Abstract
Sub-Saharan Africa as a region accounts for the bulk of the global under-five mortality rate, to which diarrhea is major contributor. Millions of children die from diarrheal diseases each year and those who survive often do so facing suboptimal growth. Preventing the common pathways of transmission for diarrhea-causing pathogens, including improved water, sanitation, and hygiene (WASH) are regarded as the most cost-effective measures for tackling this life-threatening disease. This study aimed to quantitatively assess the quality of living arrangement and access to WASH, and their impact on diarrheal outcomes among under-five children in Nigeria. Methods: Data were collected from the 2013 Nigeria Demographic and Health survey (NDHS). Study participants included 28,596 mother-child pairs. Household construction material for wall, floor, and ceiling, access to electricity, and improved water and toilet, were included as the main explanatory variables. Data were analyzed using descriptive and multivariable regression methods. Results: The prevalence of diarrhea was 11.3% (95% CI = 10.2–12.6), with the rate being markedly higher in rural (67.3%) as compared to urban areas (32.7%). In the regression analysis, lacking access to improved toilet and water facilities were associated with 14% and 16% higher odds, respectively, of suffering from diarrhea as compared to those who had improved access. Conclusion: There is evidence of a weak, but statistically significant, relationship between the quality of living environment, including water and sanitation facilities, and diarrhea among under-five children in Nigeria. The study concludes that investing in living conditions and WASH may have potential benefits for child mortality prevention programs in the country.
Highlights
Nigeria’s under-five mortality rate is ranked as the eighth highest in the world, and diarrhea is known to be a major contributor to this statistic [1]
Cases of under-five diarrhea were significantly higher in rural areas of residence in comparison to urban areas of residence, with 67.3% of cases being situated in urban regions and 32.7% in rural ones
This study aims to investigate the association between family household environments including access to safe and adequate WASH, and diarrheal outcomes in under-five children in Nigeria, based on the Nigeria Demographic and Health survey (NDHS) 2013
Summary
Nigeria’s under-five mortality rate is ranked as the eighth highest in the world, and diarrhea is known to be a major contributor to this statistic [1]. There is no indication of the seasonal incidence in the NDHS, prior research illustrates that the incidence of diarrhea among under-five children was the highest during the peak of the dry season (February and April), and the lowest during the rainy season (May–October) [7]. This highly preventable disease causes severe dehydration, which results in nutritional deficits and/or malnourishment, which can lead to impaired child growth or death [8]. Research has shown that poor, unhealthy housing environments increases the risk of infectious diseases, and this is strongly reflected in the nature of the United Nations sustainable development goals
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