Maternal knowledge, clean water availability, and hygiene practices associated with diarrhea among children under five in south sorong, indonesia
DOI:
https://doi.org/10.61099/jakespol.v1i4.560Keywords:
child, diarrhea, health knowledge, hygiene, water supplyAbstract
Introduction: Diarrhea remains an important public health problem among children under five, particularly in remote settings where access to safe water and adequate hygiene practices may be limited. Maternal knowledge and household environmental conditions can influence the occurrence of diarrhea in young children. This study aimed to examine the associations between maternal knowledge, clean water availability, maternal hygiene practices, and diarrhea among children under five in the working area of Kais Community Health Center, South Sorong Regency, Indonesia.
Methods: A quantitative analytical observational study with a cross-sectional design was conducted in June 2026. The study included 43 mothers of children under five selected through total sampling. Data were collected using questionnaires and observation checklists. Univariate analysis was used to describe participant characteristics and study variables, while associations were assessed using the Chi-square test.
Results: Among respondents, 55.8% had adequate knowledge, 60.5% had access to clean water, and 53.5% reported inadequate hygiene practices. Diarrhea was identified in 32.6% of children under five. Significant associations were found between diarrhea and maternal knowledge (p < 0.001), clean water availability (p = 0.003), and maternal hygiene practices (p = 0.003).
Conclusion: Maternal knowledge, access to clean water, and hygiene practices were significantly associated with childhood diarrhea. Strengthening maternal health education, safe water access, and household hygiene practices should be prioritized in community-based diarrhea prevention programs in remote areas.
Downloads
References
1. Abera MG, Werkneh AA, Welde RS, Islam MA, Redae GH. Diarrhea prevalence and water, sanitation, and hygiene (WASH) factors among internally displaced children under-five in Mekelle city, Northern Ethiopia. Clin Epidemiol Glob Heal. 2024;28:101660. doi:https://doi.org/10.1016/j.cegh.2024.101660
2. Benzamin M, Hoque M. Use of ‘Diarrhea Stool Card’ in acute diarrhea management in under 5 Years children in resource constraints country. Gastroenterol Endosc. 2024;2(2):96-101. doi:https://doi.org/10.1016/j.gande.2024.03.008
3. Bose D, Bhattacharya R, Kaur T, et al. Overcoming water, sanitation, and hygiene challenges in critical regions of the global community. Water-Energy Nexus. 2024;7:277-296. doi:https://doi.org/10.1016/j.wen.2024.11.003
4. Esan DT, Owoeye ID, Adesuyi EO, et al. Personal and Environmental Hygiene Practices of Mothers in Selected Primary Health Centers in Ekiti State, Nigeria: A Cross-Sectional Study. Open Public Health J. 2024;17. doi:https://doi.org/10.2174/0118749445269664241003072612
5. Fatima M, Ünsal Ö. Geospatial analysis of diarrhoea determinants among children under five in Pakistan using Multiscale Geographically Weighted Regression (MGWR). Appl Geogr. 2024;172:103434. doi:10.1016/j.apgeog.2024.103434
6. Fatima SH, Judge MA, Le Souëf PN, Bradshaw CJA. Impact of climate change on diarrhoea risk in low- and middle-income countries. Environ Res. 2025;285:122412. doi:10.1016/j.envres.2025.122412
7. Huo S, Wang K, Liu Z, et al. Influence of Maternal Exposure to Mass Media on Growth Stunting Among Children Under Five: Mediation Analysis Through the Water, Sanitation, and Hygiene Program. JMIR Public Heal Surveill. 2022;8(4). doi:https://doi.org/10.2196/33394
8. Husain Z, Das P. Reducing child diarrhoea in India: Shifting policy focus from source of water to quality. Water Resour Econ. 2023;42:100221. doi:https://doi.org/10.1016/j.wre.2023.100221
9. Juvakoski A, Rantanen H, Mulas M, et al. Evidence of waste management impacting severe diarrhea prevalence more than WASH: An exhaustive analysis with Brazilian municipal-level data. Water Res. 2023;247:120805. doi:10.1016/j.watres.2023.120805
10. Kamguia B, Tadadjeu S. Linking international financial inflows and access to drinking water, sanitation and hygiene in schools. Int Econ. 2025;184:100641. doi:https://doi.org/10.1016/j.inteco.2025.100641
11. Liu Q, Liu M, Liu J. Association of drinking water services with the disease burden of diarrhea in children under five in 200 countries from 2000 to 2021. Cell Reports Sustain. 2024;1(9):100177. doi:https://doi.org/10.1016/j.crsus.2024.100177
12. Maphanga D, Mavhungu ML, Muedi KL, Masindi V, Foteinis S. Unveiling the chlorine demand and decay in aged drinking water supply systems: Complementing experimental results with modelling and predictive artificial intelligence. Desalin Water Treat. 2026;326:101789. doi:https://doi.org/10.1016/j.dwt.2026.101789
13. Meierhofer R, Kunwar BM, Shrestha A. Changes in water treatment, hygiene practices, household floors, and child health in times of Covid-19: A longitudinal cross-sectional survey in Surkhet District, Nepal. Int J Hyg Environ Health. 2023;249:114138. doi:https://doi.org/10.1016/j.ijheh.2023.114138
14. Mezza M, Doig-Alba L, Ruiz-Ruiz MI, Luz Pineda Restrepo B. “Exploring vulnerabilities: A mixed-method Transdisciplinary Study of Dengue and Diarrhea in Peru.” J Clim Chang Heal. 2026;28:100669. doi:https://doi.org/10.1016/j.joclim.2026.100669
15. Rupa FH, Tariqujjaman M, Rahman M, Hossian M, Towfiquzzaman M, Arifuzzaman. Trends and disparities in childhood illness prevalence and treatment patterns in Bangladesh: A decade of insights on diarrhea, fever and ARI from BDHS (2011–2022). Next Res. 2025;2(4):100886. doi:https://doi.org/10.1016/j.nexres.2025.100886
16. Sangalang SO, Prado NO, Lemence ALG, et al. Diarrhoea, malnutrition, and dehydration associated with school water, sanitation, and hygiene in Metro Manila, Philippines: A cross-sectional study. Sci Total Environ. 2022;838:155882. doi:https://doi.org/10.1016/j.scitotenv.2022.155882
17. Scott ME, Irwin Kristmanson D, Ortega-Barria E, Koski KG. Unbalanced Macronutrient Intakes, Multiple Micronutrient Inadequacies, and Diarrhea Underscore Low-Height-for-Age in Indigenous Panamanian Preschool Children. Curr Dev Nutr. 2025;9(10):107547. doi:https://doi.org/10.1016/j.cdnut.2025.107547
18. Shayo MJ, Kuchaka D, Beti M, et al. Identification of enteric viral pathogens in Tanzanian children under the age of five with diarrhea using nanopore-based metagenomic sequencing. Virology. 2026;623:111024. doi:https://doi.org/10.1016/j.virol.2026.111024
19. Suge T, Magu D, Wanzala P. Correlation between Escherichia coli resistant gene isolated from stool samples of children under five years and that from consumed water. Sci African. 2023;22:e01937. doi:https://doi.org/10.1016/j.sciaf.2023.e01937
20. Suprapto S. Policy analysis of national health financing implementation on access and equity of healthcare services in rural communities. J Heal Policy Anal. 2026;1(3):80-89. doi:https://doi.org/10.61099/jakespol.v1i3.402
21. Thomson P, Stoler J, Byford M, Bradley DJ. The Impact of Rapid Handpump Repairs on Diarrhea Morbidity in Children: Cross-Sectional Study in Kwale County, Kenya. JMIR Public Heal Surveill. 2024;10. doi:https://doi.org/10.2196/42462
22. Tohonon AC, Koumassa OAB, Ouétchéhou R, Hounsou M, Dabadé DS. Knowledge, attitudes, and practices regarding food hygiene and safety among stakeholders in the street fruits and vegetables chains in Benin, West Africa. J Agric Food Res. 2025;24:102415. doi:https://doi.org/10.1016/j.jafr.2025.102415
23. Turk T, Buatia B, Anterea B, Faletoese R, Vaniqi A, Reiher C. Co-designing water sanitation and hygiene (WASH) messages for a social and behaviour change campaign in Kiribati. Public Heal Pract. 2026;12:100821. doi:https://doi.org/10.1016/j.puhip.2026.100821
24. Wolf J, Johnston RB, Ambelu A, et al. Burden of disease attributable to unsafe drinking water, sanitation, and hygiene in domestic settings: a global analysis for selected adverse health outcomes. Lancet. 2023;401(10393):2060-2071. doi:https://doi.org/10.1016/S0140-6736(23)00458-0
25. Yu C, Corpuz MCA, Bonifacio JM, et al. Norovirus-associated diarrhea and asymptomatic infection in children aged under 4 years: a community-cohort study in the Philippines. IJID Reg. 2025;14:100549. doi:https://doi.org/10.1016/j.ijregi.2024.100549
26. Yousafzai MT, Cornick J, Penataro Yori P, et al. The incidence and antimicrobial resistance of Shigella-attributable diarrhoea in young children in low-income and middle-income countries from the multicountry Enterics for Global Health (EFGH) Shigella Surveillance Study: a prospective, facility-based hybrid surveillance study. Lancet Glob Heal. 2026;14(5):e749-e761. doi:https://doi.org/10.1016/S2214-109X(25)00534-0
Downloads
Published
How to Cite
Issue
Section
Citation Check
License
Copyright (c) 2026 JAKESPOL Journal of Health Policy Analysis
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with JAKESPOL: Journal of Health Policy Analysis retain the copyright of their work. The journal applies a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0), which grants the following rights:
-
Copyright Retention: Authors retain the copyright of their work, maintaining full control over their intellectual property without restrictions.
-
Right of First Publication: Authors grant the journal the right of first publication of their work. This ensures that the work is initially published and credited in JAKESPOL: Journal of Health Policy Analysis.
-
License to Share and Reuse: The work is licensed under CC BY-SA 4.0, allowing others to copy, distribute, remix, and build upon the work for any purpose, even commercially, as long as proper credit is given to the authors, and any new creations are licensed under the same terms.
