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      Access to inclusive sanitation and participation in sanitation programs for people with disabilities in Indonesia

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          Abstract

          Access to inclusive sanitation for people with disabilities (PWDs) remains a global challenge, including in Indonesia, where 10–15% of its population is disabled. Inclusive sanitation facilities can be achieved when PWDs are involved in the sanitation-related decision-making process, e.g., designing toilet that meets their needs. This study aims to investigate the situation of the sanitation facility in houses of PWDs and understand knowledge, attitude, and practices related to PWD participation in sanitation programs using a case study in two provinces in Indonesia: Nusa Tenggara Barat and Nusa Tenggara Timur. Quantitative data were taken from 129 PWD households, and qualitative data were from in-depth interviews with relevant stakeholders. The latter was presented in a causal loop diagram. Less than 5% had inclusive sanitation at home, mainly due to no supportive tools and bins. The knowledge levels related to sanitation and PWDs participation in sanitation programs were relatively low. Economic condition was one of the barriers for PWDs to participate in the sanitation program. Statistical analysis found that a higher household head education level was associated with a more positive attitude and higher PWD participation in sanitation programs. Although Indonesian law supports PWD participation, the implementation remains a challenge. This study also underlines the need for capacity building in facilitating PWDs’ involvement in sanitation programs and community meetings. Finally, barriers to PWD participation can come from different levels and actors, e.g., the family, the community, the district level, and the PWD itself, indicating the need to involve actors at all levels to enhance PWD participation in the sanitation program that leads to inclusive sanitation facilities for all groups.

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          The application of systems thinking in health: why use systems thinking?

          This paper explores the question of what systems thinking adds to the field of global health. Observing that elements of systems thinking are already common in public health research, the article discusses which of the large body of theories, methods, and tools associated with systems thinking are more useful. The paper reviews the origins of systems thinking, describing a range of the theories, methods, and tools. A common thread is the idea that the behavior of systems is governed by common principles that can be discovered and expressed. They each address problems of complexity, which is a frequent challenge in global health. The different methods and tools are suited to different types of inquiry and involve both qualitative and quantitative techniques. The paper concludes by emphasizing that explicit models used in systems thinking provide new opportunities to understand and continuously test and revise our understanding of the nature of things, including how to intervene to improve people’s health.
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            Sanitation and Health

            As one article in a four-part PLoS Medicine series on water and sanitation, David Trouba and colleagues discuss the importance of improved sanitation to health and the role that the health sector can play in its advocacy.
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              Disability and Poverty: the need for a more nuanced understanding of implications for development policy and practice

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                Author and article information

                Contributors
                anindrya@itb.ac.id
                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                15 March 2023
                15 March 2023
                2023
                : 13
                : 4310
                Affiliations
                [1 ]GRID grid.8570.a, ISNI 0000 0001 2152 4506, Department of Health Behavior, Environment, and Social Medicine, Faculty of Medicine, Public Health and Nursing, , Universitas Gadjah Mada, ; Yogyakarta, Indonesia
                [2 ]GRID grid.434933.a, ISNI 0000 0004 1808 0563, Faculty of Civil and Environmental Engineering, , Institut Teknologi Bandung, ; Bandung, Indonesia
                [3 ]GRID grid.434933.a, ISNI 0000 0004 1808 0563, Center for Environmental Studies, , Institut Teknologi Bandung, ; Bandung, Indonesia
                [4 ]GRID grid.8570.a, ISNI 0000 0001 2152 4506, Department of Public Health, The Graduate School, , Universitas Gadjah Mada, ; Yogyakarta, Indonesia
                [5 ]GRID grid.412828.5, ISNI 0000 0001 0692 6937, Department of Public Health and Preventive Medicine, Faculty of Medicine, , Udayana University, ; Denpasar, Indonesia
                Article
                30586
                10.1038/s41598-023-30586-z
                10017721
                36922602
                84d8f2ef-ea95-4745-a8b1-499766205b24
                © The Author(s) 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 3 October 2022
                : 27 February 2023
                Funding
                Funded by: Institute of Development Studies, United Kingdom
                Award ID: 21/513
                Award ID: 21/513
                Award ID: 21/513
                Award ID: 21/513
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100012521, Universitas Gadjah Mada;
                Award ID: Rekognisi Tugas Akhir (RTA) 2022
                Award Recipient :
                Categories
                Article
                Custom metadata
                © The Author(s) 2023

                Uncategorized
                environmental social sciences,psychology and behaviour
                Uncategorized
                environmental social sciences, psychology and behaviour

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