Even though simple and effective treatments are available for diarrhea, it remains one of the leading causes of death in children under the age of five, accounting for 1.6 million deaths in 2017. Inadequate access to safe drinking water, particularly for pastoralists in Ethiopia, who are compelled to search for water during dry season. Thus, this study aimed to evaluate the quality of drinking water, sanitation, hygiene, and the prevalence of diarrhea among pastoralists’ children in Ethiopian. Methodology: Using a questionnaire, a cross-sectional study of 538 randomly selected households was done in 2018 to assess the prevalence of diarrhea in children younger than five years old and its association with water quality, sanitation, and hygiene. Portable DelAgua field kits were utilized to evaluate sources and home water for Escherichia coli contamination (E. coli). Logistic regression was used to assess the risk factors of water quality and diarrhea. Results: The prevalence of diarrhea was found to be 26.6% and 31.4% in the first and second weeks, respectively. There was an association between the prevalence of diarrhea in children and the consumption of low-quality water, improper storage conditions, caregivers who did not wash their hands prior to feeding a child, whenever their hands were filthy, and children aged 12 to 24 months. In terms of drinking water, households dependent on river water and unprotected dug wells had a considerably greater likelihood of faecal contamination than those dependent on protected water (Barkad). With regard to sanitation, almost all of the households surveyed lacked basic sanitation (95.9%) and hygiene. Conclusion: Water quality, hand-washing practice, water storage conditions, and the age of the children were found to be significantly associated with diarrhea. Thus, the current burden of diarrheal diseases in these children can be reduced by promoting widespread use of proven preventative measures, such as increasing awareness on handwashing, sanitation, waste disposal management and better treatment of stored water, and periodic monitoring of water quality.
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