Cadre-Led Sanitation Counseling and Maternal Stunting-Prevention Practices in Sigi Regency, Indonesia: A Cross-Sectional Study

Dedi Mahyudin Syam (Environmental Health Department, Poltekkes Kemenkes Palu, Sulawesi Tengah, Indonesia)
Andi Bungawati (Environmental Health Department, Poltekkes Kemenkes Palu, Sulawesi Tengah, Indonesia)
Udin Udin (Environmental Health Department, Poltekkes Kemenkes Palu, Sulawesi Tengah, Indonesia)

Media Publikasi Promosi Kesehatan Indonesia (MPPKI)
Vol. 9 No. 7 (2026)

Introduction: Stunting remains a major public health problem in Indonesia, particularly in high-burden areas such as Sigi Regency, Central Sulawesi. Poor sanitation and hygiene practices contribute to environmental enteric dysfunction (EED), which may impair nutrient absorption and child growth. Indonesia’s Community-Based Total Sanitation (STBM) program promotes sanitation-related behavior change through cadre-led interventions across five sanitation pillars. Methods: A cross-sectional design was used involving 80 mothers of stunted children under two years old, selected through proportional stratified random sampling across high-burden villages. Data were collected using a structured and validated 25-item questionnaire measuring behaviors aligned with the five STBM pillars. A score of ?75 (?75% of the maximum score) was categorized as "adequate," while a score <75 was classified as "inadequate." analysis was performed using Chi-square was conducted to determine associations between exposure to cadre-led activities and maternal sanitation and hygiene practices, with particular attention to behaviors.followed by logistic regression analysis. Results: Bivariate analysis showed significant associations between maternal stunting-prevention practices and counseling on open defecation elimination (p<0.00), handwashing with soap (p<0.001), and water and food management (p=0.001). However, multivariate analysis revealed that only handwashing-with-soap counseling remained significantly associated with good maternal stunting-prevention practices (Adjusted OR = 63.00; 95% CI for OR: 15.61–254.12; p<0.001). Conclusion: Handwashing-with-soap counseling was the strongest predictor of maternal stunting-prevention practices. These findings suggest that hygiene-focused behavioral interventions targeting fecal–oral transmission pathways may play a critical role in reducing stunting risk. Strengthening cadre-based handwashing promotion should be prioritized in community-based stunting prevention strategies.