Water Sanitation and Hygiene (WASH) and feeding patterns: Linkages with stunting among children aged 6-23 months

Akmal Novrian Syahruddin* -  Sekolah Tinggi Ilmu Kesehatan Tamalatea Makassar, Indonesia
Irmawati Irmawati -  Sekolah Tinggi Ilmu Kesehatan Tamalatea Makassar, Indonesia
Novi Puspita Sari -  Sekolah Tinggi Ilmu Kesehatan Nani Hasanuddin, Indonesia

Supp. File(s): common.other common.other common.other common.other

Stunting is still a significant public health problem in Indonesia. The interaction between the inadequacy of feeding practices and Water, Sanitation, and Hygiene (WASH) are the direct causes of stunting. The study aimed to assess the relationship between WASH and child feeding patterns with stunting among children aged 6-23 months. The study used a cross-sectional design conducted in July-August 2022 in the working area of Simbang Community Health Center, Maros Regency. Samples of 90 children aged 6-23 months were selected by simple random sampling. Data on sociodemographic, WASH and feeding patterns were collected by interview using a questionnaire. Stunting was measured by a height-for-age z-score. Data were analyzed using the Chi-square test and Logistic Regression. The results showed that the prevalence of stunting was 31,1%. Mother's age <20 years, low maternal height, sex of child, non-exclusive breastfeeding, complementary feeding started, the poor sewage management and availability of latrines related to stunting (p<0,05). Multivariate test results showed low maternal height (p=0,005; OR=21,015), sex of child (p=0,001; OR=22,332), poor sewage management (p=0,008; OR=10,992), and non-exclusive breastfeeding (p=0,002; OR=20,509) has a significant effect on stunting. In conclusion, the WASH and inadequacy of feeding practices contribute to stunting.

Supplement Files

Keywords : Stunting, WASH, Children, Exclusive breastfeeding

  1. Aguayo, V. M., Nair, R., Badgaiyan, N., & Krishna, V. (2016). Determinants of stunting and poor linear growth in children under 2 years of age in India: an in-depth analysis of Maharashtra’s comprehensive nutrition survey. Maternal & Child Nutrition, 12(Suppl 1), 121–140. https://doi.org/10.1111/mcn.12259
  2. Akombi, B. J., Agho, K. E., Merom, D., Renzaho, A. M., & Hall, J. J. (2017). Child malnutrition in sub-Saharan Africa: A meta-analysis of demographic and health surveys (2006-2016). PLoS One, 12(5). https://doi.org/http://dx.doi.org/10.1371/journal.pone.0177338
  3. Alfadhila Khairil Sinatrya, & Lailatul Muniroh. (2019). Hubungan Faktor Water, Sanitation, and Hygiene (WASH) dengan Stunting di Wilayah Kerja Puskesmas Kotakulon, Kabupaten Bondowoso . Amerta Nutrition, 3(3), 164–170. https://doi.org/10.2473/amnt.v3i3.2019.164-170
  4. Amaha, N. D., & Woldeamanuel, B. T. (2021). Maternal factors associated with moderate and severe stunting in Ethiopian children: analysis of some environmental factors based on 2016 demographic health survey. Nutrition Journal, 20(1), 1–9. https://doi.org/10.1186/S12937-021-00677-6/TABLES/3
  5. Badriyah, L., & Syafiq, A. (2017). The Association Between Sanitation, Hygiene, and Stunting in Children Under Two-Years (An Analysis of Indonesia’s Basic Health Research, 2013). Makara Journal of Health Research, 21(2), 35–41. https://doi.org/10.7454/msk.v21i2.6002
  6. BAPPENAS, & UNICEF. (2022). Collaboration for Recovery and Resilience Through Better Wash Access for All a Compendium of Wash Best Practices in Indonesia Collaboration for Recovery and Resilience Access for All.
  7. Basyariyah, Q., Diyanah, K. C., & Pawitra, A. S. (2022). Hubungan Ketersediaan Sanitasi Dasar terhadap Status Gizi Baduta di Desa Pelem, Bojonegoro. Jurnal Kesehatan Lingkungan Indonesia, 21(1), 18–26. https://doi.org/10.14710/jkli.21.1.18-26
  8. Beal, T., Tumilowicz, A., Sutrisna, A., Izwardy, D., & Neufeld, L. M. (2018). A review of child stunting determinants in Indonesia. Maternal and Child Nutrition, 14(4), 1–10. https://doi.org/10.1111/mcn.12617
  9. Bhutta, Z. A., Das, J. K., Rizvi, A., Gaffey, M. F., Walker, N., Horton, S., Webb, P., Lartey, A., & Black, R. E. (2013). Evidence-based interventions for improvement of maternal and child nutrition: What can be done and at what cost? The Lancet, 382(9890), 452–477. https://doi.org/10.1016/S0140-6736(13)60996-4
  10. Black, R. E., Victora, C. G., Walker, S. P., Bhutta, Z. A., Christian, P., De Onis, M., Ezzati, M., Grantham-Mcgregor, S., Katz, J., Martorell, R., & Uauy, R. (2013). Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet, 382(9890), 427–451. https://doi.org/10.1016/S0140-6736(13)60937-X
  11. BPS. (2020). Indeks Khusus Penanganan Stunting 2018-2019: Vol. 04230.2004. https://doi.org/4207002
  12. Budge, S., Parker, A. H., Hutchings, P. T., & Garbutt, C. (2019). Environmental enteric dysfunction and child stunting. Nutrition Reviews, 77(4), 240–253. https://doi.org/10.1093/nutrit/nuy068
  13. Budiastutik, I., & Rahfiludin, M. Z. (2019). Faktor Risiko Stunting pada anak di Negara Berkembang. Amerta Nutrition, 3(3), 122–129. https://doi.org/10.20473/AMNT.V3I3.2019.122-129
  14. Ch Ratu, Novelinda Punuh, Maureen I H Malonda, & Nancy S. (2018). Hubungan Tinggi Badan Orangtua Dengan Kejadian Stunting Pada Anak Usia 24-59 Bulan Di Kecamatan Ratahan Kabupaten Minahasa Tenggara. Jurnal KESMAS, 7, 24–59.
  15. de Lima, A. L. L., da Silva, A. C. F., Konno, S. C., Conde, W. L., Benicio, M. H. D. A., & Monteiro, C. A. (2010). Causes of the accelerated decline in child undernutrition in Northeastern Brazil (1986-1996-2006). Revista de Saude Publica, 44(1), 17–27. https://doi.org/10.1590/s0034-89102010000100002
  16. García Cruz, L. M., González Azpeitia, G., Reyes Súarez, D., Santana Rodríguez, A., Loro Ferrer, J. F., & Serra-Majem, L. (2017). Factors Associated with Stunting among Children Aged 0 to 59 Months from the Central Region of Mozambique. Nutrients, 9(5). https://doi.org/10.3390/NU9050491
  17. Geberselassie, S. B., Abebe, S. M., Melsew, Y. A., Mutuku, S. M., & Wassie, M. M. (2018). Prevalence of stunting and its associated factors among children 6-59 months of age in Libo-Kemekem district, Northwest Ethiopia; A community based cross sectional study. PLoS ONE, 13(5), 1–11. https://doi.org/10.1371/journal.pone.0195361
  18. Kemenkes. (2018). Riset Kesehatan Dasar (RISKESDAS).
  19. Khan, M. N., & Islam, M. M. (2017). Effect of exclusive breastfeeding on selected adverse health and nutritional outcomes: A nationally representative study. BMC Public Health, 17(1), 1–7. https://doi.org/10.1186/s12889-017-4913-4
  20. Kramer, M. S., & Kakuma, R. (2012). Optimal duration of exclusive breastfeeding. The Cochrane Database of Systematic Reviews, 2012(8). https://doi.org/10.1002/14651858.CD003517.PUB2
  21. Kwami, C. S., Godfrey, S., Gavilan, H., Lakhanpaul, M., & Parikh, P. (2019). Water, Sanitation, and Hygiene: Linkages with Stunting in Rural Ethiopia. International Journal of Environmental Research and Public Health, 16(20), 3793. https://doi.org/10.3390/ijerph16203793
  22. Lechtig, A., Cornale, G., Ugaz, M. E., & Arias, L. (2009). Decreasing stunting, anemia, and vitamin A deficiency in Peru: Results of the good start in life program. Food and Nutrition Bulletin, 30(1), 37–48. https://doi.org/10.1177/156482650903000104
  23. Lestari, M. (2021). Kontribusi Kondisi Fisik Lingkungan Rumah dengan Kejadian Diare dan Hubungannya terhadap Kejadian Stunting. Indonesian Journal of Public Health and Nutrition, 1(1), 101–113. http://journal.unnes.ac.id/sju/index.php/IJPHN
  24. Miko, A., & Al-Rahmad, A. H. (2017). Hubungan berat dan tinggi badan orang tua dengan status gizi balita di Kabupaten Aceh Besar. Gizi Indonesia, 40(1), 21. https://doi.org/10.36457/gizindo.v40i1.222
  25. Monteiro, C. A. . b, D’Aquino Benicio, M. H. . b, Konno, S. C. . b, da Silva, A. C. ., de Lima, A. L. ., & Conde, W. L. . b b. (2009). Causes for the decline in child under-nutrition in Brazil, 1996-2007 [Causas del declive de la desnutrición infantil en Brasil, 1996-2007]. Revista de Saude Publica, 43(1), 35–43. http://www.scopus.com/inward/record.url?eid=2-s2.0-67649405305&partnerID=40&md5=18bc490413f5285a9ac7c9dd86dcc363
  26. Mulyaningsih Id, T., Mohanty, I., Id, V. W., Gebremedhin, T. A., Miranti, R., & Wiyono, V. H. (2021). Beyond personal factors: Multilevel determinants of childhood stunting in Indonesia. https://doi.org/10.1371/journal.pone.0260265
  27. Pongou, R., Ezzati, M., & Salomon, J. A. (2006). Household and community socioeconomic and environmental determinants of child nutritional status in Cameroon. BMC Public Health, 6, 1–19. https://doi.org/10.1186/1471-2458-6-98
  28. Rahmad, A. H. Al, Iskandar, I., Fadjri, T. K., & Hadi, A. (2022). Utilization of the growth chart module in increasing mother’s knowledge to monitor the grow up of toddlers. Kesmas Indonesia, 14(1), 110–120. https://doi.org/10.20884/1.ki.2022.14.1.640
  29. Richard, S. A., Black, R. E., Gilman, R. H., Guerrant, R. L., Kang, G., Lanata, C. F., Mølbak, K., Rasmussen, Z. A., Sack, R. B., Valentiner-Branth, P., & Checkley, W. (2013). Diarrhea in Early Childhood: Short-term Association With Weight and Long-term Association With Length. American Journal of Epidemiology, 178(7), 1129. https://doi.org/10.1093/AJE/KWT094
  30. Smith, L. C., Khan, F., Frankenberger, T. R., & Wadud, A. K. M. A. (2013). Admissible Evidence in the Court of Development Evaluation? The Impact of CARE’s SHOUHARDO Project on Child Stunting in Bangladesh. In World Development (Vol. 41, Issue 1). https://doi.org/10.1016/j.worlddev.2012.06.018
  31. Syahruddin, A. N., Ade Ningsih, N., Menge, F., & Tinggi Ilmu Kesehatan Tamalatea Makassar, S. (2022). Hubungan Kejadian Stunting dengan Perkembangan Anak Usia 6-23 Bulan. Poltekita : Jurnal Ilmu Kesehatan, 15(4), 327–332. https://doi.org/10.33860/JIK.V15I4.733
  32. Titaley, C. R., Ariawan, I., Hapsari, D., Muasyaroh, A., & Dibley, M. J. (2019). Determinants of the stunting of children under two years old in Indonesia: A multilevel analysis of the 2013 Indonesia basic health survey. Nutrients, 11(5). https://doi.org/10.3390/nu11051106
  33. Torlesse, H., Cronin, A. A., Sebayang, S. K., & Nandy, R. (2016). 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 Public Health, 16(669), 1–11. https://doi.org/DOI 10.1186/s12889-016-3339-8
  34. Ulfa Ali, R., Zulkarnaini, Z., & Affandi, D. (2016). Hubungan Personal Hygiene dan Sanitasi Lingkungan dengan Angka Kejadian Kecacingan (Soil Transmitted Helminth) Pada Petani Sayur di Kelurahan Maharatu Kecamatan Marpoyan Damai Kota Pekanbaru. Dinamika Lingkungan Indonesia, 3(1), 24. https://doi.org/10.31258/dli.3.1.p.24-32
  35. UNICEF, WHO, & World Bank. (2018). Levels and Trends in Child malnutrition. Key findings of the 2018 edition. In Geneva: WHO. https://doi.org/10.1016/S0266-6138(96)90067-4
  36. UNICEF, World Health Organization, & The World Bank. (2012). Joint Child Malnutrition Estimates: Levels & trends in child malnutrition. Africa, 35.
  37. Waller, A., Lakhanpaul, M., Godfrey, S., & Parikh, P. (2020). Multiple and complex links between babyWASH and stunting: an evidence synthesis. Journal of Water, Sanitation and Hygiene for Development, 10(4), 786–805. https://doi.org/10.2166/WASHDEV.2020.265
  38. WHO. (2021). Billions of people will lack access to safe water, sanitation and hygiene in 2030 unless progress quadruples – warn WHO, UNICEF. World Health Organization..

Open Access Copyright (c) 2023 Akmal Novrian Syahruddin, Irmawati, Novi Puspita Sari
Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

AcTion: Aceh Nutrition Journal
Published by: Department of Nutrition at the Health Polytechnic of Aceh, Ministry of Health.
Soekarno-Hatta Street, No. 168. Health Polytechnic of Aceh, Aceh Besar, 23352. Telp/Fax: 0651 46126 / 0651 46121.
Website: https://gizipoltekkesaceh.ac.id/
E-mail: jurnal6121@gmail.com

e-issn: 2548-5741, p-issn: 2527-3310

All content is licensed under a: Creative Commons Attribution ShareAlike 4.0 International License

View My Stats

Get a feed by atom here, RRS2 here and OAI Links here