Beyond Access to Sanitation Services: How Maternal Education Moderates Childhood Diarrhea Risk in Indonesia's...

Area of Science:

• Public Health
• Environmental Health
• Health Equity

Background:

• Childhood diarrhea remains a significant public health issue in Indonesia.
• Existing water, sanitation, and hygiene (WASH) infrastructure improvements have not fully addressed health equity.
• This study investigates child, household, and environmental factors influencing diarrhea risk.

Purpose of the Study:

• To analyze the determinants of childhood diarrhea in Indonesia.
• To examine the interplay between child, household, and environmental factors on diarrhea risk.
• To understand the role of maternal education and household wealth in moderating sanitation's impact on health equity.

Main Methods:

• Cross-sectional study utilizing data from the 2017 Indonesia Demographic and Health Survey (IDHS).
• Multilevel logistic regression analysis including 16,632 children, nested within households and clusters.
• Examination of interactions between sanitation, maternal education, and household wealth on diarrhea prevalence.

Main Results:

• Children aged 12-23 months, those with low birth weight, and those born to mothers with low education exhibited significantly higher odds of diarrhea.
• Poor sanitation disproportionately affected children of less-educated mothers and children in low-income households.
• Children in non-Java-Bali regions showed persistently higher diarrhea rates.

Conclusions:

• Sanitation access alone is insufficient to ensure health equity.
• Maternal education is a critical factor in achieving better health outcomes from infrastructure investments.
• Integrated, equity-focused sanitation programs incorporating poverty reduction and maternal empowerment are vital for achieving Sustainable Development Goals 6 and 10.