ENVIRONMENTAL, DEMOGRAPHIC, AND SOCIO-ECONOMIC CORRELATES OF ACCESS TO IMPROVED SANITATION: EMPIRICAL EVIDENCE FROM PAPUA AND WEST PAPUA PROVINCES

Papua and West Papua provinces are two of many lagging provinces in Indonesia in terms of access to adequate sanitation. Hence, this paper aims to reveal determinants of access to improved sanitation by investigating the environmental, demographic, and socio-economic correlation in both provinces. Data from the 2011 Multiple Indicator Cluster Survey (MICS) were used to determine the demographic and socio-economic correlates of households access to improved sanitation facilities. Probit regression models were fitted to the data. The results suggest that district, place or residence, type and location of household water source, household size, age of household head, education of household head, and household wealth have significant correlation with access to improved sanitation. These corroborate previous findings and more importantly, it can be used to inform policy makers in Indonesia especially in Papua and West Papua Provinces.

Download Full-text

What has poverty got to do with it? Analysis of household access to improved sanitation in Ghana

Journal of Water Sanitation and Hygiene for Development ◽

10.2166/washdev.2017.101 ◽

2017 ◽

Vol 7 (1) ◽

pp. 129-139

Author(s):

Simon Mariwah ◽

Joshua Amo-Adjei ◽

Prisca Anima

Keyword(s):

Urban Areas ◽

Qualitative Data ◽

Household Wealth ◽

Rural And Urban Areas ◽

Rural And Urban ◽

Multiple Indicator Cluster Survey ◽

Household Assets ◽

Improved Sanitation ◽

Multiple Indicator ◽

Group Interviews

This paper investigates antecedents to demand for household sanitation in Ghana. We employed a sequential, mixed-method approach, relying on the 2011 Ghana Multiple Indicator Cluster Survey (MICS) and primary qualitative data generated from individual and group interviews. The aim was to ascertain the role of household assets (measured by household wealth) in access to improved sanitation in Ghana. The study found that although wealth positively influenced household ownership of improved sanitation, the effect is strongly noticed only at the pinnacle of wealth quintiles (the richest households). From the qualitative data, we find that, beyond poverty, a mix of cultural, social, political and economic nuances influenced and somehow perpetuate low access to improved sanitation in Ghanaian households. We therefore surmise that means targeting of the poor and application of social marketing of sanitation in both rural and urban areas can help trigger awareness and demand for improved sanitation in Ghana.

Download Full-text

ASSOCIATION OF SOCIO-DEMOGRAPHIC FACTORS WITH DIARRHEA IN CHILDREN LESS THAN FIVE YEARS: A SECONDARY ANALYSIS OF MULTIPLE INDICATOR CLUSTER SURVEY SINDH 2014

Pakistan Journal of Public Health ◽

10.32413/pjph.v7i2.39 ◽

1970 ◽

Vol 7 (2) ◽

pp. 85-89

Author(s):

Muhammad Irfan ◽

Syed Mustansir Hussain Zaidi ◽

Hira Fatima Waseem

Keyword(s):

Rural Areas ◽

Demographic Factors ◽

Wealth Index ◽

Household Wealth ◽

Cluster Survey ◽

Multiple Indicator Cluster Survey ◽

Increased Risk ◽

Multiple Indicator ◽

Mother Education ◽

Socio Demographic Factors

Background: Diarrhea founds to be the major cause of morbidity and mortality in children less than five years. Various factors are associated with diarrhea but socio-demographic factors are the main key elements, which associated with diarrhea. Methods: This study was examined association of socio-demographic factors with diarrhea in children less than five years of age of Sindh, Pakistan, using data from the Multiple Indicator Cluster Survey (MICS) conducted from January 2014 to August 2014. Data were collected for 18,108 children in whom 16,449 children had complete data of demographic variables being included in the analysis. Bivariate analysis was done using Pearson's Chi square test and multivariate analysis being done using binary logistic regression. Results: We found increased risk of diarrhea among children lives in rural areas while household wealth index quintile was also associated with diarrhea. Children in the poor, middle and fourth wealth index quintiles being at increased risk of diarrhea compared to children in the richest wealth index quintile. The highest risk of diarrhea was found for the child having mother with no education as well as children aged 12-23 months. Conclusion: Age of child, mother education and wealth index found significant with diarrhea while Male children, child aged 12-23 months, child with no mother education, child from rural areas and child from poor households found with high risk of diarrhea.

Download Full-text

Association Between Water and Sanitation with Anemia in Preschool Children: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) Project (P10-087-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz034.p10-087-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Emma Xinchun Yu ◽

Anne Williams ◽

O Yaw Addo ◽

Parminder Suchdev ◽

Junjue Guo ◽

...

Keyword(s):

Preschool Children ◽

Survey Design ◽

Hemoglobin Concentration ◽

Water Source ◽

Population Based ◽

Drinking Water Source ◽

Chi Square ◽

Household Water ◽

Improved Sanitation ◽

Logistic Regressions

Abstract Objectives We aimed to assess the associations between water source and sanitation with anemia in preschool children (age: 6–59 months) in 16 population-based surveys. Methods We analyzed data from the BRINDA project. Sixteen surveys, representing 15 countries (n = 25,214), that had measures of hemoglobin, household water source and sanitation, type of residence, and socioeconomic (SES) status were included in this analysis. Anemia was defined as altitude-adjusted hemoglobin concentration <110 g/L. Water source and sanitation were defined as improved household drinking water source and improved toilet facility, respectively. Bivariate analyses were done using Rao-Scott chi-square test (except for age, a continuous predictor using logistic regressions). Multivariable logistic regressions were conducted to examine associations between anemia and water source and sanitation, adjusting for age, sex, rural-urban location, and SES. All analyses were conducted with SAS 9.4, accounting for complex survey design. Results The prevalence of anemia ranged from 20.0% in Nicaragua to 72.1% in Kenya 2010. The prevalence of improved water source and improved sanitation ranged from 44.1% in Laos to 98.4% in Bangladesh, and from 0.1% in Kenya 2007 to 93.7% in Ecuador, respectively. Improved water source alone was protective of anemia in two surveys. Improved sanitation alone was protective of anemia in three surveys. Improved water source alone was negatively associated with anemia in one survey. Improved water source and sanitation combined was protective of anemia in 4 out of 16 surveys, specifically Afghanistan (adjusted OR = 0.55, 95% CI: 0.31–0.96), Azerbaijan (adjusted OR = 0.55, 95% CI: 0.31–0.999), Bangladesh (adjusted OR = 0.03, 95% CI: 0.002–0.28), and Laos (adjusted OR = 0.37, 95% CI: 0.17–0.80). Conclusions Improved household water source and sanitation was inversely associated with anemia in some settings. However, results were not consistent across surveys, and there may be thresholds at which water source and sanitation impacts anemia. Further research is warranted to evaluate the potential mechanisms that explain links between water source and sanitation with anemia. Funding Sources Bill & Melinda Gates Foundation.

Download Full-text

Predictors of wealth-related inequality in institutional delivery: a decomposition analysis using Nepal Multiple Indicator Cluster Survey (MICS) 2019

10.21203/rs.3.rs-539128/v1 ◽

2021 ◽

Author(s):

Umesh Prasad Bhusal

Keyword(s):

Institutional Delivery ◽

Relative Concentration ◽

National Level ◽

Household Head ◽

Decomposition Analysis ◽

Cluster Survey ◽

Related Inequality ◽

Multiple Indicator Cluster Survey ◽

Multiple Indicator ◽

Status Of Women

Abstract Background Inequality in maternal healthcare use is a major concern for low-and middle-income countries (LMICs). Maternal health indicators at the national level have markedly improved in the last couple of decades in Nepal. However, the progress is not uniform across different population sub-groups. This study aims to identify the determinants of institutional delivery, measure the wealth-related inequality, and examine the key components that explain the inequality. Methods Most recent nationally representative Multiple Indicator Cluster Survey (MICS) 2019 was used to extract data about married women (15–49 years) with a live birth within two years preceding the survey. Logistic regression models were employed to assess the association of independent variables with the institutional delivery. The concentration curves (CC) and concentration indexe (CIX) were used to analyze the inequality in institutional delivery. Wealth index scores were used as a socio-economic variable to rank households. Decomposition was performed to identify the determinants that explain socio-economic inequality. Results The socio-economic status of households to which women belong was a significant predictor of institutional delivery, along with age, parity, four or more ANC visits, education status of women, area of residence, sex of household head, religious belief, and province. The concentration curve was below the line of equality and the relative concentration index (CIX) was 0.097 (p < 0.001), meaning the institutional delivery was disproportionately higher among women from wealthy groups. The decomposition analysis showed the following variables as the most significant contributor to the inequality: wealth status of women (53.2%), education of women (17 %), residence (8.64 %) and ANC visit (6.84 %). Conclusions The pro-poor strategies are urgent to reduce the existing inequality between wealthy and poorer women. The strategies should focus on raising the education level of women especially from the rural and relatively backward province (Province 2). Increasing antenatal care (ANC) coverage through out-reach campaigns is likely to increase facility-based delivery and decrease inequality. Monitoring of healthcare indicators at different sub-population level (for example wealth, residence, province) is key to ensure equitable improvement in health status and achieve universal health coverage (UHC).

Download Full-text

Child Disciplinary Practices in relation to Household Head Education and beliefs in Five Middle East and North African (MENA) countries: Cross Sectional study-Further analysis of Multiple Indicator Cluster survey data

University of the Future: Re-Imagining Research and Higher Education ◽

10.29117/quarfe.2020.0168 ◽

2020 ◽

Author(s):

Abeer Hamdan ◽

Manar Abdel-Rahman

Keyword(s):

Household Head ◽

Cross Sectional Study ◽

Physical Punishment ◽

Mena Region ◽

Cross Sectional ◽

Disciplinary Practices ◽

Mena Countries ◽

Positive Discipline ◽

Multiple Indicator Cluster Survey ◽

Multiple Indicator

Introduction:Internationally, eight out of ten children are exposed to violent discipline by their caregivers. To reduce the prevalence of violent discipline against children, we should understand the social and economic factors that affect the choice of disciplinary methods. Despite the high prevalence of violent discipline in the Middle East and North African (MENA) region, only a few studies explored disciplinary methods in this region. Aim: This study aims to determine the prevalence of positive and violent disciplinary practices in five selected MENA countries and assess their association with household head education and beliefs of physical punishment. Methods: This is a cross-sectional study design based on available secondary data from the Multiple Indicator Cluster Survey on its fourth round (MICS-4). A child was selected randomly from the household, and the Parent-Child Conflict Scale (CTSPC) tool was used to report disciplinary methods the child encountered during the last month period preceding the survey. Univariate and multivariable logistic regression were used to investigate the association between disciplinary practices with household head education and respondent's beliefs of physical punishment. The analysis was conducted using pooled data from all selected surveys and also for individual countries. Result: The overall prevalence of positive discipline was only 15% (95% CI: 14.4-15.8), in the five countries, while the prevalence of violent discipline was 80% (95% CI: 79.0 -80.5). The prevalence of positive discipline was highest in Qatar (40%; 95% CI: 35.0-44.4) and lowest in Tunisia (5%; 95% CI: 4.3-5.9) while the prevalence of violent discipline was highest in Tunisia (93%; 95% CI: 92.1-94.1), and lowest in Qatar (50%; 95% CI: 44.7-55.0). Overall, the household head education was not significantly associated with either positive or violent discipline after adjusting for covariates. However, respondents believe of disciplinary methods was significantly associated with both positive and violent discipline (OR=5.88; 95% CI: 4.97-6.96) and (OR=6.27; 95% CI: 5.40-7.28), respectively. Conclusion: High rates of violent discipline in the MENA region might indicate an increase in mental, behavioral, and social problems and disorders in our future generation. Rapid action is needed to reduce the worsening of violent discipline, and it is consequences. There is a need for educational programs for caregivers to teach them alternative non-violent methods of discipline. Besides, these numbers should inform policymakers about the importance of the existence and the implementations of laws, policies, and regulations to protect children from all forms of violence to protect our future youths and ensure their health and wellbeing.

Download Full-text

Exploring the important determinants of access to safe drinking water and improved sanitation in Punjab, Pakistan

Water Policy ◽

10.2166/wp.2021.001 ◽

2021 ◽

Author(s):

Shahid Adil ◽

Muhammad Nadeem ◽

Irfan Malik

Keyword(s):

Drinking Water ◽

Social Norms ◽

Household Head ◽

Household Wealth ◽

Education Level ◽

Living Standard ◽

Safe Drinking Water ◽

Wealth Status ◽

Improved Sanitation

Abstract Access to safe drinking water and improved sanitation is a fundamental human right and basic ingredient of public health. However, one of the major problems faced by developing countries in the twenty-first century is the lack of access to these facilities. Punjab is the most populous province of Pakistan with more than 50% of the country's population is no exception. Keeping in view its importance, the current study is an effort to investigate important determinants of access to safe drinking water and improved sanitation in Punjab to ensure the provision of these services to the masses. Multiple Indicator Cluster Survey Household data from 2017 to 2018 has been used for analysis. The results of a logistic regression model revealed that household media exposure, education level of household head, household wealth status, and ethnic background of the household head are some of the important determinants of household access to safe drinking water. For household access to improved sanitation, along with these factors, the role of social norms and place of residence are also important. Particularly, the role of social norms is very profound. Findings from the study suggest that efforts should be made to provide readily available media access, household education level needs to be enhanced, policies should be made to raise the living standard of the poorest households, and the social norm for the use of improved sanitation needs to be promoted.

Download Full-text

Understanding household water-use behaviour in the city of Johannesburg, South Africa

Water Policy ◽

10.2166/wp.2021.157 ◽

2021 ◽

Author(s):

Genius Murwirapachena

Keyword(s):

South Africa ◽

Water Use ◽

Water Consumption ◽

Demand Management ◽

Water Security ◽

Probit Regression ◽

Policy Makers ◽

Household Water ◽

Management Policies ◽

Efficient Water Use

Abstract Climate change, population growth and industrial activities continue to threaten water security, especially in the semi-arid regions. Demand management policies are essential in minimising the effects of acute water shortages. Such policies require information on household water consumption patterns and their behavioural practices. This study examines household water consumption behaviour and the adoption of water-efficient appliances in Johannesburg, South Africa. The study uses probit regression models to analyse survey data collected from 889 households during the period November 2017 to February 2018. Results show that while most households do not have water-efficient appliances installed in their homes, they do practise water-efficient behaviour. Older respondents as well as males and lower-income respondents are found to be more likely to practise efficient water-use behaviour. However, biographical variables do not generally influence the adoption of water-efficient appliances. These results are essential for policy-makers when formulating targeted water demand management policies. Thus, policy-makers should focus more on younger people, women and higher-income households when developing campaigns on efficient water-use behaviour.

Download Full-text

Women’s education and desire for additional children in Vietnam: regional differences and the role of son preference

Journal of Biosocial Science ◽

10.1017/s0021932021000511 ◽

2021 ◽

pp. 1-20

Author(s):

Yen Thi Hai Nguyen ◽

Pataporn Sukontamarn

Keyword(s):

Women's Education ◽

Son Preference ◽

Probit Regression ◽

Population Policies ◽

Multiple Indicator Cluster Survey ◽

The Social ◽

Multiple Indicator ◽

Nationally Representative ◽

Economic Regions ◽

Mixed Gender

Abstract This paper investigates the relationship between women’s education and desire for additional children across the six economic regions of Vietnam. The study employed data from the nationally representative Vietnam Multiple Indicator Cluster Survey (MICS) 2014. Probit regression results showed that for women with one child, higher levels of education were associated with higher fertility desire in two out of six regions. Similar results were found for women with two or more children. Children’s sex composition played a role in the desire for additional children, reflecting both son preference and mixed-gender preference. In Vietnam overall, among women with at least one boy, those with lower levels of education were more likely not to want another child. The results, however, differed by region. The findings suggest that the social and economic context of each region, particularly sex ratio at birth and total fertility rate, should be taken into account when designing population policies in Vietnam.

Download Full-text

Prevalence and determinants of antenatal tetanus vaccination in Sudan: a cross-sectional analysis of the Multiple Indicator Cluster Survey

Tropical Medicine and Health ◽

10.1186/s41182-022-00398-4 ◽

2022 ◽

Vol 50 (1) ◽

Author(s):

Sagad Omer Obeid Mohamed ◽

Esraa Mohammed Ahmed

Keyword(s):

Population Sample ◽

Multivariate Logistic Regression Analysis ◽

Household Wealth ◽

World Health ◽

Women Of Childbearing Age ◽

Childbearing Age ◽

Cluster Survey ◽

Multiple Indicator Cluster Survey ◽

Multiple Indicator ◽

Tetanus Vaccination

Abstract Background Tetanus vaccination is an indispensable component of the antenatal care (ANC) and is considered one of the most effective and protective measures against tetanus deaths. However, data on antenatal tetanus vaccination in Sudan are scarce. We aimed to explore the level of antenatal tetanus vaccination and to identify the influencing factors in a nationally representative population sample. Methods We used the latest available data (2014) of the Sudan Multiple Indicator Cluster Survey (MICS), developed by the United Nations Children’s Fund (UNICEF). We assessed the level of antenatal tetanus vaccination among women of childbearing age who gave at least one birth preceding the survey and defined adequate antenatal tetanus vaccination according to the World Health Organization (WHO) recommendations. Data analysis was performed using descriptive statistics, bivariate analysis, and multivariate logistic regression analysis. Results The total number of women of childbearing age involved in this analysis was 5433. Most of the participants (28.6%) were 25–29 years old, and vast majority of them (73.7%) live in rural areas. The prevalence of mothers who had adequate tetanus vaccination was 60.0%. Antenatal tetanus vaccination was significantly associated with higher level of mothers’ education (AOR = 1.70, 95% CI 1.25–2.32), higher household wealth index (AOR = 1.89, 95% CI 1.41–2.54), having four or more ANC visits (AOR = 1.49, 95% CI 1.30–1.71), and living in areas with low intensity of armed conflicts (AOR = 1.34, 95% CI 1.14–1.57). Conclusions Socioeconomic status had a significant impact on adequate antenatal tetanus vaccination. The results indicate the existence of variable rates and unequal access to tetanus vaccination among women of childbearing age in Sudan.

Download Full-text

Association between anemia and household water source or sanitation in preschool children: the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqaa148 ◽

2020 ◽

Vol 112 (Supplement_1) ◽

pp. 488S-497S ◽

Cited By ~ 1

Author(s):

Emma X Yu ◽

O Yaw Addo ◽

Anne M Williams ◽

Reina Engle-Stone ◽

Jiangda Ou ◽

...

Keyword(s):

Preschool Children ◽

Maternal Education ◽

Prevalence Ratio ◽

Water Source ◽

Population Based ◽

Household Water ◽

Improved Sanitation ◽

Meta Analyses ◽

Hb Concentration ◽

Variance Estimates

ABSTRACT Background The associations between anemia and household water source and sanitation remain unclear. Objectives We aimed to assess the associations between anemia and household water source or sanitation in preschool children (PSC; age 6–59 mo) using population-based surveys from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project. Methods We analyzed national and subnational data from 21 surveys, representing 19 countries (n = 35,963). Observations with hemoglobin (Hb) and ≥1 variable reflecting household water source or sanitation were included. Anemia was defined as an altitude-adjusted Hb concentration <110 g/L. Household water source and sanitation variables were dichotomized as “improved” or “unimproved.” Poisson regressions with robust variance estimates were conducted for each survey, adjusting for child sex, age, household socioeconomic status, maternal education, and type of residence. Results Access to an improved water source and improved sanitation ranged from 29.9% (Burkina Faso) to 98.4% (Bangladesh, 2012), and from 0.2% (Kenya, 2007) to 97.4% (Philippines), respectively. Prevalence of anemia ranged from 20.1% (Nicaragua) to 83.5% (Bangladesh, 2010). Seven surveys showed negative associations between anemia and improved sanitation. Three surveys showed association between anemia and improved water, with mixed directions. Meta-analyses suggested a protective association between improved household sanitation and anemia [adjusted prevalence ratio (aPR) = 0.88; 95% CI: 0.79, 0.98], and no association between improved household water and anemia (aPR = 1.00; 95% CI: 0.91, 1.10). There was heterogeneity across surveys for sanitation (P < 0.01; I2 = 66.3%) and water (P < 0.01; I2 = 55.8%). Conclusions Although improved household sanitation was associated with reduced anemia prevalence in PSC in some surveys, this association was not consistent. Access to an improved water source in general had no association with anemia across surveys. Additional research could help clarify the heterogeneity between these conditions across countries to inform anemia reduction programs.

Download Full-text