Wetland constraints and system traps in rural sanitation: lessons from CLTS implementation in wetland areas in Indonesia

ABSTRACT

Graphical abstract illustrating how wetland geography intensifies governance, financial, and sociocultural constraints, creating reinforcing feedback loops and highlighting key leverage points for improving CLTS implementation in Indonesia.

Community-led total sanitation, implemented in Indonesia as Sanitasi Total Berbasis Masyarakat, often underperforms in wetland areas where geographic and governance constraints interact. This study examined barriers to its implementation in West Tanjung Jabung Regency, Jambi Province, Indonesia, using a systems-thinking approach. A qualitative Community-Led Total Sanitation Rapid Appraisal Protocol study was conducted in June 2022 using observations, document review, and semi-structured interviews and was analysed thematically and through causal loop diagram modelling. Low-lying wetland villages achieved significantly lower open defecation-free status than higher-elevation areas (p < 0.001). Wetland conditions intensified interconnected governance, financial, institutional, and sociocultural challenges to sanitation implementation. Sanitation responsibilities were fragmented, sanitation was not a cross-sector performance indicator, and the WASH Working Group lacked effective coordination. Governments were reluctant to set ambitious targets given high construction costs, while funding accounted for only 0.06–0.07% of the health budget, with uneven deployment of sanitation workers and no cadre training. Systems analysis identified three reinforcing feedback loops linking governance, partnership and community behaviour, while wetland geography acted as an external system condition intensifying implementation challenges. Stagnation reflects interacting governance, financial, behavioural, and geographic constraints, requiring locally adapted implementation and wetland-appropriate technologies.