Association Between Household Drinking Water Access and Management Factors and Diarrhea in East Kalimantan Province: Analysis Of SKAMRT 2024 Data
DOI:
10.29303/jpm.v21i4.12360Published:
2026-08-31Downloads
Abstract
Diarrheal disease remains a significant public health concern and is closely associated with access to drinking water and household drinking water management practices. According to the 2023 Indonesian Health Survey (SKI), the reported prevalence of diarrhea was 4.3% nationally and 4.2% in East Kalimantan Province. This study aimed to examine the association between household drinking water access and management factors and diarrhea in East Kalimantan Province using data from the 2024 Household Drinking Water Quality Surveillance (SKAMRT). A cross-sectional study was conducted using secondary data from 2,051 households. The main independent variables were drinking water source, drinking water continuity, household drinking water treatment, and drinking water storage. Education of the household head, household size, and place of residence were included as covariates. Data were analyzed using descriptive statistics, bivariate analyses with the chi-square test, and multivariable logistic regression. The prevalence of reported diarrhea was 4.5%. After adjustment for the other variables included in the model, intermittent drinking water access was significantly associated with higher odds of diarrhea (AOR = 6.10; 95% CI: 3.21–11.57; p < 0.001). Unsafe drinking water storage was also significantly associated with higher odds of diarrhea (AOR = 2.67; 95% CI: 1.38–5.19; p = 0.004). Drinking water source and household drinking water treatment were not significantly associated with diarrhea. These findings highlight the importance of improving the reliability of the drinking water supply and strengthening household education on safe drinking water storage. These findings should be interpreted cautiously because of the cross-sectional design and reliance on household-reported diarrhea.
Keywords:
Diarrhea Drinking Water Continuity Drinking Water Storage East Kalimantan SKAMRT 2024References
[1] World Health Organization (WHO), “Diarrhoeal disease.” Accessed: Dec. 29, 2025. [Online]. Available: https://www.who.int/news-room/fact-sheets/detail/diarrhoeal-disease
[2] World Health Organization (WHO) & United Nations Children’s Fund (UNICEF), “Progress on Household Drinking Water, Sanitation and Hygiene 2000–2024: Special Focus on Inequalities,” WHO/UNICEF Joint Monitoring Programme, Geneva, 2025.
[3] A. Kundu, W. A. Smith, D. Harvey, and S. Wuertz, “Drinking water safety: Role of hand hygiene, sanitation facility, and water system in semi-urban areas of India,” Am. J. Trop. Med. Hyg., vol. 99, no. 4, pp. 889–898, 2018, doi: 10.4269/ajtmh.16-0819.
[4] G. Mulatu et al., “Association of drinking water and environmental sanitation with diarrhea among under-five children: Evidence from Kersa demographic and health surveillance site, eastern Ethiopia,” Front. Public Heal., 2022, [Online]. Available: https://doi.org/10.3389/fpubh.2022.962108
[5] N. Agustia, “Hubungan Pengolahan Air Minum dan Pendapatan Keluarga dengan Kejadian Diare Pada Balita di Kecamatan Baturaja Barat Tahun 2021,” Cerdika J. Ilm. Indones., vol. 2, no. 2, pp. 206–212, 2022, doi: 10.59141/cerdika.v2i2.324.
[6] A. W. Bivins et al., “Estimating Infection Risks and the Global Burden of Diarrheal Disease Attributable to Intermittent Water Supply Using QMRA,” Environ. Sci. Technol., vol. 51, no. 13, pp. 7542–7551, 2017, doi: 10.1021/acs.est.7b01014.
[7] Kementerian Kesehatan RI, “Survei Kesehatan Indonesia (SKI) 2023,” Badan Kebijakan Pembangunan Kesehatan, Kementerian Kesehatan Republik Indonesia, Jakarta, 2024.
[8] Kementerian Kesehatan RI, “Profil Kesehatan Indonesia 2024,” Jakarta, 2025.
[9] Kementerian Kesehatan RI, “Hasil Surveilans Kualitas Air Minum Rumah Tangga Tahun 2024 (Dalam Angka),” Direktorat Kesehatan Lingkungan, Direktorat Jenderal Penanggulangan Penyakit, 2026.
[10] R. Bain, R. Cronk, J. Wright, H. Yang, T. Slaymaker, and J. Bartram, “Fecal Contamination of Drinking-Water in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis,” PLoS Med., vol. 11, no. 5, 2014, doi: 10.1371/journal.pmed.1001644.
[11] N. E. Soboksa, “Associations Between Improved Water Supply and Sanitation Usage and Childhood Diarrhea in Ethiopia: An Analysis of the 2016 Demographic and Health Survey,” Environ. Health Insights, vol. 15, 2021, doi: 10.1177/11786302211002552.
[12] P. A. Torres-Slimming et al., “Diarrheal disease and associations with water access and sanitation in Indigenous Shawi children along the Armanayacu River basin in Peru. Rural and Remote Health,” Rural Remote Health, vol. 23, no. 3, p. 7198, 2023, [Online]. Available: https://doi.org/10.22605/RRH7198
[13] A. M. Girmay et al., “Associations of WHO/UNICEF Joint Monitoring Program (JMP) Water, Sanitation and Hygiene (WASH) Service Ladder service levels and sociodemographic factors with diarrhoeal disease among children under 5 years in Bishoftu town, Ethiopia: a cross-sectional st,” BMJ Open, vol. 13, no. 7, pp. 1–11, 2023, doi: 10.1136/bmjopen-2022-071296.
[14] I. Adamu, F. C. D. Andrade, and C. R. Singleton, “Availability of Drinking Water Source and the Prevalence of Diarrhea among Nigerian Households,” Am. J. Trop. Med. Hyg., vol. 107, no. 4, pp. 893–897, 2022, doi: 10.4269/ajtmh.21-0901.
[15] S. Hubbard et al., “Household Illness and Associated Water and Sanitation Factors in Peri-Urban Lusaka, Zambia, 2016–2017,” NPJ Clean Water, vol. 3, no. 1, 2020, doi: 10.1038/s41545-020-0076-4.
[16] C. N. Mock, K. R. Smith, R. Nugent, O. Kobusingye, and A. Alwan, “Injury prevention and environmental health (English),” 2017. doi: 10.1596/978-1-4648-0522-6_ch9.
[17] J. Wolf et al., “Impact of drinking water, sanitation and handwashing with soap on childhood diarrhoeal disease: updated meta-analysis and meta-regression,” Trop. Med. Int. Heal., vol. 23, no. 5, pp. 508–525, 2018, doi: 10.1111/tmi.13051.
[18] J. Trudeau, A.-M. Aksan, and W. F. Va´squez, “Water system unreliability and diarrhea incidence among children in Guatemala,” 2017, doi: 10.1007/s00038-017-1054-6.
[19] C. Okolimong, E. Walekula, S. Orech, D. Okia, D. Mukunya, and P. Olupot-Olupot, “Association of diarrheal disease with solid waste management practices and perceptions among residents of industrial division in Mbale City: a cross sectional study,” BMC Public Health, vol. 26, no. 1, 2026, doi: 10.1186/s12889-026-26463-9.
[20] D. Mosisa, M. Aboma, T. Girma, and A. Shibru, “Determinants of diarrheal diseases among under five children in Jimma Geneti District, Oromia region, Ethiopia, 2020: a case-control study,” BMC Pediatr., vol. 21, no. 1, pp. 1–13, 2021, doi: 10.1186/s12887-021-03022-2.
[21] B. Kalakheti, K. Panthee, and K. C. Jain, “Risk Factors of Diarrhea in Children Under Five Years in Urban Slums,” J. Lumbini Med. Coll., vol. 4, no. 2, p. 94, 2016, doi: 10.22502/jlmc.v4i2.99.
[22] G. Tubatsi, M. C. Bonyongo, and M. Gondwe, “Water use practices, water quality, and households’ diarrheal encounters in communities along the Boro-Thamalakane-Boteti river system, Northern Botswana,” J. Heal. Popul. Nutr., vol. 33, no. 1, pp. 1–12, 2015, doi: 10.1186/s41043-015-0031-z.
[23] R. Meierhofer and S. Peter, “Household Water Treatment and Safe Storage (HWTS): Sandec Training Tool 1.0 – Module 3,” Eawag/Sandec, Department of Water and Sanitation in Developing Countries, Dübendorf, Switzerland, 2008. [Online]. Available: https://www.eawag.ch
[24] World Health Organization (WHO), “Drinking-water.” Accessed: Mar. 12, 2026. [Online]. Available: https://www.who.int/news-room/fact-sheets/detail/drinking-water
[25] R. V. N. Sangma, S. K. Rasania, J. G. Prasuna, R. Das, and M. Jais, “Bacteriological quality of drinking water and diarrhoeal outcome among under five children in resettlement colony, Delhi: A community-based study,” Proc. World Congr. New Technol., vol. 0, no. August, pp. 1–8, 2019, doi: 10.11159/icepr19.187.
[26] M. G. Abera, A. A. Werkneh, R. S. Welde, M. A. Islam, and G. H. Redae, “Diarrhea prevalence and water, sanitation, and hygiene (WASH) factors among internally displaced children under-five in Mekelle city, Northern Ethiopia,” Clin. Epidemiol. Glob. Heal., vol. 28, no. June, p. 101660, 2024, doi: 10.1016/j.cegh.2024.101660.
[27] K. Fagerli et al., “Comparison of boiling and chlorination on the quality of stored drinking water and childhood diarrhoea in Indonesian households,” Epidemiol. Infect., vol. 145, no. 15, pp. 3294–3302, 2017, doi: 10.1017/S0950268817002217.
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