Globally, an estimated 11.2billion tons of municipal solid waste are generated annually. The increasing volume and complexity of waste, together with rapid urbanization, pose major risks to human health through diarrheal disease outbreaks. In many urban centers of low- and middle-income countries, solid waste management (SWM) practices remain inadequate. In Mbale City, Uganda, diarrheal disease ranks among the top five causes of morbidity and mortality, with over 28,000 cases reported in 2018. This study assessed the association between diarrheal disease and SWM practices and perceptions among residents of Industrial Division, Mbale City. A descriptive cross-sectional study employing both quantitative and qualitative approaches was conducted among 424 adult respondents (≥ 18 years) during the entire month of February 2020 in the Industrial Division of Mbale City. Quantitative data were collected using a structured questionnaire, while qualitative data were obtained through Focus Group Discussions (FGDs) and Key Informant (KI) interviews with community leaders and municipal officials. Data were entered into Epidemiological Data Software (EpiData) and analyzed using STATA. Potential confounders were identified from literature and expert consultation, including age, sex, education, water source, sanitation, and family size. Bivariable and multivariable logistic regression analyses were performed to assess associations between diarrhea and predictor variables. Qualitative data were analyzed using thematic content analysis. Diarrheal disease was defined as the passage of three or more loose or watery stools in 24h (WHO). The prevalence of diarrheal disease among adults in Industrial Division was 36.8%. After adjusting for confounders (age, sex, education, water source, water treatment, and toilet type), only the type of solid waste generated was significantly associated with diarrhea: households generating textiles had lower odds compared to those generating paper waste (AOR = 0.46; 95% CI: 0.24-0.90). Other significant factors included household size, source of drinking water, and toilet ownership. While overall SWM practices were moderate, key risk factors for diarrheal disease included unsafe water sources, lack of household toilets, and larger household sizes. The findings underscore the urgent need for improved sanitation, safe water supply, and community awareness on proper waste handling. Local authorities should strengthen community sensitization on SWM, ensure continuous water quality surveillance, promote construction of household toilets, and integrate family planning initiatives into urban public health programs.

Why is water insecurity so distressing? Evidence from Iran that interpersonal conflict is key.

Socioecological determinants of dog ownership in Mara region, Tanzania.

Association of Vision Impairment With Food Insecurity in U.S. Children.

Household consumption, financial constraints, and size structure of rent

TThis study analyses socioeconomic patterns through income disparities, offering a comprehensive overview of three critical factors: household income, size and composition, and consumption and expenditures. Apparently, the decline in average consumer spending due to job losses and reduced income levels is further exacerbated by the increased cost of living which has intensified financial pressures causing people to struggle financially. Considering the persistent income gap, B40 households are vulnerable to financial instability arising from low incomes, economic uncertainty, and a lack of resources that significantly limit their ability to afford basic needs and save for emergencies. Subsequently, the provision of essentials for household dependents is largely determined by household income. Nevertheless, household size and composition with the presence of multiple dependents substantially influence resource allocation and expenditure priorities. Following a comprehensive database search, this study employs Scopus AI to perform an extensive analysis of the academic publications, applying methods such as descriptions and concept maps. The findings shed light on the disparities between higher-income and lower-income households. Addressing income inequality and allocating household resources efficiently could enhance the financial resilience of B40 households, promoting stronger economic stability and progress towards sustainable development goals.

Dissonant approaches for measuring persisting symptoms after concussion (PSaC) make it difficult to predict who will experience prolonged symptoms. We sought to identify medical and sociodemographic characteristics associated with symptom burden and assess how such factors shape symptom evolution and PSaC classification after mild traumatic brain injury (mTBI). This analysis involved 1947 Post-Concussion Symptom Scale reports from 1117 youths (11-21 years): 380 with mTBI, 737 without mTBI (194 healthy non-mTBI; 543 non-mTBI with underlying medical conditions). Multivariate regressions were used to assess the relationship of symptom burden with medical and sociodemographic factors among non-mTBI youths, and interrogate how these factors impacted longitudinal symptom burden among mTBI participants. PSaC rates were characterized in the mTBI group 30 days after injury using 5 definitions: symptom burden, symptom severity, simple change in symptom burden and severity, and response to, 'What percent of normal do you feel?' In the absence of mTBI (i.e. baseline), symptom burden was associated with female sex, neuropsychiatric history, BMI and orthopaedic injury. In the 30 days following mTBI, age, sex and neuropsychiatric history were associated with symptom burden. Smaller household size, sports participation and parent education were protective. Rates of PSaC were 14.7-18.9%, displaying 84% agreement across the 5 definitions. However, PSaC misclassification was high among non-mTBI youths with underlying medical conditions (37.2-50.6%), especially with the single-item screener. Medical and sociodemographic factors affect concussion symptom reports and influence PSaC rates. A single-item screener for PSaC may be useful but risks over-detection among certain youths.

Indigenous fruits and vegetables (IFVs) are vital for enhancing dietary diversity and addressing nutritional deficiencies in developing countries. However, despite their nutritional importance, IFVs remain underutilized in many communities across Ghana, with consumption patterns shaped by complex gender and geographic disparities that are poorly understood. This study explores gender and spatial dynamics of IFV perception and consumption patterns in Ghana. Data were collected through a cross-sectional survey of 489 randomly selected IFV consumers across all sixteen administrative regions. Descriptive statistics and Poisson regression analysis were used to determine the factors influencing IFV consumption intensity. The findings reveal significant regional variations, with southern Ghana exhibiting higher IFV consumption compared to northern Ghana. Okra, kontomire (cocoyam leaf), and garden egg were the most frequently consumed IFVs. Women consistently consumed more IFVs than men, reflecting gender-based dietary preferences. Key determinants of IFV consumption intensity included age, education level, household size, and geographical location. The study underscores the importance of integrating gender and spatial considerations in policy interventions to promote IFV consumption. These insights offer valuable guidance for developing targeted strategies to improve dietary diversity, food security, and nutrition in Ghana, while addressing the broader challenges of nutritional deficiencies and sustainable food systems.

Purpose This study examines the effects of digital health technologies on enhancing children's healthcare utilization in the Kigoma region of Tanzania. It also investigates the factors that influence both the adoption and the extent of usage of digital health technologies among caregivers. Design/methodology/approach A cross-sectional research design was employed, using data collected from 400 respondents selected through a multi-stage sampling technique. A double-hurdle model was applied to analyze the determinants of digital health technology adoption and usage intensity, while a probit model was used to assess the effect of digital health usage on children's healthcare utilization. Findings The results indicate that awareness (ß = 0.643; p = 0.061), ease of use (ß = 0.113; p = 0.000), internet connectivity (ß = 0.512; p = 0.000), and participation in digital health education campaigns (ß = 0.373; p = 0.000) significantly increase the likelihood of adopting digital health technology. In contrast, negative attitudes (ß = −0.738; p = 0.069), low household income (ß = −0.649; p = 0.000), and larger household sizes (ß = −0.217; p = 0.000) reduce the probability of adoption. Among adopters, usage intensity is significantly enhanced by ease of use (ß = 0.747; p = 0.000), better internet connectivity (ß = 0.406; p = 0.001), higher household income (ß = 0.429; p = 0.000), participation in health education programs (ß = 0.607; p = 0.000), and healthcare provider assistance (ß = 0.419; p = 0.001). The double-hurdle model is strongly significant (?2 = 148.61; p = 0.000), confirming the explanatory strength of the selected variables. Regarding children's healthcare utilization specifically on vaccination uptake, mobile health applications (dy/dx = 0.384; p = 0.000) and online appointment/reminder systems (dy/dx = 0.725; p = 0.000) have significant positive effects, while electronic health records show a marginal positive influence (dy/dx = 0.162; p = 0.075). Also, socio-economic factors such as education level of the respondent (dy/dx = 0.118, p < 0.01) is positively and significantly associated with timely vaccination, Household income (dy/dx = 0.074, p < 0.05) similarly shows a positive and statistically significant effect, Participation in health education campaigns (dy/dx = 0.244, p < 0.01) is positively associated with vaccination uptake. Research limitations/implications Although the study provides valuable insights, several limitations should be considered. First, the cross-sectional design restricts causal interpretation of the observed associations. Second, self-reported measures on digital health usage may be influenced by recall or social desirability bias. Third, the study focused on mothers with children under five years, and perspectives from fathers or other caregivers were not captured. Lastly, findings are limited to Kigoma and may not fully represent all regions of Tanzania with different digital health infrastructures. Future studies could adopt longitudinal or mixed-method approaches to strengthen causal inference and generalizability. Practical implications The study recommends expanding digital health training, improving internet access, subsidizing digital health services and strengthening trust-building initiatives to enhance adoption and utilization. Policymakers should focus on integrating digital health into mainstream healthcare services to maximize its impact on healthcare accessibility, particularly for children in resource-constrained settings such as Kigoma. Originality/value This study is among the first to empirically assess both the determinants and effects of digital health technology adoption on children's healthcare utilization in a resource-constrained setting such as Kigoma, Tanzania. By applying a double hurdle model alongside a probit framework, it provides a nuanced understanding of adoption drivers, usage intensity and health outcomes. The findings highlight the distinct impact of mobile health applications and online reminder systems on pediatric healthcare access, offering actionable insights for policymakers and practitioners aiming to integrate digital health into underserved healthcare systems.

India is experiencing a major demographic and socio-economic transformation that is marked by significant changes in population structure, fertility behaviour, life expectancy, urbanization as well as household consumption patterns. The decreasing birth rates and increasing life expectancy are an indication that India is well progressing into the later phases of its demographic transition leading to age structure, household size, and dependency ratio adjustments. Concurrently, there are changes in labour markets, job opportunities and living conditions especially urbanisation and internal migration that is changing the nature of urban centres. The implications of these demographic changes are far reaching in terms of income distribution, participation of labour and household expenditure behaviour. It uses recent secondary data on population growth, age and gender structure, literacy levels, fertility and mortality pattern, household composition, and household consumption expenditure to provide a comprehensive overview of the changing demographic profile in India as well as the relationship between the changing demographic profile and the household economic behaviour. As the analysis shows, although income is the greatest factor that determines household consumption, demographic information include household size, age composition, and place of residence is critical in determining the expenditure patterns among the food, health, and non-food items. The fall in fertility and the reduction in the size of household are linked to the per capita consumption shift and the growing life expectancy has contributed to the slow increase in health-related expenditure. The results also show that there are continuing and, in other instances, increasing rural urban consumption differentials. The consumption level and the diversity of expenditure baskets are typically high in urban households, and low in rural households, though a significant portion of their expenditure remains devoted to food. These trends highlight the necessity of policy response, which is strategically and regionally focused, and which can mitigate income inequality, enhance the strength of employment opportunities, health and educational services accessibility, and inclusive growth of consumption within the framework of the current demographic shift in India.

Purpose Although interest in biofortified foods in Africa is emerging, the adoption is low, while knowledge and information are still not well advanced. Our study considered knowledge and perception in adopting biofortified food while evaluating the critical determinants from Rogers' framework to understand consumer adoption of biofortified food. Design/methodology/approach A cross-sectional online survey of Nigerian consumers was analysed using a mix of descriptive and statistics, correlation and multinomial logistic regression. Constructs of Rogers frameworks were applied to examine adoption factors and barriers. Findings Knowledge and perception were revealed to have a significant association with the adoption of biofortified food, though with paradoxical negative relationship. The critical determinants that motivate adopters' probability of adopting biofortified food are complexity, observability, gender, education, and occupation. The non-adopters’ knowledge revealed that compatibility, complexity, trialability and household size were critical in non-adoption of biofortified food. Our findings supported the use of social marketing approaches and direct marketing techniques to improve the adoption of biofortified food in the study population. Research limitations/implications The study also calls for further research into the reasons behind non-adoption, particularly focusing on how to address the barriers faced by non-adopters. Given the cross-sectional nature of the study, a longitudinal survey would be valuable for capturing changes in consumer attitudes and behaviour over time. Originality/value The originality is buttressed by the value it provides for biofortified food systems in Nigeria. No prior study has been conducted in Nigeria that examined the issue of biofortified or functional food as a system. The analysis using Roger's diffusion of innovation added more value to this study.

This research examines how agribusiness entrepreneurship can support income growth and sustainability in smallholder farmers in the Nyagatare District in Rwanda. A mixed-methods study design was used to collect data using structured questionnaires on 262 farmers and supplemented by a qualitative approach of key informants. Descriptive outcomes indicated moderate-high involvement in the entrepreneurial activities, especially in using better seeds, record keeping, and diversification of the enterprise, but little value addition had been done. Crop rotation, mulching, erosion control, reduced use of chemicals, irrigation, and post-harvest technologies were implemented on a widespread adoption, whereas there were moderate adoptions of irrigation and post-harvest technologies. Regression showed that Agribusiness entrepreneurship positively impacts both income development (b = 0.482, p < 0.001) and sustainability outcomes (b = 0.361, p < 0.01). The education level and farm size were also positively influencing variables, but not gender, age, or household size. The results are consistent with the previous research, indicating that entrepreneurship is one of the ways to get better involved in the market, use technologies, and be environmentally resilient. All in all, the research finds that agribusiness entrepreneurship should be encouraged to improve the livelihoods in rural areas, make them more sustainable, and increase the economic resilience of smallholder farmers in Rwanda. It suggests increased training, better access to finance, as well as investing in value-addition and market infrastructure in order to make the most out of entrepreneurial effects.

Rohingya refugees in Bangladesh face major healthcare challenges, and access to services to those relocated to Bhasan Char is a growing global concern. This study explores the prevalence of unmet healthcare needs across physical and mental health conditions among Rohingya refugees, compare variations between camps in Cox’s Bazar and Bhasan Char, and identifies key determinants of unmet healthcare needs overall and by camp location. We analyzed data from 11,421 individuals using two surveys: the 2023 Bhasan Char Needs Assessment and the 2024 Joint Multi-Sectoral Needs Assessment (J-MSNA) in Cox’s Bazar, both conducted using similar procedures. The outcome variable was unmet healthcare needs (yes vs no), and explanatory variables included age, sex, disability level, age of household head, household size, distance to the nearest health facility from home, and mode of travel to healthcare facilities. Multivariable logistic regression models were used to explore the associations between the outcome and explanatory variables. We found approximately 10% of Rohingya refugees reported unmet healthcare needs, with the highest unmet needs observed for acute illnesses (80%), followed by preventive care (18.3%), chronic conditions (14.7%), and trauma care (4.8%). Significant variation was observed within Cox’s Bazar’s camps, with refugees in Teknaf camps having a 25% (aOR: 1.25; 95% CI: 1.07–1.46) higher odds of unmet healthcare needs compared to those in Ukhiya camps. Key determinants of unmet healthcare needs include older age, moderate to severe disabilities, and larger household size. No significant differences in unmet healthcare needs were found between residents of Cox’s Bazar and Bhasan Char. These findings highlight that, although overall differences between Bhasan Char and Cox’s Bazar were not evident, substantial inequalities exist across camps within Cox’s Bazar. This underscores the need for targeted interventions, particularly in Teknaf camps, and tailored strategies to support vulnerable groups such as those living with disabilities.

ABSTRACT The residential sector in Jordan accounts for 61% of national primary energy consumption, with low-income households contributing substantially to this demand. However, empirical evidence on household energy use remains scarce. This study draws on survey data from nearly 400 households in Amman to identify key determinants of energy consumption. Data on building attributes, household characteristics, and energy-related behaviours were collected through interviewer-administered questionnaires. Descriptive statistics and stepwise multiple linear regression were employed to assess how these factors influence energy consumption. Four regression models were tested: building characteristics (e.g. floor area, thermal performance); household attributes (e.g. household size, age composition); energy-related behaviour (e.g. heating-and-cooling patterns, sociocultural practices); and a combined model, against energy expenditure as the dependent variable. Building factors explained 9.6% of the variance in energy expenditure, while household characteristics and behavioural factors accounted for 40.2% and 30.3%, respectively. Air-conditioner ownership emerged as the strongest predictor, followed by the presence of young adults, heating-and-cooling duration, number of cooling devices, and daylight quality. This study represents one of the first empirical assessments of how building and occupant-related factors collectively influence household energy demand, providing an evidence-based foundation for future research and policy in Jordan and comparable contexts across the Global South.

Long-acting reversible contraceptives (LARCs) are critical for reducing maternal mortality and unintended pregnancies, yet adoption remains low in Sub-Saharan Africa (SSA) due to systemic inequities, cultural barriers, and fragmented healthcare access. Despite global advancements, only 8% of women in SSA use LARCs, underscoring the need for data-driven insights to address this gap. This study applies machine learning (ML) to identify key predictors of LARC use and guide interventions. Nationally representative data from 14,275 women across nine SSA countries were analyzed. Preprocessing included k-NN imputation and advanced class balancing (SMOTEENN). Feature engineering derived interaction terms (age×household size, education×media exposure) with SHAP-driven selection. Eight ML models were trained and hyperparameter-tuned using stratified cross-validation. After hyperparameter tuning and class balancing, Random Forest achieved excellent discriminative performance (AUC-ROC: 1.00). Key predictors were household size (SHAP = 0.464), age at first contraceptive use (0.396), and current age (0.376). Socio-cultural factors (religion, marital status) showed negligible impact and were excluded. LARC uptake remained critically low (3.3%) with persistent rural-urban disparities. The model's key predictors directly inform policy; we recommend: 1) Mobile clinics for young women in large households, targeting the two strongest negative predictors (young age and large household size), 2) Media campaigns tailored to educated populations, leveraging the significant interaction between education and media exposure, and 3) Adolescent-focused education on contraceptive timing, addressing the critical predictor of age at first use.

As the global demand for sustainable energy intensifies in response to climate change and energy insecurity, renewable energy has become a vital component of development strategies, especially in low- and middle-income countries. In sub-Saharan Africa, where a significant portion of the population remains either unconnected to the national grid or faces unreliable electricity access, the shift toward renewable energy is not just a matter of environmental sustainability but also of economic necessity. Zambia, despite its vast hydroelectric potential, faces challenges in energy distribution and affordability, particularly in low-income urban communities. Consequently, many households are exploring renewable alternatives such as solar power to meet their energy needs. This study assessed the effectiveness of household renewable energy adoption in reducing energy-related costs within the Munali community. Specifically, the study aimed to evaluate the effects of renewable energy adoption on household energy expenditure, examined the types of renewable energy sources adopted, identified socio-economic factors associated with renewable energy adoption, established the limitations households face in transitioning from traditional to renewable energy sources and evaluated the impact of adoption on household energy costs. The study embraced an exploratory case study design, employing a mixed method approach consisting of both qualitative and quantitative methods of gathering primary data. The study employed a simple random sampling approach to ensure that every household in Munali constituency has an equal chance of being selected. Data was collected through structured surveys and interviews, utilizing standardized questionnaires. Data entry and analysis was done using STATA. Descriptive statistics, including frequencies, percentages, and means, were used to summarize data. Chi-square was used to determine associations between variables. The study found that renewable energy adoption in Munali Constituency was influenced by socio-economic factors such as income levels, employment status, household size, and expenditure patterns, with unreliable ZESCO supply as the main driver. Solar was the most widely adopted source, mainly for lighting, with financing largely through household savings and limited subsidies. Adoption significantly reduced household energy expenditure, enabling savings for food security, education, healthcare, and assets, though challenges of high upfront costs, limited technical support, poor product accessibility, and maintenance issues persisted. Despite these barriers, most households expressed strong willingness to fully transition if affordability, accessibility, and technical assistance were improved. The study recommends enhancing affordability of renewable energy through subsidies, low-interest loans, and flexible payment schemes while strengthening technical support by training local technicians and establishing service centers. Improving product accessibility through local manufacturing and stronger distribution networks, coupled with awareness campaigns and demonstration projects, can address knowledge gaps. Policies should encourage diverse use of renewable energy beyond lighting, supported by public–private partnerships to expand access through innovative financing models. Finally, clear regulatory frameworks and quality standards are needed to promote trust, affordability, and sustainable adoption.

Background: Women play a critical role in both household management and agricultural production in rural Bangladesh. In Dumuria Upazila, Khulna district, it is well known that women dairy farmers contribute significantly to household income and food security. However, they face socio-economic and gender-based barriers that affect their access to resources, decision-making power and adoption of modern technologies. This study explores gender roles, access to credit, ownership perception and the adoption of climate-smart agricultural practices among women dairy farmers, who spend their time mostly on the farming. Methods: A qualitative interviewfor gender analysis was conducted among 133 women dairy farmers selected from a broader population of 3,050 women aged 20 to 89 years in Dumuria Upazila of Khulna district. The family income of those farmers comes mostly from dairy farming. Data were collected through 12 Key Informant Interviews (KIIs) and 3 Focus Group Discussions (FGDs) on demographics, household size, educational background, farming experience, access to credit, financial and decision-making involvement, asset perception and adoption of climate-smart technologies. The responses were analyzed to understand the gender dynamics and socio-economic conditions affecting the livelihood of those women. Result: The higher number of the respondents (44 farmers, 33%) were aged between 30-49. Women managed both household and farming responsibilities, with family sizes ranged from 2 to 10 members and dairy farming experience ranging from new entrants to over 30 years. Educational attainment varied. Only 35 (26.31%) respondents had access to credit. Nevertheless, women showed increasing involvement in financial decisions and milk distribution. Although most assets were officially registered in their husbands’ names, 131 (98.50%) women perceived the assets as their own. Joint decision-making in income management was common, though in households with elders or in-laws decisions were largely elder-driven.Regarding climate-smart technologies, only 14 (10.5%) respondents acknowledged familiarity. Nine (6.77%) used biogas plants and two used biogas combined with vermi-composting. Other mentioned to include rubber mats, water pumps and fans-suggesting unintentional use of such technologies. However, 64 (48%) respondents were unaware, 53 (39.85%) marked “N/A,” and one responded negatively, highlighting a major awareness gap in climate-smart farming practices.It was concluded from the findings that while women in dairy farming are increasingly participating in financial and household decision-making, their formal financial empowerment, such as buying assets in their names or opening fixed deposit in bank and access to climate-smart technologies remain limited, with a significant awareness gap in sustainable farming practices underscoring the need for targeted education and support interventions.

Due to the ongoing aging process in many societies, Successful Aging-SA is of paramount importance both individually and socially. The objective criteria for SA, as formulated by Rowe and Kahn, are the subject of critical debate. One criticism is the lack of a subjective assessment of SA by individuals. The aim was to examine SA and its determinants from the perspective of older adults. The study included 2,964 individuals aged 60-103years (mean 70.44;SD = 7.09) - 1,974 women (66.60%) and 990 men (33.40%). The study area was southern Poland. The research tool was a questionnaire consisting of a metric section and a proprietary tool - the Successful Aging Index-SAI. Additionally, the study utilized questionnaires assessing health-related quality of life - the SF-12, physical activity - the PAQE, and anxiety and depression - the HADS. SAI was higher in women than in men. There was no correlation between age and the domains or the overall SAI. Sociodemographic variables: education, size of residence, marital status, household management, presence of chronic disease, and having children differentiated SAI and its domains: p < 0.0001. Regression results showed that physical and mental health components, education level, and household size positively influenced SAI levels. A sense of physical and mental health has a key impact on SA. Important moderators of SA include individual agency, sociodemographic factors, and, in particular, education level and household type. Due to the difficulties in defining unambiguous quality criteria, SA should be treated as a linear variable.

The present study employs cluster analysis to segment Bulgarian domestic tourists based on microdata from a nationally representative survey (n = 1003) of summer holidaymakers on the Black Sea coast destinations. The primary objective is to identify homogeneous groups of tourists with similar demographic and behavioural characteristics, thereby enabling the development of more targeted tourism policies and marketing strategies. The methodological framework includes both hierarchical and non-hierarchical (k-means) clustering, applied to standardized variables such as age, household size, satisfaction with various aspects of the tourist experience, and behavioural intentions. The analysis reveals four distinct tourist profiles, each characterized by specific patterns of evaluation and travel behaviour—retirement age loyalists, middle-aged sceptics, younger moderate enthusiasts and young high loyalists. The findings reveal the heterogeneity of the domestic tourism market in Bulgaria and provide a data-driven foundation for enhancing the effectiveness of tourism management and promotional efforts.

BackgroundChildhood diarrhea continues to be a major contributor to morbidity and mortality among children under five years of age. This study provides an analysis of global childhood diarrhea prevalence, drawing on standardized, nationally representative survey data collected over a four-decade period from 1985 to 2024.MethodsA systematic review of Demographic and Health Surveys and Multiple Indicator Cluster Surveys conducted up to October 30, 2024, was undertaken, with findings reported in accordance with PRISMA guidelines. Random-effects meta-analyses were used to estimate pooled mean prevalence, while meta-regression analyses were conducted to examine associations and assess temporal trends. Factor analysis was employed to construct a Socioeconomic and Child Nutrition Index, integrating socioeconomic, water, sanitation, hygiene, and nutrition indicators.ResultsThe analysis identified 593 relevant studies, estimating a global pooled mean childhood diarrhea prevalence of 14.4% (95% CI: 13.8–15.0%) across all regions and time periods. Prevalence declined at a rate of 1% per year, falling from 22.2% in 1985–1989 to 10.9% in 2020–2024, with consistent declines observed in all regions except the Eastern Mediterranean Region. Prevalence was highest in the African Region and lowest in the European Region. Higher prevalence was observed in countries with larger household sizes, longer water collection times, and higher rates of underweight, stunting, and wasting. Conversely, lower prevalence was found in countries with greater urbanization, higher maternal education, population density, Human Development Index, income per capita, and access to improved water sources and sanitation facilities. A higher Socioeconomic and Child Nutrition Index was strongly and consistently associated with lower diarrhea prevalence, demonstrating a dose–response relationship.ConclusionChildhood diarrhea prevalence has declined over recent decades, reflecting the combined impact of public health interventions and broader structural improvements. These findings underscore the need for an integrated approach that pairs targeted health strategies with sustained socioeconomic development to address upstream determinants and support long-term progress in child health.DisclosuresAll Authors: No reported disclosures