Determinants of Diarrhea in Under-Five Children Among Health Extension Model and Non-Model Families in Wama Hagelo District, West Ethiopia: Community-Based Comparative Cross-Sectional Study

Abstract

Desalegn Bekele,1 Elias Merdassa,1 Markos Desalegn,1 Getu Mosisa,2 Ebisa Turi1 1Department of Public Health, Wollega University, Nekemte, Oromia Region, Ethiopia; 2School of Nursing and Midwifery, Wollega University, Nekemte, Oromia Region, EthiopiaCorrespondence: Markos DesalegnDepartment of Public Health, Wollega University, Nekemte, Oromia Region, EthiopiaTel [phone]Email [email protected]: Diarrhea is a major leading cause of under-five morbidity and mortality in developing countries. Although the health extension program has been implemented for decades, diarrhea continues to be a major public health problem.Objective: To determine determinants of diarrhea among under-five-year-old children in the health extension model and non-model families of Wama Hagelo District 2019.Methods: A community-based comparative cross-sectional study was conducted among 512 under-five children among 257 model and 255 non-model health extension families. A multi-stage sampling technique was used. Households with at least one under-five child were selected using a simple random sampling method. Data were collected using an interviewer-administered questionnaire. Bivariate analysis was done to select candidate variables at p ≤ 0.2. Determinants of childhood diarrhea were determined by a multivariable logistic regression model at p-value less than 0.05.Results: The two-week prevalence of diarrhea among under-five children in model and non-model families was 7.8% (95% CI=4.5– 11.1%) and 27.8% (95% CI 22.3– 33.3%), respectively. Unimproved water sources (AOR [95% CI] =5.5[2.2, 97.7]) and no vaccination against Rotavirus (AOR [95% CI] = 49.8 [4.2– 94.8]) were associated with diarrhea among under-five children in model families. Family size > 5 (AOR [95% CI] = 5.2 [1.7– 17.6]), using unimproved water sources (AOR [95% CI] = 7.2 [1.6– 13.2]), not using latrine (AOR [95% CI] = 6 [1.8– 20.6]), child not vaccinated against Rotavirus (AOR [95% CI] = 10.9 [2.9– 41.1]), child not supplemented with vitamin A (AOR [95% CI] = 3.2 [1.4– 7.2]), and not being health extension model families (AOR [95% CI] = 2.4 [1.15– 4.99]) predict diarrhea among under-five children in non-model families.Conclusion: Diarrhea was more frequent among non-model than model families. Family size, type of water source, using a latrine, place of childbirth, child vaccination against Rotavirus, and vitamin A supplementation were independently associated with the occurrence of diarrhea in under-five children. Encouraging all non-model families to become models in implementing all health extension packages by strengthening community participation is important to decrease childhood diarrhea in under-five children.Keywords: under-five diarrhea, model and non-model families

Keywords

• under-five diarrhea
• model and non-model families