Plausibility Evaluation of Integrated WASH, Health, and Nutrition Programming on Childhood Growth and Maternal and Child Illness in Oromia, Ethiopia Público
Head, Jennifer Renee (2016)
Published
Abstract
Background: Exposure to poor water, sanitation, and hygiene (WASH) may reduce absorption and utilization of essential nutrients, leading to sub-optimal growth. The Development Food Aid Program in Ethiopia targets maternal and child undernutrition through programs of one of two types: 1) health and nutrition only, or 2) integrated WASH, health, and nutrition. The health and nutrition only intervention involved training of health workers and community nutrition education; the integrated intervention added installation of water taps and community-led total sanitation and hygiene (CLTSH). Four years post program initiation, our objectives were to compare prevalence of undernutrition and two-week disease history in women and children 0-59 months between intervention groups and to examine the contribution of intervention components by quantifying associations between diet and WASH conditions and nutritional and disease outcomes.
Methods: A cross-sectional household survey (n=1,007) of mothers of children 0-59 mo was conducted in the Oromia Region of Ethiopia. Household selection followed a three-stage random-selection process. Household WASH conditions and diet and disease history were measured for each mother and one randomly selected child per household, and anthropometry was measured for this child. Data were analyzed using logistic regression, accounting for clustering at the kebele level. Baseline data were not representative of the area surveyed in this study due to resource constraints and were not used in analysis.
Results: Children in kebeles receiving the integrated intervention had a 16 percentage point lower prevalence of stunting (HAZ≤-2) and a 13.5 percentage point lower prevalence of caretaker-reported fever than children in kebeles receiving the health and nutrition intervention (p<0.05). Household sanitation facility was the strongest predictor of stunting, underweight and diarrhea in children, controlling for education level of mother and head of household, diet, child age and sex, and other environmental conditions. Factors associated with reduced disease in women included increased household food security, access to an improved water source, and a separate enclosure for livestock (p<0.05).
Conclusion: Integration of WASH activities and health and nutrition interventions was associated with less stunting and fever in children within the Oromia Region. Improvements in sanitation, targeted through CLTSH, may have contributed.
Table of Contents
Introduction..................................1
Literature Review...........................2
Manuscript....................................7
Abstract........................................7
Introduction..................................8
Methods......................................11
Results........................................14
Discussion...................................17
Conclusion..................................23
Acknowledgements......................23
Conclusion and Recommendations...23
Figures and Tables.......................26
References..................................33
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