Does water and sanitation effects on children’s physical development? Evidence from Indonesia Family life Survey (IFLS) 2014 (original) (raw)
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The Effect of Sanitation on Stunting Prevalence in Indonesia
Populasi, 2022
Preparing children from birth can boost productivity and competitiveness later in their lives. However, the occurrence of malnutrition and stunting during childhood period will reduce their productivity and increases the risk of non-communicable diseases later in their lives. This study examines the effect of sanitation, drinking water sources, and drinking water treatment on stunting in Indonesian children (0-59 months). This study analyses crosssectional data from the 2014 Indonesia Family Life Survey (IFLS) 5 with 3,834 children living with their biological mothers. The Logistic Regression to estimate the coefficients is applied here. The results show that the variables of sanitation, drinking water sources, and drinking water treatment before consuming affected stunting. Children who consume tap water are less likely to be stunted (OR=0.81, 95% CI 0.66-0.99). Birth weight, economic conditions, and mother's level of education also affect risk of stunting. Hence, to overcome the risk of stunting, the government have to accelerate the supply of basic sanitation, to protect the good quality of drinking water sources, and to promote the awareness of boiling water before consumption.
IOP conference series, 2019
Indonesia still bears a significant public health problem of stunting among under-5 (U-5) children. Environmental factors have been demonstrated to be associated with stunting as indirect causes. However, the extent to which the environmental factors determine the stunting burden in rural Indonesia is stil underexplored. Hence, this study investigates environmental factors that determine stunting among U-5 children in the rural areas of Indonesia. We employed data from the Indonesia Family Life Survey 2014/2015 (IFLS5) and selected a sample size of 2,571 children under five years of age residing in rural areas. We performed a multivariable logistic regression analysis and estimated the "population attributable fraction" (PAF) of drinking water, sanitation, and garbage collection on stunting. The results suggest that unimproved drinking water source and improper garbage collection correspond with higher odds of child stunting. Inadequate sanitation facility, however, was not found to be significantly influencing the odds of stunting. Moreover, household wealth is protective of risk of stunting. Furthermore, the PAF analysis demonstrated that 21.58% of the stunting burden among U-5 children residing in rural areas are preventable by providing access to an improved drinking water source and better household solid waste management to prevent repeated infections.
Makara Journal of Health Research
Background: This study aims to identify the relationship between sanitation, hygiene, and stunting in children under two-years in Indonesia. Methods: This was a cross-sectional study that examined 9,688 children under the age of two. We obtained data from Indonesia's Basic Health Research paper that was released in 2013 and applied multiple logistic regression analysis. The prevalence of stunting amongst children under two-years in 2013 was 33.3%. Results: Our analysis showed that stunting is closely related to low birth weight, age, gender, exclusive breastfeeding, socioeconomic status, garbage removal, and waste management. Appropriate sanitation and hygiene had a significant impact on stunting amongst children under two-years in Indonesia, with waste management and low birth weight being the most important indicators. Conclusions: Nutrition, socioeconomic status, and a healthy environment are key to ensure children under two-years meet the recommended growth standards.
BMC Public Health, 2016
Background: Stunting in early life has considerable human and economic costs. The purpose of the study was to identify factors associated with stunting among children aged 0-23 months in Indonesia to inform the design of appropriate policy and programme responses. Methods: Determinants of child stunting, including severe stunting, were examined in three districts in Indonesia using data from a cross-sectional survey conducted in 2011. A total of 1366 children were included. The analysis used multiple logistic regression to determine unadjusted and adjusted odds ratios. Results: The prevalence of stunting and severe stunting was 28.4 % and 6.7 %, respectively. The multivariate analysis on determinants of stunting identified a significant interaction between household sanitary facility and household water treatment (P for interaction = 0.007) after controlling for potential covariates: in households that drank untreated water, the adjusted odds on child stunting was over three times higher if the household used a unimproved latrine (adjusted odds ratio 3.47, 95 % confidence interval 1.73-7.28, P <0.001); however, in households that drank treated water, the adjusted odds on child stunting was not significantly higher if the household used an unimproved latrine (adjusted odds ratio 1.27, 95 % confidence interval 0.99-1.63, P = 0.06). Other significant risk factors included male sex, older child age and lower wealth quintile. The risk factors for severe stunting included male sex, older child age, lower wealth quintile, no antenatal care in a health facility, and mother's participation in decisions on what food was cooked in the household. Conclusions: The combination of unimproved latrines and untreated drinking water was associated with an increased odds on stunting in Indonesia compared with improved conditions. Policies and programmes to address child stunting in Indonesia must consider water, sanitation and hygiene interventions. Operational research is needed to determine how best to converge and integrate water, sanitation and hygiene interventions into a broader multisectoral approach to reduce stunting in Indonesia.
Proceedings of the 4th International Symposium on Health Research (ISHR 2019), 2020
Some sub-districts in Bali province have stunting prevalence more that national average which might be associated with the environmental health condition in those areas. This study aimed to examine the association between environmental health factors with stunting prevalence among children age 2-5 years. Case-control study was conducted at Karangasem district with 101 case and 101 control. Cases were obtained from the list of stunted children from the result of PSG 2017 in 4 sub-districts. The controls were children at the same age and sex which were randomly selected from the available list of children in the health center. Bivariate and multivariate (logistic regression) were used for analysis. The study shows that cases and controls were comparable for age, sex, health access, nutrition sensitive intervention, infection history, water access, solid waste management. Cases and controls differed for variables: education level of parents, toilet access and ownerships, disposal of child's feces, hand washing practice dan facilities, and distance to livestock shelter. Logistic regression showed that only father's education (AOR=2.429; 95%CI: 1.304-4.525) associated with stunting among children age 2-5 years. The optimum prediction model was obtained with variables of father's education, disposal of child's feces and distance to animal shelter. In conclusion, only father's education was found associated with stunting and only weak associations were found between environmental health factors and stunting.
2021
(1) Background: Stunting remains a challenge in Indonesia, where 30.8% of under-five children are stunted and may never reach full potential height and cognitive function. We aimed to investigate the risk factors of stunting in Nangapanda subdistrict, East Nusa Tenggara; (2) Methods: The design was cross-sectional study located in rural area as part of PINTERMIDI UI project. We collected quantitative data on social determinants, weight, height, hemoglobin, ferritin, serum zinc, CRP, worm infection, history of deworming, co-morbidity, food security, and nutrient intake; (3) Results: A total of 196 under-five children included and 74% households were food insecure. The prevalence of stunting was 29.9% in this population (31.8% worm infection, 30.3% iron deficiency, and 28.1% zinc deficiency). Multivariate analysis showed household with 5-8 members (AOR 3.076; 95% CI 1.132-8.356) and unsafe drinking water (AOR 1.702; 95% CI 0.825-3.512) were significant independent risk factors of stunting after adjusted by child's gender, father's occupation, caregiver's education, monthly expenses, sanitary facilities, and food security status; (4) Conclusions: The number of household members is the only independent risk factor of stunting among children age 24-59 months in rural area of Eastern Indonesia. Development of nutrition sensitive intervention and promotion of family planning are needed in order to increase adequate child's care and feeding practices in rural area of Eastern Indonesia.
International Journal Of Community Medicine And Public Health
Background: Stunting toddlers describe the existence of chronic nutritional problems, influenced by prospective maternal, fetal period, and toddler age, including illnesses during infancy. Children who stunted impact not only on intelligence, productivity and future performance after adulthood.Methods: The study in 10 villages in Purwojati Subdistric, Banyumas district, Central Java, Indonesia in 2017. The cross-sectional study design with population is households that have children aged 6-35 months. A sample of 348 children aged 6-35 months was taken by the cluster whit design effect of 2.Results: Respondents consisted of 52.3% boys, 45.4% aged 12-23 months. Most of the energy, protein, fat and carbohydrate intake is more than 80% of the recommended dietary allowance and a small proportion of children suffer from measles, Acute Respiratory Infection and diarrhoea. For sanitation 68.4% of the houses are in the poor, poor waste management is 92%, non-plumbing sources 68.9%, dirty lat...
Universal Journal of Public Health, 2023
Severity of stunting is frequently associated as a result of the effects of environmental factors, such as ecological differences, poor quality sanitation, and potential effects on parental livelihood. Knowledge about the effect of sanitation and parental livelihood at three ecological zones on stunting severity at South Lampung Regency is unknown. The aim of this study is to determine the effect of ecological zones, sanitation performance, and parental livelihood on stunting severity in toddlers aged 0-59 months at South Lampung Regency, Indonesia. The cross-sectional study was conducted in a sample of 182 households that were spread over the hilly zone, 82 lowland zones, and 49 coastal zones at South Lampung Regency, Indonesia. Data were collected using a structured questionnaire that captured the sanitation performance and parental livelihood. Toddler’s heights were measured using a standard procedure and categorized manually according to national references. The ordinal logistic regression model was used to claim the effect. The higher probability of toddlers to be stunting was found significant on lowland zone, coastal zone, and clean water from drilled wells source, while lower probability significant on gallon drinking water, standard latrines, wastewater sewerage construction materials from cement and pipes, managed solid waste, ventilation not all rooms, bright lighting in rooms, and father's livelihood as a civil servant and entrepreneur. Stunting severity at South Lampung Regency is affected by ecological zones, sanitation performance, and father’s livelihood. The results of our study are expected to assist the government in developing appropriate stunting reduction policy programs, especially comprehensive intervention by adjusting the ecological zone.
BMC Public Health
Background: This study's purpose was to understand associations between water, sanitation, and child growth. Methods: We estimated stunting (height-forage Z score <−2 SD) and thinness (BMI-Z <−2 SD) risk ratios using data from 7,715 Ethiopian, Indian, Peruvian, and Vietnamese children from the Young Lives study. Results: In unadjusted models, household access to improved water and toilets was often associated with reduced stunting risk. After adjusting for child, household, parent, and community variables, access to improved water was usually not associated with stunting nor thinness except in Ethiopia where access to improved water was associated with reduced stunting and thinness at 1y and 5y. In contrast, in both unadjusted and adjusted models, stunting at 1y was less common among children with good toilet access than among those without access and this difference persisted when children were 5y and 8y. For example, in adjusted estimates, Vietnamese 5y olds with access to improved toilets had relative stunting risk at 8y 0.62-0.68 that of 5y olds with no access to improved toilets. Water and toilets were rarely associated with thinness. Conclusions: Results from our study indicate that access to improved sanitation is more frequently associated with reduced stunting risk than access to improved water. However, additional studies are needed before drawing definitive conclusions about the impact of toilets relative to water. This study is the first to our knowledge to demonstrate the robust and persistent importance of access to improved toilets in infancy, not only during the first year but continuing into childhood. Additional longitudinal investigations are needed to determine concurrent and long-term associations of WASH with stunting and thinness.
2020
Background: Today, 36% of children under the age of five in Indonesia are being stunted. Many programs have been applied to solve this problem. But among all, diarrhea seems to have escaped attention as an important factor contributing to stunting rates. Even though nutrition sensitive intervention (diarrhea is one of its contributors) has higher contribution than nutrition specific intervention to stunting. Therefore, this study aims to investigate the correlation between diarrhea and stunting incidence that would be used as reference data for planning future health programs on reducing stunting in Indonesia. Materials and Methods:This is a descriptive study, by using the data on cases of diarrhea and stunting in Indonesia for two years (2016-2017). The data of diarrhea and stunting were obtained from the Information Center of the Ministry of Health of the Republic of Indonesia. Meanwhile the data of river water conditions in Indonesia was obtained from the Ministry of Environment ...