Hand hygiene practices are important not only during the corona virus disease 2019 (COVID-19) pandemic, but also critical to prevent the possible spread of other infectious diseases. This study aims to examine the current hand hygiene behaviors during the COVID-19 pandemic, post pandemic behavior intentions, and the relationship between behavior, psychosocial and contextual factors. A cross-sectional online survey was conducted from 28 May to 12 June 2020, with 896 valid responses obtained from Indonesian citizens over 18 years old. The survey questions included demographic characteristics, individual practices, risk perceptions, attitude, norm factors and ability factors related to hand hygiene during the COVID-19 pandemic. Descriptive analysis, chi square and multiple logistic regression tests were used to analyse the data. The results showed that 82.32% of female respondents and 73.37% male respondents reported handwashing practice 8 times or more per day during COVID-19 pandemic. Participants who perceived themselves at higher risk of contracting SARS-CoV-2 (OR 7.08, 2.26–22.17), had less negative perception toward the practice (OR 1.93, 1.32–2.82), perceived handwashing as an effective preventive measure (OR 1.77, 1.23–2.54), were female (OR 1.71, 1.21–2.41), perceived a more supportive norm (OR 1.68, 1.15–2.44) and noticed more barriers in access to handwashing facilities (OR 1.57, 1.05–2.36) were more likely to engage in hand hygiene practice more frequently during the pandemic. In conclusion, the majority of respondents did increase their frequency of hand hygiene practices during COVID-19 pandemic. In line with previous studies in other pandemic contexts, sex, perceived susceptibility and effectiveness are important predictors of hand hygiene practices, which are similar to findings from previous studies in other pandemic contexts. Addressing social norm related to the perceived hand hygiene practices of friends and important people is a potential health promotion strategy by creating hand hygiene norms in the community.

Rapid tourism growth can place unprecedented strain on water resources and reduce access for local communities. This study explored the state of Inclusive water, sanitation and hygiene (WASH) in the tourism sector and local communities of Labuan Bajo, one of Indonesia's ‘super-premium’ tourism destinations. The formative research applied an Inclusive WASH-at-Work framework; data were collected using a case study methodology through semi-structured interviews (n = 20) and focus groups (n = 6) with government, tourism and community stakeholders. The findings identified growing tensions over inequitable water service levels and WASH access. Significantly, reported negative impacts were disproportionately experienced by women and girls, elderly and disabled members of the community, who suffer most from inadequate WASH facilities in hotels, public settings and their homes. Governance of and capacity constraints around WASH management highlighted the value of Inclusive WASH solutions to overcome the challenges Labuan Bajo faces as a rapidly developing tourism destination. Critically, solutions must be locally-driven, build local capacity and open pathways to collaboration between the community and decision-makers in the national government, provincial government and private tourism sector. Enhanced stakeholder collaboration and increased private sector contributions are needed to ensure a more equitable distribution of tourism benefits to underpin WASH and destination sustainability.

There is a wealth of literature indicating that socio-cultural understanding is crucial in the implementation of sanitation programmes. However, in Indonesia, the exploration and response to this understanding in regard to sanitation uptake and sustainability remain weak. This study aims to gain an understanding of the cultural determinants underpinning sanitation issues across all sanitation stages in one part of Indonesia in order to address both uptake and sustainability. A qualitative exploratory study in two rural communities in Bali identified some cultural values and traditional roles that can affect sanitation uptake and sustainability. A set of values relating to harmony and purity, and community and individual roles defined by culture appears to modify the perception of risks and barriers, and sets priorities for resources and commitment. The paper also discusses how to translate the understanding of local values and roles into action strategies in order to improve sanitation uptake and sustainability.

Despite increased promotion, sanitation programmes have varying degrees of success partly because of limited consideration of the wider context beyond individual factors in programme design. Although a recent model, Integrated Behaviour Model for Water Sanitation and Hygiene (IBM-WASH) comprehensively addresses this gap, the model focuses on the initial adoption factors and lacks emphasis on the functioning of the entire sanitation system from toilet usage to the safe disposal of the waste. Hence application of the model is limited, to some degree, in achieving the Sustainable Development Goals for sanitation which have broadened the scope for sustainable sanitation service. Based on a review of available frameworks, this paper proposes an alternative comprehensive framework using an ecological public health approach to health determinants but does so through application across the spectrum of sanitation stages. A systematic literature review on sanitation adoption factors and comparative analysis of the proposed framework and the IBM-WASH framework was conducted to analyse the benefits of the framework. The findings show that different factors operate differently for each sanitation service stage, requiring a different set of actions for each stage. Our alternative framework can better address factors across sanitation stages and encourage collaboration among stakeholders with different disciplinary backgrounds.

This study aimed to apply the integrated WASH assessment tool and assess the performance of WASH services in three Internally Displaced Person (IDP) camps in Rakhine State, Myanmar. The tool was applied in a unique non-household setting that is vulnerable to annual storms and storm-induced flooding, while also facing the complexity of political and social constraints. The assessment focused on nine components of the tool: water, sanitation, hygiene, financial, institutional, environmental impacts, technical, social, and climate change. Afterwards, the overall WASH services performance of the three IDP camps was determined. The assessment revealed good performance in water, financial, institutional, and social components across all camps. However, environmental impact, technical, and climate change components showed the need for improvement due to recurrent climate hazards, and their impacts on WASH facilities, such as latrine destruction, saltwater intrusion into handpumps, and increased diarrhea cases. Based on the findings, the study recommends constructing disaster-resilient latrines, reinforcing handpumps with watertight materials, elevating wellheads to prevent contamination, and forming emergency response teams with appropriate training. Overall, Ohn Taw Gyi (South) and Kaung Doke Khar (2) camps had a good level of WASH performance with a 6.38 sum of net scores of components (SAS), and with 6.06 SAS, respectively. Thet Kae Pyin camp had a moderate level of performance with 5.35 SAS. The application of the assessment tool provided valuable data to support evidence-based decision-making. It serves as a useful resource for WASH professionals, humanitarian organizations, and local governments to evaluate service performance and ensure sustainable service provision in their areas.