Unraveling the Multilevel Dynamics of Water, Sanitation, and Child Anthropometry in Indonesia

Background: Anthropometrics, reflecting nutritional status, growth, and development, are crucial elements that can predict a person’s health and well-being. However, low anthropometric measures among children under 5 years remain a significant issue in Indonesia, often influenced by various factors...

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Main Authors: Rifa Kirana, Ahmad Komarulzaman
Format: Article
Language:English
Published: Universitas Indonesia 2024-08-01
Series:Makara Journal of Health Research
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Online Access:https://scholarhub.ui.ac.id/mjhr/vol28/iss2/2/
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author Rifa Kirana
Ahmad Komarulzaman
author_facet Rifa Kirana
Ahmad Komarulzaman
author_sort Rifa Kirana
collection DOAJ
description Background: Anthropometrics, reflecting nutritional status, growth, and development, are crucial elements that can predict a person’s health and well-being. However, low anthropometric measures among children under 5 years remain a significant issue in Indonesia, often influenced by various factors at the household and community levels. Access to clean water and adequate sanitation has been identified as major determinants of these adverse health outcomes. This study analyzes the relationship between anthropometric measures and access to water and sanitation at household and community levels using a multilevel analysis approach. Methods: The study employs cross-sectional data from the Indonesian Family Life Survey (IFLS) waves 4 (2007) and 5 (2014), comprising a combined sample of 7,583 children. Furthermore, height-for-age z-scores (HAZ) and weight-for-height z-scores (WHZ) serve as the dependent variables, while improved water and sanitation access are the main independent variables. To account for the hierarchical nature of the data, a multilevel linear regression model is employed, clustering individuals, households, and communities at various levels. Results: The results indicate that improved sanitation at the household level and water coverage at the community level are significantly associated with higher HAZ, increasing the scores by 0.171 standard deviation (SD) (p < 0.01) and 0.004 SD (p < 0.1), respectively. However, the water and sanitation variables do not reveal a significant association with WHZ. Conclusions: The results of the study emphasize the importance of household-level sanitation and community-level water sources in influencing children’s health. Effective interventions must target improvements in water and sanitation facilities at household and community levels simultaneously to enhance children’s health and well-being. Recognizing and addressing the contextual factors at multiple levels is crucial for developing comprehensive health strategies.
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spelling doaj-art-06ceb5d369fa4f6b9b32038e2bed45ce2025-08-20T03:12:38ZengUniversitas IndonesiaMakara Journal of Health Research2356-36642356-36562024-08-01282818810.7454/msk.v28i2.1622Unraveling the Multilevel Dynamics of Water, Sanitation, and Child Anthropometry in IndonesiaRifa Kirana0Ahmad Komarulzaman1Department of Economics, Faculty of Economics and Business, Universitas Padjadjaran, West Java 45363, IndonesiaDepartment of Economics, Faculty of Economics and Business, Universitas Padjadjaran, West Java 45363, IndonesiaBackground: Anthropometrics, reflecting nutritional status, growth, and development, are crucial elements that can predict a person’s health and well-being. However, low anthropometric measures among children under 5 years remain a significant issue in Indonesia, often influenced by various factors at the household and community levels. Access to clean water and adequate sanitation has been identified as major determinants of these adverse health outcomes. This study analyzes the relationship between anthropometric measures and access to water and sanitation at household and community levels using a multilevel analysis approach. Methods: The study employs cross-sectional data from the Indonesian Family Life Survey (IFLS) waves 4 (2007) and 5 (2014), comprising a combined sample of 7,583 children. Furthermore, height-for-age z-scores (HAZ) and weight-for-height z-scores (WHZ) serve as the dependent variables, while improved water and sanitation access are the main independent variables. To account for the hierarchical nature of the data, a multilevel linear regression model is employed, clustering individuals, households, and communities at various levels. Results: The results indicate that improved sanitation at the household level and water coverage at the community level are significantly associated with higher HAZ, increasing the scores by 0.171 standard deviation (SD) (p < 0.01) and 0.004 SD (p < 0.1), respectively. However, the water and sanitation variables do not reveal a significant association with WHZ. Conclusions: The results of the study emphasize the importance of household-level sanitation and community-level water sources in influencing children’s health. Effective interventions must target improvements in water and sanitation facilities at household and community levels simultaneously to enhance children’s health and well-being. Recognizing and addressing the contextual factors at multiple levels is crucial for developing comprehensive health strategies.https://scholarhub.ui.ac.id/mjhr/vol28/iss2/2/anthropometrychildindonesiasanitationwater
spellingShingle Rifa Kirana
Ahmad Komarulzaman
Unraveling the Multilevel Dynamics of Water, Sanitation, and Child Anthropometry in Indonesia
Makara Journal of Health Research
anthropometry
child
indonesia
sanitation
water
title Unraveling the Multilevel Dynamics of Water, Sanitation, and Child Anthropometry in Indonesia
title_full Unraveling the Multilevel Dynamics of Water, Sanitation, and Child Anthropometry in Indonesia
title_fullStr Unraveling the Multilevel Dynamics of Water, Sanitation, and Child Anthropometry in Indonesia
title_full_unstemmed Unraveling the Multilevel Dynamics of Water, Sanitation, and Child Anthropometry in Indonesia
title_short Unraveling the Multilevel Dynamics of Water, Sanitation, and Child Anthropometry in Indonesia
title_sort unraveling the multilevel dynamics of water sanitation and child anthropometry in indonesia
topic anthropometry
child
indonesia
sanitation
water
url https://scholarhub.ui.ac.id/mjhr/vol28/iss2/2/
work_keys_str_mv AT rifakirana unravelingthemultileveldynamicsofwatersanitationandchildanthropometryinindonesia
AT ahmadkomarulzaman unravelingthemultileveldynamicsofwatersanitationandchildanthropometryinindonesia