Unsafe child feces disposal status in Ethiopia: what factors matter? Analysis of pooled data from four demographic and health surveys

Biniyam Sahiledengle

doi:10.1186/s12889-020-08945-6

Abstract

BackgroundThe only safest way to dispose of a child’s feces is to help the child use a toilet or, for very young children, to put or rinse their feces into a toilet, whereas other methods are considered unsafe. This study aimed to determine the magnitude and factors associated with unsafe child feces disposal in Ethiopia.MethodsThis was a cross-sectional study using pooled data from the four rounds of Demographic and Health Surveys (DHS) conducted in Ethiopia (2000, 2005, 2011, and 2016). Data on child feces disposal practice was collected for all children born during the 5 years preceding survey. Mothers were asked for the youngest child born, “The last time child passed stools, what was done to dispose of the stools?”.Descriptive statistics were computed to illustrate the given data. Multivariable logistic regression was performed to identify factors associated with unsafe child feces disposal.ResultsThe pooled dataset contains data for 40,520 children younger than 5 years, male accounts 20,629 (50.9%). Overall, 77.7% (95%CI: 76.3–79.0) of children feces disposed of unsafely. In the multivariable logistic regression model, those mothers whose child was 13–24 months [AOR: 0.68, 95% CI: (0.60–0.78)] and ≥ 25 months [AOR: 0.66, 95% CI: (0.60–0.72)] were lower odds of unsafe child’s feces disposal. Children born into households having two or fewer children were 33% lower [AOR: 0.67, 95% CI: (0.56–0.79)] odds of unsafe child’s feces disposal than their counterparts. The odds of disposing of feces unsafely among households having improved toilet facility was 76% lower [AOR: 0.24, 95% CI: (0.19–0.29)] that of households lacking such facilities. Further, being an urban resident, having improved drinking water facility, a high level of maternal and paternal education, paternal occupational status (work in non-agriculture), and maternal age (25–34 and ≥ 35 years) were factors that associated with lower odds of unsafe child’s feces disposal.ConclusionsThree in four Ethiopian children feces disposed of unsafely. Household and socio-demographic factors, such as access to improved toilet facility, the child’s age (older age), and both higher maternal and paternal education levels were important factors that significantly associated with lower odds of unsafe child feces disposal.

Highlights

The only safest way to dispose of a child’s feces is to help the child use a toilet or, for very young children, to put or rinse their feces into a toilet, whereas other methods are considered unsafe
The purpose of this study is to determine the magnitude and factors associated with unsafe child feces disposal in Ethiopia using pooled data from the Ethiopian Demographic and Health Survey (EDHS 2000–2016)
Unsafe child feces disposal This study revealed that 77.7% (95%confidence interval (CI): 76.3–79.0) of the children feces in Ethiopia were disposed of unsafely (Table 2)

Summary

Introduction

The only safest way to dispose of a child’s feces is to help the child use a toilet or, for very young children, to put or rinse their feces into a toilet, whereas other methods are considered unsafe. Recent studies conducted in Asian and African countries showed that unsafe disposal of children’s feces in the community was strongly associated with increased risk of diarrhea and enteric infections [5,6,7,8,9,10,11,12,13,14]. Complementing this finding, a review by Gil et al found that unsafe disposal of children’s feces associated with a 23% increase in the risk of diarrheal diseases in children [7]. A recent study in Bangladesh reported that young children mouthing soil during play in households with visible feces on their compound had an increased risk of stunting [16]

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