Undernutrition among under-five children is a public health concern in developing countries and has been linked with poor water, sanitation, and hygiene (WASH) practices. This study aimed at assessing WASH practices and its association with nutritional status of under-five children in semi-pastoral communities of Arusha. The study was cross-sectional in design. Mother-child pairs from 310 households in four villages of Monduli and Longido were involved. Weight and height of children were measured using weighing scale and length/height board, respectively. Children's age was recorded using clinic cards. Hemoglobin level of each child was tested using Hemo Cue Hb 201 + photometer (HemoCue AB, Ängelholm, Sweden) machine. Structured questionnaire was used to gather information on WASH, child morbidity, demographic, and sociocultural characteristics. Prevalence of stunted, underweight, wasted, anemia, and diarrhea were 31.6%, 15.5%, 4.5% 61.2%, and 15.5%, respectively. Children with diarrhea 2 weeks preceding the survey ( = 0.004), children using surface water for domestic purposes ( < 0.001), and those with uneducated mothers ( = 0.001) had increased risk of being stunted and underweight. Children introduced to complementary foods before 6 months of age ( = 0.02) or belonging to polygamous families ( = 0.03) had increased risk of being stunted. Consumption of cow's milk that is not boiled ( = 0.05) or being a boy ( = 0.03) was associated with underweight. Prevalence of undernutrition among under-five children in the population under study was alarming and it could be associated with poor WASH practices and other sociocultural factors. This study underlines the importance of incorporating WASH strategies in formulation of interventions targeting on promotion of nutrition and disease prevention in pastoral communities.

The study aimed at assessing water, sanitation, and hygiene practices and their influence on infectious diseases among under-five children in semipastoral communities of Arusha. The study was cross-sectional in design. Prevalence of infectious diseases among under-five children was derived from patients' attendance register. Mothers randomly sampled from households were interviewed using questionnaire. Information regarding child morbidity and sociodemographic and WASH characteristics was gathered. Hospital data revealed that 2/3 of under-five patients visited the hospitals annually were suffering from infectious diseases. Mean percentage of diarrhea prevalence for years 2013–2015 in Longido was higher than the mean of the respective years prevalence in Monduli (p = 0.02). Households' survey showed that 15.5% of under-five children were suffering from diarrhea. Children who consumed foods kept in kibuyu (p < 0.001) or used unboiled cows' milk (p = 0.01) or were drinking surface water (p = 0.04) or born to uneducated mothers (p = 0.01) had increased risk of developing diarrhea compared to their counterparts. Storing complementary foods in kibuyu was strongly associated with diarrhea among under-five children. To address the problem, communities under study need to be motivated through health education on food hygiene, proper handling of food storage containers, and domestic water treatment at the household level.

Formative research findings from the fast-growing Babati town were used to assess the prevalence of sanitation and hygiene practices among individuals and institutions and associated factors. A cross-sectional study involving household surveys, spot-checks, focus group discussions, in-depth interviews, and structured observations of behaviors showed that 90% of households have sanitation facilities, but 68% have safely managed sanitation services. The most common types of household sanitation facilities were pit latrines with slab (42%) followed by flush/pour flush toilets (32%). Therefore, the management of wastewater depends entirely on onsite sanitation systems. The majority of households (70%) do not practice proper hygiene behaviors. Thirteen percent of the households had handwashing stations with soap and water, handwashing practice being more common to women (38%) than men (18%). The reported handwashing practices during the four critical moments (handwashing with soap before eating and feeding, after defecation, after cleaning child's bottom, and after touching any dirt/dust) differed from the actual/observed practices. Households connected to the town's piped water supply were more likely to practice handwashing than those not directly connected. Sanitation and hygiene behaviors of the people in the study area were seen to be influenced by sociodemographic, cultural, and economic factors. The conditions of sanitation and hygiene facilities in public places were unsatisfactory. There is an urgent need to ensure that the sanitation and hygiene services and behaviors along the value chain (from waste production/source to disposal/end point) are improved both at the household level and in public places through improved sanitation services and the promotion of effective hygiene behavior change programs integrated into ongoing government programs and planning.

Under-nutrition and common infections among children aged below five years in semi-pastoral communities of northern Tanzania could be contributed by poor water, sanitation and hygiene (WASH) practices. The burden of these practices to the health of children under-five years seem to be given less consideration and much focus is on curative measures, vaccination and food supplementation. WASH interventions have been reported elsewhere to reduce the problems of under-nutrition and common infections among this age group. However, no any WASH intervention done in semi-pastoral communities to reduce the problems of under-nutrition and common infections among children under-five years. This study assessed the influence of WASH interventions on common infections and nutritional status among children under-five years in semi-pastoral communities of Arusha, Tanzania. The study reviewed hospital attendance registers from Monduli and Longido District hospitals for year 2013 to 2015 to identify the existing trends of common infections among under-five children, followed by a household survey where a total of 310 mother-child pairs were randomly selected and data on child morbidity, WASH practices, cultural and socio-demographic characteristics was collected through facilitated interviews. Anthropometric measurements and hemoglobin levels of under-five children were taken. Thereafter, participants from Longido District were divided into intervention and control groups. The intervention group was provided with WASH package consisting of health education and nano-filters for filtering drinking water. The control group continued with their normal WASH practices. After six months follow up, assessment to determine the effectiveness of the interventions on diarrhea prevalence and nutritional status among under-five children was done. Samples of fresh milk ready to feed children and drinking water from storage containers were also tested to see status of E. coli in samples from the two groups. About two third of under-five patients attended the hospitals were suffering from infectious diseases. Household survey revealed that 87% of respondents did not have toilets and 96% of those with no toilets were practicing open defecation. About 12% of respondents reported washing hands with soap during critical moments while 46% of respondents reported using unsafe surface water for domestic purposes. Again, 31.6% of under-five children were stunted, 61.2% were anemic while 15.5% had suffered from diarrhea two weeks preceding survey. Children fed on complementary foods kept in calabash/kibuyu (p < 0.001) had increased risk of suffering from diarrhea. Use of surface water for domestic purposes was ii strongly associated with diarrhea, stunting and/or under-weight (p < 0.001). After intervention, incidences of diarrhea (p = 0.03) and rate of underweight (p = 0.02) were significantly reduced among under-five children when compared to those from the control group. Conclusion: Use of surface water for domestic purposes, storage of complementary foods in calabash/kibuyu, and lack of formal education among mothers of under-five children were found to contribute significantly to diarrhea and under-nutrition among this participant population. This study highlights the need for health education promotion and treatment of drinking water at the point of use to address the problems of under-nutrition and common infections among children under-five years in semi pastoral communities and similar settings.

Sub-Sahara African countries face immense challenges in ensuring adequate sanitation and hygiene behaviours to the rapidly growing populations. Attempts to address these challenges require empirical evidence to inform policy and planning. We contribute toward that goal by unveiling findings of formative research conducted in Babati, a rapidly growing town in Tanzania. We conducted a cross-sectional study involving 486 households, to unwind motives and barriers for individuals to invest in improved sanitation services and hygiene behaviour change. We used several methods including household survey, focus group discussions, behaviour observations and spot checks. The findings revealed that households derive their motivation to invest in improved sanitation and hygiene practices from comfort, raising social status, and the need for personal safety and privacy. Other motives include fear of penalties and fines and fear of disease outbreaks, whilst the barriers include, limited water availability and accessibility, environmental factors, property rights, cultural issues, financial constraints, and a person’s attitude. Quantitative data were subjected to multivariate analysis to identify determinants of households to invest in sanitation and hygiene practices. The logistic regression analyses revealed that sources of water, property rights, and education level were the main determinants of households to invest in sanitation and hygiene facilities, while household income was the main determinant for households to invest in both construction of handwashing facility and water treatment. We argue that the initiative to promote sanitation and hygiene behaviour change in small towns should focus on promoting motivation factors and abating the determinant factors identified in this study.