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      Burden of Common Childhood Diseases in Relation to Improved Water, Sanitation, and Hygiene (WASH) among Nigerian Children

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          Abstract

          Having access to improved water, sanitation, and hygiene (WASH) facilities constitute a key component of healthy living and quality of life. Prolonged exposure to insanitary living conditions can significantly enhance the burden of infectious diseases among children and affect nutritional status and growth. In this study we examined the prevalence of some common infectious diseases/disease symptoms of childhood among under-five children in Nigeria, and the association between the occurrence of these diseases with household’s access to WASH facilities. Types of diseases used as outcome variables included diarrheal, and acute respiratory infections (fever and cough). Access to WASH facilities were defined by WHO classification. The association between diarrhoea, fever and chronic cough with sanitation, and hygiene was analyzed by logistic regression techniques. Results showed that the prevalence of diarrhoea, fever and cough was respectively 10.5% (95% CI = 9.7–2.0), 13.4% (95% CI = 11.9–14.8), and 10.4% (95% CI = 9.2–11.5). In the regression analysis, children in the households that lacked all three types of facilities were found to have respectively 1.32 [AOR = 1.329, 95% CI = 1.046–1.947], 1.24 [AOR = 1.242, 95% CI = 1.050–1.468] and 1.43 [AOR = 1.432, 95% CI = 1.113–2.902] times higher odds of suffering from diarrhea, fever and cough. The study concludes that unimproved WASH conditions is an important contributor to ARIs and diarrheal morbidities among Nigerian children. In light of these findings, it is recommended that programs targeting to reduce childhood morbidity and mortality from common infectious diseases should leverage equitable provision of WASH interventions.

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          Diarrhoea: why children are still dying and what can be done.

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            The Integrated Behavioural Model for Water, Sanitation, and Hygiene: a systematic review of behavioural models and a framework for designing and evaluating behaviour change interventions in infrastructure-restricted settings

            Background Promotion and provision of low-cost technologies that enable improved water, sanitation, and hygiene (WASH) practices are seen as viable solutions for reducing high rates of morbidity and mortality due to enteric illnesses in low-income countries. A number of theoretical models, explanatory frameworks, and decision-making models have emerged which attempt to guide behaviour change interventions related to WASH. The design and evaluation of such interventions would benefit from a synthesis of this body of theory informing WASH behaviour change and maintenance. Methods We completed a systematic review of existing models and frameworks through a search of related articles available in PubMed and in the grey literature. Information on the organization of behavioural determinants was extracted from the references that fulfilled the selection criteria and synthesized. Results from this synthesis were combined with other relevant literature, and from feedback through concurrent formative and pilot research conducted in the context of two cluster-randomized trials on the efficacy of WASH behaviour change interventions to inform the development of a framework to guide the development and evaluation of WASH interventions: the Integrated Behavioural Model for Water, Sanitation, and Hygiene (IBM-WASH). Results We identified 15 WASH-specific theoretical models, behaviour change frameworks, or programmatic models, of which 9 addressed our review questions. Existing models under-represented the potential role of technology in influencing behavioural outcomes, focused on individual-level behavioural determinants, and had largely ignored the role of the physical and natural environment. IBM-WASH attempts to correct this by acknowledging three dimensions (Contextual Factors, Psychosocial Factors, and Technology Factors) that operate on five-levels (structural, community, household, individual, and habitual). Conclusions A number of WASH-specific models and frameworks exist, yet with some limitations. The IBM-WASH model aims to provide both a conceptual and practical tool for improving our understanding and evaluation of the multi-level multi-dimensional factors that influence water, sanitation, and hygiene practices in infrastructure-constrained settings. We outline future applications of our proposed model as well as future research priorities needed to advance our understanding of the sustained adoption of water, sanitation, and hygiene technologies and practices.
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              Women’s decision-making autonomy and utilisation of maternal healthcare services: results from the Bangladesh Demographic and Health Survey

              Objectives The aim of this study was to determine the association between women’s decision-making power and utilisation of maternal healthcare services (MHS) among Bangladeshi women. Settings This is a nationally representative survey that encompassed Dhaka, Rajshahi, Rangpur, Chittagong, Khulna, Barisal and Sylhet in Bangladesh. Sample households were selected by a two-stage stratification technique. First, 207 clusters in urban areas and 393 in rural areas were selected for 600 enumeration areas with proportional probability. In the second stage, on average 30 households were selected systematically from the enumeration areas. Finally, 17 989 households were selected for the survey of which 96% were interviewed successfully. Participants Cross-sectional data on 4309 non-pregnant women were collected from Bangladesh demographic and health survey 2014. Decision-making status on respondent's own healthcare, large household purchases, having a say on child’s healthcare and visiting to family or relatives were included in the analysis. Results Prevalence of at least four antenatal attendance, facility delivery and postnatal check-up were respectively 32.6% (95% CI 31.2 to 34), 40.6% (95% CI 39.13 to 42.07) and 66.3% (95% CI 64.89 to 67.71). Compared with women who could make decisions alone, women in the urban areas who had to decide on their healthcare with husband/partner had 20% (95% CI 0.794 to 1.799) higher odds of attending at least four antenatal visits and those in rural areas had 35% (95% CI 0.464 to 0.897) lower odds of attending at least four antenatal visits. Women in urban and rural areas had respectively 43% (95% CI 0.941 to 2.169) and 28% (95% CI 0.928 to 1.751) higher odds of receiving postnatal check-up when their health decisions were made jointly with their husband/partner. Conclusion Neither making decisions alone, nor deciding jointly with husband/partner was always positively associated with the utilisation of all three types of MHS. This study concludes that better spousal cooperation on household and health issues could lead to higher utilisation of MHS services.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                12 June 2018
                June 2018
                : 15
                : 6
                : 1241
                Affiliations
                [1 ]School of Politics and Public Administration, Southwest University of Political Science & Law, Chongqing 401120, China; houis123@ 123456163.com (Z.H.); mrzds023@ 123456163.com (D.Z.)
                [2 ]School of International Development and Global Studies, University of Ottawa, Ottawa, ON K1N 6N5, Canada; brammaputram@ 123456gmail.com (G.B.); sanni.yaya@ 123456uOttawa.ca (S.Y.)
                [3 ]Health Information Center, Chongqing 401120, China; czhbtx@ 123456163.com
                Author notes
                [* ]Correspondence: mszhouyan023@ 123456163.com
                Author information
                https://orcid.org/0000-0003-4461-3821
                https://orcid.org/0000-0002-4876-6043
                Article
                ijerph-15-01241
                10.3390/ijerph15061241
                6025597
                29895758
                24ef4b4b-6ef3-450f-875a-22e4bc8663ae
                © 2018 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 25 April 2018
                : 07 June 2018
                Categories
                Article

                Public health
                diarrhea,fever,cough,nigeria,infant health
                Public health
                diarrhea, fever, cough, nigeria, infant health

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