Associations of WHO/UNICEF Joint Monitoring Program (JMP) Water, Sanitation and Hygiene (WASH) Service Ladder service levels and sociodemographic factors with diarrhoeal disease among children under 5 years in Bishoftu town, Ethiopia: a cross-sectional study
Vivian Hoffmann,
Masresha Tessema,
Sisay Derso Mengesha,
Danial Abera Dinssa,
Getachew Tollera,
Aderajew Mekonnen Girmay,
Abel Weldetinsae,
Ermias Alemayehu Adugna,
Zinabu Assefa Alemu,
Bedasa Wagari,
Melaku Gizaw Serte,
Kaleab Sebsibe Awoke,
Tesfaye Legesse Bedada,
Mesaye Getachew Weldegebriel,
Tsigereda Assefa Alemayehu,
Moa Abate Kenea,
Kirubel Tesfaye Tekulu,
Waktole Gobena,
Getinet Fikresilassie,
Wendayehu Wube,
Abayew Wassie Melese,
Ekram Redwan
Affiliations
Vivian Hoffmann
Department of Economics and School of Public Policy and Administration, Carleton University, Ottawa, Ontario, Canada
Masresha Tessema
Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Sisay Derso Mengesha
Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Danial Abera Dinssa
Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Getachew Tollera
Health System and Reproductive Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Aderajew Mekonnen Girmay
Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Abel Weldetinsae
Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Ermias Alemayehu Adugna
Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Zinabu Assefa Alemu
Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Bedasa Wagari
Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Melaku Gizaw Serte
Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Kaleab Sebsibe Awoke
Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Tesfaye Legesse Bedada
Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Mesaye Getachew Weldegebriel
Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Tsigereda Assefa Alemayehu
Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Moa Abate Kenea
Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Kirubel Tesfaye Tekulu
Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Waktole Gobena
Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Getinet Fikresilassie
Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Wendayehu Wube
Department of Hygiene and Environmental Health, Ministry of Health, Addis Ababa, Ethiopia
Abayew Wassie Melese
Department of Hygiene and Environmental Health, Ministry of Health, Addis Ababa, Ethiopia
Ekram Redwan
Department of Hygiene and Environmental Health, Ministry of Health, Addis Ababa, Ethiopia
Objective To determine the associations of WHO/UNICEF Joint Monitoring Program Water, Sanitation and Hygiene (WASH) Service Ladder service levels and sociodemographic factors with diarrhoeal disease among children under 5 years in Bishoftu town, Ethiopia.Design A community-based cross-sectional study.Setting Bishoftu town, Ethiopia, January–February 2022.Participants A total of 1807 mothers with at least one child under 5 years were included. Sociodemographic and WASH variables were collected using a structured questionnaire. 378 drinking water samples were collected.Outcome The response variable was diarrhoeal disease among children under 5 years.Results The 2-week prevalence of diarrhoeal disease among children under 5 years was 14.8%. Illiteracy (adjusted OR 3.15; 95% CI 1.54 to 6.47), occupation (0.35; 0.20 to 0.62), mother’s age (1.63; 1.15 to 2.31), family size (2.38; 1.68 to 3.39), wealth index (5.91; 3.01 to 11.59), residence type (1.98; 1.35 to 2.90), sex of the child (1.62; 1.17 to 2.24), child’s age (3.52; 2.51 to 4.93), breastfeeding status (2.83; 1.74 to 4.59), food storage practice (3.49; 1.74 to 8.26), unimproved drinking water source (8.16; 1.69 to 39.46), limited drinking water service (4.68; 1.47 to 14.95), open defecation practice (5.17; 1.95 to 13.70), unimproved sanitation service (2.74; 1.60 to 4.67), limited sanitation service (1.71; 1.10 to 2.65), no hygiene service (3.43; 1.91 to 6.16) and limited hygiene service (2.13; 1.17 to 3.86) were significantly associated with diarrhoeal disease.Conclusion In this study, diarrhoea among children is a significant health issue. Child’s age, drinking water service, residence type and hygiene service were the largest contributors with respect to the prevalence of diarrhoeal disease. This investigation provides information that could help to inform interventions to reduce childhood diarrhoea. The findings suggest that state authorities should initiate robust WASH strategies to achieve the Sustainable Development Goal 3 agenda.
