Improved Water, Sanitation and Utilization of Maternal and Child Health Services in South Asia-An Analysis of Demographic Health Surveys.

Negar Omidakhsh,Ondine S Von Ehrenstein

doi:10.3390/ijerph18147667

Abstract

Globally, many millions of people still lack access to safe drinking water and sanitation facilities. Here, we examined associations between household availability of improved drinking water and sanitation, respectively, and use of maternal and child health (MCH) services in South Asian countries. Demographic and Health Survey population-based data from Bangladesh, Nepal, India, and Pakistan were used, restricted to women with a child aged 0–36 months (n = 145,262). Types of households’ water source and sanitation facilities were categorized based on the World Health Organization and UNICEF’s definitions of “improved” and “unimproved”. We applied logistic regressions to estimate odds ratios (OR) and 95% confidence intervals (CI) for improved water and sanitation, respectively, and reported antenatal care visits, having a skilled attendant at birth, and infant vaccination coverage, stratified by maternal education. Among lower educated women, access to improved water source was associated with greater ORs for presence of a skilled attendant at delivery and their children having up-to-date immunizations (OR: 1.29; 95% CI: 1.17, 1.42). Among lower and higher educated women, improved sanitation (vs. unimproved) was associated with greater ORs for having had adequate antenatal care visits (OR: 1.74; 95% CI: 1.62, 1.88; OR: 1.71; 95% CI: 1.62, 1.80), and similarly for having had a skilled attendant at birth, and children with up-to-date immunizations. Approaches addressing water/sanitation and MCH services across sectors could be a suggested public health strategy.

Highlights

IntroductionIt is estimated that over 700 million people lack access to improved drinking water, and that three billion do not have access to improved sanitation, putting women and children in low- and low middle-income countries at increased risk for adverse health outcomes [1]
The aim of this study was to examine associations of household availability of improved drinking water and sanitation, respectively, with reported usage of basic maternal and child health (MCH) health services, namely antenatal care, presence of a skilled attendant at birth, and infant vaccination coverage based on a large population sample from the most recent Demographic and Health Surveys (DHS) in four
antenatal care (ANC) visits, children with up-to-date immunizations, and a skilled birth attendant for both lower and higher educated women. These findings may suggest that increasing access to improved water source among lower socioeconomic groups and to improved sanitation facilitates among all women, may be a strategy that could be linked with access and utilization of MCH services, thereby contributing on multiple levels to maternal and child health in South Asia

Summary

Introduction

It is estimated that over 700 million people lack access to improved drinking water, and that three billion do not have access to improved sanitation, putting women and children in low- and low middle-income countries at increased risk for adverse health outcomes [1]. As it has been recently highlighted, “water serves as an (often) unacknowledged but essential connecting factor for attaining the different Sustainable. Development Goals ” [2]; in particular, for attaining Sustainable Development Goal (SDG).

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Conclusion