• Vera Yulyani Faculty of Public Health, Malahayati University, Jl. Pramuka No. 27, Kemiling Permai, Kemiling, Kota Bandar Lampung, Lampung 35152, Indonesia
  • Dina Dwi N Facultyof Public Health, Malahayati University, Jl. Pramuka No. 27, Kemiling Permai, Kemiling, Kota Bandar Lampung, Lampung 35152, Indonesia
  • Dina Kurnia Dinas Lingkungan Hidup Kabupaten Tanggamus, Kota Agung, Lampung 35384, Indonesia



Latrine Use, Open Defecation, Tanggamus Regency


Indonesia is the second-most-populated country still practicing open defecation. The low utilization of latrines is a big problem that can affect human health and the environment. Several sub-districts in Tanggamus Regency have the lowest reported use of a latrine. This study aimed to determine associated factors of latrine usage in Tanggamus Regency in 2017.. A cross-sectional study was conducted among 399 households in Tanggamus Regency, Lampung. Sampling was proportional to the total number of household in 20 sub-districts. Respondents were interviewed by a structured questionnaire . Data were analyzed using SPSS version 18.0. The study observed that a majority (55.6%) of the respondents used a latrine; furthermore, more than half of all respondents indicated good knowledge (55.9%), positive attitude (57.4%), good economic status (56.1%), access to a proper latrine (57.6%), good support from health office (55.4%), and availability of clean water (53.4%). Multivariate analysis showed that attitude was the most dominant factor related to the utilization of latrine (P<0.05 and adj OR=3.2). Encouraging communities to translate their positive attitudes into the behavior was very important. Policies, community leaders, and heads of households should all be influenced to change community attitudes to drive consistent latrine use.


WHO/UNICEF. Progress On Sanitation and Drinking Water - 2015 Update and MDG Assessment. 2015;

United Nations. Water for Life 2005-2015. Igarss 2014. 2014;(1):1–5.

Wolf J, Johnston R, Hunter PR, Gordon B, Medlicott K, Prüss-ustün A. International Journal of Hygiene and A Faecal Contamination Index for interpreting heterogeneous diarrhoea impacts of water , sanitation and hygiene interventions and overall , regional and country estimates of community sanitation coverage with a focus on low- and middle-income countries. Int J Hyg Environ Health [Internet]. Elsevier; 2018;(August):0–1. Available from:

Clasen T, Boisson S, Routray P, Torondel B, Bell M, Cumming O, et al. Effectiveness of a rural sanitation programme on diarrhoea, soil-transmitted helminth infection, and child malnutrition in Odisha, India: A cluster-randomised trial. Lancet Glob Heal [Internet]. Clasen et al. Open Access article distributed under the terms of CC BY-NC-ND; 2014;2(11):e645–53. Available from:

Zin T, SabaiAung T, Saupin S, Myint T, Daw Khin SN, Aung MS, et al. Influencing factors for cholera and diarrhoea: Water sanitation and hygiene in impoverished rural villages of Beluran district, Sabah Malaysia. Malaysian J Public Heal Med. 2015;15(1):30–40.

WHO/UNICEF. Diarrhea : why children are still dying and what can be done. Who/Unicef. 2009;

Diallo MSAF, Cong X, Henderson WA, Mcgrath J. International Journal of Nursing Studies Management of childhood diarrhea by healthcare professionals in low income countries : An integrative review. Int J Nurs Stud [Internet]. Elsevier Ltd; 2017;66:82–92. Available from:

Fischer Walker CL, Perin J, Aryee MJ, Boschi-Pinto C, Black RE. Diarrhea incidence in low- and middle-income countries in 1990 and 2010: A systematic review. BMC Public Health [Internet]. BioMed Central Ltd; 2012;12(1):220. Available from:

Chang AY, Riumallo-Herl C, Resch SC, Verguet S. Estimation of distribution of childhood diarrhoea, measles, and pneumonia morbidity and mortality by socio-economic group in low-income and middle-income countries. Lancet Glob Heal [Internet]. 2017;5: S15. Available from:

Kementerian Kesehatan Republik Indonesia. Profil Kesehatan Indonesia Tahun 2017. 2018.

Spears D. Exposure to open defecation can account for the Indian enigma of child height. J Dev Econ [Internet]. Elsevier B.V.; 2018;(August):1–17. Available from:

Vyas S, Kov P, Smets S, Spears D. Disease externalities and net nutrition: Evidence from changes in sanitation and child height in Cambodia, 2005–2010. Econ Hum Biol [Internet]. Elsevier B.V.; 2016;23:235–45. Available from:

Freeman MC, Garn J V., Sclar GD, Boisson S, Medlicott K, Alexander KT, et al. The impact of sanitation on infectious disease and nutritional status: A systematic review and meta-analysis. Int J Hyg Environ Health [Internet]. Elsevier GmbH.; 2017;220(6):928–49. Available from:

Dickin S, Bisung E, Savadogo K. Geoforum Sanitation and the commons : The role of collective action in sanitation use. Geoforum [Internet]. Elsevier; 2017;86(December 2016):118–26. Available from:

World Health Organization, Unicef. Progress on Drinking Water , Sanitation and Hygiene. 2017.

O’Reilly K, Dhanju R, Goel A. Exploring “The Remote” and “The Rural”: Open Defecation and Latrine Use in Uttarakhand, India. World Dev. 2017;93:193–205.

Alexander K, Allton C, Felsman C, Hahn M, Okegbe T, Palmer D, et al. Ending Open Defecation in India: Insights on Implementation and Behavior Change for Swachh Bharat Abhiyan. 2016; Available from: Workshop Report_FINAL_2.25.2016.pdf

Spears D, Ghosh A, Cumming O. Open Defecation and Childhood Stunting in India: An Ecological Analysis of New Data from 112 Districts. PLoS One. 2013;8(9):1–9.

Kurniawati LD, Windraswara R. Faktor-Faktor yang Berpengaruh terhadap Perilaku Kepala Keluarga dalam Pemanfaatan Jamban di Pemukiman Kampung Nelayan Tambaklorok Semarang Abstrak. 2017;2(1):72–9.

UNICEF INDONESIA. Annual Report Indonesia 2015. 2016;

Petaling DH, Faculty M, Ismail A. Original Article Housing Infrastructure and Quality of Life of Orang Asli and Non- Orang Asli Populations in Kuala Langat Selangor. Malaysian J Public Heal Med. 2018;18(1).

Kementerian Kesehatan Republik Indonesia. Laporan Kemajuan Akses Sanitasi [Internet]. 2019. Available from:

Susila, Suyanto. Metode Penelitian Epidemiologi Bidang Kedokteran dan Kesehatan. Yogyakarta: Bursa Ilmu; 2014.

Notoatmodjo S. Health Promotion and Behavioral Science. Jakarta: Rineka Cipta; 2012.

Badan Penelitian dan Pengembangan Kesehatan. Riset Kesehatan Dasar. 2013;306.

Sudaryono. METODOLOGI PENELITIAN. Jakarta: Raja Grafindo; 2017. 311-317 p.

Crocker J, Saywell D, Shields KF, Kolsky P, Bartram J. Science of the Total Environment The true costs of participatory sanitation : Evidence from community-led total sanitation studies in Ghana and Ethiopia. Sci Total Environ [Internet]. The Authors; 2017;601–602:1075–83. Available from:

Chaudhuri S, Roy M. Rural-urban spatial inequality in water and sanitation facilities in India: A cross-sectional study from household to national level. Appl Geogr [Internet]. Elsevier Ltd; 2017;85:27–38. Available from:

O’Connell K. What influences open defecation and latrine ownership in rural households?: Findings from a global review. 2014;(August):38.

Pane E. Pengaruh Perilaku Keluarga terhadap Penggunaan Jamban. J Kesehat Masy Nas. 2009;3(5):229–34.

Sangaran G, J AT, Aniza I. Original Article Level of Satisfaction in Using the Hospital Information System. Malaysian J Public Heal Med. 2014;14(1):29–38.

Denison J. Behavior Change - A Summary of Four Major Theories. Fam Heal Int. 2011;(July).

Lee L, Lee Y, Altschuld JW, Pan Y. Energy literacy : Evaluating knowledge , affect , and behavior of students in Taiwan. Energy Policy [Internet]. Elsevier; 2015;76:98–106. Available from:

Junias MS. Factors of Knowledge and Toilet Availability in Affecting Behavior of Open Defecation. 2016;6(5):440–3.

Manika D, Gregory-Smith D, Papagiannidis S. The influence of prior knowledge structures on website attitudes and behavioral intentions. Comput Human Behav [Internet]. Elsevier Ltd; 2018;78:44–58. Available from:

Devine J, Devine J. Introducing SaniFOAM : A Framework to Analyze Sanitation Behaviors to Design Effective Sanitation Programs. 2009;(October).

Kroesen M, Handy S, Chorus C. Do attitudes cause behavior or vice versa? An alternative conceptualization of the attitude-behavior relationship in travel behavior modeling. Transp Res Part A Policy Pract [Internet]. Elsevier Ltd; 2017;101:190–202. Available from:

Niu G, Zhao G. Religion and trust in strangers among China’s rural-urban migrants. China Econ Rev [Internet]. Elsevier; 2018;50(November 2017):265–72. Available from:




How to Cite

Vera Yulyani, Dina Dwi N, & Dina Kurnia. (2019). LATRINE USE AND ASSOCIATED FACTORS AMONG RURAL COMMUNITY IN INDONESIA. Malaysian Journal of Public Health Medicine, 19(1), 143–151.