Water pollution and sanitation in Indonesia: a review on water quality, health and environmental impacts, management, and future challenges

As an archipelagic tropical developing country, Indonesia is characterized by vast expanses of rural and isolated areas. This review aims to discuss water pollution and sanitation's existing condition, health, and environmental impacts, alongside its management and challenges in Indonesia. The systematic review approach was utilized to ensure transparency and replicability, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Many water sources in Indonesia are contaminated by various pollutants such as heavy metals, microplastics, pesticides, and endocrine-disrupting chemicals (EDCs). Moreover, the existing water and wastewater treatment plants cannot completely remove pollutants, including bacteria that cause waterborne diseases. The lack of proper sanitation facilities, including toilets and latrines, is not only reported in rural areas but also in peri-urban regions of Indonesia. This situation forces many to rely on unimproved water sources, such as river water, for their daily use and engage in open defecation, which may increase the risk of direct exposure to waterborne contaminants. Insufficient sanitation has been linked to significant public health issues in Indonesia, including maternal health complications, childhood stunting, and an increased incidence of waterborne diseases such as diarrhea. Based on the findings of this review, Indonesia still needs to improve its sanitation and water treatment facilities, as well as reduce pollution of the aquatic environment. This condition not only illustrates the condition of water and sanitation in Indonesia but can also be used as an illustration of how developing countries face various pollution and sanitation problems during the massive development and industry.