Unsafe child feces disposal status in Ethiopia: what factors matter? analysis of pooled data from four demographic and health surveys

Abstract

Background: The only safest way to dispose of a child’s feces is to help the child use a toilet or, for very young children, to put or rinse their feces into a toilet; whereas all other disposals are considered unsafe (feces put/rinsed into a drain or ditch, bush or thrown into the garbage, buried or left on the ground, and not disposed of). The study aims to determine the magnitude and factors associated with unsafe child feces disposal in Ethiopia.Methods: The study is cross-sectional in nature and based on the pooled data from the four rounds of Demographic and Health Surveys (DHS) conducted in Ethiopia (2000-16). Data on child feces disposal practice was collected for all children born during the five years preceding survey. To get detail about the disposal of children’s feces, mothers of under-five children were asked, “The last time passed stools, what was done to dispose of the stools?” with respect to the youngest child born. Descriptive statistics were computed to illustrate the given data. Multivariable logistic regression was performed to identify factors associated with unsafe child feces disposal. Results: The pooled dataset contains data for 40,520 children younger than 5 years, male accounts 20,629 (50.9%). Overall, 77.7% (95%CI: 76.3-79.0) of children feces disposed of unsafely. In the multivariable logistic regression model, those mothers whose child was 13-24 months [AOR: 0.68, 95% CI: (0.60-0.78)] and ≥ 25 months [AOR: 0.66, 95% CI: (0.60-0.72)] were lower odds of unsafe child’s feces disposal. Children born into households having two or fewer children were 33% lower [AOR: 0.67, 95% CI: (0.56-0.79)] odds of unsafe child’s feces disposal than their counterparts. The odds of disposing of feces unsafely among households having improved toilet facility was 76% lower [AOR: 0.24, 95% CI: (0.19-0.29)] that of households lacking such facilities. Further, being an urban resident, having improved drinking water facility, a high level of maternal and paternal education, paternal occupational status (work in non-agriculture), and maternal age (25-34 and ≥ 35 years) were factors associated with lower odds of unsafe child's feces disposal.Conclusions: Three in four Ethiopian children feces disposed of unsafely. Household and socio-demographic factors, such as access to improved water and toilet facility, area of a resident (urban), the child’s age (older age), and both higher maternal and paternal education levels were significantly associated with lower odds of unsafe child feces disposal.

Safe stool disposal and associated factors among mothers of children under-two age in Gambia: Evidence from Gambia Demographic Health Survey 2019/20

“…Those from rich households were less likely to dispose of stool as compared with those from the poor wealth quantiles. Although many studies have revealed that, the highest wealth quantile increases the likelihood of safe waste disposal (16,20,22,30). The ndings of our study are in contrary to those ndings.…”

“…The prevalence of safe stool disposal among mothers whose child was aged below two years of age was 56.3%( 95%CI: 54.5%, 58.1%)). The nding of the study is higher than studies done in Eswatini, Ethiopia, Bangladesh, India, and Orissa (3,15,20,23,24). On the other hands, the nding of the current study is lower than the study conducted in Malawi, Cambodia and Sub-Saharan Africa (19,25,26).…”

“…Different studies have been done on safe child stool disposal and associated factors among children but there is no study done in Gambia. Among the studies that investigated child feces disposal, most found that the age of the child, maternal age, maternal education, household wealth index, number of children, number of children,sex of the child, availability of toilet facility, improved drinking water, number of living under-ve children and history of diarrhea (18) (19) (20). According to the Gambia Demographic Health Survey (GDHS) 2019/20, safe child stool disposal among children under the age of 2 years has been decreased from 82% in 2013 to 56% in 2019-20.…”

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

“…Mothers' access to information through mass media (television and radio), and ANC attendance may enhance safe children's faeces disposal practice. Several authors [19,23,42] have explained that women exposed to media and those who attend ANC are more likely to have information on positive attitudes and may value the importance of safe disposal of children's stools. Other scholars have also postulated that mothers who have exposure to media and those who attend ANC are more exposed and in a better position to understand the causes of childhood illnesses and consider the practice of hygienic behaviours, such as safe disposal of children's stool and other childcare practices (e.g., good grooming), as significant in protecting their children from illness [19,50].…”

“…Hence, gathering empirical evidence is essential, considering the challenges with sanitation practices in a number of sub-Saharan African countries [8]. Moreover, in examining the predictors of safe disposal of children's stool, only few studies [19][20][21][22] used nationally-representative surveys and multilevel modelling [19,20,23] to better account for the hierarchical data structure of the surveys. To the best of our knowledge, there has not been any multi-country study on the predictors of safe stool disposal.…”