Factors associated with prevalence of diarrhea among children under five years of age in Pakistan

Abstract

ObjectivesThe study aimed to identify the determinants of childhood diarrhea in Pakistan with a specific focus on water, sanitation, hygiene, and mother’s decision-making ability. MethodsThis study is based on nationally representative Demographic and Health Survey of Pakistan. The working sample is 3,067 children. Bi-variate and multi-variate logistic regressions are used to estimate the unadjusted and adjusted odds ratios of the determinants of diarrhea, respectively. ResultsIn bivariate regression, type of water source i.e., tube well/bore has significantly lower odds [OR = 0.85, 95 CI = 0.76–0.96] of diarrhea among children of age less than five years compared to piped water. Although, this variable is not significant in the multivariate model. Though, the variable of toilet type, Flush to Septic Tank, is significant in multivariate analysis with the odds of [OR = 0.77, 0.59–0.99] meaning that odds of household with a flush to septic tank type of toilet observe 23 percent less diarrhea compared to households with piped to sewer type of toilet. Moreover, the presence of a handwashing facility is an insignificant predictor of diarrhea. In a household where a mother does not make health-related decisions, a child is significantly likely to have diarrhea [OR = 1.25, 95% CI = 1.12–1.39]. Although, this association is lost in multivariate regression analysis. ConclusionThe results show that mothers should be empowered to make their health-related decisions, as children of empowered mothers are less susceptible to diarrhea. Similarly, the findings suggest that WASH interventions are likely to work better if they target multiple WASH sectors instead of focusing on one of the components, as children with access to multiple improved WASH components are less likely to get diarrhea as compared to the children who have access to one of them.