Basic Sanitation and Personal Hygiene: Risk Factors for Stunting in North Sumatra Coastal Areas

Background: The reduction of stunting is a global public health priority under target of the United Nations Sustainable Development Goals and a major public health challenge in Indonesia, with a national prevalence of 21.6 % in 2022, and 13.9 % in North Sumatra. Objective: To examine basic sanitation and personal hygiene as risk factors associated with stunting among toddlers in coastal areas of North Sumatra. Materials and Methods: This cross-sectional quantitative study was conducted in Paluh Sibaji Village, Deli Serdang Regency, and involved 141 mothers of toddlers selected by simple random sampling from a total population of 375. Data collection involved validated questionnaires, observation sheets, and inspections of basic sanitation and personal hygiene, with a focus on clean water availability (quantity, quality, continuity, and affordability). Stunting was determined using anthropometric measurements by the WHO Z-score standards. Results: The prevalence of stunting was 16.3 %. The analysis of stunting risk factors showed a significant relationship between clean water continuity (OR 3.365, 95 % CI: 1.154–9.816, p = 0.026), latrine ownership (OR 4.272, 95 % CI: 1.240–14.720, p = 0.021), ownership of wastewater disposal facilities (OR 7.301, 95 % CI: 2.233–23.872, p = 0.001), the practice of washing hands by cleaning between the fingers with soap and running water (OR 5.772, 95 % CI: 1.830–18.205, p = 0.003) and stunting. Conclusion: Poor hygiene practices, inadequate access to drinking water, and inadequate ownership of toilets, wastewater disposal facilities, and waste management can increase the risk of stunting among toddlers in Paluh Sibaji Village. The absence of wastewater disposal facilities emerged as the strongest risk factor, thus highlighting the importance of improving sanitation systems as part of integrated communitybased stunting prevention strategies.