{ "abstract": "Climate change increasingly disrupts water, sanitation, and hygiene (WASH) services, disproportionately affecting women, children, people with disabilities, and groups with limited adaptive resources. Evidence remains limited on how WASH programs integrate climate resilience, equity, and social inclusion and on the conditions that enable benefits to reach households. Researchers examined how Climate Change Response for Inclusive WASH (CCRIW) guidance was implemented and adapted within routine programming in Indonesia, how implementation outcomes related to post-implementation household access, and which contextual factors enabled or constrained such access. Researchers conducted a mixed-methods study using program data collected between August 2023 and October 2024. Data included key informant interviews (n = 29) and a group discussion (n = 10). Quantitative data included village workshop records (n = 91) and household surveys and observations (n = 1,243) from 12 villages affected by floods, landslides, and drought. Researchers used descriptive statistics and logistic regression and triangulated the findings with deductive qualitative analysis informed by an implementation science framework. Results indicated that CCRIW guidance was perceived as relevant but was adapted during implementation rather than adopted as a complete stand-alone protocol. These adaptations appeared to improve short-term practicality while reducing consistent application, depth of learning, and recall of CCRIW as a distinct approach. Communities primarily adopted lower-cost actions aligned with immediate needs, available resources, and perceived feasibility. Household modifications supported more resilient and inclusive access but could not replace system-level investments under severe hazards. Regression models showed district-level associations for several facility-specific outcomes, limited associations with multiple-hazard exposure, and no consistent associations with reported household characteristics. The findings suggest that CCRIW could connect lived hazard experience with inclusive WASH assessment and local planning but should be embedded within sequenced programming that provides a WASH inclusion foundation and coordinated institutional support to address risks beyond household and village capacity.", "abstract_shown": true, "affiliations": [ "Department of Environmental Sciences and Engineering, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America", "University of Technology Sumbawa, Sumbawa, Indonesia", "The Water Institute at UNC, Department of Environmental Sciences and Engineering, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America", "Yayasan Plan International Indonesia, Jakarta, Indonesia", "Department of Construction Economics and Management, College of Engineering, Design, Art and Technology, Makerere University, Kampala, Uganda" ], "article_type": "Research Article", "arxiv": null, "author_total": 5, "authors": [ { "affs": [ 0 ], "name": "Silvia Landa" }, { "affs": [ 1 ], "name": "Fahrunnisa" }, { "affs": [ 2 ], "name": "Sarah Lebu" }, { "affs": [ 3 ], "name": "Novika Noerdiyanti" }, { "affs": [ 4 ], "name": "Musa Manga" } ], "bibtex": "https://research.draconitic.com/paper/akzc8dkem4wq5.bib", "cited_by": 0, "doi": "10.1371/journal.pone.0359266", "fulltext_url": null, "id": "akzc8dkem4wq5", "issns": [ "1932-6203" ], "landing_url": "https://doi.org/10.1371/journal.pone.0359266", "language": null, "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "journal", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2916|Child Nutrition and Water Access" ], [ "plos", "/Biology and life sciences/Neuroscience/Cognitive science/Cognition/Decision making" ], [ "plos", "/Biology and life sciences/Neuroscience/Cognitive science/Cognitive psychology/Decision making" ], [ "plos", "/Biology and life sciences/Psychology/Cognitive psychology/Decision making" ], [ "plos", "/Computer and information sciences/Network analysis/Network resilience" ], [ "plos", "/Earth sciences/Atmospheric science/Climatology/Climate change" ], [ "plos", "/Earth sciences/Hydrology/Flooding" ], [ "plos", "/Ecology and environmental sciences/Natural resources/Water resources" ], [ "plos", "/Medicine and health sciences/Health care/Environmental health/Sanitation" ], [ "plos", "/Medicine and health sciences/Medical conditions/Disabilities" ], [ "plos", "/Medicine and health sciences/Public and occupational health/Environmental health/Sanitation" ], [ "plos", "/Social sciences/Economics/Finance" ], [ "plos", "/Social sciences/Psychology/Cognitive psychology/Decision making" ] ], "openalex": "W7214615778", "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0359266&type=printable", "pmcid": null, "pmid": null, "published": "2026-09-28", "publisher": "Public Library of Science", "ris": "https://research.draconitic.com/paper/akzc8dkem4wq5.ris", "sources": [ { "first_seen": "2026-10-30T12:17:37Z", "native_id": "10.1371/journal.pone.0359266", "source": "plos", "url": "https://doi.org/10.1371/journal.pone.0359266" } ], "subjects": [ { "field": "biology", "origin": "plos:neuroscience", "subfield": "neuroscience" }, { "field": "earth", "origin": "plos:climate change", "subfield": "climate" }, { "field": "earth", "origin": "plos:hydrology", "subfield": "hydrology-soils" } ], "title": "Implementing a climate-resilient and inclusive WASH guidance in Indonesia: A mixed-methods case study", "title_text": "Implementing a climate-resilient and inclusive WASH guidance in Indonesia: A mixed-methods case study", "type": "peer-reviewed", "updated_at": "2026-10-30T12:17:37Z", "url": "https://research.draconitic.com/paper/akzc8dkem4wq5", "venue": "PLOS One", "versions": [] }