Does the effect of water and sanitation vary by maternal education on childhood diarrhea among under five children in Mecha district, West Gojjam, Ethiopia

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Addis Abeba Universty


BACKGROUND: Diarrhoeal disease is widely recognized as a major cause of child morbidity and mortality in many developing countries, particularly in sub-Saharan Africa including Ethiopia. While a good living environment, comprising safe water and latrine facilities, is essential in reducing the risk, it is unclear if the disadvantage associated with untreated water and lack of latrine facilities are the same for all children. Since diarrhea is transmitted through a variety of agents, we argue that other parentally provided inputs combined with water and latrine facilities in determining a child’s vulnerability. OBJECTIVES: The study assesses the effects of drinking water and latrine facilities on the risk of childhood diarrhoea among under five children and as well whether they vary by maternal education. METHODS: a community based cross-sectional study was carried out on February, 2009 with a total sample size of 768 households that had at least one under-five child, which was randomly selected from the ten rural kebeles and one urban kebele that was found in Mecha Woreda, West Gojjam, Ethiopia. Information on the households' socio-economic, environmental and behavioural characteristics was collected using structured, pre-tested questionnaire by trained data collectors. Diarrhoeal morbidity occurrence among under-five children during the two weeks preceding the time of the interview was registered to determine prevalence. Logistic regression model was employed to examine the significance of environmental factors and level of mother’s education in preventing childhood diarrhoea. RESULT: The findings of this study showed that the overall prevalence of diarrhoea in under-fives was 18.0%. Multivariate logistic regression analysis showed that children of less educated mothers had more than fivefold higher odds of having diarrhoea than their higher educated counterparts. In the analysis maternal education, mother’s history of recent diarrhea, availability of latrine facility, duration of breast feeding and age of the child had a significant association after adjusting other variables. The highest risk was found in households without improved water source and latrines facilities. When these variables stratified by maternal education, however, it became evident that children whose mothers were less educated were the most vulnerable in the absence of water and latrine facilities. CONCLUSION AND RECOMMENDATION: Highly educated mothers protect their children against diarrhea much better under poor environmental condition than their less educated counterparts. There were interaction effects of water with maternal education and sanitation with maternal education on childhood diarrhea. Thus effective educational programs that emphasize on hygiene and good home management practices and encouraging female school enrolment should be strengthen to reduce childhood diarrhoea morbidity. VI



Does the effect of water