his work in another
island / overseas
Main income:
Husband as breadwinner
Daily or monthly salary / +
income
Additional income:
Wife (few families)
Daily or monthly salary /
Occupations: income
Farmer (owns farming land)
Farm worker (does not own farming land)
Occupations:
Trader at traditional market
Farm worker (does not own farming land)
Carpenter
Trader at traditional market
Hawker
Domestic worker (i.e. servant, washer woman,
Driver of public transportation (including
masseuse)
becak)
Part-time teacher (at Kindergarten or Islamic
Teacher
Informal School)
Worker (in factory or others companies),
either in Pacitan, other island (Kalimantan) or
overseas i.e. Malaysia, Hong Kong, etc
(especially in Pacitan)

Expenditure Management
Most household tend to focus on short-term What they said
expenses. They do not have long term It is very difficult to eat everyday, so will be very difficult
saving for future expenses. Whether income to have extra money for anything else (Pacitan, male,
is received daily (for farmer and self- unimproved sanitation owner)
employed) or monthly (for employee), this It will be embarrassing if I do not help my family. If
tends to be dispensed immediately or used others can help our family, why cant I? (Pacitan, female,
to pay debt. improved sanitation owner)
Therefore any big expenditure is regarded as Well, if the expense turns out to be bigger than we
burden as most of the time they do not have planned, usually my husband will be the one who tries to
money. find a solution. May be look for someone to lend us
money. (Probolinggo, female, unimproved sanitation
While reserved money is not common among owner)
them, but respondents seems to be flexible
I cannot think of any extra expenses to spend because
for any social/community related expenditure we just dont have the money for it. Maybe if we have
i.e. relatives/neighbors marriage; they even additional income, we can think of other things besides
do not mind to sell their cattle or borrow the important ones like food or education
some money from their neighborhood should (Probolinggo, male, open defecator)
this kind of expenditure were considering big.
When there is the need of a big expenditure
(planned) such as buying durables or house
renovation, this is postponed until they
receive big income such as at harvest time.

Expenditure Model
Routine Accidental
Will be spent whether i.e. monthly i.e. Gift or
money is available or not: donation for
shopping,
Money available electricity, tuition others (marriage,
dispense fee, house rent, sickness,
Money is not available etc bereavement)
borrow
Expenses
Waiting for
extra money
Only spent when money is i.e. life stock (goat, Having latrine
available (having extra cow), pay debt, (included in house
money), i.e.: house renovation renovation) is only
Harvest time (including latrine)
considered when they
Husbands working on have extra money
other island / overseas
not prioritized
Donation from family
members

Prioritization of Accidental Expenditure
Explanation Needs Fulfilled
Prioritized
Gift or donation It is such an unwritten social obligation to

Most
for others give donation or gift to others on special Social Needs

(sickness, occasions. Absence or insufficient value of
marriage, expected donation will create feeling of
bereavement) embarrassment or guilty feeling.
Safety & Security Needs

School needs Childrens education is prioritized among
(building fee, others, as most regard education as key to
picnic fee, etc) success.
Children or family Childrens needs such as circumcision or

needs buying toys are treated as urgent and would
be fulfilled. How big or how well the event is Social Needs
(circumcision,
would reflect family status.
wedding, toys, etc)
Budget for This occasion is regarded very special, thus

Lebaran i.e. special preparations are done. Even if they Social Needs
children clothing, have limited money, but they do not mind to
Prioritized
food, home
Least
sacrifice other needs for this occasion

decoration

When extra money is available
Explanation Needs Fulfilled
Prioritized
Most
Payment of debt is prioritized as this is Security needs

Pay debt
considered as obligation
Extra money is treated like saving, but most

Things that can be of them do not have the habit of saving
sold later when money at a bank. They tend to buy things Safety & Security Needs
money is needed that they can sell later when money is
needed i.e. life stock (goat, cow), gold, cart
for business, etc
Luxurious
Durables (Pacitan: Having electronics will ease and entertain
TV, HP; their lives. These also somehow reflect Social Needs
status of family.
Probolinggo: HP,
refrigerator)
For most, home renovation / refurbishment Social Needs

Home Renovation are usually done in stages due to economical Ego Needs
Prioritized
(including latrine) condition. Having latrine however, is not

Least
considered a must have. The needs may

arise later after other needs above are
fulfilled.

Decision of Big Expenditures in the Family
Husband and wife usually

Decision discuss and decide which big Decision is not Or
agreed expenditure needs to be agreed
1 2
prioritized
Wife area: Husband area:
Food, childrens Electronics,
needs durables, home
renovation
Final decision is based on Ask opinion of elders

husband s decision as (parents, parents in law,
husband is regarded as older brother/sister)
head of the family
Expenses

Key Learning
Decision making for major household expenditures are based on

discussion between husband and wife. This is to avoid possible
conflict in the future.
Sanitation is only considered after routine and accidental expenditures
are met and if extra money is available (as part of house renovation or
refurbishment).
However, it still competes with paying debts, buying things that can be
sold later (i.e. gold, goat, cow, etc), luxurious durables. There are
indications that sanitation is not considered a valuable asset in the
household.

Defecation Behavior
Open Defecation
Unimproved Sanitation
Improved Sanitation
Common Practices of Open Defecation
The 2 places common for open defecation:
Pacitan and Probolinggo
Riverside I usually go to the riverside because it

is so close to my house (Pacitan,
(Kali / Housewives)
Kalen)
The riverside is only like 100 meters
from my house (Probolinggo, Head of
Household)
Mostly in Pacitan
When in the forest, I cannot wait to return

Bush / home so I defecate among the bushes
Forest (Pacitan, Head of Household, Farmer)

Open Defecation Habit
RIVERSIDE BUSH / FOREST
Who?
Males in emergency cases where they have to

Female, male, children who live near riverside defecate when working in the forest or during
and do not have their own sanitation dry season where there is limited water in river
Tend to be in the morning (when it is still dark) Tend to be in day light

When
?
or night Can be more frequent if suffer from diarrhea

Can be more frequent if suffer from diarrhea
10 m 300 m from home Quite far from home and from river
How
far?
Housewife: Alone or with children Husband usually goes alone

whom?
With
Husband: Usually alone, except when their

wives ask them to accompany at night
The body: with water in the river, some clean The body: with stone or leaf, and cleaned
How to
clean?
it again with water later but some not with water later when arrive at home
The waste: will be gone with water flow or The waste: buried in the ground
eaten by fish

Evaluation of Open Defecation (1/3)
+
Well, we dont have to feel ashamed because we
dont use toilets of others. It is ok to use it once
They do not have to use neighbors awhile but to do so every day will be improper
toilet, considered not bothering because we throw our waste at their place (Pacitan,
neighbor independent male, open defecator)
I think its not a mistake as I often see that my waste

Some believe that the human waste is beneficial to feed the fish in the river. They eat it
directly while it is there (Pacitan, male, open
will be naturally processed as in
defecator)
case for those who defecate in the
river: If the water goes to the paddy field, (my waste) can
food for fish act as fertilizer, it will help the paddy to grow, using
fertilizer to help paddy field to grow organic fertilizer (Probolinggo, male, open defecator)
Reduce the possibility of facing own If I defecate in the river, I feel more comfortable. I
bad smell (few open defecators at dont have to smell my own waste unlike when Im
riverside) doing it in a (closed) toilet (Probolinggo, male, open
defecator)

-
I have to run from home if I am really in hurry to
Difficult access from home: defecate (Pacitan, female, open defecator)
Will be burden if in a hurry to defecate We have to control our defecation, so we do not easily
Will be burden if they have need to defecate, for example defecating every morning
defecate at night, rainy seasons or when (Pacitan, female, open defecator)
they are sick (i.e. suffer from diarrhea) It is very disturbing when we need to defecate at night
or at rainy seasons, as we have to ask our husband to
accompany (Pacitan, female, open defecator)
I have to cross big street to reach the river, sometimes it
is scary (Probolinggo, female, open defecator)
Lack of safety, i.e.:

When river is flooded or water flowing Usually children like to play with water without
knowing the danger. So we have to pay attention
swiftly, especially for children (below 7 especially when the river is quite flooded and the
years old) water run swift (Pacitan, female, open defecator)
Possibility of meeting thugs or people
who mean harm (especially among Oh, yes, I encountered alligator once, sometimes
women) snakes. Since Im scared, I just defecate in paddy field
Possible attack of animals: fish, eel, or (Probolinggo, female, open defecator)
even snakes

- If anybody passes by, we have to manage so they
wont see our waste thrown out. It is like cutting it
(Pacitan, male, open defecator)
Being embarrassed when other people Yeah, I am embarrassed if people pass by, but I think
pass by and see. However, as it is everybody ist used to it, everybody does that also
common in their neighborhood, this is (Pacitan, female, open defecator)
considered acceptable
In dry season is a bit complicated, we cannot
defecate in the river as the waste will not flow. So we
Other barriers for immediate release: are forced to defecate in my parents house, their
Limited water in the river (during dry house is not far from me (Pacitan, female, open
season) must go to another place defecator)
(neighbors, relatives)
Possibility of having to wait for turn If there is someone else doing it at my usual place, I
because others are currently using the have to wait for my turn (Probolinggo, male, open
defecator)
usual place
The river near my house carry disposal from kitchen as

Health issues (few, appear in
well, so sometimes the water is sticky, not good for skin
Probolinggo): (Probolinggo, male, open defecator)
Water that are polluted from other waste
(industrial, household) can result in
The water is cold so sometimes I get rash on my feet
itchiness or other skin disease
(Probolinggo, female, open defecator)
Cold water can result rash on feet

View of owners vs. others view of owners
Those who do not have own View point of others, of those

improved sanitation see who do not have improved
themselves as: sanitation as:
Poor, do not have enough money From lower economic social class,
to build improved sanitation but lack funds to build own toilet
believe society still accepts their Have limited area in their house to
habit (many still do that) build toilet
Some believe that they do not Lack awareness of health
really contribute to polluting the environment
environment as waste will be Have less shame of themselves
naturally processed (do not create and their body (esp. women)
bad smell or become trash)
Its not so proper, there are many who already I dont think they are poor as that, if they prioritize
have toilet in their home but it is something it Im sure they will have their own toilet someday
common in my neighborhood. Sometimes those (Pacitan, female, improved sanitation owner)
who have toilets at home still go to the riverside
(Pacitan, male, open defecator)
Maybe they want to have their own toilet but they
just dont have the money (Probolinggo, male,
I think in my village, even some of the rich ones improved sanitation owner)
still go to the river to defecate, because it is the
habit (Probolinggo, female, open defecator)

Open Defecator Means
High
Physiological Aspect
S
Have to hold if there is a need to defecate a
t
Uncomfortable when defecating; possibility I
to get cold / hot, to get itchiness, to pay s
attention to children at the same time f
a
c
Psychological Aspect t
i
o
To avoid embarrassment of using n
Open improved sanitation of others to look
independent l
Defecator Embarrassment, especially for women e
v
although they know that it is quite common e
to defecate in the riverside l
Low
Social Aspect
Low satisfaction towards
Those who do not own improved sanitation current defecation
is considered from low economic class, method and want to have
not well educated and do not care about improved sanitation, not
environment unimproved because
their land size is limited

Sowhy do they keep defecating in the open?
Explanation Key Learning:
Mentioned
No funds can be Scarce living condition

Most
allocated to Limited funds and socially

Lack of income & uncertainty of accepted habit make people
sanitation income still practice open defecating
No social punishment for open

defecating
Social and Some of them still consider it as
personal habit natural habit (cannot defecate in
still accepted closed space)
There is no major
Open defecating is Contamination of waste to health is motivator to change
not associated not clearly understood habit
with health
Health sanitation They dream of having health

is one of the sanitation but it seems they do not
put prioritization on this
Mentioned
dreams but not

Least
prioritized

Defecation Behavior
Open Defecation
Improved Sanitation
Common Practices of Unimproved Sanitation -
PACITAN
When
Anytime
?
Definition of Unimproved Sanitation:
Hole dig 2 m of deep used to 10 m 30 m from the house, but still
How
far?
Unimprove
keep the waste within own land
d
Sanitation Have wood, cement or
something more permanent as Alone except children below 7 years
whom?
With
a place to step on old usually still accompanied / helped
Jumbleng / The hole can be opened or half by parents
Cemplung closed
The body: with water that they brought
No water needed to throw the
How to
clean?
waste
from bathroom. Some already have
source of water near the hole
The waste: No need to clean, it will be
thrown in the hole

Triggers of Having Unimproved Sanitation - PACITAN
Not in close proximity with the river

GEOGRAPHICAL Live on hills or slopes where clean water is difficult to find, especially
SITUATION during dry season
Thus digging hole as way of having (unimproved) sanitation
Present themselves as independent

Borrow or use other peoples toilet can create embarrassment it is
SOCIAL EGO considered bothering and impolite (because we give waste to others)

Evaluation of Unimproved Sanitation (1/2) - PACITAN
+
Well, at least we have our own defecation place,
They do not have to use neighbors
although it is still improper but it is already accepted
sanitation, considered not bothering (Pacitan, male, unimproved sanitation owner)
neighbor look independent
The waste is kept in one place, do not Well. At least the waste does not contact directly
pollute the environment with airit is kept in the hole, so does not easily
pollute the air (Pacitan, male, open defecator)

Evaluation of Unimproved Sanitation (2/2) - PACITAN
-
Bad smell
While defecating: As the hole is opened,
the user will easily breathe bad smell
What I dont like is the bad smell my husband
While not defecating: The users leave
smokes while defecating but as I dont smoke, I
the hole open or not perfectly closed, so just close my nose like this (Pacitan, female,
the bad smell can still be smelt from unimproved sanitation owner)
home
As the hole will be full after 2 years, they

have to re-dig much to do
The wood is easily rots because of rain as
mine does not have permanent roof, hence I
Some still have impermanent place to stand once fell into the hole.hahaha (Pacitan,
on (i.e. made from wood), this will easily rot male, unimproved sanitation owner)
Still far from home (min. 10 m), so its quite

difficult to get there when it rains / at night

View of users vs. others view of users - PACITAN
Those who do not have own Those who do not have own
sanitation see themselves as: sanitation are regarded :
Poor, do not have enough funds From low economic class who
to build improved sanitation but have quite large land to build
at least they feel independent of unimproved sanitation
having their own sanitation Quite shy compared to those
who defecate on the riverside
Sometimes bad smell is smelt
from others home pollute air
I think they are quite shy because the

sanitation place is closed, they do not want
to show their body to others (Pacitan,
female, improved sanitation owner)

Using an Unimproved Sanitation - PACITAN
High
S
Have to stand bad smell (especially during a
t
defecating) I
s
f
a
c
i
o
More independent have their own n
Unimproved sanitation at home
l
Sanitation e
v
e
l
Low
Social Aspect
Low satisfaction towards
More accepted compared to defecating in current defecation
the riverside or among bushes. method and want to have
improved sanitation

Common Practices of Unimproved Sanitation -
PROBOLINGGO
In Probolinggo, many houses are close to rivers. It is common to find people who
own latrines (including modern sitting toilet) but do not have septic tank. They
dispose human waste to the river using PVC pipe.
These people may not consider themselves as owners of unimproved sanitation.
Instead the definition comes from us.
Definition of Unimproved Sanitation
Human waste is disposed to

Unimprove
the river, through a certain
d length of PVC pipe, without the
Sanitation use of a septic tank
Do Not Own
Septic Tank

Reasons for Not Having Septic Tank - PROBOLINGGO
Soil condition in the area becomes the main reason for these people for not having
septic tank:
Condition of the Soil
GEOGRAPHICAL Water easily comes out from the soil. Thus, one must build strong and
SITUATION thick septic tank to avoid possibility of human waste seeping through
and polluted the source of clean water in the neighborhood
There is not enough land space in their house to build septic tank
The water source is not
deep. If we build a septic
tank, it will pollute the water
source (Probolinggo, female,
unimproved sanitation owner) Expensive to build and maintain septic tank
More expensive to build septic tank (need to be strong and thick).
I used to have septic tank, Since the toilet is used by other people, must do regular maintenance
near the beach, but when the (cleaning the septic tank because it will fill up a lot quicker) which means
sea water rises, the water additional cost to prepare.
inside the tank also rises. So,
I decided to use PVC pipe
and dispose it to river
(Probolinggo, male,
unimproved sanitation owner) Since my house is near the river stream
I just use PVC pipe and dispose the waste to the river. It is cheaper
and at the same time it protects clean water source in the area.

Triggers for Having Toilet Even Without Septic Tank -
PROBOLINGGO
Protect family well-being

Mostly from husbands point of view; having toilet means protecting family
PERSONAL EGO from harm (especially wives who are afraid of the dark, floods, snakes or
even criminals)
Have experienced discomfort when family members suffered from
diarrhea (especially among their children) must frequently go to the
river
Have experienced parents being old and sick; cannot go to the river
anymore (few)
Present themselves as modern and advanced

SOCIAL EGO Usually, visitors from out of town do not have the habit to defecate in the
river. To avoid feeling embarrassed, they prefer to build toilet to address
this matter
Feel that having toilet is one step ahead in climbing the social ladder
My wife never goes to the river, she is not used to it. She feels embarrassed and uncomfortable. So I thought
Id better build my own toilet (Probolinggo, male, unimproved sanitation owner)
The river near my house sometimes floods, so I am afraid that when I go there I might be carried by the
water.. So I told my husband and we agreed that it would be better if we have our own toilet (Probolinggo,
female, unimproved sanitation owner)

Evaluation of Unimproved Sanitation (1/3) -
PROBOLINGGO
These consumers feel that they have moved one step away from open defecating
practice. They have similar assessment to their toilet as those who have septic tank.
+ We get visitors from out of town sometimes, and

they are not used to defecate in the river
(Probolinggo, female, unimproved sanitation user)
Social advance:
Do not feel embarrassed when having
visitors from out of town (especially big
cities); if the visitors need to use toilet,
they do not have to go to the river
Comfort: If, for instance, in the middle of the night, we get

Can use the toilet anytime they want (day stomachache and need to go, we can just go. We
or night); do not have to wait for turn dont have to be afraid of going to the river anymore
Easy access, especially for children or (Probolinggo, female, unimproved sanitation owner)
older people (their parents)

PROBOLINGGO
+
We have to protect our body. If we have our own
Privacy toilet, we can protect our body parts, so nobody
else can see it (Probolinggo, male, unimproved
Do not have to worry or be embarrassed
sanitation owner)
by people seeing their body parts
(especially for some husbands, who feel
that they have to protect their wifes I can use it as long as I want to, be alone with my
honor) thoughts (Probolinggo, male, unimproved
sanitation owner)
Give chance to be alone with their
thoughts
Safety
Reduce the possibility of being harmed,
either by animal or other people

PROBOLINGGO
The disadvantages are not due to the fact that they do not have septic tank. Instead,
these consumers see from the angle of sharing the toilet as their toilet is
sometimes used by other people (family members or neighbors)
- Sometimes other people who use it do not flush

the waste after use. My toilet is sometimes used
by other people including those who come to my
Lack of cleanliness small store (Probolinggo, female, unimproved
sanitation owner)
Other people sometimes do not have
the same level of hygiene do not flush
or clean the toilet after use

View of users vs. others view of users -
PROBOLINGGO
Those who do not have own From others view, those who
septic tank see themselves as: do not have septic tank are
Socially advanced, compared to regarded as:
open defecators Lower economic class (compared
Aware of environment, because to those who have septic tank)
septic tank is considered dangerous Have close access to the river
as it can pollute drinking source if not
carefully planned
If I build septic tank, the cost will be very big. Plus Maybe their house is near the river, so they have
Im worried that it will pollute the water source. If I easier access to dispose it there (Probolinggo,
dispose it to the river, my environment will be free female, improved sanitation owner)
from pollution (Probolinggo, male, unimproved
sanitation owner) Maybe they want to reduce the cost (Probolinggo,
male, improved sanitation owner)

Using Unimproved Sanitation - PROBOLINGGO
High
More comfortable easy
access, clean
S Have relatively high level
a of satisfaction with
t
I current sanitation
Psychological Aspect s practice.
f
a Do not see themselves as
More independent feeling c polluting the river
Unimproved have their own sanitation at t
home i
Sanitation More modern and upscale o
n
feeling more confident about
themselves l How to make them see
e
v that their practice is no
e different from those of
Social Aspect l
open defecators?
More advanced compared to
open defecators

Defecation Behavior
Open Defecation
Improved Sanitation
Common Practices of Improved Sanitation
When
Anytime
?
Definition of Improved Sanitation
Permanent pit-toilet with goose Some: part of the house (located near
How
far?
Improved neck kitchen or at the back of the house)
Sanitation Sitting or squatting pit-toilet
Some: outside the house (<10 m)
Alone except children below 7 years
whom?
With septic tank
With
old usually still accompanied / helped
by parents
The body: with water available near
How to
clean?
toilet (through water tap or bucket)
The waste: flushed through the pit

Triggers for Having Improved Toilet (With Septic
Tank)
Present themselves as modern and advanced
Another step up on social ladder perception in the society that
SOCIAL EGO household with higher economic class should have advanced housing,
which includes toilet (economically, they are more advanced)
Having modern and more comfortable lifestyle

PERSONAL EGO Coming from bigger city (cases in Probolinggo); accustomed to having
improved sanitation thus unwilling to down grade their lifestyle
Having own toilet improves their feeling of comfort while defecating
Protect family well-being

Mostly from husbands point of view; having toilet means protecting family
from harm (especially wives who are afraid of the dark, flood, snakes or
even criminals)
Experienced discomfort when family members suffered from diarrhea
(especially among their children) must frequently go to the river

Evaluation of Improved Sanitation (1/2)
+
It is close to my house and I dont have to wait for
my turn (Probolinggo, female, improved sanitation
Comfort and privacy: owner)
Easy access
Can go anytime they want If we get stomachache suddenly, where can we run
Sense of privacy (closed and private) to if we do not have our own toilet? (Probolinggo,
male, improved sanitation owner)
Social appearance
Convey independent, modern, and
upscale image
For arisan (social gathering of housewives in the

Environmental friendly same neighborhood which is conducted routinely),
Waste is processed properly; do not people will choose home with integrated toilet. So its
like upgrading the status (Pacitan, female,
pollute environment
improved sanitation owner)
More healthy; no contamination with
waste

Evaluation of Improved Sanitation (2/2)
-
Water availability (in Pacitan):

During dry season, when water is scarce,
it is difficult to find clean water to flush the
toilet
Lack of cleanliness (in Probolinggo)

If shared with other people do not have
the same level of hygiene, i.e. do not flush
or clean the toilet after use

View of users vs. others view of users
Those who own sanitation see Quite similar with how others see
themselves as: themselves, they perceive those
Quite wealthy, well educated with healthy sanitation is regarded:
Higher social status compared to Quite wealthy, well educated
those dont have Higher social status compared to
those dont have
Those who receive donation from
government to build improved
sanitation

Using Improved Sanitation
High
S
More comfortable easily access, clean, a
t
doesnt smell I
s
f
a
c
i
o
More independent have own sanitation at n
Improved home
More modern and upscale more l
Sanitation confident of themselves e
v
e
l
Low
Social Aspect
High satisfaction toward
Home with improved sanitation is regarded current sanitation,
an ideal home already regarded as the
Home with improved sanitation is more best they can have
preferred as a place for gathering

Condition of the Sanitation Methods
Pacitan: Water availability and

Area with enough Home located far from the condition of soil impact
water to throw the river (i.e. on slope) the sanitation
Improved dirt away ownership in ones
Sufficient land to build
Sanitation Wherever is unimproved sanitation area.
suitable for improved
sanitation
Usually limited water esp. Improved sanitation
during dry season must be supported with
availability of clean
water so that the
Probolinggo:
option will be relevant
Home located near Soil condition is rather to be applied.
Open the river wet; oil, water easily
defecator comes out from the soil
user Have insufficient
land Near the river, so they can
throw the waste into the
river

Hierarchy of Needs (Based on Maslows Hierarchy of Needs)
Key Learning:
Having sanitation is
SELF-ACTUALIZATION
Specific hobbies
related to ego and
social needs
fulfillment, thus
EGO NEEDS
(Luxurious home (permanent and well furnished home), motorcycle or these will be drivers
car, luxurious durables including hand phone to change
SOCIAL NEEDS
(Gift/donation for others (sickness, marriage, bereavement), family gathering
(children circumcision, marriage), having sanitation
SAFETY & SECURITY

Children tuition fee, school building fee, life stock (i.e. goat &
cow)
Blue font : routine
expenditure
PHYSIOLOGICAL NEEDS
(Food, water, electricity, rent a house, children clothing, health, basic Pink font:
shelter / home (not including latrine) accidental
expenditure
Green font: extra
money:

Understanding of toilet
Perception of toilet:
It is clear that there is a GAP
A room complete with pit-toilet between physical structure of
and water to flush the waste
toilet and its function.
Pit-toilet can be squatting or
WC sitting
These people do not see the
Sitting model is considered the
modern type of pit-toilet (just actual function of toilet. In
WC is their term like in the big cities) their perception, a toilet would
(only few familiar
with term Squatting toilet can be cheap or consist of several elements
jamban) expensive, depending on the (including the actual room with
materials (porcelain or cement)
cement, pit-toilet, and the
water to flush)
The reason for not having a toilet is price barrier based on their perception of
the physical set up.

Barriers to Adopt Improved Sanitation
Among Open Defecator and Unimproved Sanitation Users
1 3
Economical: Conditions:
Scarce living condition and sanitation is of Pacitan: Home with limited water supply (i.e.
low priority compared to other needs on slope area)
Probolinggo: River (or water stream) is in
close proximity; it is seen as easy and cheap
access to dispose waste compared to
building septic tank
2 Social: Physiological: 4
Some of them still consider it is part of the Cannot defecate in closed room; smell their
habit (socially accepted) own waste
Cannot defecate if the buttocks do not touch
water
Orange fonts : barriers that need to be supported by external factors

Green fonts : barriers that still can be changed through communication internal factors

Sanitation Shopping Process
General Illustration Sometimes also get information about
price estimation from neighbors who
have built toilet facility
Consult mason about materials

needed, i.e.:
Cement, coarse sand, stones
Pipe
Pit-toilet (mostly ceramic-made)
Also ask masons about their working

Go find Mason (easily fee (usually per day)
Husband and wife
agree to have toilet found in their area)
facility
Go to building material store; at

Build the toilet; sub-district (kecamatan) or district
will take no longer than 1 capital (kota kabupaten)
week (usually 2 4 days)

Issues in Different Districts
PACITAN PROBOLINGGO
MATERIALS MATERIALS
Since Pacitan is a hilly area, materials Area in Probolinggo included in this
such as coarse-sand (pasir), stones, even study is mainly coastal or near river, thus
wood can easily be obtained. Thus, most materials are bought from stores.
materials bought are mainly cement and
pit-toilet
STORES STORES
In Pacitan, material stores can be found in In Probolinggo, material stores at sub-
sub-district (kecamatan) but usually limited district (kecamatan) are sometimes more
to 1 2 stores. Thus, most buy everything than two stores. Thus, some consumers
needed in one place (one stop shopping) prefer to buy materials from different
stores to get the cheapest prices.

So, is it a difficult process?
Consumers do not feel that shopping for sanitation materials is a

complex or complicated process. Both materials and masons
needed to build the toilet are available in their area.
Thus, barrier to having personal toilet is not due to lack of

outlets or human resources to build it. The main drawback is
the funds to buy the materials or pay the masons.

Evaluation of Health Sanitation Concepts
Concept 1: Is Your Prayer Correct with Given
Procedures?
As long as the river flows, it is still
correct according to given rituals. Even if
the water is contaminated
(Probolinggo, female, unimproved
sanitation owner)
The river here is big and the water flows.

So it is okay (Probolinggo, male,
But here, people usually take water

for wudhu at well, not at the river.
Even when we take a bath, we take
water from well (Pacitan, female,
open defecators)
I think it is still correct because the

water flows (Pacitan, female,

Concept 1: Is Your Prayer Correct with Given
Procedures?
EVALUATION
Comprehension
Respondents cannot easily take out the key
message of this concept as they somehow feel
that the situation is irrelevant to the actual
procedure of praying because:
Water that flows along is okay to use for wudhu
even though it is contaminated.
In addition, most masjid (mosque) as shown in the
Relevance Appeal concept will already provide clean water for
wudhu; so people will not use water from the river
Thus, this concept lacks appeal and relevance

Concept 2: Dont Be The Subject of Gossip
Exactly, the reason why we have toilet is

to cover our aurat (Islam term: body
parts that must be hidden from non-
member of family) (Probolinggo,
male, unimproved sanitation owner)
Yes, that happens a lot, sometimes when

we are defecating, there are men who are
fishing near us, we feel embarrassed
(Probolinggo, female, open defecators)
I think here, it is common. I mean, it

is not a strange thing anymore
(Pacitan, male, unimproved sanitation
owner)
I dont think there are people here

who own DVD but do not have toilet
(Pacitan, male, open defecators)

Concept 2: Dont Be The Subject of Gossip
EVALUATION
Comprehension
The part of his wifes buttocks is considered
funny and easily generates laughter. It is relevant
to current situation since it has high possibility
to occur among open defecators.
The second part of own DVD but do not yet have
toilet is not considered highly relevant. DVD is
considered a luxury item in both areas. It will be
Relevance Appeal more relevant if the concept talked about a more
common household item, i.e.: TV.
This concept generates some appeals, especially the part with wifes
buttocks. Some respondents feel that this can make husbands consider
having own toilet to avoid embarrassment of displaying his wifes body.
However, among some open defecators, this situation is not considered
unusual they accept it as it is.

Concept 3: Cak Kemplung Stop Plung
Well, it is true, usually Maduranese

defecate at the river (Probolinggo,
male, open defecators)
Even if we do not defecate in the river, it

will not make any difference because
industrial waste that is being thrown in the
river (Probolinggo, male, unimproved
sanitation owner)
I think here, this portrayal is not

relevant. When we defecate, it will be
immediately eaten by fishes (so it will
not result in pile of waste) (Pacitan,
male, open defecators)
I dont think it is relevant because here

only one or two people go to the river. It
will not create pollution (Pacitan,
female, improved sanitation owner)

Concept 3: Cak Kemplung Stop Plung
EVALUATION
This concept is relatively easier to comprehend.
Comprehension
However, in terms of relevancy, some noted that
there are other factors that make rivers dirty or
polluted aside from human waste, i.e.: industrial
waste from various factories in the area. Thus,
cleaning the river cannot be done only by making
people stop defecating there.
In addition, in reality, they feel that human waste can
Relevance Appeal easily be naturally processed (i.e. eaten by fish) thus
will not create heavy pollution as portrayed by the
concept.
There is no strong rejection of Cak Kemplung
portrayal because respondents only see him as a
spokesperson.
This concept is moderately appealing although it does not carry

new information, only the idea of cleaning the river.

Key Learning
All three concepts do not seem to be highly effective to make people think
twice about the consequences of open defecating. Most respondents from
Pacitan and Probolinggo do not quickly draw the intended key messages in
the concepts.
Only the concept of possibility of having wifes buttocks displayed seem to be
closer to current reality and may generate second thoughts among
husbands.
However, this also does not have a very strong pull. This situation is
considered an everyday fact among open defecators. They tackle this issue
simply by observing surroundings when defecating (avoid when there are
many people around), building semi-permanent toilet above the river to hide
themselves from public eyes (as with several cases in Probolinggo) or go to
the riverside early in the morning, when it is still dark (several cases found in
Pacitan)
Thus, motivating people to change their open defecating
habit might have to come from a different angle.

Concept Jamat Jamban Sehat

Evaluation
The term Jamat:
It is not a common term; Jamat
sounds like Camat (head of sub-
district) or even Jumat (Friday). Few
in Probolinggo even think that Jamat
is a brand name for pit-toilet product
For some respondents in Probolinggo,
Jamban is not associated with WC,
but as pit-toilet or public toilets
provided by government
Jambanku sehat! means:

Toilet that is clean
Toilet that does not produce bad smell
(invite flies)
Toilet that does not pollute
This line means that one is expected to buy environment
the product thus, Jamat is a built-in Toilet with septic tank (among
product (most likely the pit-toilet) improved sanitation owners)
Modern toilet - sitting toilet, complete
with toilet-cover (few, Pacitan)

Evaluation
PAJAMAT means:
An officer from Health Department or
District government that gives counsel or
information regarding health and
sanitation (Most).
People who know how to build healthy
toilet (few, Probolinggo)
This line linked to a place that sells pit-

toilet product. Some see that it only sells
the pit-toilet without other needed
materials.

Key Learning
Consumers only see Jamat concept as an advice or suggestion to purchase

pit-toilet. It does not generate high appeal or high level of comprehension.
Majority only guess what Jamat is all about without actually understanding
the idea of Healthy (Improved) Toilet.
To some, the introduction of PAJAMAT is translated that this suggestion is
coming from government or its agency. Thus, it opens possibility of getting
financial aid to buy Jamat product
Must be careful to introduce this concept as it might mislead

people to think that it is a campaign of getting free or
cheap pit-toilet product from government

Conclusions and Proposed Actions
Barriers to Adopt Improved Sanitation
1 3
Economical (Prioritization): Geographical:
Scarce living condition and sanitation is in Pacitan (who use Jumbleng): Home with
low priority compared to others limited water supply as water is necessary to
Why? (see next slide) flush the waste (i.e. at slope area) as they
still perceive that improved sanitation is one
with pit-toilet
Probolinggo (use pit toilet with no septic
tank): River (or water stream) is in close
proximity; it is seen as easy and cheap
access to dispose waste compared to
building septic tank
2 4
Social: Physiological:
Some of them still consider it is part of the Cannot defecate in closed room; smell their
habit (socially accepted) own waste
Cannot defecate if the buttocks do not touch
water

Economical barriers for not prioritizing sanitation
Sanitation is still considered of low priority. It is done regularly but is not

seen as improving either present life condition or as investment for the
future.
Important factors in the present time:
Daily survival (meaning food or clothing)
To be part of the society (giving gift or donation to others)
Important factor for the future:
To make sure my children get better life (meaning education)
Sanitation is not directly associated with health

Do not understand the contamination disease-route
Poor health condition is seen as consequence of poor living situation and often taken
for granted
Health is not a strong motivator to change behavior
There is a lack of understanding the function of toilets

Perceived sanitation is skewed towards physical structure (close cemented area with
pit-toilet), which is expensive to build

What are the drivers of behavior change?
Social status
Do not want to be subject of gossip
One step up the social class ladder
Seen as being more advanced, more independent, and
modern
Self esteem Health

Protect family honor and well-being is not a
Avoid being looked-down by outside visitors motivator
Have more comfortable lifestyle
I want be better than the rest of the people in my society

Comprehensive Solutions Social Reinforcement
Role of high respected persons in
Communication tapping into
the society is important to endorse
Social Ego & Ego Needs
/ advice health sanitation.
Drivers and Saving Education
Need to reinforce people to adopt
Communication tapping into health sanitation i.e. reward those
social ego: who can build sanitation within 1
Defecating in open space can year
be an object of gossip among Economical
neighbors create
embarrassment feeling! (Prioritization)
Having improved sanitation
Provide Water Source &
creates more advanced, more Give information on health
modern and independent sanitation
image Pacitan:
Communication tapping into Unavailability of water source
ego needs driver: Geographical Social should be tackled by the
community to provide water source
Something relevant to their access; or
ego, i.e. protect family from
harm, not regarded looked Educate that health sanitation can
be achieved through having
down by visitors, etc jumbleng with closed cover to
Need to educate through avoid bad smell
communication that having Probolinggo
healthy sanitation is something Educate the right way to build
affordable and achievable! septic tank for land close to river;
Share success story of those thus not polluting water source
who saved to build sanitation

Thank you

Confidential & Proprietary Copyright 2007 The Nielsen Company

Report Qualitative Sanitation Study in East Java

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Understanding Sanitation Habits

A Qualitative Study in East Java Indonesia

March 13, 2008

Confidential & Proprietary Copyright 2008 The Nielsen Company

1 Business Needs Assessment

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FGDs were conducted on February 20 - 22 at:

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Gift or donation It is such an unwritten social obligation to

for others give donation or gift to others on special Social Needs

Safety & Security Needs

Children or family Childrens needs such as circumcision or

Budget for This occasion is regarded very special, thus

sacrifice other needs for this occasion

Confidential & Proprietary

Payment of debt is prioritized as this is Security needs

Extra money is treated like saving, but most

For most, home renovation / refurbishment Social Needs

(including latrine) condition. Having latrine however, is not

considered a must have. The needs may

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Husband and wife usually

Final decision is based on Ask opinion of elders

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Decision making for major household expenditures are based on

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The 2 places common for open defecation:

Pacitan and Probolinggo

Riverside I usually go to the riverside because it

When in the forest, I cannot wait to return

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Males in emergency cases where they have to

Tend to be in the morning (when it is still dark) Tend to be in day light

or night Can be more frequent if suffer from diarrhea

Housewife: Alone or with children Husband usually goes alone

Husband: Usually alone, except when their

Confidential & Proprietary

I think its not a mistake as I often see that my waste

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Lack of safety, i.e.:

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The river near my house carry disposal from kitchen as

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Those who do not have own View point of others, of those

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No funds can be Scarce living condition

allocated to Limited funds and socially

No social punishment for open

Health sanitation They dream of having health

dreams but not

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Hole dig 2 m of deep used to 10 m 30 m from the house, but still

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Not in close proximity with the river

Present themselves as independent

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