Individual and contextual factors associated with disposal of children’s stools in Papua New Guinea: evidence from the 2016–2018 demographic and health survey

Abstract

Background Proper sanitation has been one of the topmost priorities on the global public health agenda. In the past few decades, sanitation programs targeting households have often paid little attention to the disposal of children’s stools. We assessed the individual and contextual factors associated with disposal of children’s faeces in Papua New Guinea. Methods The data used for this study forms part of the 2016–2018 Papua New Guinea Demographic and Health Survey (PDHS). For this study, we focused on women with children less than five years (n = 2095). Both descriptive and inferential analyses were carried out. Descriptive statistics were used to summarize the data, using frequency counts and percentages. The inferential analysis used multilevel logistic regression models to investigate the individual and contextual factors associated with disposal of children’s stools. These models were presented as adjusted odds ratio (AORs), together with their corresponding 95% confidence intervals. Statistical significance was set at p < 0.05. Results More than half (56%) of the women had disposed of their children’s stools unsafely. With the individual level factors, the results showed that women with children < 12 months [AOR =1.71; CI = 1.28–2.29] and women aged 20–24 [AOR =2.58; CI = 1.24–5.37], 35–39 [AOR =2.34; CI = 1.09–5.04], and 40 years and above [AOR =2.51; CI = 1.09–5.79] were more likely to practice unsafe disposal of children’s stool. The odds of unsafe disposal of faeces was also higher among women who visited the health facility for child diarrhea [AOR =1.69; CI = 1.25–2.28]. With the contextual factors, the odds of unsafe disposal of children’s stool was higher among women who lived in the Southern region [AOR =4.82; CI = 2.08–11.18], those who lived in male-headed households [AOR =1.79; CI = 1.19–2.70], and those who had unimproved toilet facilities [AOR =1.96; CI = 1.39–2.76]. On the contrary, women with unimproved source of drinking water were less likely to dispose of their children’s stool unsafely [AOR =0.54; CI = 0.35–0.83]. Conclusion Both individual and contextual factors predict unsafe disposal of children’s faeces in Papua New Guinea. It is recommended that sanitation programs should focus on behavioral change and not only on the extension of water and improved toilet facilities. Such programs should also focus on both individual and contextual factors of women.

Associated factors of safe child feces disposal in sub-Saharan Africa: Evidence from recent demographic and health surveys of 34 sub-Saharan countries

“…The current study also showed that improved water supply was associated with safe child feces disposal which is in line with other studies in Guinea [ 23 ] and Nigeria [ 37 ]. Accessibility of improved water is a strategy to reduce the susceptibility of children to diarrhea and other poor sanitation-induced health conditions.…”

A multilevel analysis of individual and contextual factors associated with the practice of safe disposal of children’s faeces in sub-Saharan Africa

“…Unlike previous studies that found no association between mothers' education and safe disposal of child stools [20][21][22]49], this present study revealed that mothers without formal education were more likely to practise safe disposal. This finding seems counter-intuitive; however, the absence of formal education does not imply the absence of health education or knowledge on personal hygiene.…”

Unsafe fecal disposal practices in children and the nexus with childhood diarrhea in low- and middle-income countries: a systematic review and meta-analysis

“…Azage & Haile 2015;Cronin et al 2016;Bawankule et al 2017;Islam et al 2018;Aliyu & Dahiru 2019;Sahiledengle 2019Sahiledengle , 2020Seidu et al 2020Seidu et al , 2021Simelane et al 2020;Getahun & Adane 2021;Soboksa 2021;Soboksa et al 2021;Vong et al 2021), while 6 studies were of moderate(Wilunda & Alessio 2009;Siruri 2013;Mihrete et al 2014;Aluko et al 2017;Sidabalok et al 2019;Alemayehu et al 2021) according to our assessment (Supplementary Material, Table…”

“…Several studies done in Nepal (Lamichhane et al 2018), Indonesia (Cronin et al 2016), Thailand (Wilunda & Alessio 2009), Cambodia (Vong et al 2021), India (Bawankule et al 2017), and Kenya (World Bank/UNICEF 2015) have linked unsafe fecal disposal to an increased risk of childhood diarrhea. However, studies conducted in Ethiopia (Sahiledengle 2020), Papua New Guinea (Seidu et al 2020), Nigeria (Aluko et al 2017), and Eswatini (Simelane et al 2020) found that unsafe fecal disposal in children reduces the risk of childhood diarrhea. It might be that the availability of physical infrastructure alone is insufficient to assure the adoption of safe child feces disposal practices.…”

“…Prevalence of unsafe child feces disposalAs shown in Figure2, based on 20 studies with 240,706 participants, the pooled prevalence of unsafe children's feces disposal practice among mothers/guardians was 52.63% (95% CI: 0.43-0.62)(Wilunda & Alessio 2009;Siruri 2013;Mihrete et al 2014;Azage & Haile 2015;Cronin et al 2016;Aluko et al 2017;Bawankule et al 2017;Aliyu & Dahiru 2019;Sahiledengle 2019Sahiledengle , 2020Islam et al 2020;Seidu et al 2020Seidu et al , 2021Simelane et al 2020;Alemayehu et al 2021;Getahun & Adane 2021;Soboksa 2021;Soboksa et al 2021;Vong et al 2021).…”