scholarly journals Interventions to improve water quality and supply, sanitation and hygiene practices, and their effects on the nutritional status of children

Author(s):  
Alan D Dangour ◽  
Louise Watson ◽  
Oliver Cumming ◽  
Sophie Boisson ◽  
Yael Velleman ◽  
...  
2021 ◽  
Vol 15 ◽  
pp. 117863022199963
Author(s):  
Negasa Eshete Soboksa ◽  
Sirak Robele Gari ◽  
Abebe Beyene Hailu ◽  
Bezatu Mengistie Alemu

Background: Inadequate water supply, sanitation, hygiene practices, and diarrhea are related to malnutrition, but there is limited evidence in Ethiopia about their association. Thus, the objective of this study was to describe childhood malnutrition and the association with diarrhea, water supply, sanitation and hygiene practices. Methods: A case-control study design was performed from December 2018 to January 2019 in Kersa and Omo Nada districts of the Jimma Zone, Ethiopia. Both children aged 6 to 59 months were chosen randomly from malnourished and well-nourished children in 128 cases and 256 controls, respectively. Bodyweight, length/height, mid-upper arm circumference, and presence of edema of the children were measured according to the WHO references. Then, the nutritional status of the children was identified as a case or control using the cutoff points recommended by the WHO. To see the association-dependent and independent variables, logistic regression analysis was used. Results: A total of 378 children were included in this study (98.44%). Malnutrition was significantly increased among children who delayed breastfeeding initiation(AOR = 3.12; 95% CI: 1.62-6.00), had diarrhea (AOR = 9.22; 95% CI: 5.25-16.20), were living in households indexed as the poorest (AOR = 2.50; 95% CI: 1.12-5.62), defecated in a pit latrine without slab/open pit (AOR = 2.49; 95% CI: 1.17-5.30), collecting drinking water from less than/equal to 1 km distance (AOR = 4.77; 95% CI: 1.01-22.71) and sometimes practiced hand washing at the critical times (AOR = 2.58; 95% CI: 1.16-5.74) compared with their counterparts. However, lactating during the survey (AOR = 0.35; 95% CI: 0.18-0.67), water collection from unprotected sources (AOR = 0.22; 95% CI: 0.05-0.95) and collection and disposal of under-5 children feces elsewhere (AOR = 0.06; 95% CI: 0.01-0.49) significantly reduced the likelihood of malnutrition. Conclusions: Early initiation of exclusive breastfeeding, diarrhea prevention, and the use of improved latrine and handwashing practices at critical times could be important variables to improve the nutritional status of children.


2020 ◽  
Author(s):  
Negasa Eshete Soboksa ◽  
Sirak Robele Gari ◽  
Abebe Beyene Hailu ◽  
Bezatu Mengistie Alemu

Abstract Objective: This study aimed to describe the association of childhood undernutrition with water supply, sanitation, and hygiene interventions in Kersa and Omo Nada districts of the Jimma Zone, Ethiopia.Design: A case-control study design was undertaken from December 2018 to January 2019.Setting: Kersa and Omo Nada districts of the Jimma Zone, Ethiopia.Subjects: 128 cases and 256 controls were randomly selected from malnourished and well-nourished children, respectively.Outcome measures: Bodyweight, length/height, mid-upper arm circumference and presence of edema of the children were measured according to the WHO references. Then, the nutritional status of children was identified as case or control using cutoff points recommended by the WHO based on the Z-score, edema, and MUAC values recorded.Results: A total of 378 children were included in this study, with a response rate of 98.44%. Undernutrition was significantly increased among children who delayed breastfeeding initiation (AOR=2.60; 95% CI: 1.02-6.65), diarrhea (AOR=9.50; 95% CI: 5.19-17.36), living with households indexed as the poorest (AOR=2.57; 95% CI: 1.09-6.07) and defecated in a pit latrine without slab/open pit (AOR=2.49; 95% CI: 1.17-5.30), and sometimes practiced hand washing at the critical times (AOR=2.52; 95% CI: 1.10-5.75) compared with their counterparts. However, lactating during the survey (AOR=0.35; 95% CI: 0.18-0.71) and collection and disposal of under-five children feces elsewhere (AOR = 0.08; 95% CI: 0.01-0.75) significantly reduced the likelihood of undernutrition.Conclusions: Early initiation of exclusive breastfeeding, diarrhea prevention, the use of improved latrine, and always handwashing practices at critical times could be important variables to improve the nutritional status of children.


2020 ◽  
Vol 35 (7) ◽  
pp. 829-841 ◽  
Author(s):  
D J Momberg ◽  
P Mahlangu ◽  
B C Ngandu ◽  
J May ◽  
S A Norris ◽  
...  

Abstract Associations between different forms of malnutrition and environmental conditions, including water, sanitation and hygiene (WASH), contribute to poor child health, nutritional status and physical growth. The primary responsibility for the provision of water and sanitation, as a basic service and human right, lies with the State, as such, a number of stakeholders are involved. Despite relatively high levels of WASH infrastructure coverage in South Africa, enteric infections and stunting remain high for a middle-income country. The aim of this study is to elucidate the landscape of WASH in South Africa in relation to nutritional status of children under the age of 5 years in the South African, Gauteng and City of Johannesburg contexts. The authors detailed the national and provincial public sector departments and through purposive sampling proceeded to map the various departments and associated policies that are responsible for the provision of WASH facilities, as well the nutritional status of children. Of the six policies identified for review, three mentioned WASH, nutrition and children; however, none explicitly linked WASH to nutritional status in children. An in-depth review and analysis of these three crucial policy documents was conducted. Finally, a set of expert interviews were conducted and a consensus development conference convened, with experts at the intersection between WASH and nutritional status. The authors found that the public sector would benefit from better integration of the concept of WASH into their policy, planning and implementation frameworks. The WASH sector should emphasize the role in which WASH plans consider the impact of WASH on the nutritional status of children. The various public sector departments involved in WASH service provision, and other WASH stakeholders, including community-based organizations, non-governmental organizations and intergovernmental organizations, should be involved in the decision-making of the nutrition sector.


2020 ◽  
Author(s):  
Akina Shrestha ◽  
Jeanne Six ◽  
Dikshya Dahal ◽  
Rubika Shrestha ◽  
Madan Bhatta ◽  
...  

Abstract Background: Providing universal access to safe water, sanitation and hygiene (WASH) in remote Nepal remains challenging. Efforts to improve WASH access in these areas are impeded by a dearth of information on the status of WASH conditions and its association with health and nutritional status of children in Nepal. Methods: We investigated nutritional status, WASH practices, and their association with intestinal parasitic infections, diarrhoea, undernutrition and clinical signs of nutritional deficiencies (hereafter health outcomes) during March to May 2018. Data was collected through a cross-sectional survey of 1427 households, including questionnaires, observations, stool analysis, anthropometry, water quality measurements and assessment of clinical signs of nutritional deficiencies. Results: We found that 55.5% had undernutrition, 63.9% had clinical signs of nutritional deficiencies, 51.1% of children were suffering from intestinal parasitic infections, and 52.2% had waterborne illnesses. Multivariate mixed logistic regression analysis revealed statistically significant associations (p<0.05) between aforementioned health outcomes and a better socioeconomic status (adjusted odds ratio (AOR)=0.43, 95% confidence intervals (CI)=0.25-0.75), caregivers who can read (AOR=4.07, 95% CI=1.00-16.5), own food production of food (AOR=0.67, 95% CI=0.46-0.97), providing food supplements to the children (AOR=0.57, 95% CI=0.38-0.84), intermittent water supply (AOR=2.72, 95% CI=1.18-6.31), source water quality (AOR=10.44, 95% CI=1.61-67.4), washing hands when they look dirty (AOR=0.47, 95% CI=0.32-0.71), no toilet at home (AOR=6.12, 95% CI=1.08-14.25), cleanliness of the available toilet (AOR=0.68, 95% CI=0.47-0.98), handwashing after going to toilet (AOR=0.37, 95% CI=0.13-1.02), cleanliness of caregivers hand (AOR=0.61, 95% CI=0.41-0.89), presence of earthen floor (AOR=2.29, 95% CI=1.20-4.37), animals inside the house overnight (AOR=1.71, 95% CI=1.17-2.51) and regular deworming of the children (AOR=0.44, 95% CI=0.20-0.94). Conclusions: Findings suggest improvements in WASH services, along with household hygiene and nutritional interventions, may together reduce child morbidity and mortality in Nepal. Keywords: Drinking Water Quality, Sanitation and Hygiene, Child Health, Diarrhoea, Undernutrition, Intestinal Parasitic Infections, Nepal.


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