The Influence of Environmental Sanitation, Clean Water Access, and Hygiene Behavior on Stunting Incidence: A Community-Based Public Health Study

Authors

  • Gusman Gusman Poltekkes Kemenkes Palu Author

DOI:

https://doi.org/10.62872/a82fps64

Keywords:

Clean water access, Environmental sanitation, Hygiene behavior, Public health, Stunting

Abstract

Stunting remains a major public health challenge in many developing countries and reflects long term nutritional deficiencies combined with environmental and behavioral determinants affecting child growth. In addition to inadequate dietary intake, environmental sanitation, access to clean water, and hygiene behavior are increasingly recognized as critical factors influencing stunting incidence among children under five years of age. This study aims to analyze the influence of environmental sanitation, clean water access, and hygiene behavior on the occurrence of stunting within a community based public health context. The study employed a quantitative cross sectional design involving households with children under five years old. Data were collected through structured questionnaires, environmental observations, and anthropometric measurements based on the World Health Organization Child Growth Standards. Data analysis included descriptive statistics, chi square tests, and logistic regression to identify significant determinants associated with stunting incidence. The results indicate that poor environmental sanitation, limited access to clean drinking water, and inadequate hygiene practices are significantly associated with increased risk of stunting. Children living in households with inadequate WASH conditions are more vulnerable to repeated infections such as diarrhea and intestinal diseases, which impair nutrient absorption and growth. In conclusion, improving environmental sanitation, ensuring access to safe drinking water, and strengthening hygiene behavior are essential public health strategies to reduce stunting prevalence and promote healthy child development..

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References

Ademas, A., Adane, M., Keleb, A., Berihun, G., & Tesfaw, G. (2021). Water, sanitation, and hygiene as a priority intervention for stunting in under-five children in northwest Ethiopia: A community-based cross-sectional study. Italian Journal of Pediatrics, 47. https://doi.org/10.1186/s13052-021-01128-y

Ain, H., Solikhah, F., Pertami, S., & Kasiati, K. (2023). Dynamic self-determination of self-care and positive deviance model for stunting prevention in Indonesia. Pesquisa Brasileira em Odontopediatria e Clínica Integrada. https://doi.org/10.1590/pboci.2023.043

Baffour, B., Aheto, J., Das, S., Godwin, P., & Richardson, A. (2023). Geostatistical modelling of child undernutrition in developing countries using remote-sensed data: Evidence from Bangladesh and Ghana demographic and health surveys. Scientific Reports, 13. https://doi.org/10.1038/s41598-023-48980-y

Batool, M., Saleem, J., Zakar, R., Butt, M., Iqbal, S., Haider, S., & Fischer, F. (2023). Relationship of stunting with water, sanitation, and hygiene (WASH) practices among children under the age of five: A cross-sectional study in Southern Punjab, Pakistan. BMC Public Health, 23. https://doi.org/10.1186/s12889-023-17135-z

Budiastutik, I., Pranaka, R., Amaliyah, N., Hediyanti, G., & Trisnawati, E. (2024). The relation of infectious diseases, water access, hygiene practice, and sanitation with stunting: A case-control study in Sambas Regency. Amerta Nutrition. https://doi.org/10.20473/amnt.v8i1sp.2024.70-75

Cahyawati, S., & Riana, E. (2025). The influence of environmental sanitation on incidence of stunting: A systematic review. Journal of Maternal and Child Health. https://doi.org/10.26911/thejmch.2025.10.03.03

Gizaw, Z., Yalew, A., Bitew, B., Lee, J., & Bisesi, M. (2022). Stunting among children aged 24–59 months and associations with sanitation, enteric infections, and environmental enteric dysfunction in rural northwest Ethiopia. Scientific Reports, 12. https://doi.org/10.1038/s41598-022-23981-5

Gustina, M., Saputra, A., Basthari, R., Prijanto, T., Yorita, E., & Suprijandani, S. (2025). Development of scoring application model and community-based total sanitation education (SESAMA) on stunting prevention behavior. Malahayati International Journal of Nursing and Health Science. https://doi.org/10.33024/minh.v7i11.630

Heni, H., Idaningsih, A., Wianti, A., & Setyawati, A. (2025). Identification of sanitation and hygiene risk factors on the incidence of stunting in Indonesia: A scoping review. Multidiscience: Journal of Multidisciplinary Science. https://doi.org/10.59631/multidiscience.v2i1.302

Ilma, N., Namangdjabar, O., Yulianti, H., Al-Tadom, N., & Boimau, A. (2025). Peningkatan perilaku hidup bersih dan sehat (PHBS) sebagai upaya pencegahan stunting melalui kegiatan edukasi di SD Negeri Tunfeu 2 Kabupaten Nekamese. Health Care: Journal of Community Service. https://doi.org/10.62354/healthcare.v3i2.114

Kamila, P., & Salami, I. (2022). Study of clean water and sanitation access and its relationship to waterborne and stunting prevalence in Bandung Regency. IOP Conference Series: Earth and Environmental Science, 1065. https://doi.org/10.1088/1755-1315/1065/1/012039

Mulyani, A., Khairinisa, M., Khatib, A., & Chaerunisaa, A. (2025). Understanding stunting: Impact, causes, and strategy to accelerate stunting reduction—A narrative review. Nutrients, 17. https://doi.org/10.3390/nu17091493

Mulyaningsih, T., Mohanty, I., Widyaningsih, V., Gebremedhin, T., Miranti, R., & Wiyono, V. (2021). Beyond personal factors: Multilevel determinants of childhood stunting in Indonesia. PLoS ONE, 16. https://doi.org/10.1371/journal.pone.0260265

Novianti, S., Huriyati, E., & Padmawati, R. (2023). Safe drinking water, sanitation and mother's hygiene practice as stunting risk factors: A case control study in a rural area of Ciawi Sub-district, Tasikmalaya District, West Java, Indonesia. Ethiopian Journal of Health Sciences, 33, 935–944. https://doi.org/10.4314/ejhs.v33i6.3

Nur, S., Malikhah, A., & Anwar, M. (2024). Risk factors of home sanitation on the incidence of stunting in the working area of Tetewatu Health Centre, North Konawe. Public Health Research Development. https://doi.org/10.36568/phrd.v1i2.28

Nurhidayati, V., & Riyadi, H. (2022). Quality of water sources, sanitation, and hygiene in households with stunted children in rural and urban areas in West Java. Amerta Nutrition. https://doi.org/10.20473/amnt.v6i1sp.2022.13-18

Rizaldi, M., Ali, K., Rara, S., & Panjaitan, B. (2025). Water, sanitation and hygiene (WASH) and its association with stunting in developing countries in Asia: A systematic review. Svāsthya: Trends in General Medicine and Public Health. https://doi.org/10.70347/svsthya.v2i2.81

Sari, D., Yusuf, S., Andid, R., Darussalam, D., Dimiati, H., & Amna, E. (2024). Water, sanitation, and hygiene (WASH) factors associated with stunting among under-fives: A hospital-based cross-sectional study in Banda Aceh, Indonesia. AcTion: Aceh Nutrition Journal. https://doi.org/10.30867/action.v9i3.2022

Shatriadi, H., Putra, C., Said, F., & Rashid, N. (2024). Healthy environment for optimal growth and development: Preventing stunting early. Jurnal Inspirasi Kesehatan. https://doi.org/10.52523/jika.v2i2.127

Telan, A., Tarigan, L., & Sinaga, E. (2025). Community-based total sanitation practices in families suffering from stunting in Raknamo Village, Kupang Regency. Jurnal Penelitian Pendidikan IPA. https://doi.org/10.29303/jppipa.v11i4.10744

Victora, C., Christian, P., Vidaletti, L., Gatica-Domínguez, G., Menon, P., & Black, R. (2021). Revisiting maternal and child undernutrition in low-income and middle-income countries: Variable progress towards an unfinished agenda. Lancet, 397, 1388–1399. https://doi.org/10.1016/s0140-6736(21)00394-9

Wolf, J., Hubbard, S., Brauer, M., Ambelu, A., Arnold, B., Bain, R., Bauza, V., Brown, J., Caruso, B., Clasen, T., Colford, J., Freeman, M., Gordon, B., Johnston, R., Mertens, A., Prüss-Ustün, A., Ross, I., Stanaway, J., Zhao, J., Cumming, O., & Boisson, S. (2022). Effectiveness of interventions to improve drinking water, sanitation, and handwashing with soap on risk of diarrhoeal disease in children in low-income and middle-income settings: A systematic review and meta-analysis. Lancet, 400, 27–40. https://doi.org/10.1016/s0140-6736(22)00937-0

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Published

2026-03-26

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Articles

How to Cite

The Influence of Environmental Sanitation, Clean Water Access, and Hygiene Behavior on Stunting Incidence: A Community-Based Public Health Study. (2026). Journal of Public Health Indonesian, 2(6), 33-44. https://doi.org/10.62872/a82fps64

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