Faktor Penentu Perilaku Child Feces Disposal (CFD) Pada Balita di Kecamatan Puuwatu Kota Kendari

Sitti Zahra Aulia Nazar, Dr. Mubasysyir Hasanbasri, MA; Dr. Daniel, M.Sc

2023 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Pembuangan tinja balita (child feces disposal) yang tidak sesuai menjadi salah satu sumber potensial dari perilaku buang air besar sembarangan. Padahal, kotoran balita yang tidak dikelola dengan baik dapat menimbulkan risiko kontaminasi pada lingkungan hingga penyakit pada anak seperti penyakit diare, stunting, maupun hepatitis. Penelitian terkait faktor penentu perilaku child feces disposal dengan identifikasi sub faktor psikososial RANAS dan kontekstual masih sangat jarang dilakukan baik secara global maupun di Indonesia. Oleh karena itu, topik ini perlu diteliti lebih lanjut. Tujuan: Penelitian ini bertujuan untuk mengidentifikasi gambaran dan faktor penentu perilaku child feces disposal menggunakan pendekatan model perilaku RANAS (Risk, Attitude, Norm, Ability, Self regulation). Metode: Metode yang digunakan adalah jenis kuantitatif dengan teknik pengambilan sampel stratified random sampling. Pada penelitian ini terdapat 349 sampel yang datanya diolah menggunakan analisis regresi logistik dengan aplikasi IBM statistik SPSS. Hasil:  Hasil dari analisis regresi logistik multivariat terdapat 2 faktor kontekstual dan 9 sub faktor psikososial yang berpengaruh terhadap perilaku child feces disposal. Untuk faktor kontekstual, peneliti menemukan bahwa responden memiliki persepsi pembuangan tinja aman yang lebih kuat ketika mereka memiliki informasi sanitasi yang lebih besar. Untuk faktor psikososial, responden lebih intens melakukan pembuangan tinja yang aman ketika mereka yakin bahwa anak mereka dapat menderita penyakit maupun kontaminasi cukup parah apabila tidak diperhatikan cara pengelolaan tinja anak yang benar. Kesimpulan: Gambaran perilaku child feces disposal di Kecamatan Puuwatu masih didominasi oleh perilaku child feces disposal yang tidak aman. Mayoritas perilaku tersebut ialah perilaku pembuangan tinja balita menggunakan popok yang langsung dibuang ke tempat sampah tanpa dibersihkan terlebih dahulu sebanyak 60.2%. Selain itu, faktor yang paling berpengaruh dengan perilaku child feces disposal adalah keparahan (severity) (OR = 81.792). Adapun beberapa faktor lainnya yang juga mempengaruhi perilaku child feces disposal antara lain pengetahuan faktual (health knowledge) (OR = 13.745); informasi sanitasi (OR = 7.958); keyakinan afektif 2 (affective belief 2) (OR = 6.482); kerentanan (vulnerability) (OR = 5.272); kontrol tindakan (action control) (OR = 3.968); norma perintah 2 (injunctive norm 2) (OR = 2.804); usia balita (OR = 1.124); keyakinan afektif 1 (affective belief 1) (OR = 0.274); keyakinan instrumental 1 (instrumental belief 1) (OR = 0.206) dan perencanaan penanggulangan (barier planning) (0.006). Implikasi praktis yang sesuai dengan melihat determinan tersebut ialah pertama, memperbanyak fasilitas sanitasi; kedua, mengupayakan penerapan inisiasi jamban dini dan popok kain; ketiga, mengembangkan kebijakan program recycling untuk meminimalisir sampah popok di lingkungan.

Background: Inappropriate child feces disposal is a potential source of open defecation. In fact, toddler excrement that is not managed properly can pose a risk of contamination in the environment and diseases in children such as diarrhea, stunting, and hepatitis. Research related to the determinants of child feces disposal practice by identifying RANAS and contextual psychosocial sub-factors is still very rarely done both globally and in Indonesia. Therefore, this topic needs further research. Purpose: This study aims to identify the descriptions and determinants of child feces disposal practice using the RANAS behavior model approach (Risk, Attitude, Norm, Ability, Self regulation). Method: The method used is a quantitative type with stratified random sampling technique. In this study there were 349 samples whose data were processed using logistic regression analysis with the IBM SPSS statistical application. Results: The results of the multivariate logistic regression analysis show that there are 2 contextual factors and 9 psychosocial sub-factors that influence child feces disposal practice. For contextual factors, the researcher found that respondents have a stronger perception of safe excreta disposal when they have greater sanitation information. For psychosocial factors, respondents were more intense in carrying out safe disposal of feces when they believed that their child could suffer from serious illness or contamination if proper management of children's feces was not observed. Conclusion: The description of child feces disposal behavior in Puuwatu District is still dominated by unsafe child feces disposal practice. The majority of unsafe practice is the behavior disposing of toddler feces using diapers which are immediately thrown into the trash without cleaning first as much as 60.2%. In addition, the most influential factor with child feces disposal practice is severity (OR = 81.792). There are several other factors that also influence the practice of child feces disposal, including factual knowledge (health knowledge) (OR = 13.745); sanitation information (OR = 7.958); affective belief 2 (OR = 6.482); vulnerability (OR = 5.272); action control (OR = 3.968); injunctive norm 2 (OR = 2.804); toddler age (OR = 1.124); affective belief 1 (OR = 0.274); instrumental belief 1 (OR = 0.206) and barrier planning (0.006). The practical implications that are in accordance with these determinants are first increasing sanitation facilities; second, seeking the implementation of early toilet initiation and cloth diapers; third, developing a recycling program policy to minimize diaper waste in environment.

Kata Kunci : Child Feces Disposal, Balita, Faktor Kontekstual, Faktor Psikososial, RANAS