The study evaluates the impact of a rural sanitation project, known as the Total Sanitation and Sanitation Marketing (TSSM) project, which was launched by the Indonesian government to improve sanitation in rural communities of East Java. TSSM includes three main components: 1) Community-Led Total Sanitation (CLTS), 2) Social Marketing of Sanitation, and 3) Strengthening the Enabling Environment. In the CLTS component, external facilitators lead community discussions about sanitation and the potential affects of open defecation. Facilitators work with the community to draw a map of where defecation occurs, and then explain how defecation in particular areas may contaminate water and food. The community then builds an action plan to eliminate open defecation. Social Marketing focuses on marketing the increasing availability of sanitation-related products and services. And, the Strengthening the Enabling Environment component supports the development of policies and institutional practices that facilitate scaling up, program effectiveness, and sustainability.