Unsafe drinking water and poor sanitation and hygiene lead to deterioration of the child health condition in low-and middle-income countries. This study aimed to evaluate the nutritional and health status of children living in an urban slum and to clarify the factors contributing to undernutrition and diarrhea prevalence by focusing on water, sanitation, and hygiene from three viewpoints: household environments, child personal hygiene practices, and knowledge and awareness. The study was conducted at a preschool and two elementary schools in the densely populated area of Bandung, Indonesia. Participants were 228 pairs of children and their caretakers. The survey involved 1) anthropometric measurements (height and weight), 2) handwashing observation using a checklist, and 3) questionnaires. On multivariate logistic regression analysis, not using a towel for handwashing practices (adjusted odds ratio [AOR] = 2.37; 95% confidence interval [CI] = 1.13-4.96) was significantly associated with an increased risk of stunting. Regarding household environments, children from households using tap water as drinking water were significantly associated with an increased risk of stunting and thinness compared with households using tank water (AOR = 2.26; 95% CI = 1.03-4.93; and AOR = 2.88; 95% CI = 1.13-7.35, respectively). Moreover, children from households using open containers for water storage were significantly associated with an increased risk of diarrhea (AOR = 5.01; 95% CI = 1.08-23.15). Therefore, drinking water management at home and proper personal hygiene practices of children are important for maintaining and promoting child health in urban Indonesian slums.

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With a 270 million Indonesian population, domestic wastewater is one of the major contributors to wastewater generated from human activities. This review aimed to give an overview of the current state of domestic wastewater generation, characteristics and treatment systems in Indonesia. Overall, grey water quantity in Indonesia was 1 to 4 times higher than black water quantity, while the quantity of untreated grey water was 3 to 6 times higher than untreated black water. Parameters of concern include suspended solids, biochemical oxygen demand, chemical oxygen demand, oil and grease, nitrogen and coliforms. Our analysis shows that grey water can be a significant source of water pollution due to the large quantity and lack of treatment. In addition, black water treatment that relies mainly on on-site treatment is often inadequate due to the lack of quality control for the infrastructure, operation and maintenance. An incentive or penalty scheme to build and ensure the quality of domestic wastewater treatment is required and can be applied at the household, community or central (city) level.