Clean Water, Housing Condition, and Diarrhea among Children under Five Years Old in Indonesia: Partial Least Square-Structural Equation Modeling (PLS-SEM)

Diarrhea is still a challenging health problem for children under five years of age in Indonesia. This study aimed to analyze the effect, either direct or indirect, of child characteristics, family characteristics, drinking water sources and housing conditions on diarrhea in Indonesia. Children under five years old were selected from the total samples used in the Indonesia Demography and Health Survey (IDHS)in 2017. The research samples accounted for 17,263 children chosen for further investigation. Multiple regression logistics and PLS-SEM tests were employed to analyze the relationship between the independent and dependent variables. The logistic analysis yielded results that family wealth, toilet, walls, floor of the house, and location of the houses significantly influenced the access to clean water sources. Moreover, child’s gender, age, family wealth, floor of the house, and location were significantly associated with the prevalence of diarrhea. Obtained from Partial Least Square-Structural Equation Modeling (PLS-SEM) analysis, results found that wealth had the highest path coefficient of 0.324, indicating a high effect on diarrhea rates. The contribution of the residence to housing (β = 0.035) and water (β = 0.204) to diarrhea incidence was of positive significance, while water and diarrhea were statistically negative in contributing to diarrhea incidence (β =-0.019). In addition, residence and wealth on water and diarrhea had a partial mediator effect (β = -0.004 and -0.004, respectively). Our findings suggest that the accessibility to clean water source was an intervening variable that plays an important role in diarrhea cases in Indonesia. Besides, wealth and residence influenced the prevalence of diarrhea.