Abstract
Diarrhea remains an important cause of morbidity and mortality among under-five children, particularly where socioeconomic constraints and inadequate sanitation intersect. This study analyzed the associations of parental income, waste disposal, wastewater drainage, and bioethical dimensions of sanitation access with diarrhea among under-five children in the Banjar I Primary Health Center area, Singaraja. We conducted an analytic observational cross-sectional study involving 100 mothers of children aged 1 to 5 years. We collected data through structured questionnaires and observation and analyzed associations using Chi-square tests in SPSS version 27. Low parental income characterized 64% of respondents, while 56% of children experienced diarrhea. Diarrhea showed significant associations with parental income (p < 0.001), waste disposal (p < 0.001), wastewater drainage (p < 0.001), autonomy in sanitation-related decision making (p = 0.009), and justice in access to waste collection and wastewater infrastructure (p < 0.001). These findings indicate that diarrhea prevention requires more than household behavioral change. Public health strategies should combine socioeconomic support, compliant household sanitation, informed decision making, and equitable sanitation services across communities.