Integrated policy planning for accelerating and sustaining open defecation free (ODF) status: a bardach policy analysis

Abstract

Open defecation (OD) remains a multidimensional sanitation challenge in Palembang City because it is shaped not only by household behavior but also by access to clean water, geographic conditions, socioeconomic capacity, housing characteristics, sanitation facilities, knowledge, attitudes, and cross-sector governance. This study transforms empirical evidence on OD in Palembang into an integrated policy design for accelerating and sustaining Open Defecation Free (ODF) status. The analysis applies Bardach's policy evaluation framework using four criteria: technical feasibility, economic and financial possibility, political viability, and administrative operability. The empirical evidence underlying the analysis identified nine factors associated with OD behavior. Clean-water source was the most dominant factor (OR = 11.558; p < 0.001), followed by household geographic location (OR = 3.558; p = 0.015). At the end of 2023, 32.5% of respondents still practiced OD, while 67.5% were already ODF. Seven policy alternatives were examined, including cross-sector prioritization, inter-agency coordination, One Map ODF, inclusive sanitation and water access, area-specific interventions linked to poverty reduction, strengthened hygiene behavior assistance, and collaborative financing with post-declaration monitoring. The analysis indicates that the most coherent policy package combines One Map ODF as a technical planning instrument, continuous hygiene behavior education and assistance as an economically efficient intervention, formal establishment of P2-ODF as a cross-sector development priority, and collaborative financing supported by verification and post-declaration monitoring. The study contributes an area-based, evidence-informed planning model that links sanitation infrastructure, clean water, behavior change, poverty reduction, spatial targeting, financing, and governance within one policy architecture for Palembang City.