Knowledge, attitudes, and practices on Water, Sanitation, And Hygiene (WASH), diarrhea occurrence, and the nutritional status of children among riverine communities in the cities of Tanauan and Santo Tomas, Batangas, Philippines

Water, Sanitation, And Hygiene (WASH) significantly influence child nutrition, particularly in vulnerable settings such as riverine communities. This study assessed the WASH-related knowledge, attitudes, and practices of household heads, along with the nutritional status and two-week diarrhea prevalence among children from 85 randomly selected households in Tanauan and Santo Tomas City, Batangas, Philippines. Findings revealed high knowledge (95%), positive attitudes (51%), and good practices (95%) on WASH among household heads. Among children, the prevalence of underweight, stunting, wasting, and thinness was 28%, 34%, 13%, and 15%, respectively, while the two-week prevalence of diarrhea was 16.47%. The rate of underweight, stunting, and wasting was highest among toddlers (1–2 years) and thinness among adolescents (13–15 years), while diarrhea was more prevalent among children under five. Statistically significant and very strong associations were observed between WASH knowledge and the age (p = 0.024, V = 0.348) and educational attainment (p = 0.007, V = 0.400) of household heads, with higher levels of knowledge observed among those aged 25-44 years and those with at least a high school education. The occupation of household heads also demonstrated a very strong association with children's height- for-age (p = 0.039, V = 0.395), with stunting more frequently observed among children of household heads engaged in domestic service than among those whose household heads were employed in sales and services or skilled manual work. Despite the high levels of knowledge and reported practices, misconceptions and inconsistent adherence to recommended practices remain. These findings highlight the need for context-appropriate interventions that promote proper handwashing with soap and water for at least 20 seconds, regular treatment of drinking water, and safe waste management, particularly the proper disposal of children’s stool and animal dung. Given the high prevalence of undernutrition, particularly among children aged 1-2 years, future research should explore other contributing factors, including dietary intake, caregiving practices, and household food security, to provide a more comprehensive understanding of the determinants of child nutrition in riverine communities.