Diare masih menjadi masalah kesehatan masyarakat signifikan, khususnya pada balita. Salah satu upaya penanggulangannya di Indonesia adalah melalui program Sanitasi Total Berbasis Masyarakat (STBM) yang mencakup lima pilar. Penelitian ini bertujuan menganalisis pengaruh pelaksanaan lima pilar STBM terhadap kejadian diare balita di Pulau Jawa tahun 2023. Penelitian menggunakan desain studi ekologi dengan pendekatan kuantitatif dan analisis regresi negatif binomial. Data sekunder diambil dari Profil Kesehatan Provinsi empat provinsi di Pulau Jawa (Banten, Jawa Barat, Jawa Tengah, dan Jawa Timur), mencakup 99 kabupaten/kota. Variabel yang dianalisis adalah persentase capaian lima pilar STBM dan jumlah kasus diare balita terkonfirmasi. Hasil analisis menunjukkan tiga pilar—SBABS (Stop Buang Air Besar Sembarangan), PSRT (Pengelolaan Sampah Rumah Tangga), dan PLCRT (Pengelolaan Limbah Cair Rumah Tangga)—berpengaruh signifikan terhadap kejadian diare balita (p < 0,05). Peningkatan pelaksanaan SBABS dan PLCRT menurunkan risiko diare masing-masing sebesar 1,65% dan 2,57%, sedangkan PSRT justru meningkatkan risiko sebesar 3,37%. Pilar CTPS dan PAMMRT menunjukkan arah negatif, namun tidak signifikan. Pemerintah perlu menguatkan lintas sektor serta evaluasi berkala agar pelaksanaan STBM lebih efektif.

Diarrhea remains a major public health issue, particularly among children under five. One of Indonesia’s strategies to address this is the Community-Based Total Sanitation (STBM) program, which consists of five pillars. This study aims to analyze the influence of the five STBM pillars on the incidence of diarrhea among children under five in Java Island in 2023. An ecological study design with a quantitative approach and negative binomial regression analysis was used. Secondary data were obtained from the Provincial Health Profiles of four provinces in Java (Banten, West Java, Central Java, and East Java), covering 99 districts/cities. Variables analyzed included the percentage implementations of the five STBM pillars and the number of confirmed diarrhea cases in children under five. The results showed that three pillars—SBABS (Stop Open Defecation), PSRT (Household Waste Management), and PLCRT (Household Wastewater Management)—had a statistically significant effect on diarrhea incidence (p < 0.05). Increased implementation of SBABS and PLCRT reduced diarrhea risk by 1.65% and 2.57%, respectively, while PSRT was associated with a 3.37% increase. CTPS (Handwashing with Soap) and PAMMRT (Drinking Water and Food Management) showed a negative but non-significant association. Strengthened cross-sector efforts and regular evaluations are recommended to enhance STBM effectiveness.