Influence of Water, Sanitation, and Hygiene (WASH) on Children’s Health in an Urban Slum in Indonesia

Abstract Unsafe drinking water, poor sanitation, and inadequate hygiene are key contributors to deteriorating child health in low- and middle-income countries. This chapter focuses on (1) evaluating child health and nutritional status; (2) clarifying the factors contributing to undernutrition and diarrhea prevalence by focusing on water, sanitation, and hygiene (WASH); and (3) evaluating fecal contamination and children’s hand hygiene. The study was conducted at a preschool and two elementary schools in densely populated Bandung, Indonesia, targeting children and their caretakers, using anthropometric measurements, handwashing observation, hand bacteria testing, and questionnaires. The results showed that not using a towel after handwashing was significantly associated with increased risk of stunting. Children from households using tap water instead of tank water as drinking water suffered from increased risk of stunting and thinness. Moreover, children from households using open containers for water storage were associated with increased risk of diarrhea. Most children (98.7%) had hand fecal contamination, with girls having significantly less Escherichia coli (E. coli) than boys. E. coli counts were negatively correlated with handwashing technique, handwashing with soap, and a developed WASH index. The findings suggest that successful home drinking water management and proper personal hygiene practices are important for attaining better child health.