Effectiveness of a community-based water, sanitation, and hygiene (WASH) intervention in reduction of diarrhoea among under-five children: Evidence from a repeated cross-sectional study (2007–2015) in rural Bangladesh

Dey, Nepal C.; Parvez, Mahmood; Islam, Mir Raihanul; Mistry, Sabuj Kanti; Levine, David I.

doi:10.1016/j.ijheh.2019.08.006

Cited by 37 publications

(51 citation statements)

References 32 publications

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“…It further leads to an increase in the risk of morbidity among household members. Our finding is consistent with other studies [30][31][32][33][34][35][36][47][48][49][50][51][52][53]. The unhygienic household environment causes morbidity among household members which leads to absenteeism from work thereby reduces the marginal productivity of the workers and causes decline in household income [42,54].…”

Section: Discussionsupporting

confidence: 92%

Impact of change in household environment condition on morbidity in India: Evidence from longitudinal data

Brahmanandam

Nagarajan

2021

PLoS ONE

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Background Household environment condition is an important predictor of morbidity of the household members. Without forming a healthy household environment, creating a healthy population is not possible. In this background, this study assesses the impact of change in household environment conditions on morbidity. Methods For the empirical analysis purpose of this study, we used two waves of longitudinal data from India Human Development Survey (2004–05, 2011–12). This study is based on 34131 re-contacted households in 2011–12 from the base year 2005. The bivariate and ANOVA tests were performed to assess any short-term morbidity (diarrhoea, fever and cough) with respect to change in household environment condition from 2005 to 2011. The multivariate linear regression was performed to assess the impact of change in household environment conditions on morbidity. The multinomial logistic regression was used to assess the impact of change in household environment condition on change in morbidity. Results The results from multivariate linear regression have shown that the share of household members fell sick due to any short-term morbidity (ASM) was significantly lower (β = –0.060, P<0.001) among the households who lived in clean environment condition in both the periods, 2004–05 and in 2011–12 as compared to those who were living in poor environment condition in both periods net of other socio-economic characteristics of the households. The share of household members fell sick due to any short-term morbidity has significantly declined (β = –0.051, P<0.001) among the household whose household environment condition has changed from poor in 2004–05 to clean environment in 2011–12 as compared to the households who have lived in poor environment condition in both periods in 2004–05 and 2011–12. The results of adjusted percentage from multinomial logistic regression have shown that the household members who fell sick with ASM was remained higher (4.9%; P<0.05) among the households whose environment condition was remained poor in both years in 2005 and 2011 as compared to the other households (2.7%) who remained in the better-off condition in both years in 2005 and 2011. Conclusion Considering the findings of the study, we suggest that ongoing government flagships programmes such as Swacch Bharat Mission (Clean India Mission), Pradhan Mantri Ujjwala Yojana (Prime Minister Clean Energy Scheme) and Pradhan Mantri Awas Yojana (Prime Minister Housing Scheme), and Jal Jeevan Mission (Improved Source of Drinking Water Scheme) should work in tandem to improve household environment conditions.

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Section: Discussionsupporting

confidence: 92%

Impact of change in household environment condition on morbidity in India: Evidence from longitudinal data

Brahmanandam

Nagarajan

2021

PLoS ONE

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“…This is almost consistent with a previous similar study, which found unsafe child feces disposal reported by 67% of households in Ethiopia [14]. However, this figure was lower than unsafe child faces disposal reported from India 79% [3], 72.4% [21], and Bangladesh 80% [20,25], 84% [26]. This discrepancy may due to the operational definition used in classifying unsafe child stool disposal; as the study from Bangladesh includes buried as safe child feces disposal [20].…”

Section: Discussionsupporting

confidence: 91%

Geographical variation and factors associated with unsafe child stool disposal in Ethiopia: A spatial and multilevel analysis

Sahiledengle

Teferu

Tekalegn

et al. 2020

Preprint

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Background: Unsafe disposal of childrens stool makes children susceptible to fecaloral diseases and children remain vulnerable till the stools of all children are disposed of safely. There is a paucity of data on spatial distribution and factors associated with unsafe child stool disposal in Ethiopia. Previous estimates, however, do not include information regarding individual and community level factors associated with unsafe child stool disposal. Hence, the current study aimed to explore the spatial distribution and to identify factors associated with unsafe child stool disposal in Ethiopia. Methods: A secondary data analysis was conducted using the recent 2016 Ethiopian demographic and health survey data. A total of 4145 children aged 0 to 23 months with their mother were included in this analysis. The Getis Ord spatial statistical tool was used to identify high and low hotspots areas of unsafe child stool disposal. The Bernoulli model was applied using Kilduff SaTScan version 9.6 software to identify significant spatial clusters. A multilevel binary logistic regression model was fitted to identify factors associated with unsafe child stool disposal. Results: Unsafe child stool disposal was spatially clustered in Ethiopia (Morans Index 0.211, p value< 0.0001), and significant spatial SaTScan clusters of areas with a high rate of unsafe child stool disposal were detected. The most likely primary SaTScan cluster was detected in Tigray, Amhara, Afar (north), and Benishangul Gumuz (north) regions (LLR: 41.62, p<0.0001). Unsafe child stool disposal is more prevalent among households that had unimproved toilet facility (AOR=1.54, 95%CI: 1.17-2.02), and those with high community poorer level (AOR: 1.74, 95%CI: 1.23-2.46). Higher prevalence of unsafe child stool disposal was also found in households with poor wealth quintiles. Children belong to agrarian regions (AOR: 0.62, 95%CI 0.42-0.91), children 6/11 months of age (AOR: 0.66, 95%CI: 0.52-0.83), 12-17 months of age (AOR: 0.68, 95%CI: 0.54-0.86), and 18/23 months of age (AOR: 0.58, 95%CI: 0.45-0.74) had lower odds of unsafe child stool disposal. Conclusions: Unsafe child stool disposal was spatially clustered. Higher odds of unsafe child stool disposal were found in households with high community poverty level, poor, unimproved toilet facility, and with the youngest children. Hence, the health authorities could tailor effective child stool management programs to mitigate the inequalities identified in this study. It is also better to consider child stool management intervention in existing sanitation activities considering the identified factors.

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“…According to the recent EDHS report, one in three households have no toilet facility and children's stools are more likely to be disposed of unsafely in households that use open defecation and have no toilet facility [11]. Relatively higher unsafe child stool disposal was also reported from studies done in India 72.4%-79% [3,21] and Bangladesh 80%-84% [20,27,28]. The inconsistency between studies maybe due to the fact that in the aforementioned studies the operational definition utilized in classifying unsafe child stool disposal incorporates buried as safe child feces disposal [20].…”

Section: Discussionmentioning

confidence: 99%

Geographical variation and factors associated with unsafe child stool disposal in Ethiopia: A spatial and multilevel analysis

et al. 2021

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Background Unsafe disposal of children’s stool makes children susceptible to fecal-oral diseases and children remain vulnerable till the stools of all children are disposed of safely. There is a paucity of data on spatial distribution and factors associated with unsafe child stool disposal in Ethiopia. Previous estimates, however, do not include information regarding individual and community-level factors associated with unsafe child stool disposal. Hence, the current study aimed (i) to explore the spatial distribution and (ii) to identify factors associated with unsafe child stool disposal in Ethiopia. Methods A secondary data analysis was conducted using the recent 2016 Ethiopian demographic and health survey data. A total of 4145 children aged 0–23 months with their mother were included in this analysis. The Getis-Ord spatial statistical tool was used to identify high and low hotspots areas of unsafe child stool disposal. The Bernoulli model was applied using Kilduff SaTScan version 9.6 software to identify significant spatial clusters. A multilevel multivariable logistic regression model was fitted to identify factors associated with unsafe child stool disposal. Results Unsafe child stool disposal was spatially clustered in Ethiopia (Moran’s Index = 0.211, p-value< 0.0001), and significant spatial SaTScan clusters of areas with a high rate of unsafe child stool disposal were detected. The most likely primary SaTScan cluster was detected in Tigray, Amhara, Afar (north), and Benishangul-Gumuz (north) regions (LLR: 41.62, p<0.0001). Unsafe child stool disposal is more prevalent among households that had unimproved toilet facility (AOR = 1.54, 95%CI: 1.17–2.02) and those with high community poorer level (AOR: 1.74, 95%CI: 1.23–2.46). Higher prevalence of unsafe child stool disposal was also found in households with poor wealth quintiles. Children belong to agrarian regions (AOR: 0.62, 95%CI 0.42–0.91), children 6–11 months of age (AOR: 0.65, 95%CI: 0.52–0.83), 12–17 months of age (AOR: 0.68, 95%CI: 0.54–0.86), and 18–23 months of age (AOR: 0.58, 95%CI: 0.45–0.75) had lower odds of unsafe child stool disposal. Conclusions Unsafe child stool disposal was spatially clustered. Higher odds of unsafe child stool disposal were found in households with high community poverty level, poor, unimproved toilet facility, and with the youngest children. Hence, the health authorities could tailor effective child stool management programs to mitigate the inequalities identified in this study. It is also better to consider child stool management intervention in existing sanitation activities considering the identified factors.

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Effectiveness of a community-based water, sanitation, and hygiene (WASH) intervention in reduction of diarrhoea among under-five children: Evidence from a repeated cross-sectional study (2007–2015) in rural Bangladesh

Cited by 37 publications

References 32 publications

Impact of change in household environment condition on morbidity in India: Evidence from longitudinal data

Impact of change in household environment condition on morbidity in India: Evidence from longitudinal data

Geographical variation and factors associated with unsafe child stool disposal in Ethiopia: A spatial and multilevel analysis

Geographical variation and factors associated with unsafe child stool disposal in Ethiopia: A spatial and multilevel analysis

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