The effect of sanitation risk on toddler stunting incident with geographically weighted regression approach in Malang Regency, Indonesia 10.55131/jphd/2023/210107
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Abstract
Stunting is a fundamental problem in Indonesia's human development. The risk factors for stunting are very complex, including inadequate environmental sanitation. This study aims to analyze and map the influence of spatially correlated sanitation risk on the incidence of stunting toddlers in Malang Regency, Indonesia. Data collection was carried out by interviewing respondents using questionnaires, counting stunting toddlers, and observing environmental sanitation objects. Determination of respondents was done purposively with the following stages. First, at the village level, 75 sites were selected based on the following criteria: population density; poverty level; the presence of streams, drainage or irrigation canals; and flood vulnerability. Furthermore, in each village, 40 respondents were selected based on the following criteria: women aged between 18 to 65 years, came from poor families and had a child (or children). When the number of respondents who were willing to participate is less than 40 people in each village, they were replaced by other respondents based on recommendations from village officials. A total of 3000 respondents have participated in this study. The selected respondents include wives, dependent married women or widows. The spatial analysis approach was carried out using the Geographically Weighted Regression (GWR) method. Based on the results of the analysis of the spatial effect of the GWR model, the Sanitation Risk Factors that significantly affected the incidence of stunting in Malang Regency were; Environmental Drainage (greywater), Solid Waste, and Domestic Wastewater (black water). Clean and Healthy Lifestyles and Water Sources have less effect on sanitation risk. This study recommends government and public interventions to improve environmental sanitation including integrated waste management, improvement of drainage infrastructure, construction of standardized toilets, and carrying out health promotion efforts with education to increase public awareness.
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References
World Health Organization. WHA global nutrition targets 2025: Stunting policy brief. Geneva; 2014.
De Onis M, Dewey KG, Borghi E, Onyango AW, Blössner M, Daelmans B, et al. The World Health Organization's global target for reducing childhood stunting by 2025: rationale and proposed actions. Matern Child Nutr. 2013;9 Suppl 2(Suppl 2):6-26.
Manggala AK, Kenwa KWM, Kenwa MML, Jaya AAGDP, Sawitri AAS. Risk factors of stunting in children aged 24-59 months. Paediatr Indones. 2018;58(5):205–12.
Danaei G, Andrews KG, Sudfeld CR, Fink G, McCoy DC, Peet E, et al. Risk Factors for Childhood Stunting in 137 Developing Countries: A Comparative Risk Assessment Analysis at Global, Regional, and Country Levels. PLOS Med. 2016;13(11):e1002164
Vilcins D, Sly PD, Jagals P. Environmental Risk Factors Associated with Child Stunting: A Systematic Review of the Literature. Ann Glob Health. 2018;84(4):551-62. doi: 10.9204/aogh.2361.
Christian P. Fetal growth restriction and preterm as determinants of child growth in the first two years and potential interventions. Nestle Nutr Inst Workshop Ser. 2014;78:81-91.
World Health Organization. Child Stunting. World Health Statistics Data Visualizations Dashboard [Internet]. 2019. Available from: https://apps. who.int/gho/data/node.sdg.2-2-viz-1?lang=en#content
Maulina EET, Alma LR, Nurrochmah S. Relationship of Chronic Energy Deficiency, Birthweight and Exclusive Breastfeeding with Stunting in Kedungrejo Village, Pakis District, Malang. KnE Life Sciences. 2021:102-14.
Damanik MR, Ekayanti I, Hariyadi D. Analisis pengaruh pendidikan ibu terhadap status gizi balita di Provinsi Kalimantan Barat. J Gizi Pangan. 2010;5(2):69–77.
Dewey KG, Mayers DR. Early child growth: how do nutrition and infection interact? Matern Child Nutr. 2011;7:129–42.
Picauly I, Toy SM. Analisis determinan dan pengaruh stunting terhadap prestasi belajar anak sekolah di Kupang dan Sumba Timur, NTT. J Gizi Pangan. 2013;8(1):55–62.
Monteiro CA, Benicio MHD, Conde WL, Konno S, Lovadino AL, Barno AJ. Narrowing socioeconomic inequality in child stunting: The Brazilian Experience, 1974-2007. Bull WHO [Internet]. 2010;88:305-11. Available from: http://www.who.int/bulletin/ volumes/88/4/09-069195/en/
Fink G, Günther I, Hill K. The effect of water and sanitation on child health: evidence from the demographic and health surveys 1986–2007. Int J Epidemiol. 2011;40(5):1196–204.
Fazekas M, Allakulov U, Sanchez AH, Aje J. Water and Sanitation Sector Integrity Risk Index. In Scientific Papers of Water, Megacities and Global Change Second International Conference (Online Pre-Conference 7–11 December 2020) [Internet]. [cited on 2020 Dec 12]. Available from: https://en.unesco.org/sites/default/ files/pres_fazekas. pdf
Hemani R, Bassi N, Dinesh Kumar M, Chandra U. Mapping Climate-Induced Risk for Water Supply, Sanitation and Hygiene in Rajasthan. In: Kumar MD, Kabir Y, Hemani R, Bassi N, editors. Management of Irrigation and Water Supply Under Climatic Extremes: Empirical Analysis and Policy Lessons from India. Cham: Springer International Publishing; 2021. p. 241-85.
Murtaza F, Muzaffar M, Mustafa T, Anwer J. Water and sanitation risk exposure in children under-five in Pakistan. Journal of Family & Community Medicine. 2021;28(2): 103.
Pangestu S, Sitorus JRH. Penyusunan Indeks Sanitasi Provinsi-Provinsi di Indonesia. In Seminar Nasional Official Statistics. 2021;1: 363-72.
Ministry of Health. Indeks risiko sanitasi (IRS) - lembar fakta. Jakarta: Kemenkes. 2014.
Statistic Indonesia. Data of Health 2020. 2020.
Pramoedyo H, Mudjiono M, Fernandes AA, Ardianti D, Septiani K. Determination of Stunting Risk Factors Using Spatial Interpolation Geographically Weighted Regression Kriging in Malang. Mutiara Medika: Jurnal Kedokteran dan Kesehatan. 2020;20(2):98-103.
Yudono A, Purnomo J, Damayanti R. Geographical Weighted Regression of Risk Factor of Stunting in Malang Regency, Indonesia. In Forum Geografi. 2021;35(1).
Fregonese F, Siekmans K, Kouanda S, Druetz T, Ly A, Diabaté S, et al. Impact Of Contaminated Household Environment On Stunting In Children Aged 12 – 59 Months In Burkina Faso. J Epidemiol Community Health. 2017;71(4):356–63.
Sarwar M. Insect vectors involving in mechanical transmission of human pathogens for serious diseases. Int J Bioinform Biomed Eng. 2015; 1(3):300–6.
Gaugler R. Medical Entomology for students. Am Entomol. 2016;62(2):130.
Cumming O, Cairncross S. Review article can water, sanitation and hygiene help eliminate stunting? Curr Evid Policy Implic. 2016;12:91–105.
Kwami CS, Godfrey S, Gavilan H, Lakhanpaul M, Parikh P. Water, Sanitation ,and Hygiene : Linkages with Stunting in Rural Ethiopia. Int J Environ Res Public Heal. 2019; 16(3793).
Headey D, Palloni G. Water, sanitation, and child health: evidence from subnational panel data in 59 countries. Demography. 2019;56(2):729–52.
Bapenas (Badan Perencanaan Pembangunan Nasional). Rencana Aksi Nasional Pangan dan Gizi 2011-2015. Jakarta; 2011.
Soeracmad YSY. Hubungan Sanitasi Lingkungan Rumah Tangga Dengan Kejadian Stunting Pada Anak Balita Di Puskesmas Wonomulyo Kabupaten polewali Mandar Tahun 2019. J-KESMAS J Kesehat Masy. 2019; 5(2):138–50.
Sahu O. Reduction of organic and inorganic pollutant from waste water by algae. Int Lett Nat Sci. 2014;8(1).
Dodos J, Mattern B, Lapegue J, Altmann M, Ait Aissa M. Relationship between water, sanitation, hygiene, and nutrition: what do Link NCA nutrition causal analyses say? Waterlines. 2017; 36(4):284–304.
Lubis NDA, Amelia S, Yulfi H, Panggabean M, Rozi MF. Evaluation of Water, Sanitation, and Hygiene, Behavioral Aspects, Household State for the Diarrhea Prevalence among Students in the Valley of Sinabung Volcano, North Sumatera, Indonesia. Open Access Maced J Med Sci. 2021; 9(E):1175-81.
Macler BA, Merkle JC. Current knowledge on groundwater microbial pathogens and their control. Hydrogeol J. 2000;8(1):29–40.
Komarulzaman A, Smits J, de Jong E. Clean water, sanitation and diarrhoea in Indonesia: Effects of household and community factors. Glob Public Health. 2017;12(9):1141-55. doi: 10.1080/ 17441692.2015.1127985.
Torlesse H, Cronin AA, Sebayang SK, Nandy R. Determinants of stunting in Indonesian children: evidence from a cross-sectional survey indicate a prominent role for the water, sanitation and hygiene sector in stunting reduction. BMC Pub Health. 2016; 16(1):1–11.
Cahyono F, Manongga, Picauly I. Faktor Penentu Stunting Anak Balita Pada Berbagai Zona Ekosistem Di Kabupaten Kupang. J Gizi Pangan. 2016;11(1):9–18.
Badriyah L, Syafiq A. The association between sanitation, hygiene , and stunting in children under two-years. Makara J Heal Res. 2017;21(2):35–41.
Hafid F, Djabu U, Udin, Nasrul. Efek Program SBABS Terhadap Pencegahan Stunting Anak Baduta di Kabupaten Banggai dan Sigi. Indones J Hum Nutr. 2017;4(2):79–87.
Hasanah I, Susanti H. Does water and sanitation effects on children ’ s physical development ? Evidence from Indonesia Family life Survey (IFLS) 2014. 2018;09007(74).
Hasan A, Kadarusman H. Akses ke Sarana Sanitasi Dasar sebagai Faktor Risiko Kejadian Stunting pada Balita Usia 6-59 Bulan. J Kesehat. 2019;10(3).
Nasrul. Pengendalian Faktor Risiko Stunting Anak Baduta Di Sulawesi Tengah. Promot J Kesehat Masy. 2018;8(2):131–46.
Rahayu RM, Pamungkasari EP, Wekadigunawan CSP. The biopsychosocial determinants of stunting and wasting in children aged 12-48 months. J Matern Child Heal. 2018;3(2):105–18.
Otsuka Y, Agestika L, Sintawardani N, Yamauchi T. Risk Factors for Undernutrition and Diarrhea Prevalence in an Urban Slum in Indonesia : Focus on Water, Sanitation, and Hygiene. Am J Trop Med Hyg. 2019;100(3):727–32.
Fikru M, Van Doorslaer E. Population Health Explaining the fall of socioeconomic inequality in childhood stunting in Indonesia. SSM - Popul Heal. 2019;9.
Rahayu B, Darmawan S. Hubungan Karakteristik Balita, Orang Tua, Higiene dan Sanitasi Lingkungan terhadap Stunting pada Balita. Binawan J. 2019;22–27.
Ahmadi, Sulistyorini L, Azizah R, Oktarizal H. Association between toilet availability and handwashing habits and the incidence of stunting in young children in Tanjung Pinang City , Indonesia. Malaysian J Med Heal Sci. 2020;215–8.
Choirunnisa R, Indrayani T, Anshor FL. Analysis of factors related to stunting in toddlers aged 25- 59 months in Puspasari Village, Puspahiyang, Tasikmalaya 2019. Str J Ilm Kesehat. 2020;9(1):177–82.
Dwipayanti NMU, Sutiari NK, Dewiyani CIM. Potential association of sanitation factors on stunting incidences among children under age 5 in Bali Province , Indonesia. Adv Heal Sci Res. 2020;22:24–8.
Herawati, Anwar A, Setyowati DL. Hubungan sarana sanitasi , perilaku penghuni , dan kebiasaan cuci tangan pakai sabun (CTPS) oleh ibu dengan kejadian pendek (Stunting) pada Batita Usia 6-24 Bulan di Wilayah Kerja Puskesmas Harapan Baru , Samarinda. J Kesehat Lingkung Indones. 2020;19(1):7–15.
Bagcchi S. India ’ s poor sanitation and hygiene practices are linked to stunting in children. study finds 1564. 2015;5180.
Owino V, Ahmed T, Freemark M, Kelly P, Loy A, Manary M, et al. Environmental enteric dysfunction and growth failure/stunting in global child health. Pediatrics. 2016;138(6).
Brown K, Henretty N, Chary A, Webb MF, Wehr H, Moore J, et al. Mixed-methods study identifies key strategies for improving infant and young child feeding practices in a highly stunted rural indigenous population in Guatemala. Matern Child Nutr. 2016;12(2):262-77.