Evaluating community and household assistance for reducing plastic waste burning with enhanced waste management (CARE) in Malang, Indonesia
| ISRCTN | ISRCTN14580292 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN14580292 |
| Secondary identifying numbers | NIHR203247 |
- Submission date
- 24/09/2025
- Registration date
- 29/09/2025
- Last edited
- 26/09/2025
- Recruitment status
- No longer recruiting
- Overall study status
- Ongoing
- Condition category
- Other
Plain English summary of protocol
Background and study aims
Indonesia generates a large volume of plastic waste each year, with a significant portion openly burned—a common practice in both households and community settings. The problem is further compounded by imported plastic waste, which adds pressure to domestic waste management systems.[1] In East Java, particularly in Banyuwangi and Malang, this has led to significantly degraded air quality. A 2020 report by the Ministry of Environment and Forestry found that PM2.5 levels in these areas exceeded World Health Organization (WHO) safety guidelines, reaching 1.4 times the recommended threshold. One of the most striking cases was documented near a tofu factory in Tropodo, where plastic waste is burned as fuel. Eggs collected from the vicinity contained the second-highest dioxin levels ever recorded in Asia—90 times higher than Indonesia’s regulatory limit.[2] Dioxins and fine particulate matter from plastic burning are well-documented contributors to a range of non-communicable diseases (NCDs), including chronic obstructive pulmonary disease (COPD), cardiovascular diseases, and various cancers. These findings underscore the urgent need for targeted interventions to reduce plastic waste burning as a critical step toward improving air quality and protecting community health.
This study aims to evaluate the impact of the Community and Household Assistance for Reducing Plastic Waste Burning with Enhanced Waste Management (CARE) intervention on waste management practices, including household plastic waste burning
Who can participate?
This study will be implemented in 12 purposively selected villages in East Java Province, Indonesia, comprising six intervention villages in Malang District and six control villages in Banyuwangi District. The selection of villages was guided by a set of criteria to ensure comparability and reduce contamination between arms. These criteria include rural classification, similar levels of population density, predominant employment types (e.g., agriculture or home industry), lowland geographical characteristics, and existing waste management infrastructure such as operational waste banks or waste bank cells. From these 12 villages, a total of 1,374 households (687 households per district) will be recruited to participate in the study.
What does the study involve?
CARE will consist of three core components: regulation at the village level, waste management facilities, and education and training of community members and environmental kaders (kader lingkungan). The co-designed intervention will be delivered by a multidisciplinary intervention team responsible for its design, implementation, and monitoring. It includes academic researchers from the University of Brawijaya, local government stakeholders such as the District Environmental Authority, sub-district and village officials, as well as waste management practitioners and environmental kaders. The kaders serve as primary implementers at the community level, delivering training, managing waste bank operations, and engaging households through existing social and religious forums.
What are the possible benefits and risks of participating?
Benefits:
- Participating households will benefit directly from improved waste management (e.g access to waste banks, better collection systems)
- Community members will receive education and training on safer waste practices, which may reduce exposure to harmful pollutants from plastic burning.
- Over time, reduced open burning is expected to contribute to better local air quality and associated health improvements.
Risks:
The study has minimal risk of participation since the intervention is non-invasive.
Where is the study run from?
Six villages in Malang and six villages in Banyuwangi, Indonesia.
When is the study starting and how long is it expected to run for?
March 2025 to May 2027
Who is funding the study?
National Institute for Health and Care Research (NIHR) (UK)
Who is the main contact?
NIHR GHRC Indonesia Team, globalhealth@ub.ac.id
Contact information
Public, Scientific, Principal Investigator
5th Floor Auditorium of Gedung Pusat Pembelajaran (GPP) Faculty of Medicine, Brawijaya University
Malang
65145
Indonesia
 ORCID ID |
0000-0002-9040-4775 |
|---|---|
| Phone | +62 341 569117 |
| dr.sriandarini.fk@ub.ac.id |
Public, Scientific
5th Floor Auditorium of Gedung Pusat Pembelajaran (GPP) Faculty of Medicine, BrawijayaUniversity
Malang
65145
Indonesia
| ORCID ID |
0000-0003-4197-4592 |
|---|---|
| Phone | +62 8122721219 |
| sujarwoto@ub.ac.id |
Study information
| Study design | Quasi-experimental design |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Non randomised study |
| Study setting(s) | Community |
| Study type | Prevention |
| Participant information sheet | 48054 PIS_CARE Study v4.0 06July2025.pdf |
| Scientific title | Evaluating Community and household Assistance for Reducing plastic waste burning with Enhanced waste management (CARE) in Malang, Indonesia |
| Study acronym | CARE |
| Study objectives | Aims: To evaluate the impact of the CARE intervention on waste management practices, including household plastic waste burning. Objectives: 1. To explore whether the development and implementation of village-level waste management regulation is effective in reducing plastic waste burning 2. To assess whether the development and implementation of waste management infrastructure, including neighbourhood and village waste banks improve waste management practices in the community. 3. To assess the effectiveness of training and awareness generation activities on plastic waste management and waste burning practices. |
| Ethics approval(s) |
Approved 14/04/2025, Health Research Ethics Committee Faculty of Medicine Brawijaya University (Jalan Veteran, Malang, 65145, Indonesia; +62 341569117; sekr.fk@ub.ac.id), ref: 77.1/EC/KPK/04/2025 |
| Health condition(s) or problem(s) studied | Prevention of non-communicable diseases (NCDs) -including chronic obstructive pulmonary disease (COPD), cardiovascular diseases, and various cancers- triggered by plastic waste burning through Community and household Assistance for reducing plastic waste burning with Enhanced waste management (CARE) intervention. |
| Intervention | The Community and Household Assistance for Reducing Plastic Waste Burning with Enhanced Waste Management is a comprehensive intervention designed to address the environmental and health risks associated with plastic waste burning in rural communities. CARE will consist of three core components: regulation at the village level, waste management facilities, and education and training of community members and environmental kaders (kader lingkungan). The co-designed intervention will be delivered by a multidisciplinary intervention team responsible for its design, implementation, and monitoring. It includes academic researchers from the University of Brawijaya, local government stakeholders such as the District Environmental Authority, sub-district and village officials, as well as waste management practitioners and environmental kaders. The kaders serve as primary implementers at the community level, delivering training, managing waste bank operations, and engaging households through existing social and religious forums. |
| Intervention type | Other |
| Primary outcome measure | The reduction in household plastic waste burning measured as a binary variable (yes/no) after 1 year of intervention implementation. |
| Secondary outcome measures | 1. Improved knowledge and skills to sort and manage plastic (both environmental kaders and community members), measured using validated questionnaires. 2. Increased plastic waste collection through use of waste banks or community collection points, measured by the proportion of the intervention households utilising the waste banks, after 1 year of intervention implementation. 3. Reduction in PM2.5 level in the neighbourhood, measured using Airly Open Air Model O-1PST, after 1 year of intervention implementation. |
| Overall study start date | 01/03/2025 |
| Completion date | 31/05/2027 |
Eligibility
| Participant type(s) | Other |
|---|---|
| Age group | Not Specified |
| Sex | Both |
| Target number of participants | 1,374 households (687 households per arm) |
| Key inclusion criteria | This study will be implemented in 12 purposively selected villages in East Java Province, Indonesia, comprising six intervention villages in Malang District and six control villages in Banyuwangi District. The selection of villages was guided by a set of criteria to ensure comparability and reduce contamination between arms. These criteria include rural classification, similar levels of population density, predominant employment types (e.g., agriculture or home industry), lowland geographical characteristics, and existing waste management infrastructure such as operational waste banks or waste bank cells. In this cluster-based quasi-experimental trial, villages serve as the clusters that were allocated to intervention or control, while households within these villages will serve as the units of analysis. |
| Key exclusion criteria | No exclusion criteria is applied in this study. Household that is not consented to participate in this study will not be included in the study. |
| Date of first enrolment | 01/03/2025 |
| Date of final enrolment | 30/04/2025 |
Locations
Countries of recruitment
- Indonesia
Study participating centre
Malang
65145
Indonesia
Sponsor information
Government
Grange House
15 Church Street
Twickenham
TW1 3NL
England
United Kingdom
| Phone | +44 20 8843 8000 |
|---|---|
| ccf@nihr.ac.uk | |
| Website | https://www.nihr.ac.uk |
"ROR" |
https://ror.org/0187kwz08 |
Funders
Funder type
Government
Government organisation / National government
- Alternative name(s)
- National Institute for Health Research, NIHR Research, NIHRresearch, NIHR - National Institute for Health Research, NIHR (The National Institute for Health and Care Research), NIHR
- Location
- United Kingdom
Results and Publications
| Intention to publish date | 31/05/2027 |
|---|---|
| Individual participant data (IPD) Intention to share | No |
| IPD sharing plan summary | Data sharing statement to be made available at a later date |
| Publication and dissemination plan | The results of this study is planned to be published in a high-impact peer-reviewed journal and presenred at international conference. Result dissemination is also planned to be conducted to the study participants and key stakeholders. |
| IPD sharing plan | The data sharing plan of this study is currently unavailable and will be defined at a later stage. |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Participant information sheet | version 4.0 | 06/07/2025 | 26/09/2025 | No | Yes |
Additional files
Editorial Notes
26/09/2025: Trial's existence confirmed by Health Research Ethics Committee Faculty of Medicine Brawijaya University.
