WASH practices and its association with nutritional status of adolescent girls in poverty pockets of eastern India

Aparajita Chattopadhyay,Manisha Ruikar,Abhishek Saraswat,Rabi N Parhi,Shivani Dar,Neha Sareen,Sourav Bhattacharjee,H P S Sachdev,Nikita Surani,Vani Sethi,Vikas Bhatia,Vikash Nath,Sayeed Unisa,Varsha P Nagargoje,C M Singh,Rajkumar Gope,Arjan De Wagt,Abner Daniel,Neeraj Agarwal

doi:10.1186/s12905-019-0787-1

Abstract

BackgroundWater, Sanitation, and Hygiene (WASH) practices may affect the growth and nutritional status among adolescents. Therefore, this paper assesses WASH practices and its association with nutritional status among adolescent girls.MethodsAs a part of an intervention programme, this study is based on baseline cross-sectional data. It was conducted between May 2016–April 2017 in three Indian states (Bihar, Odisha, and Chhattisgarh). From a sample of 6352 adolescent girls, information on WASH practices, accessibility to health services and anthropometric measurements (height, weight and mid upper arm circumference (MUAC)) was collected. Descriptive statistics were used to examine WASH practices, and nutritional status among adolescent girls. Determinants of open defecation and menstrual hygiene were assessed using logistic regression. Association between WASH and nutritional status of adolescent girls was determined using linear regression.ResultsFindings showed 82% of the adolescent girls were practicing open defecation and 76% were not using sanitary napkins. Significant predictors of open defecation and non use of sanitary napkin during menstruation were non Hindu households, households with poorer wealth, non availability of water within household premise, non visit to Anganwadi Centre, and non attendance in Kishori group meetings. One-third of adolescent girls were stunted, 17% were thin and 20% had MUAC < 19 cm. Poor WASH practices like water facility outside the household premise, unimproved sanitation facility, non use of soap after defecation had significant association with poor nutritional status of adolescent girls.ConclusionsConcerted convergent actions focusing on the provision of clean water within the household premise, measures to stop open defecation, promotion of hand washing, accessibility of sanitary napkins, poverty alleviation and behavior change are needed. Health, nutrition and livelihood programmes must be interspersed, and adolescents must be encouraged to take part in these programmes.

Highlights

Water, Sanitation, and Hygiene (WASH) practices may affect the growth and nutritional status among adolescents
Our study established that WASH practices have a significant association with the nutritional status of adolescent girls (girls who accessed water from outside, used unimproved sanitation facility and were not using soap after defecation were more likely to be stunted, thin and had low Mid upper arm circumference (MUAC) (< 19 cm))
The present study found that poor WASH practices and nonparticipation in health and nutrition services had a significant association with nutritional status of adolescent girls

Summary

Introduction

Sanitation, and Hygiene (WASH) practices may affect the growth and nutritional status among adolescents. Nutritional status of adolescents is an important health issue because the growth during this period is quicker in an individual’s life except infancy. Growths during this phase of life help overall development and provide adequate stores of energy for pregnancy and healthy adulthood. Few studies provided data on nutritional status of adolescents. In India, 42% of adolescent girls aged 15–19 years have Body Mass Index below 18.5 kg/m2 and 50% have anemia. According to the fourth round of National Family Health Survey (NFHS4) 2015–2016, 43.2% adolescent girls in Bihar, 38.5% in Chhattisgarh and 37.1% in Odisha have low BMI [3]

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Conclusion