Diare pada anak masih menjadi masalah kesehatan masyarakat yang penting di Malawi. Survei Demografi dan Kesehatan Malawi (MDHS) tahun 2015–2016 dan 2024 sama-sama melaporkan prevalensi diare sekitar 22%, yang menunjukkan belum adanya penurunan yang berarti selama satu dekade terakhir. Penelitian ini bertujuan menganalisis hubungan antara faktor air, sanitasi, dan higiene rumah tangga (WASH) dengan diare pada anak balita di Malawi. Penelitian ini menggunakan desain potong lintang dengan data Malawi Demographic and Health Survey (MDHS) 2024, yang mencakup 23.070 rumah tangga dan 12.312 anak balita. Setelah penerapan kriteria inklusi dan eksklusi, sebanyak 11.514 anak balita diikutsertakan dalam analisis. Analisis dilakukan menggunakan Complex Samples Logistic Regression (CSLOGISTIC) dengan mempertimbangkan faktor anak, ibu, rumah tangga, dan geografis.Prevalensi diare dalam dua minggu terakhir adalah 22,4%. Akses terhadap sumber air minum layak tergolong tinggi, namun cakupan sanitasi layak, pengolahan air minum rumah tangga, dan fasilitas cuci tangan dengan sabun dan air masih rendah. Setelah penyesuaian, sanitasi tidak layak dan tidak adanya pengolahan air minum rumah tangga berhubungan dengan peningkatan peluang diare pada anak. Usia anak, usia ibu, pendidikan ibu, dan status pekerjaan ibu juga berhubungan signifikan dengan kejadian diare. Hubungan antara sanitasi dan diare lebih kuat pada anak yang tinggal di daerah perdesaan dibandingkan daerah perkotaan. Hasil penelitian menunjukkan bahwa peningkatan sanitasi, pengolahan air minum rumah tangga, dan intervensi yang berfokus pada kelompok rentan berpotensi mengurangi beban diare pada anak di Malawi.

Childhood diarrhoea remains a major public health problem among children under five years of age in Malawi. The Malawi Demographic and Health Surveys (MDHS) 2015–2016 and 2024 both reported a diarrhoea prevalence of approximately 22%, indicating limited progress in reducing the burden of the disease over the past decade. This study examined the association between household water, sanitation, and hygiene (WASH) factors and childhood diarrhoea among children under five years of age in Malawi. A cross-sectional study was conducted using data from the 2024 Malawi Demographic and Health Survey, which surveyed 23,070 households and identified 12,312 children under five years of age. After applying the inclusion and exclusion criteria, 11,514 children were included in the analysis. Complex Samples Logistic Regression (CSLOGISTIC) was used to assess the association between household WASH factors and childhood diarrhoea while accounting for child, maternal, household, and geographic factors. The two-week prevalence of childhood diarrhoea was 22.4%. Access to improved drinking water sources was high, but coverage of improved sanitation facilities, household water treatment, and handwashing facilities with soap and water remained low. After adjustment, unimproved sanitation facilities and lack of household water treatment were independently associated with higher odds of childhood diarrhoea. Child age, maternal age, maternal education, and maternal employment status were also significant predictors. The association between sanitation facilities and childhood diarrhoea was stronger among rural children than among urban children. Childhood diarrhoea remains a persistent public health challenge in Malawi. Improving sanitation infrastructure, promoting household water treatment, and strengthening interventions targeting vulnerable children and mothers may contribute to reducing the burden of childhood diarrhoeal disease.