Access to Sanitation and Its Impact on Stunting in Toddlers in EastNusa Tenggara, Indonesia

Abstract

 Background: Stunting is still one of the focuses of health problems in the world.
Stunting is caused by many factors, including access to sanitation. Inadequate access to sanitation can cause infectious diseases that impair nutritional absorption in
toddlers during digestion, leading to stunting. Objective: This study examines the
connection between sanitation access and stunting in East Nusa Tenggara Province
along with its confounding variables consisting of access to drinking water, toddler
age, gender, and residence. Method: The study design was cross-sectional with a
sample size of 4,224 children aged 0-59 months analyzed from the 2023 Indonesian Health Survey (IHS) data. Data were analyzed using univariate, bivariate (ChiSquare test), and multivariate (multiple logistic regression analyses with a risk factor
model). Results: Studies showed households with inadequate sanitation access can
increase the risk of stunting by 1.56 compared to those with adequate sanitation access. Other factors significantly associated with stunting included toddler age, gender, and residence. The problem of access to sanitation is related to residence and
defecation behavior. Conclusion: Increasing indiscriminate defecation behavior can
increase exposure to pathogens from feces which can cause diseases such as diarrhea, resulting in malnutrition and stunted growth. To reduce stunting in East Nusa
Tenggara Province, the government is suggested to enhance programs to expand
access to sanitation, especially in rural areas.