Unhygienic stool-disposal practices among mothers of children under five in Cambodia: Evidence from a demographic and health survey

Abstract

Background Unhygienic disposal of children’s stools affects children’s health in terms of their susceptibility to many diseases. However, there are no existing studies into the impact of unhygienic stool disposal in Cambodia. Therefore, this study aimed to identify factors associated with the unhygienic disposal of children’s stools among children under the age of five in Cambodia. Methods An analytical cross-sectional study was conducted using data from the Cambodia Demographic and Health Survey (CDHS) 2014. A multivariable binary logistic regression was conducted using Stata to analyze factors associated with the unhygienic disposal of children’s stools. Results Overall, the prevalence of practicing unhygienic disposal of children’s stools was 29.27% (95%CI: 27.51%- 31.09%). Factors statistically associated with this practice were: living in the Central Plain, Plateau and Mountains, Coastal and Sea regions (AOR = 1.65; 95% CI: 1.33–2.04), (AOR = 2.53; 95% CI: 1.98–3.24) and (AOR = 4.16; 95% CI: 3.15–5.48) respectively, poor household wealth (AOR = 1.58; 95% CI: 1.31–1.91), the mother having no education (AOR = 1.45; 95% CI: 1.14–1.85), a high number of children aged under five (AOR = 1.11; 95% CI: 1.03–1.20), being in the “other” religious category (AOR = 1.77; 95% CI: 1.25–2.51), living in a household with unimproved toilet facilities (AOR = 1.22; 95% CI: 1.11–1.34), living in a household with inadequate hygiene (AOR = 1.33; 95% CI: 1.12–1.59), and the household not being visited by a family planning worker in the last year (AOR = 1.45; 95% CI: 1.19–1.77). However, an increase in the child’s age by even a month had significant negative associations with unhygienic practice (AOR = 0.65; 95% CI: 0.60–0.70), even when controlling for other covariates. Conclusion Almost one third of the mothers do not practice hygienic disposal of children’s stools in Cambodia. Unhygienic practices were more prevalent in certain regions, and were also associated with low wealth, lack of education, an increase in the number of children under five in the household, religion, lack of sanitation and access to healthcare professionals. Conversely, the child’s age was found to be positively associated with the hygienic disposal of children’s stools.

Hygienic Child Feces Disposal Practice and Its Associated Factors among Mothers/Caregivers of Under Five Children in West Armachiho District, Northwest Ethiopia

“…The level of safe CFD revealed in this study is comparable to that found in a study conducted in Madagascar (38%), 30 and Ethiopia. 21 However, the proportion of CFD practice in the current study was lower than studies of Zambia (77.81%), 21 Nigeria (56.95%), 21 Malawi (84.67%), 21 Kenya (70%), 31 Malawi (79%), 32 Mali (63.5), 21 Cambodia (70.73%), 33 and Uganda (75%). 34 This difference might be due to socio-demographic, environmental, cultural, institutional, economic, and individual livelihood factors of the current study compared to the previous settings.…”

Unsafe fecal disposal practices in children and the nexus with childhood diarrhea in low- and middle-income countries: a systematic review and meta-analysis

“…Azage & Haile 2015;Cronin et al 2016;Bawankule et al 2017;Islam et al 2018;Aliyu & Dahiru 2019;Sahiledengle 2019Sahiledengle , 2020Seidu et al 2020Seidu et al , 2021Simelane et al 2020;Getahun & Adane 2021;Soboksa 2021;Soboksa et al 2021;Vong et al 2021), while 6 studies were of moderate(Wilunda & Alessio 2009;Siruri 2013;Mihrete et al 2014;Aluko et al 2017;Sidabalok et al 2019;Alemayehu et al 2021) according to our assessment (Supplementary Material, Table…”

“…The highest prevalence was reported in Nigeria (80.33%) (Aluko et al 2017), Bangladesh (80.33%) (Islam et al 2020), and India (79.00%) (Bawankule et al 2017). In contrast, studies from Ethiopia (9.20%) (Alemayehu et al 2021), Kenya (30%) (World Bank/UNICEF 2015), and Cambodia (29.27%) (Vong et al 2021) reported the lowest prevalence.…”

“…According to a meta-analysis study, unsafe child feces disposal practices like open defecation, stool disposal in the open, stools not removed from soil, and feces observed on the ground increased the risk of diarrheal diseases by 23% (Gil et al 2004). Several studies done in Nepal (Lamichhane et al 2018), Indonesia (Cronin et al 2016), Thailand (Wilunda & Alessio 2009), Cambodia (Vong et al 2021), India (Bawankule et al 2017), and Kenya (World Bank/UNICEF 2015) have linked unsafe fecal disposal to an increased risk of childhood diarrhea. However, studies conducted in Ethiopia (Sahiledengle 2020), Papua New Guinea (Seidu et al 2020), Nigeria (Aluko et al 2017), and Eswatini (Simelane et al 2020) found that unsafe fecal disposal in children reduces the risk of childhood diarrhea.…”

“…Prevalence of unsafe child feces disposalAs shown in Figure2, based on 20 studies with 240,706 participants, the pooled prevalence of unsafe children's feces disposal practice among mothers/guardians was 52.63% (95% CI: 0.43-0.62)(Wilunda & Alessio 2009;Siruri 2013;Mihrete et al 2014;Azage & Haile 2015;Cronin et al 2016;Aluko et al 2017;Bawankule et al 2017;Aliyu & Dahiru 2019;Sahiledengle 2019Sahiledengle , 2020Islam et al 2020;Seidu et al 2020Seidu et al , 2021Simelane et al 2020;Alemayehu et al 2021;Getahun & Adane 2021;Soboksa 2021;Soboksa et al 2021;Vong et al 2021).…”