The effect of sanitation risk on toddler stunting incident with geographically weighted regression approach in Malang Regency, Indonesia

Abstract

Stunting is a fundamental problem in Indonesia's human development. The risk factors for stunting are very complex, including inadequate environmental sanitation. This study aims to analyze and map the influence of spatially correlated sanitation risk on the incidence of stunting toddlers in Malang Regency, Indonesia. Data collection was carried out by interviewing respondents using questionnaires, counting stunting toddlers, and observing environmental sanitation objects. Determination of respondents was done purposively with the following stages. First, at the village level, 75 sites were selected based on the following criteria: population density; poverty level; the presence of streams, drainage or irrigation canals; and flood vulnerability. Furthermore, in each village, 40 respondents were selected based on the following criteria: women aged between 18 to 65 years, came from poor families and had a child (or children). When the number of respondents who were willing to participate is less than 40 people in each village, they were replaced by other respondents based on recommendations from village officials. A total of 3000 respondents have participated in this study. The selected respondents include wives, dependent married women or widows. The spatial analysis approach was carried out using the Geographically Weighted Regression (GWR) method. Based on the results of the analysis of the spatial effect of the GWR model, the Sanitation Risk Factors that significantly affected the incidence of stunting in Malang Regency were; Environmental Drainage (greywater), Solid Waste, and Domestic Wastewater (black water). Clean and Healthy Lifestyles and Water Sources have less effect on sanitation risk. This study recommends government and public interventions to improve environmental sanitation including integrated waste management, improvement of drainage infrastructure, construction of standardized toilets, and carrying out health promotion efforts with education to increase public awareness.