Diarrhoea is an important health issue in low- and middle-income countries, including Indonesia. We applied a multilevel regression analysis on the Indonesian Demographic and Health Survey to examine the effects of drinking water and sanitation facilities at the household and community level on diarrhoea prevalence among children under five (n = 33,339). The role of the circumstances was explored by studying interactions between the water and sanitation variables and other risk factors. Diarrhoea prevalence was reported by 4820 (14.4%) children, who on average were younger, poorer and were living in a poorer environment. At the household level, piped water was significantly associated with diarrhoea prevalence (OR = 0.797, 95% CI: 0.692–0.918), improved sanitation had no direct effect (OR = 0.992, 95% CI: 0.899–1.096) and water treatment was not related to diarrhoea incidence (OR = 1.106, 95% CI: 0.994–1.232). At the community level, improved water coverage had no direct effect (OR = 1.002, 95% CI: 0.950–1.057) but improved sanitation coverage was associated with lower diarrhoea prevalence (OR = 0.917, 95% CI: 0.843–0.998). Our interaction analysis showed that the protective effects of better sanitation at the community level were increased by better drinking water at the community level. This illustrates the importance of improving both drinking water and sanitation simultaneously.

Clean water provision remains a serious problem in low- and middle-income countries. In 2017, about 30% of the world population relied on unimproved water sources located outside of the dwellings. Often women and children are occupied in fetching water. This situation increases the prevalence of water-related diseases such as diarrhoea and reduces children's study time. School attendance may decrease due to the combined effects of diarrhoea and time spent on fetching water. We investigate the effects on school absenteeism and primary school enrolment in Indonesia, using a panel data set for 295 districts over the period 1994–2014. Districts with higher diarrhoea prevalence are found to have lower school enrolment (B: −0.202, sig p < 0.01) and higher school absenteeism (B: 2.334, sig p < 0.001). Districts, where more households have access to private water facilities, have higher school enrolment (B: 0.025, sig p < 0.01) and lower school absenteeism (B: −0.027, sig p < 0.01). More use of piped and bottled water in a district is associated with a lower diarrhoea prevalence (B: −0.004, sig p < 0.05). Policy-makers should take the benefits of improved water supply into account when making cost–benefit analyses regarding investments in water infrastructure.

In recent years, the consumption of refillable bottled water has increased considerably in emerging countries. However, the quality of this water is often questionable, as authorities lack the capacity to properly check refilling depots. Given that refillable bottled water not only replaces unimproved water sources, but also better-quality sources, like piped and branded bottled water, its increasing use poses a major health risk. We investigate the motives behind the decision to switch to refillable bottled water in Indonesia. Findings indicate that this switch is driven by lifestyle motives, as well as by cost and availability considerations. It is mostly the young affluent households who switch from piped and ‘other’ sources to refillable bottled water. In rural areas, the tendency to make this switch is negatively affected by availability problems and the higher price of refillable bottled water. Availability and cost also influence the switch from branded bottled to refillable bottled water, but here it is the poorer households who have a higher propensity to switch. Further exploration of the lifestyle motive and affordability issues, as well as better monitoring of the refilling depots, are needed to improve the quality of drinking water in Indonesia and other emerging countries.

The sustainable development goals (SDGs) provide an integrated framework of targets and indicators, including the elimination of stunting, to support better development planning. Indonesia faces a significant challenge as it ranks fourth globally in terms of stunting prevalence, exacerbated by disparities across regions, gender, and socioeconomic status, further compounded by the ongoing COVID-19 pandemic. Given the interlinked nature of SDGs, this study provides empirical support for the prioritization of SDG indicators, primarily in the context of stunting elimination at the district level in Indonesia. This study employed a combination of economic complexity and network theory, utilizing data from a comprehensive set of 54 indicators spanning 28 targets within 13 SDG goals in 514 districts. The analysis is based on network metrics, including revealed comparative advantage (RCA), proximity, centrality, and density to establish the SDG interlinkage network and identify key priority indicators. The findings highlight the importance of prioritizing indicators such as civil registration, health facilities and services, access to basic facilities and housing, and access to ICT in efforts to reduce stunting, particularly among disadvantaged households. Given the unique resources and capacities of each region, our analysis offers district-specific prioritization strategies for stunting elimination.