The effectiveness of community-led total sanitation cadre intervention in improving stunting knowledge and behavior

Abstract

The prevalence of stunting remains high in Central Sulawesi Province, Indonesia. Poor sanitation is a significant risk factor for stunting, and community-based interventions such as Community-Led Total Sanitation (CLTS) show promise in addressing this issue. Despite the government’s multi-sectoral and integrated approach, encompassing both specific and sensitive nutrition interventions, the problem of stunting persists. This study aimed to assess the effectiveness of cadre-led interventions in improving community knowledge and behavior related to CLTS as a means of stunting prevention. A quasi-experimental, non-randomized design was used, with proportional stratified random sampling applied to a population of 332, resulting in a sample size of 182 individuals. Data collection was conducted from July to September 2023. The intervention involved CLTS cadres delivering counseling and triggering activities to mothers of stunted children. Knowledge and behavior regarding the five pillars of CLTS were measured as the dependent variables using a CLTS questionnaire with a scoring system. Data analysis was performed using SPSS version 22.0, specifically employing the independent-sample t-test with a significance threshold of p<0.05. Results indicated a significant increase in knowledge across the five pillars of CLTS (p=0.000), as well as a significant improvement in behavior concerning handwashing with soap, drinking water, food management, and household wastewater management (p=0.000). The findings suggest that cadres play an effective role in enhancing community knowledge and behavior regarding CLTS, contributing to stunting prevention efforts.