Review of the documents and activities of the ISSDP showed that there are many examples of gender equality and poor-inclusive approaches in the program. A clear definition and a systematic approach to including these approaches throughout the program has however been missing.
Local Government staff and Pokjas did not know about gender or were previously not interested in Gender Perspectives/Sensitiveness, but now many of them want to know about and are interested in gender issues.
Gender equality can be strengthened in the national communication strategy and campaigns. The campaign for hand washing now addresses only the responsibilities of immediate caretakers of under-fives, who are mainly females. This is understandable for reasons of efficiency and effectiveness (good campaigns need to be focused), but overlooks that without support from husbands hand washing can increase the burdens of especially poor women.
Poor women seem to buy PDAM water mainly for drinking and cooking (the message having been that these need safe water, leaving out other activities such as teeth brushing and washing hands and kitchen utensils) and were concerned about the financial implications of higher water consumption. The financial responsibilities of male heads of households for financing of safe water are however not addressed.
In contrast, the sanitation awareness campaign addresses only men. It does not recognize household couples as the unit of complementary male and female responsibilities and decision-making for a safe environment. It also overlooks the community-level dimensions of safe sanitation and hygiene which is currently dominated by men. When more women participate in setting and implementing public agendas, sanitation and hygiene will gain much more prominence than they have now.
The draft poor-inclusive strategy has a similar absence of men from promoting domestic hygiene and women from public decision-making.
Program management understands the gender equality concepts and practices it informally, but without an internal policy and systematic approach.
At city level, the combination of secondary city data on population density and poverty with primary data on environmental health risks has resulted in digital mapping of least to highest risk areas in the cities. This has provided an excellent tool for planning improvements and monitoring progress, with good opportunities for linkage with participatory data at community level.
Each city has brought out examples of lower middle class and lower/lowest class women and men undertaking community managed services for improved sanitation, hygiene and solid waste. Models emerging are (1) community managed MCKs; (2) women’s groups recycling organic waste and selling resulting products; (3) combinations of women’s segregation with community-employed collection and recycling; (4) self-employed male and female workers collecting and recycling solid waste from the primary (household), secondary (temporary disposal stations) and tertiary level (city dumps); and (5) single female entrepreneurs and married couples among those running recycling businesses at city level.
In five ISSDP cities, the men/husbands/fathers still have the highest position in decision making in their family and community groups, although reportedly they always discuss with women/wives/mothers before taking decisions. The exception is Payakumbuh-West Sumatera, where the women/mothers have become decision makers in their family and among neighbours because the West Sumatera culture is matrilineal: mothers/women have the highest position and can cancel or delay anything agreement that has earlier been decided by men. There was a notably high participation of women in our meetings at city level (pasar improvements, City Forum), although men took the lead in discussions.
Pilot projects and documentation of model city cases with a gender and poverty focus, which are in their first stages, deserve further development as well as show casing in the media and major sector events.
Economic data from ISSDP demonstrate that the informal sector for solid waste collection and recycling provides an economically interesting livelihood for the poor and constitutes an excellent alternative for economic management of waste. It has a high participation of low-income women, but this has not yet been systematically mapped. Risks are, however, that giving over informal recycling to the formal private sector poor workers will reduce their livelihoods.
The SANIMAS models developed and installed by BaliFokus are relatively high cost and where seen, were not really community managed. Replication to serve all poor communities would take a minimum of 19 and a maximum of 30 years in Denpasar alone and at a constant city population. Moreover, the service does not serve all households/household members. ISSDP has calculated that for one high-cost model, 15 simple and decentralised MCKs can be built and that on average a community can pay off a construction loan in three years. The closer these MCKs are to the users, the greater the chances that all can and will use them, especially when they can be open at all times needed and communities themselves take actions to end open defecation.
The proposed Community Health Clubs haven been demonstrated elsewhere to be cost-effective in achieving measured behaviour change. They can be merged with existing male, female and mixed groups and the programs of Puskesmas/Posyandu, PKK and/or Community Empowerment. Session subjects stem however from Zimbabwe and will need adjustment to include also community level aspects of safe sanitation, SWM, waste water disposal and drainage. Hygiene promotion should further also reach men on male roles and responsibilities in sanitation and hygiene, e.g. financing safe water supply and sanitation, practicing good hygiene themselves, participating in promoting good habits in their children, and supporting women’s participation in community decision making and management.