Peer-reviewed article
Transforming Coastal Household Sanitation: A Family-Centered PHAST Adaptation for Malnutrition and Environmentally Related Diseases-Vulnerable Communities
Evi Naria, Indra Chahaya, Rusmalawaty Rusmalawaty, Diza Fathamira Hamzah, Syafrina Ulfah ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study tested a family-centered version of the PHAST sanitation method with 30 households that have children under five in Medan Belawan, a coastal district of Indonesia. Researchers used participatory action research, combining interviews and observation with simple before-and-after sanitation indicators and anthropometric data. Baseline conditions were poor, including unsafe toilets, open wastewater channels and weak waste management. After the intervention, sanitation practices improved and families reported more awareness and shared responsibility. The authors say the approach looks feasible and acceptable, but longer-term health effects still need to be evaluated.
Key points
- Baseline showed unsafe toilets, open wastewater channels, and poor hygiene and waste management.
- After the intervention, all families stored water and food in covered containers.
- 83.3% of households disposed of waste daily after the intervention.
- 50% of households performed actions such as closing toilet holes and cleaning up scattered waste.
- Reduced malnutrition is described as a plausible but unmeasured downstream benefit.
Limitations
The study was small (30 households), had no comparison group and used descriptive indicators, so it cannot show that the intervention caused the changes. Effects on disease and malnutrition were not measured.
Abstract
Poor environmental sanitation in coastal areas is closely associated with environmentally related diseases and malnutrition among under-five children, but participatory interventions are rarely evaluated at the household level. Therefore, this study aimed to implement and evaluate a family-centered adaptation of the Participatory Hygiene and Sanitation Transformation (PHAST) method in Medan Belawan District, Indonesia. A Participatory Action Research (PAR) design engaged 30 households with children under five years of age. Qualitative interview and observation data were triangulated with descriptive pre- and post-intervention sanitation indicators and anthropometric data to validate the thematic evidence. The results from the baseline assessment showed inadequate sanitation conditions, including unsafe toilets, open wastewater channels, as well as poor hygiene and waste management. Following the intervention, all families stored water and food in covered containers, 83.3% disposed of waste daily, and 50% performed actions such as closing toilet holes and cleaning up scattered waste. The intervention increased household environmental awareness, strengthened shared family responsibility for sanitation, and produced measurable improvements in sanitation practices. This reduced the risk of environmentally related diseases, and malnutrition remains a plausible, unmeasured downstream benefit. In conclusion, the adaptation appears feasible and acceptable for strengthening household sanitation ownership in low-resource coastal communities, warranting further evaluation of its longer-term health impact.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- A family-centered adaptation of the Participatory Hygiene and Sanitation Transformation (PHAST) method delivered through participatory action research
- Population
- 30 households with children under five years in Medan Belawan District, Indonesia
Key finding
All families stored water and food in covered containers after the intervention.
Naria et al. · OpenAlex · 4 Oct 2026