Maternal Personal Hygiene, Sanitation, Family Size, and the Risk of Diarrhea in Children Under Five: A Precede-Proceed Model in Surakarta

Erick Zicof1), Setyo Sri Rahardjo2), Bhisma Murti1)


1)Masters Program on Public Health, Universitas Sebelas Maret

2 )Faculty of Medicine, Universitas Sebelas Maret



Background: Running counter to the widely accepted hypothesis, an earlier study in Indonesia reported that overall poor mother’s food-hygiene practices did not contribute to the occurrence of diarrhea in Indonesian children. This study aimed to determine the associations between maternal personal hygiene, sanitation, family size, and the risk of diarrhea in children under five, using a PRECEDE-PROCEED model.

Subjects and Method: This was a cross sectional study carried out in Su­ra­kar­ta, Central Java, Indonesia, from February to April 2018. A sample of 200 chil­dren under five years of age were selected for this study by fixed disease sam­pling, comprising 100 children with diarrhea and 100 children without diar­rhea. The dependent variable was diarrhea. The independent variables were mater­nal personal hygiene, sanitation, and family size. The data were collected by questionnaire. Data on diarrhea status were taken on medical record at Pus­kes­mas (Community Health Center). The data were analyzed by multiple regression mo­del.

Results: Diarrhea in children under five was negatively associated with good mater­nal personal hygiene (OR= 0.13; 95% CI= 0.06 to 0.29; p< 0.001), good sanitation (OR= 0.22; 95% CI= 0.11 to 0.46; p<0.001), and family size ≥4 (OR= 2.55; 95% CI= 1.28 to 5.10; p= 0.008). Nagelkerke R2= 39.4%.

Conclusion: The risk of diarrhea in children under five is associated with poor ma­­­ternal personal hygiene, poor sanitation, and family size ≥4.

Keywords: personal hygiene, sanitation, family size, diarrhea, children under five

Correspondence: Erick Zicof. Masters Program on Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami No. 36A, Surakarta 57126, Central Java. Email: Mobile: +6281363425870.


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