Perception and Disposal Practices of Toddler Feces by Mothers in Suburban Area of Kendari, Indonesia

Abstract

Unsafe child feces disposal (CFD) is another form of open defecation and can pose a risk of disease in children. More than 30% of Indonesian households practice unsafe CFD, yet, its determinants are unknown. This study aims to identify the contextual and behavioral determinants of CFD through the lens of the Risk, Attitude, Norm, Ability, and Self-regulation (RANAS) framework. The cross-sectional study was conducted in 349 households in the suburbs of Kendari City, Southeast Sulawesi Province, Indonesia, in mid-2023. About 64% of the respondents practiced unsafe CFD. Most respondents used diapers that were immediately thrown into the trash without cleaning (i.e., 60.2%). Logistic regression analysis found two significant contextual factors associated with safe CFD: having received sanitation-related information and toddler age, i.e., children below 5 years old. Perceived severity was the most influential psychological factor behind the CFD practice, followed by knowledge. This study suggests that informing caregivers about the negative health effects of practicing unsafe CFD, especially on their children, can be a positive trigger for them to practice safe CFD. In addition, the promotion of early toilet initiation and recycling programs for used diaper waste should also be conducted to ensure comprehensive CFD management.