Hygiene and sanitation are basic human needs to reduce health risk and to increase comfortability in living. Any sanitation system should meet requirements on a sustainable society, which conceptually differ from current systems in developed countries. Requirements on a sustainable society based on strong sustainability are stated in detail. Since the development of sanitation systems should be based on technology, social capitals and economy in the society, these items are discussed in detail. Sanitation systems in developing countries should not directly transferred from those in developed countries. The systems may dynamically change in functions due to social conditions and needs in a region, so that the sanitation systems should be flexible. The sanitation system may create several values. Sanitation value chain is one of them, which brings benefit and incentive for self-operation of sanitation to local societies. This sanitation value chain may be disturbed by global and wide-regional economy systems, so that local currency is recommended to be introduced to the local society.
Currently, Indonesia is a developing country with awareness and involvement in a community-based total sanitation program. One pillar of this program is handwashing practice as a prevention from an infectious disease, since many studies revealed a lack of handwashing behavior leads to bacterial contamination from hands. School children are the most vulnerable to bacterial contamination which can lead to nutritional problems. On the other hand, over population and poor-infrastructure also contribute to a lack of sanitation and personal hygiene, and these play important roles in child behavior. Therefore, this study aims to analyze handwashing skills among school children based on World Health Organization (WHO) guidelines regarding hand bacteria reduction and child nutritional status in an urban slum of Indonesia. We conducted a cross-sectional study on elementary school children in the urban slum of Bandung. Participants were the 6th grade children (11 to 14 years old). Forty-one children (24 boys and 17 girls) participated in this study. Our measures were: 1) handwashing skill observation using a checklist, 2) hand bacteria assessment before and after handwashing using a swab, and 3) child anthropometry (height and weight measurement). The association among handwashing skill, handwashing’s total time duration, and bacterial assessment were analyzed using Spearman’s rank correlation tests, comparison between hand bacteria before and after handwashing, and between handwashing skill and child nutritional status were studied using paired t-tests and t-test, respectively. Results showed that handwashing reduced the E. coli count by 0.70 log CFU/hand. Allocating time specifically to pouring water before lathering significantly lowered E. coli count after handwashing. Moreover, neglecting hand drying was identified as a potential factor that caused hand contamination and lowered child nutritional status.
In a pilot study of an agro-sanitation business model introduced in Burkina Faso, only one of four pilot families succeeded in earning cash from their agro-sanitation business. We conducted a time allocation survey of these pilot families and several control families to measure the additional workload resulting from the application of the agro-sanitation business model. We then sought to identify differences between the family that succeeded in its adoption of the model and those that did not, and attempted to determine the factors that explained these differences. Overall, we found that (1) the additional workload seems small in comparison to other work, (2) among the activities associated with the agro-sanitation business, processing products for sale and selling in the market require considerable time, although the time for these activities was not distinguishable from the time required in customary practice, (3) characteristic differences in time allocation were mainly observed in working-age females, (4) a significant feature of the workingage females in the successful pilot family was the allocation of considerable time for economic activity in the dry season and for subsistence activities in the rainy season, and the relatively short time devoted to housekeeping in the rainy season and to personal activities throughout the year, and (5) important factors for success appear to be that the women in the family are familiar with selling their products in the market and are able to manage their time efficiently. Based on these findings, reasonable strategy for diffusing the agro-sanitation business model should include focusing on women as the key players, identifying women who have features similar to the women in the successful family described in this study, and devising an effective cultivation schedule that considers their seasonal time allocation.