Household Sanitation Inequalities in Flats, Slum Areas, and

Residences in Achieving the Criteria for Healthy Housing,

Samarinda City

Ayudhia Rachmawati, Vivi Filia Elvira and Syamsir Syamsir

Department of Environmental Health, Public Health Faculty, University of Mulawarman, Samarinda, Indonesia

Keywords: Flats, Household Sanitation, Inspection, Recidences, Slum Areas.

Abstract: The availability of healthy housing is one of the elements that affect public health. In general, there are three

types of houses in Samarinda City: residences, flats, and slum houses. The issue with Samarinda City’s

housing is that there are still some homes with poor sanitation. The research aims to determine the relationship

between housing criteria, housing components, sanitation facilities, and occupant behaviour. This study was

carried out in November 2022. This study's sample size was 30 houses divided into three settlement groups

(residences, slums, and flats). The data analysis used was univariate, and bivariate analysis used the chi-square

test. There is no relationship between the housing components and the final score for determining the criteria

for a healthy house (p<0.0001). While the variables of sanitation facilities and occupants' behaviour were

significantly related to the assessment of healthy home criteria (p<0.013), There is a relationship between the

sanitation facilities and occupants' behaviour and the housing criteria of residences, slums, and flats.

1 INTRODUCTION

The availability of healthy housing is one of the

elements that affect public health. Good sanitation

should be standard in every home. Homes with poor

sanitation can act as breeding places for disease

agents. The level of risk of disease transmission for

the occupants is affected by the sanitation of the

living space. The components of safe housing and the

accessibility of sanitation facilities that satisfy the

standards can support the occupants health

(Agungnisa, 2019).

Based on national data for 2020–2022, access to

proper sanitation for households in Indonesia has not

exceeded 81% (BPS, 2022). This indicates that there

are still homes with inadequate sanitation facilities.

Access to good sanitation in the community is

affected by its financial status. For example, it costs a

lot of money to create proper latrines. For people with

lower incomes, it has been difficult to access proper

latrines (Dirjen PPM & PL, 2022). Actually, there is

already a PAMSIMAS programme that helps those in

poverty get appropriate sanitary facilities. However,

the programme has not been able to reach more

people (Direktorat Air Minum Kementerian PUPR,

2022).

Samarinda City, the capital city of East

Kalimantan Province, has a fairly dense population.

In general, there are three types of houses in

Samarinda City: residences, flats, and slum houses.

The issue with Samarinda City’s housing is that there

are still some homes with poor sanitation.

Particularly, the house near the river lacks proper

sanitary facilities (Rofandy, 2017).

Some of the slum houses in Samarinda City are

located around a tributary of the Mahakam River.

People who live in slum areas find it difficult to get

basic sanitation because of their low level of funds. In

addition, the risk of sickness is increased by the lack

of a clean and healthy lifestyle among the people in

the slum area. Some homes use river water as a source

of water for sanitation and hygiene needs. Even

though the quality of the river water does not meet

health standards (Daramusseng & Syamsir, 2021).

Compared to slum homes, Samarinda City’s flats are

better organised, but they still have issues with

sanitation, including a high occupancy rate and a

subpar physical environment. Many people in

Samarinda City choose residences for their homes.

There are still around 42 hectares of slum areas in

Samarinda City. The population density in the area is

relatively high (Dinas Perkim Kota Samarinda,

2022). There are three flats in Samarinda City that are

Rachmawati, A., Elvira, V. F. and Syamsir, S.

Household Sanitation Inequalities in Flats, Slum Areas, and Residences in Achieving the Criteria for Healthy Housing, Samarinda City.

DOI: 10.5220/0012898200004564

Paper published under CC license (CC BY-NC-ND 4.0)

In Proceedings of the 5th International Conference on Social Determinants of Health (ICSDH 2023), pages 19-23

ISBN: 978-989-758-727-6; ISSN: 2975-8297

located in Bengkuring, Sungai Kunjang, and Harapan

Baru. Most of the population lives in dense

residences. It is necessary to conduct a study related

to the description of the house’s environmental health

quality and the healthy life behaviour of the house.

Based on the problem, the research aims to determine

the relationship between housing criteria, housing

components, sanitation facilities, and occupant

behaviour.

2 METHODS

The research design for this study is cross-sectional

(Wang & Cheng, 2020). This study is part of an

observational study that analyses data on housing

components, sanitation, and resident behaviour in

correlation with assessing healthy housing criteria in

three different groups: residences, slums, and flats.

This study was carried out in November 2022. This

study’s sample size was 30 houses divided into three

settlement groups. Purposive sampling has been used

to collect data (Dolores &Tongco, 2007). The sample

selection in this study was based on the researcher's

considerations; the criteria were permanent residence

(not nomadic), and heterogeneity in sample selection

was highly recommended. In this study, direct

observation and interviews were conducted using a

healthy home assessment form developed by the

Ministry of Health, Republic of Indonesia (Ditjen PP

&PL Depkes RI, 2007). The data analysis used was

univariate, describing the differences in the

proportion of healthy homes fulfilled in the three

settlement groups studied. Furthermore, the bivariate

analysis used the chi-square test to see the

relationship between the independent variables

(house components, sanitation, and occupant

behaviour) and the dependent variable (assessment of

healthy home criteria). If the data cannot meet the

existing requirements, the Fisher's exact test will be

used. A house is declared healthy if it has a total value

of ≥ 1,068; an unhealthy home has a total value of <

1,068. The limitations of this study are the relatively

small number of samples, so the data distribution

becomes abnormal, and the bivariate analysis will

only look at the relationship without analysing the

differences in the three settlement groups.

3 RESULTS

F The condition of the ceiling, walls, floor, bedroom,

and living room windows, ventilation, kitchen

ventilation, and lighting are all assessed as housing

components. It is stated to be eligible if it fulfils five

of the eight variables measured and observed.

Sanitation amenities include clean water, latrines,

wastewater disposal facilities, and waste disposal

facilities. It is said to be eligible if it fulfils three of

the four requirements. The practice of opening

bedroom and living room windows, cleaning the yard,

disposing of infant and toddler faeces in the latrines,

and disposing of waste in its place are all examples of

occupant behaviour. It is said to be aware if it

fulfillsthreeof the four criteria asked.

Table 1: Characteristics of Housing Components,

Sanitation Facilities, and Occupants’ Behaviour in

Residences, Slums, and Flats.

Variable

Residences Slums Flats

(n) (%) (n) (%) (n) (%)

Housin

Com

onents

Not eligible 1 10.0 5 50.0 0 0.0

Eligible 9 90.0 5 50.0 10 100.0

Sanitary Facilities

Not eli

ible 8 80.0 10 100.0 5 50.0

Eli

ible 2 20.0 0 0.0 5 50.0

Occu

ants’ Behaviour

Unaware 0 0.0 5 50.0 5 50.0

Aware 10 100.0 5 50.0 5 50.0

Housin

Criteria

Unhealth

6 60.0 10 100.0 5 50.0

Healthy 4 40.0 0 0.0 5 50.0

Total 10 100.0 10 100.0 10 100.0

Table 1 shows the characteristics of the housing

components, sanitation facilities, and occupants'

behaviour of a number of 30 houses divided into 3

settlement groups. In residential areas, it was found

that 90% of the respondents' houses fulfilled the

requirements for housing components, while 50%

were in slums and 100% were in flats. An interesting

result is that 80% of residential sanitation systems

don't fulfil the requirements. This is due to

wastewater disposal facilities that keep pouring into

open ditches (80%), as well as waste disposal

facilities that are watertight but unprotected (80%).

Slum areas fail to fulfil sanitary criteria 100%,

whereas flats fail 50%. In terms of occupant

behaviour, as many as 50% of people in flats and slum

regions are unaware of the importance of

environmental protection. As a result, 100% of slum

areas, 60% of residential areas, and 50% of flats are

excluded from the criteria for healthy houses.

Table 2 shows that there is no relationship

between the housing components and the final score

for determining the criteria for a healthy house

(p<0.0001). While the variables of sanitation

facilities and occupants' behaviour were significantly

related to the assessment of healthy home criteria

(p<0.013).

ICSDH 2023 - The International Conference on Social Determinants of Health

Table 2: Relationship Between Housing Components,

Sanitation Facilities, and Occupants' Behaviour towards the

Assessment of Housing Criteria

Variable

Housin

Criteria

Unhealth

Healthy Total

P-

value

n % n % n %

Housin

Com

onents

Not

eli

ible

100

0 0.0 6

100.

0.141

Eli

ible 15

62.

5 9 37.5

100.

Sanitar

Facilities

Not

eli

ible

91.

2 8.7

100.

0 <0.00

(*)

Eli

ible 0 0 7

100.

0 7

100.

Occu

ants’ Behaviour

Unaware 10 100

0 0.0 1

100.

0 0.013

(*)

Aware 11

55.

0 9 45.0

100.

4 DISCUSSIONS

Housing and Settlement is a unified system consisting

of education, housing management, housing area

management, maintenance and repair, prevention and

improvement of slum quality, land acquisition,

financing systems, and community participation. The

government's efforts in implementing sanitation

inspections of housing and settlements are one of the

steps to describe the environmental quality conditions

of people in residential and residential environments.

The physical, chemical, and biological conditions

that exist in the house, dwelling, and residential

environment determine the health of the housing and

settlement environment to ensure that residents are in

optimal health. Healthy housing requirements and the

housing environment are technical health regulations

that must be completed in order to protect occupants

and persons living in housing or settlements, as well

as the surrounding community, from risks or health

concerns. Healthy housing criteria, which include

environmental and housing needs as well as the house

itself, are critical since housing has a significant

impact on the health of individuals, families, and

communities.

Based on the results of the research, 90% of

respondents' residences fulfilled the standards of the

housing component in residential areas, while 50%

were in slums and 100%; were in flats. This is

contradictory to the assessment weight for sanitary

inspection of housing and settlements, which states

that the significance of the home component should

be 100%, however, the results of this study were only

found in flats that matched the standards. Ceilings,

walls, flooring, bedroom windows, living room

windows, ventilation, kitchen exhaust, and lighting

are the components of concern.

According to the Minister of Health's Decree No.

829/Menkes/SK/VII/1999, health criteria for

residential homes include the following parameters:

1. Construction materials a. Not made of materials

that can release harmful substances into the

environment, such as total dust less than 150 ug/m2,

asbestos less than 0.5 fibre/m3 per 24 hours, and lead

(Pb) less than 300 mg/kg. b. not composed of

components capable of supporting the growth and

development of harmful microbes. 2. Components

and spatial organisation a. The floor is waterproof and

easy to clean; b. The house's walls are ventilated; c.

The bathroom and laundry room are waterproof and

easy to clean; d. The house's ceilings are easy to clean

and not prone to accidents; e. lightning rods are

present; f. the space is organised according to its

function and designation; and g. the kitchen must

have a smoke disposal system. 3. Direct or indirect

natural and/or artificial lighting that illuminates the

entire space with a lighting intensity of 60 lux and

does not dazzle the eye (Kepmenkes RI No. 829,

1999).

Aspects of the physical environment in slum

settlements with a score of 50% indicate a substantial

difference in outcomes, where the component of

healthy housing is suitable if it fulfils the

government's 100% rating. This, obviously, has an

impact on public health because the house is a part of

all activities, beginning with bathing, preparing food

for the family, and spending time, which will bring

about a sense of comfort and security for each family.

This is consistent with the research results of

Wahyudi et al., who showed that a terrible

environment could disturb the balance of the agent-

host interaction process. If one feature is disrupted,

the occurrence of disease in the host can be affected.

An unsanitary environment also increases the

possibility of disease agents forming and increases

illness transmission (Wahyudi et al., 2019).

People who live in slums and begin to complain

about their health's diminishing quality must be

taught the importance of protecting the health of their

surroundings. This is supported by the behaviour of

people who are still unaware of the importance of

environmental protection, as evidenced by research

findings that, in terms of occupant behaviour, as

many as 50% of people in flats and slum settlements

are unaware of the importance of environmental

protection. People's habits of not opening their

bedroom windows, not cleaning the yard, dropping

babies' and toddlers' faeces into the toilet, and not

throwing trash into the trash can demonstrate that this

Household Sanitation Inequalities in Flats, Slum Areas, and Residences in Achieving the Criteria for Healthy Housing, Samarinda City

conduct is harmful to human health. Nurlaila's (2022)

research demonstrates that diseases such as diarrhoea

can be induced by poor habits. The analysis results

reveal that there are independent variables that have a

significant link with the incidence of diarrhoea

because all analyses had a p-value greater than 0.05.

This study concluded that there was a link between

diarrhoea and low sanitation in the environment.

Several studies have found that sanitation

facilities and occupant behaviour have a major impact

on illness incidence. One example is a study

conducted by Herawati et al. (2020), which found an

association between sanitation facility quality (p =

0.000) and occupant behavior (p = 0.000) and

stunting incidence. The incidence of stunting had no

correlation with the quality of CTPS held by moms (p

= 0.116; OR = 3.923; CI 95% = 0.678–22.705).

However, because they have an OR higher than one,

these three variables represent risk factors for stunting

incidences.

Based on the research results, the assessment of

the criteria for healthy housing in residences is also

very good and of high quality, but for slum areas and

flats, there are still a number of houses that do not

fulfil the criteria for sanitation facilities and the

behaviour of their people. This can be influenced by

a person's economic and social status in that area.

This theory is consistent with the research results of

Kusumawati et al. (2015), who found an association

between knowledge of healthy homes and occupancy

quality, a relation between social status and the

economy and housing quality, and a connection

between knowledge of healthy homes and

socioeconomic status and housing quality.

As a result, it can be inferred that everyone

requires a healthy home for their family in order to

adequately enhance their health state because an

unhealthy home reduces work productivity and

utilization. The components in the building's physical

condition indicate that it appears to be quite

satisfactory, implying that the majority of

respondents live in residential areas since they are

supported by qualified sanitation facilities.

5 CONCLUSIONS

The housing component does not have a significant

relationship in determining the criteria for a healthy

home, while sanitation facilities and occupant

behaviour are closely related in determining the

criteria for a healthy home in Samarinda. Only the

flats are suitable for the criteria when looking at the

house's components. Slum areas are unable to fulfil

the criteria for sanitation facilities. All occupants who

are living in residences are aware of the environment.

The importance of the dissemination of knowledge in

fulfilling the criteria for a healthy household in

reducing disease and improving public health.

ACKNOWLEDGEMENTS

Our appreciation is given to the Department of

Environmental Health, Faculty of Public Health,

Mulawarman University, for facilitating our research

and the conference.

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