Long-term usage, condition, and cultural acceptability of the BALatrine project: findings from a subsidised sanitation improvement intervention in rural Central Java, Indonesia
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Much work remains to achieve the sustainable development goals for improved sanitation access for all. Subsidised sanitation interventions are often criticised due to the possibility of the infrastructure being neglected or culturally inappropriate for target communities. The BALatrine intervention is a novel approach consisting of a community-wide subsidised recipient-aided installation of an improved latrine with septic tank ('BALatrine') and education package. This study aimed to investigate the long-term usage and cultural acceptability of the BALatrine project four to six years following its implementation in a main trial. METHODS: We conducted a cross-sectional follow-up study in September 2022 of 88 households who received BALatrines in two villages between 2016 and 2017. Quantitative and qualitative interviews with the household head and members were conducted to understand BALatrine usage and perceptions. Descriptive statistics were used to tabulate interview responses. RESULTS: The BALatrines were still in excellent condition with 89% still functional as initially intended corresponding to 95% of participants regularly passing a bowel motion in the BALatrine. A 77% reduction in self-reported open defecation was achieved. Participants expressed concerns towards the prospect of having to empty the septic tanks. Interviews with key village stakeholders demonstrated participants desire for aid and financial difficulties in obtaining and maintaining such improved sanitation. CONCLUSIONS: Follow-up results of the BALatrine intervention demonstrate that the BALatrine's in the two surveyed villages are overall culturally acceptable and well-maintained. The BALatrine intervention may be suitable for use in other rural areas of Indonesia and the region for improving sanitation coverage.
Source: Infectious Diseases of Poverty
Authors: Callum Lowe, Matthew Kelly, Salvador Amaral, Novia Handayani, Bagoes Widjanarko, Budiyono Budiyono, Nissa Kusariana, Budi Laksono, Juniawati Juniawati, Muharsono Muharsono, Sukoto Sukoto, Suharyo Hadisaputro, Kinley Wangdi, Aparna Lal, Johanna Kurscheid, Susana Vaz Nery, Ricardo J. Soares-Magalhaes, Kate Halton, James McCarthy, Archie C. A. Clements, Donald Stewart, Darren Gray
Institutions: Australian National University, QIMR Berghofer Medical Research Institute, Menzies School of Health Research, Diponegoro University, Kementerian Kesehatan Republik Indonesia, Politeknik Kesehatan Kemenkes Semarang, University of Canberra, Swiss Tropical and Public Health Institute, University of Basel, UNSW Sydney, Kirby Institute, The University of Queensland, Queensland University of Technology, The University of Melbourne, Walter and Eliza Hall Institute of Medical Research, Queen's University Belfast, Griffith University
Language: English
Subfield: Nutrition and Dietetics
Field: Nursing
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,690
OpenAlex ID: W7140288199
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