Analisis implementasi program sanitasi total berbasis masyarakat (STBM) pilar 1 - Suryanti, Ratna; Joko, Tri; Darundiati, Yusniar Hanani; Sulistiyani, Sulistiyani; Nurjazuli, Nurjazuli (Holistik Jurnal Kesehatan, 2026)
Background: Environmental sanitation is a crucial factor influencing public health. However, open defecation (ODS) remains common and has the potential to pollute the environment and increase the risk of environmentally transmitted diseases. The Community-Based Total Sanitation (CTS) program is a government effort to encourage community behavior change through five sanitation pillars, one of which is Stopping Open Defecation (SBS). However, SBS achievement in Muara Wis District, Kutai Kartanegara Regency, remains low, and not all villages in the area have achieved SBS status. Purpose: To analyze the implementation of the community-based total sanitation program, pillar 1. Method: This study used an observational, analytical, and cross-sectional design. This study focused on the implementation of STBM Pillar 1, namely bus stops for open defecation prevention, in seven villages (Enggelam, Lebak Cilong, Lebak Mantan, Melintang, Muara Enggelam, and Sebemban) in Muara Wis District, Kutai Kartanegara, from October 2025 to February 2026. A total of 2,944 households in Muara Wis District, with 110 respondents randomly selected using the Slovin formula, were sampled. Data were collected through questionnaires and field observations, then analyzed univariately for frequencies and bivariately using the chi-square test with p < 0.05. Results: Most families had implemented open defecation prevention (71.8%). The bivariate analysis also found a significant relationship between the availability of vacant land (p = 0.001), clean water (p = 0.001), toilets (p = 0.001), and level of knowledge about STBM with open defecation behavior. Meanwhile, attitudes toward the implementation of STBM (Open Defecation-Free Zones) did not show a significant relationship (p = 0.930). Conclusion: The availability of vacant land, clean water, toilets, and the level of information are significantly associated with the practice of open defecation. Efforts to increase access to sanitation facilities, provide clean water, and educate the community about health need to be strengthened to support the successful implementation of Pillar 1 of STBM and achieve sustainable open defecation-free villages. Suggestion: Communities and the government are expected to find alternative solutions to the limited land available for sanitation facilities, such as utilizing appropriate technology in building family toilets, implementing simple air treatment methods both individually and communally, and building healthy toilets that are appropriate to the geographical conditions of the environment.   Keywords: Community-Based Total Sanitation; Environmental Sanitation; Open Defecation.   Pendahuluan: Sanitasi lingkungan merupakan faktor krusial yang memengaruhi tingkat kesehatan masyarakat. Namun, praktik buang air besar sembarangan (BABS) masih sering terjadi dan berpotensi mencemari lingkungan serta meningkatkan risiko penyakit berbasis lingkungan. Program sanitasi total berbasis masyarakat (STBM) merupakan upaya pemerintah untuk mendorong perubahan perilaku masyarakat melalui lima pilar sanitasi, salah satunya stop buang air besar sembarangan (SBS). Namun, capaian SBS di Kecamatan Muara Wis, Kabupaten Kutai Kartanegara masih rendah dan seluruh desa di wilayah tersebut belum berstatus SBS. Tujuan: Untuk menganalisis implementasi program sanitasi total berbasis masyarakat (STBM) pilar 1. Metode: Penelitian ini menggunakan desain observasional analitik cross-sectional. Fokus penelitian adalah pelaksanaan STBM Pilar 1 stop buang air besar sembarangan di 7 desa (Enggelam, Lebak Cilong, Lebak Mantan, Melintang, Muara Enggelam, dan Sebemban), Kecamatan Muara Wis, Kutai Kartanegara, pada Oktober 2025 - Februari 2026. Sebanyak 2,944 kepala keluarga di Kecamatan Muara Wis, 110 responden dipilih secara acak dengan rumus Slovin. Demikian pula, data dikumpulkan melalui kuesioner dan observasi lapangan, kemudian dianalisis secara univariat untuk frekuensi dan bivariat menggunakan uji chi-square dengan p < 0.05. Hasil: Mayoritas keluarga telah menerapkan pencegahan buang air besar di tempat terbuka (71.8%). Analisis bivariat juga menemukan hubungan yang signifikan antara ketersediaan lahan kosong (p = 0.001), air bersih (p = 0.001), toilet (p = 0.001), dan tingkat pengetahuan tentang STBM dengan perilaku buang air besar keluarga. Sementara itu, sikap terhadap penerapan STBM tidak menunjukkan hubungan yang signifikan (p = 0.930). Simpulan: Faktor ketersediaan lahan kosong, ketersediaan air bersih, ketersediaan jamban, dan tingkat pengetahuan berhubungan signifikan terhadap praktik BABS. Upaya peningkatan akses sarana sanitasi, penyediaan air bersih, serta edukasi kesehatan masyarakat perlu diperkuat untuk mendukung keberhasilan implementasi STBM Pilar 1 dan pencapaian desa stop buang air besar sembarangan secara berkelanjutan. Saran: Masyarakat dan pemerintah diharapkan dapat mencari alternatif solusi atas keterbatasan lahan untuk pembangunan sarana sanitasi, seperti memanfaatkan teknologi tepat guna dalam pembangunan jamban keluarga, melakukan pengolahan air secara sederhana baik secara individu maupun komunal, serta membangun jamban sehat yang sesuai dengan kondisi geografis lingkungan.   Kata Kunci: Buang Air Besar Sembarangan; Sanitasi Lingkungan; Sanitasi Total Berbasis Masyarakat (STBM).