4. Objective
1. Objective:
Improved health status, productivity and quality of
life.
2. To be achieved through interventions which
focus on:
Health behaviour & services related to water borne
diseases;
Providing safe, adequate, accessible & cost-
effective water supply & sanitation services;
Enhancing sustainability and effectiveness through
community participation.
4
5. Key features
1. Demand responsive approach.
2. Poverty & gender focus.
3. Use of MPA/PHAST methodology for community
participation.
4. Villagers responsible for planning, implementation &
O&M.
5. Project funds channelled directly to villages.
6. Community contributes 20% of village implementation
funding (4% cash, 16% in kind).
7. Government (with consultant support) role as
facilitator.
8. Participatory sustainability monitoring (MPA)
5
6. Project components
Four components:
2. Community and local institutions
capacity building;
3. Improvement of health behavior and
services;
4. Provision of water and sanitation
infrastructure; and
5. Project management.
6
7. Project location
1. Project activities in 7 provinces:
Commenced 2002 (March)
East Java (500) West Nusa Tenggara (300)
West Sumatra (300) South Sumatra (260)
Bangka Belitung (40)
Commenced 2004 (June)
West Java (300)
South Sulawesi (300)
2. Operating in 34 districts and 2000 villages.
7
8. Location map
Bangka
Belitung
South
Sulawesi
East Java
West
Sumatra
South
Sumatra West Java West Nusa
Tenggara
8
9. Funding
1. Financing – total US$106.7 million.
Source Amount Source Amount
IDA 77.4 GOI 12.2
AusAID 6.5 Community 10.6
1) Allocation (US$ million)
Category Amount Category Amount
Village grants 62.1 Project management 3.8
Service contracts 28.6 Material/equipment 1.8
TA 6.5 Govt. support 3.9
9
11. Village selection
1. Provinces preselected based on poverty index,
prevalence of water borne disease; and level
of WS&S access.
2. Districts selected by provinces according
similar criteria.
3. Villages long-listed by application following
“road-show” to village representatives at
district level.
4. Village short-listing based on priorities
according to health (diarrheal disease index),
poverty and WS&S access.
11
12. Village planning (1 of 2)
1. Village Implementation Team (VIT) elected to manage
the planning and implementation of village level
activities.
2. Support provided by District Technical Consultants and
Community Facilitators.
3. CFs work directly with villagers (through VIT) to
facilitate the preparation of a Community Action Plan
(CAP).
4. MPA/PHAST are key tools for the village CAP process.
5. At the core of CAP is informed choice by community
members including women and the poor.
12
13. Village planning (2 of 2)
i. CAP components include:
Water supply infrastructure to level of detailed engineering design;
Sanitation infrastructure;
Community capacity building activities (health promotion, training).
II. Average cost of CAP is ~ Rp 200 mil (being increased to ~
Rp 250 mil in 2005). Includes community contribution.
III. Allocation is approximately Rp 175 mil for WS and Rp 25
mil for sanitation and other non WS activities.
IV. Community WS&S facilities funded directly from CAP
budget (as grant).
V. Individual household WS connections funded by
households.
VI. Household sanitation facilities funded by credit. Capital
provided to village as a grant.
13
14. CAP approval
1. CAPs are evaluated and approved by an
Evaluation Team at district level
2. CAP which exceed specfied financial and/or
technical criteria are forwarded to CPMU for
review and approval.
3. Bank approval required in some circumstances
(water supply investment cost > Rp 200
million).
4. Process monitored by PMC (CPMU - MC).
14
15. CAP implementation (1 of 2)
1. Payment made in 3 tranches
1st tranche - 25% IDA grant plus 8% GOI (APBN + APBD).
Prerequisite – approved CAP, signed agreement between
VIT and District (DPMU), 4% cash contribution and
commitment to in-kind funding.
2nd tranche - 50% IDA grant. Prerequisite – maximum
residual cash 10%.
3rd tranche - 25% IDA grant. Prerequisite – 75% physical
completion, satisfactory review of community accounts and
PMC approval.
2. Implementation by unpaid community labour with
suppliers and/or contractors engaged for equipment
supply and specialised services.
15
16. CAP implementation (2 of 2)
1. DTC and CFs continue support to
community with facilitation and training
during implementation and for a period
post completion.
2. PMC monitors process in accordance
with project systems and procedures.
16
17. Completion & hand-over
1. Community responsible for operation and
maintenance of completed facilities.
2. Village level WS&S management organisation
(WMO) established to assume responsibility post
completion.
3. Payment (water tariff) system implemented to
meet costs for sustainable O&M.
4. Assets handed over to community after completion
of construction and establishment of WMO.
5. Project cycle from shortlisting to completion takes
12 – 18 months.
17
19. Organisation Chart
Legend:
Ministry of Health Direction & reporting
Steering Committee
DG CDC & EH Coordination
Project Manager
NATIONAL
CPMU
Technical Team (Central level)
Working Group Project Team
Leader (PTL)
Management
Technical Consultant
Consultant Sub-team
Sub-team (TC)
(MC)
Provincial Project Manager
Coordination Team Technical Team
PROVINCE
Secretariat (Provincial level)
MC - Provincial Liaison
TC - Health Promotion
Officer (PLO)
Project Manager
Coordination Team Technical Team DPMU
(District level)
DISTRICT
MC - Process
DTC
Monitoring Consultant
(including CFTs)
(PMC)
OPERATIONAL POLICY,
IMPLEMENTATION - PLANNING, MANAGEMENT, COORDINATION,
STRATEGIC POLICY GUIDANCE, COORDINATION,
SUPERVISION, MONITORING & EVALUATION
SUPERVISION
19
20. Central level
1. Ministry of Health, Directorate General for CDC & EH is
executing agency.
2. National Development Planning Board and Ministries of
Education, Finance, Home Affairs, and Settlements &
Regional Infrastructure are key GOI stakeholders.
3. CPMU at central level is responsible for day to day project
management including liaison with World Bank.
4. CPMU supported by TA for project management, technical
support and MIS/M&E.
5. Project Steering Committee provides strategic policy
guidance.
6. Central Technical Team and Working Group provide
support with operational policy, coordination/liaison and
supervision. 20
21. Provincial level
1. Provincial Secretariat headed by
Provincial Health Office provides day to
day coordination and liaison.
2. Provincial Coordination Team and
Technical Team mirror arrangements
and the central level.
3. Provincial Liaison Officer (PLO -
Consultant) assists with liaison,
coordination and reporting.
21
22. District level
1. DPMU headed by District Health Office responsible for
day to day management at district level.
2. DTC provides implementation support.
3. Process Monitoring Consultant responsible for
ensuring implementation process accords with project
guidelines.
4. District Coordination Team and Technical Team mirror
arrangements and the central level. Important for cross
sectoral liaison and coordination.
5. A subdistrict level technical team facilitates project
coordination & liaison at the subdistrict level.
22
24. District level
(1 of 2)
1. TA support at district level provided through
District Technical Consultants (DTC).
2. DTC team includes community facilitators
(CFs) and a training team.
3. Intensive front end training provided plus
periodic refesher training and other capacity
development events.
4. Community empowerment and MPA/PHAST
methodologies are a key focus of training.
24
25. District level
(2 of 2)
i) DTC teams are contracted on a regional/
provincial basis.
ii) Resources include a WS&S Engineer and a
CD/Heath Consultant in each district managing
2-6 teams of CFs (CFTs).
iii) CFTs operate as a team of 3:
WS&S engineering,
Community empowerment, &
Community health.
iv) Each CFT supports planning and
implementation activities in about 4 villages
per year.
25
26. Central level
(1 of 2)
1. Project Team Leader/Adviser to CPMU –
provides overall project management
support to CPMU.
2. Technical Consultant (TC) Sub-team
provides support to CPMU, DPMU and
DTC in the key technical areas of WS&S,
water quality, CD, MPA/PHAST, school
& community health/hygiene promotion,
capacity building/training, IEC.
26
27. Central level
(2 of 2)
1. Management Consultant (MC) Sub-team
provides support to CPMU and DPMU
with financial management,
procurement, MIS/monitoring &
evaluation, and progress/management
reporting.
M&E supported by district based Process
Monitoring Consultants (PMC);
Provincial Liaison Officers (PLOs) assist
with liaison and coordination at provincial
level.
27
29. Physical progress
1. Implementation status as at June 2004:
Elapsed implementation time based on
original project timeframe 45% (27 of 60
months field activity);
Planning completed in 708 Villages (35%);
Construction substantially completed (water
systems functional) in 424 Villages (21%).
2. Overall progress estimated at 27%.
29
30. Financial progress
1. Expenditure to 30 June 2004
Source of Funds Amount (Billion Rp)
IDA 173.8 [28%]
Trust Fund (AusAID) 27.7 [53%]
GOI (APBN + APBD) 58.8 [60%]
Community 23.3 [27%]
Total 283.5 [33%]
30
32. Implementation progress (1 of 3)
1. Progress significantly behind schedule.
2. Significant variations between provinces.
3. Changes planned including:
Additional districts (increase from 34 – 40);
Implementation timeframe extended to
2007 or 2008;
Substantial increase in number of CFs
15% increase in number of target villages
without overall budget increase.
32
33. Implementation progress (2 of 3)
1. Percentage of work completed as at June 2004.
60%
50%
40%
30%
20%
10%
0%
East NTB West South Bangka West South Overall
Java Sumatra Sumatra Belitung Java Sulawesi Project
33
34. Implementation progress (3 of 3)
Productivity by province (Based on 2003 Jan – Dec):
6
5
4
3
2
1
0
East Java NTB West South Bangka Project
Sumatra Sumatra Belitung
34
35. Component 2 –
Health Behaviour & Services
1. Health component has under-performed:
Lack of integration with existing government health services and
programs;
Sanitation outcomes.
2. Strategy is being reviewed/improved to:
Engage with existing health services & programs (Puskesmas &
Sanitarian)
Increase focus on health behaviour and sanitation in CAP;
Address village-wide sanitation improvements in CAP
preparation;
Strengthen training of CFs in relevant areas;
Provide improved tools to support “informed choice” based on
broader range of technical options;
Improve credit mechanisms.
3. Field trials of new approaches also planned in
conjunction with WASPOLA.
35
36. Procurement & MIS/M&E
1. Delayed procurement of TA consultants
has impacted significantly on
implementation in West Java and South
Sulawesi, and on overall progress.
2. MIS/MONEV
Slow implementation of sustainability
monitoring.
MIS infrastructure not conducive to
effective use of data.
36