Sustainable Sanitation and Hygiene for East Indonesia (SEHATI) SUMMARY 
In Indonesia open defecation is still widespread. In rural areas only a part of the population has access to improved sanitation facilities. When it comes to Menstrual Health Management (MHM), there is still school dropout for lack of knowledge and facilities. This project aims to improve sanitation and hygiene conditions, as well as strengthen MHM and integrate it into the STBM policy (local Community Led Total Sanitation approaches). Plan Indonesia implements the project, which benefits 240,000 people in 120 villages and reaches out to 10 schools in 10 villages. It is implemented in two districts in East- (NTT) and two districts in West Nusa Tenggarra (NTB). It starts in February 2016 and runs until June 2019. Approaches include establishing STBM teams, conducting capacity building for local government, CLTS triggering, awareness raising on MHM, production of knowledge material. A particular focus is on gender equality and disability inclusion. Indonesia has the second highest people defecating in the open in the world. This issue is particularly acute in the rural areas, where only 46% of the population has access to improved sanitation facilities. In ten districts in Nusa Tenggara Barat (NTB) province only 64.83% of the population has basic sanitation facilities such as latrines, garbage bins and waste disposal management systems.
Progress has been particularly slow on the part of Indonesia’s sub-national (mainly district) governments who hold the responsibility for front-line sanitation service delivery to communities. Greater progress is inhibited for a range of reasons including: a) Decentralization of the government system leading the district level to be disconnected from STBM, b) Geographical isolation which has seen uneven access to sector resources, support and information, c) Limited sector knowledge and experience locally, d) Limited coordination in regards to sanitation and hygiene issues across government agencies, e) Inactive government STBM teams at district, sub-district and village levels, and f) Lack of investment in STBM at district level.
While Indonesia has ratified major international gender agreements, promoting gender equality remains difficult. Women are assessed to have little influence over WASH sector management and are largely excluded from decision making in the public service. 
When it comes to Menstrual Health Management (MHM), there is school dropout amongst girls because of lack of knowledge and facilities. Mothers may keep girls at home during their period and girls may need to go home for lack of facilities to change sanitary pad when it is needed. MHM is not integrated to the STBM policy. The CLTS approach is used. This is an integrated approach to achieving and sustaining
open defecation free (ODF) status. CLTS entails the facilitation of the community’s analysis of their sanitation profile, their practices of defecation and the consequences, leading to collective action to become ODF. 
International evidence has shown that family members are often included in contributing to the discrimination and stigmatization of People With Disability (PWD). Hence there is a need to specifically support families so that they feel that they can admit to having a family member with a disability and needing different WASH facilities in their home. Specifically this is a change in perception that PWD can and should participate in decision making about WASH improvements in households. 
The project has a strong gender-responsive approach. It includes a strong focus on participation and decision making of women alongside men, and monitoring of quality (not just quantity) of participation during CLTS triggering. The project contributes to gender equality by ensuring women have a greater influence in planning and implementing sanitation and hygiene services in communities and at the household level. Central to delivering these outcomes is raising awareness amongst change agents. 
As for the MHM component the main agenda is to integrate it into the existing STBM policy in order to address MHM-related issues at the grass root level and to comply with global agenda on WASH sector. The approach is through scaling up an earlier pilot, leading  to a policy change at the national level. There is a strong enabling environment at the national level for WASH, which includes STBM (Sanitasi Total Berbasis Masyarakat) which is the Indonesian adaptation of the Community-Led Total Sanitation concept . It is a five pillar approach with a community achieving ‘total sanitation’ when there is: i) Open Defecation Free (ODF) status through CLTS, ii) Hand washing with soap, iii) Safe household water treatment and food storage, iv) Solid waste management and v) Liquid waste management.
This project is part of a larger 3,5 year programme called Sustainable Sanitation and Hygiene for Eastern Indonesia (SEHATI). A consortium of Simavi and five Indonesian NGOs, supported by IRC, are responsible for implementing the programme. Simavi as the contract partner. The program’s goal is dstrict-wide access to improved and sustainable sanitation and hygiene facilities and practices, which contributes towards the Indonesian Government's target of providing universal access to water and sanitation for all population by 2019.
The project builds on and draws lessons from an earlier large program, called SHAW (Sanitation Hygiene and Water). This program was amongst others very much centred on ensuring that STBM principles are applied. This project builds on the logic of the SHAW set up as well, and several partnerships that are the same for SEHATI and SHAW.
The project builds upon lessons learned from Plan Indonesia’s rural STBM programs in Central Java and NTT provinces.    
The project component on MHM builds on a pilot done earlier in 7 schools. 240,000 people in 120 villages in the Nusa Tenggara Barat (NTB) province of Eastern Indonesia will benefit from the project. The children are also end beneficiaries, especially girls, in 10 schools in 10 villages in the Nusa Tenggara Timur (NTT) province. As for the STBM component, plan divides 42 months of project implementation into four phases as follows:

1.	District Selection and Engagement Phase (6 months)
1.1	Project introduction by Provincial Pokja AMPL (working group on water and sanitation) and letter of interest submission by district government. Districts are requested to a submit letter of interest stating their commitment to support project implementation and to fund STBM replication using their own resources. Based on the letter of interest we will decide which district that will be targeted for project implementation.
1.2	District selection. 
1.3	STBM road show at provincial level and MoU signing with provincial and selected districts. 
1.4	STBM road show at district level.
1.5	Selection of sub-districts and villages for piloting locations.
1.6	STBM Baseline survey on gender and disability including ways to identify PWD (given they are largely underestimated and often hidden). Baseline study will determine the current gender relations at the household and community levels (particularly decision making and leadership in STBM).
1.7	Project staff recruitment and office establishment.

2.	Capacity Building Phase (6 months)
2.1.	Establishment and/or strengthening of district Pokja AMPL.
2.2.	Establishment of sub-district STBM teams and selection of village volunteers.
2.3.	Learning visit for district WASH working group to districts that have succeed with STBM 
2.4.	Development of District STBM roadmap and sub-district STBM work plan. 
2.5.	Several capacity building and trainings to Pokja AMPL and sub-district STBM teams, which includes: STBM triggering and hygiene promotion training, STBM monitoring and verification training, gender equality and disability inclusion training, sanitation marketing training, budgeting advocacy workshop. Trainings are aimed to enable district, sub-district and village government to implement 5 pillars STBM triggering, hygiene promotion, monitoring and verification process. (F) The project very much integrates financial sustainability already within the project period, by ensuring that the prime responsible for water and sanitation, namely the government, is actually in the lead to fund and implement the replication of STBM to the non-piloting villages. Also support in budget making is given. Furthermore, demand creation by marketing affordable sanitation products. An entrepreneurial sanitation association is established as well to focus on the supply side of affordable facilities.
(I) Capacity is built at several levels: district, sub-district and village governments, entrepreneurs associations, sub-district STBM groups. As for the MHM component, the MOH is closely involved and capacity is built to include MHM in existing policies.
(E) The 5 pillar STBM includes environmental hygiene aspects: no open defecation, management of household solid- and liquid waste.

(T) The project focuses on affordable and technically less complex hygiene and sanitation facilities. These can be locally maintained.
(S) The project places a great emphasis on the inclusion of PWD and women in decision making and implementation. To ensure their inclusion a baseline study is conducted. As for the MHM component, there is special attention for girls and their emancipation when obstacles for their school attendance are tackled. Series of capacity building activities that have been introduced such as learning visits, facilitator training, and training for village chiefs on how to prepare an STBM budget have been deemed helpful for district, sub-district and village level governments. This has enabled them to have a holistic understanding of STBM activities, which is better than just constructing public toilet facilities as usually done thus far.
Information collected from the baseline survey has become a good starting point and has triggered stakeholders in North Lombok District to pay attention to the importance of Menstrual Hygiene Management (MHM) for girls in the early days of menstruation.