Improving Environmental Health Awareness through the PHAST Method for Household Sanitation Intervention in the Belawan Coastal Region
Abstract
Coastal areas are often faced with complex public health challenges due to environmental vulnerability and limited access to sanitation facilities. Poor sanitation contributes to a high prevalence of environment-related diseases such as diarrhea and malnutrition among children under five. This quasi-experimental study included 30 households with toddlers in Medan Belawan, Medan City. The Participatory Hygiene and Sanitation Transformation (PHAST) method was implemented to empower families in managing sanitation and hygiene practices. Data were collected through observation and assessment of household sanitation conditions before and after the intervention. Analysis was conducted using the Wilcoxon Signed Rank test at a 95% confidence interval due to non-normal data distribution. The results showed a significant improvement in household sanitation scores after the PHAST intervention (Z = -3.905; p < 0.05). Approximately 63.3% of households had increased scores, particularly in handwashing at critical times, waste management, as well as water and food storage practices, signifying a meaningful magnitude of behavioral change. However, this study was limited by its small sample size, absence of a control group, and short observation period, which hindered causal inference and generalizability. Despite the limitations, the evidences suggest that PHAST is a promising method for improving household sanitation management and hygiene behavior in coastal settings. Future studies with larger samples and controlled designs are recommended to assess sustainability and long-term health outcomes
Keywords: Household Sanitation, Environmental Diseases, Coastal Area, PHAST
Full Text:
PDFReferences
Abera, M. G., Werkneh, A. A., Welde, R. S., Islam, M. A., & Redae, G. H. (2024). Diarrhea prevalence and water, sanitation, and hygiene (WASH) factors among internally displaced children under-five in Mekelle city, Northern Ethiopia. Clinical Epidemiology and Global Health, 28(August 2023), 101660. https://doi.org/10.1016/j.cegh.2024.101660
Alum, E. U., Obeagu, E. I., & Ugwu, O. P. C. (2024). Enhancing quality water, good sanitation, and proper hygiene is the panacea to diarrhea control and the attainment of some related sustainable development goals: A review. Medicine (United States), 103(38), e39578. https://doi.org/10.1097/MD.0000000000039578
Basyariyah, Q., Diyanah, K. C., & Pawitra, A. S. (2022). Hubungan Ketersediaan Sanitasi Dasar terhadap Status Gizi Baduta di Desa Pelem, Bojonegoro. Jurnal Kesehatan Lingkungan Indonesia, 21(1), 18–26. https://doi.org/10.14710/jkli.21.1.18-26
Cecilia, S., Murayama, T., Nishikizawa, S., & Suwanteep, K. (2024). Preferences and valuation of small-scale wastewater treatment system maintenance using discrete choice method : Case of community-managed system in Jakarta , Indonesia. Journal of Environmental Management, 371(October), 123115. https://doi.org/10.1016/j.jenvman.2024.123115
Doma, R., Patrick, M., Conrad, A., Ramanarayanan, V., Arun, S., Sinharoy, S. S., & Caruso, B. A. (2023). An exploration of sanitation-related decision-making, leadership, collective action, and freedom of movement among women in urban Tiruchirappalli, India. Frontiers in Water, 5. https://doi.org/10.3389/frwa.2023.1048772
Fadilah, M., Novita, E., Roflin, E., Syakurah, R. A., Pariyana, ., & Irene, A. (2020). Analysis of the Relationship Between Implementation of Stbm Program and Reduction of Stunting’S Risk Factors in Children Under Two Years Old in Palembang. Advances in Social Sciences Research Journal, 7(12), 395–407. https://doi.org/10.14738/assrj.712.9330
Hendraswari, D. E. (2023). Studi Ekologi : Determinan Kejadian Gizi Buruk Di Indonesia Tahun 2021. J-KESMAS: Jurnal Kesehatan Masyarakat, 9(1), 84. https://doi.org/10.35329/jkesmas.v9i1.3899
Ikegulu, J. U., Onwurah, C. C., Okoye, A. C., Obele, J. O., & Machie, K. U. (2024). Participatory hygiene and sanitation transformation for hygiene behaviour among secondary school students in Awka South Local Government, Anambra State. Nigerian Journal of Health Promotion, 17(2), 59–66.
Karinja, M., Schlienger, R., Pillai, G. C., Esterhuizen, T., Onyango, E., Gitau, A., & Ogutu, B. (2020). Risk reduction of diarrhea and respiratory infections following a community health education program - A facility-based case-control study in rural parts of Kenya. BMC Public Health, 20(1), 1–9. https://doi.org/10.1186/s12889-020-08728-z
MacLeod, C., Davies, K., Mwenge, M. M., Chipungu, J., Cumming, O., & Dreibelbis, R. (2025). Behaviour change interventions to improve household sanitation and hygiene practices in urban settings: A systematic scoping review. International Journal of Hygiene and Environmental Health, 264(December 2024), 114519. https://doi.org/10.1016/j.ijheh.2025.114519
Melese, M., Esubalew, D., Malede, A., Birhan, T. A., & Azanaw, J. (2024). Environmental Predictors of Undernutrition Among Under-5 Children at Dabat District Health Facilities, Northwest Ethiopia, 2023. Environmental Health Insights, 18, 1–9. https://doi.org/10.1177/11786302241252735
Merid, M. W., Alem, A. Z., Chilot, D., Belay, D. G., Kibret, A. A., Asratie, M. H., … Aragaw, F. M. (2023). Impact of access to improved water and sanitation on diarrhea reduction among rural under-five children in low and middle-income countries: a propensity score matched analysis. Tropical Medicine and Health, 51(1). https://doi.org/10.1186/s41182-023-00525-9
Naria, E., Santoso, H., Rochadi, K., & Nurmaini, N. (2021). Exploring the potentiality of family resources on basic household sanitation management in dense settlements of binjai in north Sumatera province of Indonesia. Open Access Macedonian Journal of Medical Sciences, 9, 547–551. https://doi.org/10.3889/oamjms.2021.5720
Sawyer, R., Simpson-Hébert, M., & Wood, S. (1988). PHAST Step by Step Guide: A participatory approach for the control of diarrhoeal disease. 1998, 140. Retrieved from https://www.ircwash.org/sites/default/files/203.2-98PH-13868-2.pdf
Singh.R.Jayaram, S. (2022). Attainment of water aand sanitation goals : a review and agenda research. https://doi.org/10.1007/s40899-022-00719-9
Susilowati, E., Quyumi, E., Dharma, A., Kediri, H., Penanggungan, J., & Kediri, A. (2019). Peningkatan Status Gizi Dan Penurunan Infeksi Cacing Pada Anak Toddler Dengan Penerapan Dinamika Kelompok Sosial Improvement of Nutritional Status and Decrease of Worms Infection in Toddler with The Application of Social Group Dynamics. Jurnal Ilmu Kesehatan, 7(2), 366.
Talat, U., Ravenscroft, L., & Vlaev, I. (2023). Development of a behaviour change intervention to promote sanitation and latrine use in rural India. BMC Public Health, 23(1), 1–12. https://doi.org/10.1186/s12889-023-17061-0
Tough, H., Abdallah, A. K., Zemp, E., & Molesworth, K. (2023). Gender dynamics of community-led total sanitation interventions in Mpwapwa District, Tanzania. Global Public Health, 18(1). https://doi.org/10.1080/17441692.2022.2053733
United Nation, U. W. (n.d.). Summary Progress Update 2021 : SDG 6 — water and sanitation for all.
WHO. (2023). UN-Water Global Analysis and Assessment of Sanitation and Drinking-Water (GLAAS). 2023–2030.
Widiari, N. K. M., Budiani, N. N., & Novya Dewi, I. G. A. A. (2023). Perbedaan Perilaku Personal Hygiene Anak Prasekolah Sebelum dan Sesudah Diberikan Video Animasi di Taman Kanak-Kanak Nara Budhi Suari. Jurnal Ilmiah Kebidanan (The Journal Of Midwifery), 11(1), 105–113. https://doi.org/10.33992/jik.v11i1.2451
DOI: http://dx.doi.org/10.30829/contagion.v8i1.26695
Refbacks
- There are currently no refbacks.
Copyright (c) 2026 Evi Naria, Indra Chahaya, Rusmalawaty Rusmalawaty, Diza Fathamira Hamzah, Anggraini Anggraini, Tamia Sakinah Adjani
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
