Abstract
Abstract Children's faecal waste is a major environmental health issue despite increasing access to sanitation facilities and sanitary products in Indonesia. This cross-sectional study investigated child faecal management practice and disposable diaper usage among under-fives living in an urban slum of Indonesia. Data on household socio-demographics, child characteristics, and child faeces management practices were collected from 184 randomly selected pairs of mothers and children through interviews and observations. Findings revealed children's common defaecation sites as improved toilet, disposable diaper, and reusable diaper at 33.7, 33.2, and 16.3%, respectively. However, hygienic child faeces disposal was at 45%. Multivariate logistic regression indicated that the common use of disposable diapers and bathroom floor as the child's defaecation site increased unhygienic disposal. This prevalence decreased for mothers with higher education and those who had initiated toilet training. Promoting mothers' disposal of child faeces from disposable diapers, preventing child defaecation on the bathroom floor, and initiating toilet training as soon as a child can walk alone are thus potential interventions.
Highlights
The United Nations established the provision of safe water and sanitation for promoting the global health as one of its Millennium and Sustainable Development Goals (The ASEAN 2017; World Health Organization (WHO) 2018b)
Only 1.5% of child faeces are disposed through the toilet, while the majority are disposed within disposable diapers in open fields, rivers, and ditches, especially in urban areas (Kurnia 2011)
Unhygienic child faeces disposal was associated with the use of disposable diapers and bathroom floor as the child’s common defaecation site (AOR: 18.69; 95% CI: 5.47–63.95 and adjusted odds ratios (AOR): 17.34; 95% CI: 1.84– 163.27)
Summary
The United Nations established the provision of safe water and sanitation for promoting the global health as one of its Millennium and Sustainable Development Goals (The ASEAN 2017; WHO 2018b). The provision of basic sanitation aimed to prevent adult open defaecation and households’ unhygienic child faeces disposal (Odagiri et al 2017). Indonesia achieved 71% of the population having access to a basic toilet in 2015 (The ASEAN 2017); this increased to 80% in 2017 (BKKBN 2017). Despite the sanitation improvement, only slight changes have occurred in Indonesia’s child faeces disposal practice in the past decade (Statistics Indonesia 2003; BKKBN 2017). Unhygienic child faeces disposal practices have been considered as similar to Open Defecation Practices (ODP) among adults (Bain & Luyendijk 2015). In Africa and Asia, unhygienic child faeces disposal is reported as a cause of enteric disease and environmental enteropathy among small children (Aluko et al 2017; Bawankule et al 2017) and diarrhoea
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