Abstract
In Cambodia, children's feces are rarely disposed of in an improved sanitation facility. This study examines current practices and the role that enabling products may play in increasing hygienic management of infant and young child (IYC) feces in households with access to improved sanitation. A survey was conducted with the primary caregiver of a child under 5 years of age in 130 homes with an improved latrine in 21 villages across two provinces in Cambodia. Two focus group discussions per province were conducted after the survey to obtain caregiver feedback on new enabling products for hygienic management. Among caregivers, 63% reported child feces disposal in an improved latrine but only 36% reported doing so consistently. Besides child age, years of latrine ownership, caregiver age, consistency of adult latrine use, and presence of child feces management tools in the latrine were associated with hygienic disposal. The youngest caretakers with the newest latrines and youngest children were least likely to dispose of IYC feces hygienically, representing a key target group for interventions to improve hygienic disposal in Cambodia. Reusable diapers, child-friendly potties, and possibly latrine seats, that offer child safety, time and cost savings, and easy disposal and cleaning could potentially facilitate hygienic disposal for these ages.
Highlights
IntroductionSanitation, and hygiene interventions for its prevention, the hygienic management of children’s feces has received less attention as a target behavior to reduce diarrheal transmission, though it has been identified as one of the three “key water-related behaviors for promotion.”[2] Children’s feces are more likely to contain enteric pathogens than those of adults,[3] and open defecation by young children contaminates the household environment, a key site for diarrheal disease transmission to children and adults.[4]
Diarrheal disease is the second greatest cause of mortality for children under 5 years of age worldwide, accounting for nearly 800,000 deaths a year, primarily in developing countries.[1]Among water, sanitation, and hygiene interventions for its prevention, the hygienic management of children’s feces has received less attention as a target behavior to reduce diarrheal transmission, though it has been identified as one of the three “key water-related behaviors for promotion.”[2]
In stage 1, a household survey was conducted with the primary caregiver in 130 households comprising 145 children under 5 years of age from 21 villages in districts in Kampong Speu and Battambang provinces, Cambodia, where the nongovernmental organization Water, Sanitation and Hygiene Enterprise Development (WaterSHED) works to increase access to and use of improved sanitation
Summary
Sanitation, and hygiene interventions for its prevention, the hygienic management of children’s feces has received less attention as a target behavior to reduce diarrheal transmission, though it has been identified as one of the three “key water-related behaviors for promotion.”[2] Children’s feces are more likely to contain enteric pathogens than those of adults,[3] and open defecation by young children contaminates the household environment, a key site for diarrheal disease transmission to children and adults.[4]. In Cambodia, diarrheal incidence in children tends to be higher than that in the southeast Asian region as a whole. In 2010, those aged 6–11 and 12–23 months had the highest average annual incidences: 4.26 episodes (Cambodia) versus 3.7 episodes and 3.45 episodes versus three episodes, respectively, in the region.[5]
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