Association of Safe Disposal of Child Feces and Reported Diarrhea in Indonesia: Need for Stronger Focus on a Neglected Risk.

Robin Nandy,Aidan Cronin,Harriet Torlesse,Susy Sebayang

doi:10.3390/ijerph13030310

Abstract

Indonesia still faces several challenges in the areas of water, sanitation, and hygiene (WASH). Diarrhea remains a major killer of children and it is important to understand the local diarrhea transmission pathways to prioritise appropriate WASH interventions to reduce diarrhea burden. This study used a cross-sectional data set from a recent national household survey (the 2012 Indonesia Demographic and Health Survey) to examine the associations between diarrhea in children aged less than 24 months with WASH interventions and population characteristics. Unsafe disposal of child feces was strongly associated with an increased odds of child diarrhea (OR: 1.46; 95% CI: 1.18–1.82, p = 0.001). However, other WASH practices were not found to be associated. The findings underline the dangers of unsafe disposal of child feces and highlight the need for strengthening the related policies and program strategies and their implementation.

Highlights

Efforts to improve water, sanitation and hygiene (WASH) have been accelerated in Indonesia, as part of the overall drive to achieve the Millennium Development Goals, resulting in accelerated progress on WASH access [1]
Though access to improved water and sanitation was relatively high in this population (62% and 69% respectively) only 47% practiced safe disposal of child feces (Table 1)
Our analysis of the Indonesia Demographic Health Survey (IDHS) 2012 dataset showed that the odds on diarrhea in children aged less than 24 months were significantly higher among children living in households that practiced unsafe disposal of child’s feces compared with those that practice safe disposal after adjusting for other WASH

Summary

Introduction

Sanitation and hygiene (WASH) have been accelerated in Indonesia, as part of the overall drive to achieve the Millennium Development Goals, resulting in accelerated progress on WASH access [1]. Indonesia is reported to have met the MDG target for increased population access to an improved water source but is not on track to achieve sanitation targets [2]. Open defecation, which is practiced by an estimated 51 million people in Indonesia, remains a major challenge [2]. This is the second largest country burden of open defecation in the world, after. Every year between 136,000 and 190,000 under five children die in Indonesia [3], primarily from preventable causes with diarrhea and pneumonia likely responsible for more than 40% of these deaths.

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Discussion

Conclusion