Background Most childhood diarrheal illnesses are a result of the faeco-oral transmission of infected food, water, and unclean fingers. The present paper was conducted to estimate the prevalence of hygienic disposal of stools (HDS) and its associated factors, and further quantify the impact of HDS on diarrheal diseases among children under two years. Methods A cross-sectional design was used to evaluate three rounds of the Ghana Demographic Health Survey (GDHS) from 2003–2014 involving 4869 women with children aged under two years. The outcomes were prevalence of HDS and diarrheal diseases. Poisson regression model was employed to assess risk factors associated with HDS and dominance analysis was used to rank the important risk factors. Inverse Probability Weighting Poisson Regression Adjustment (IPWPRA) with Propensity Score 1:1 density kernel-based matching was employed to assess impact. Results The pooled prevalence rate of HDS was 26.5%(95%CI = 24.6–28.4) and it ranged from 18.7% (95%CI = 16.4–21.2) in 2014 to 38.8%(95%CI = 35.3–42.4) in 2003. Diarrhea diseases pooled prevalence was 17.9%(95%CI = 16.4–19.5) and ranged from 13.3%(95%CI = 11.1–15.9) in 2014 to 25.4%(95%CI = 22.2–28.9) in 2003. The overall growth rate for HDS and prevalence of diarrhea diseases, decreased by 21.6% and 11.4% respectively. The most important risk factors of HDS from dominance analysis included; age of the child, wealth index, and differences in region. From pooled data wealth index, increasing age of the child, and regional disparity constituted approximately 72% of the overall impact (Weighted Standardized Dominance Statistics (WSDS) = 0.30, 0.24, and 0.19 respectively). In 2014, they constituted approximately 79% (WSDS = 0.139, 0.177 and 0.471 respectively). The average prevalence of diarrheal diseases among children of women who practiced HDS reduced over the period of the GDHS compared to those whose mothers did not practice HDS [2008 ATE(95%CI) = -0.09(-0.16–0.02), 2014 ATE(95%CI) = -0.05(-0.09–0.01) and Pooled data ATE(95%CI) = -0.05(-0.09–0.02)]. Conclusion This analysis has provided empirical evidence of the impact of practicing HDS in Ghana from a national household survey. Implementation of the WASH agenda in this low-income setting requires a synergy of interventions and collaborations of actors (government, private and development partners) to improve water and sanitation facilities and to increase hygiene education to prevent the spread of diseases including diarrhea by 2025.
Background: Adolescent health has assumed greater significance globally since adolescents bear a considerable proportion of the global disease and injury burden. Thus investing in their health can yield substantial benefit. Community surveys are useful tools for identifying the needs of adolescents and promoting their health. Objective: This study was part of a medical education programme with the objective of identifying health and social problems of adolescents living in Korle Worko, a suburb of Accra, Ghana. Methods: This cross-sectional study was conducted in 2015 using structured questionnaires which were administered to 729 heads of households and 228 adolescents. Weight and height measurements were performed on the adolescents, while key informant interviews were also conducted among community elders and adolescents. Community mapping and pair-wise matrix construction were done. The data was summarized using SPSS and Geographic Information Systems. Results: The most commonly reported health complaints of adolescents were stomach ache, common cold, skin rashes, sadness or crying a lot, lack of concentration and hearing problems or earache. Asthma was the most common chronic diseases reported. Whereas 22.7% of the females were either overweight or obese, 7.4% of the males were overweight or obese and the difference was statistically significant (p=0.002). The spatial pattern of alcohol use correlates with drug abuse, suggesting that adolescent risky behaviour may be influenced by antisocial behaviour in the community at large. Conclusion: Over-nutrition, under-nutrition, abdominal, respiratory and mental health problems were prominent findings in this study. Therefore, adolescent health services should target these diseases. Additionally, efforts at preventing lifestyle related risk factors should also target the areas of influence within the community.
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