WASH Determinants of Stunting among Toddlers in Jayapura, Papua: Evidence from a Multivariate Analysis

Abstract

Stunting has severe consequences, including impaired growth, cognitive deficits, reduced productivity, and increased susceptibility to disease. This study aimed to examine the determinants of stunting, emphasizing water, sanitation, and hygiene (WASH) practices. A case-control design involving toddlers aged 25–59 months in Jayapura City from May to August 2023 was applied. Three hundred twenty-six children were recruited using consecutive sampling, with a 1:1 ratio of cases and controls. Inclusion criteria were residence within the public health center catchment area and parental consent to participate. Controls were selected after matching for age, sex, and ethnicity within the same neighborhood as cases. Data were collected through structured questionnaires and analyzed using multivariate logistic regression. The prevalence of stunting was 50%. Significant associations were observed between stunting and household factors, including drinking water and food management, access to clean water, latrine conditions, liquid waste disposal, and solid waste management. Among these, drinking water and food management practices emerged as the most dominant determinant, indicated by the highest adjusted odds ratio (AOR). These findings underscore the critical role of WASH practices in reducing the burden of stunting in Papua.