Water, sanitation, and hygiene–specific risk factors of recent diarrheal episodes in children aged under 5 years: analysis of secondary data from the multiple indicator cluster survey (MICS 2019)

Objectives

Access to safe drinking water, sanitation, and hygiene, collectively called WASH, is a fundamental human right and a cornerstone of public health. However, inadequate WASH practices and environments significantly contribute to the global burden of diarrheal diseases, particularly, in children aged under 5 years. Inadequate WASH conditions are the primary drivers of various infectious diseases, including cholera, dysentery, hepatitis A, typhoid, and polio.

Methods

We conducted secondary data analysis using the 2019 Zimbabwe Multiple Indicator Cluster Survey to investigate the specific WASH risk factors associated with recent diarrheal episodes in children aged under 5 years.

Results

A total of 853 (14%) of 6092 children were reported to have experienced an episode of diarrhea in the last 2 weeks preceding the survey. Having insufficient water in the household was associated with 17.0% diarrhea episodes compared with 13.6% in those who did not face this problem. The availability of soap or detergents to wash hands was associated with a risk of diarrhea, with an odds ratio and 95% confidence interval of 1.19 (1.01-1.40), P = 0.033. The use of surface water, including rivers, dams, lakes, ponds, streams, canals, and irrigation channels, was associated with differences in diarrheal episodes, although this was of borderline significance, P = 0.082. Of the children who had a recent episode of diarrhea, 41.0% had their parents or caregivers seeking medical attention.

Conclusions

There is need for an improvement in safe water supply to households and an improvement in health education on the importance of using soap after using the toilet to avoid contamination of food and water.