Water, sanitation and hygiene practices associated with improved height-for-age, weight-for-height and weight-for-age z-scores among under-five children in Nepal

Abstract

Background: Evidence of the influence of water, sanitation and hygiene (WASH) behaviors on childhood nutritional status is inconsistent. Few studies have examined their interactive effects. This study aimed to examine associations and interactions between WASH variables and preschool child undernutrition. Methods: Data from a nationally representative sample of 2352 children assessed during the 2016 Nepal Demographic and Health Survey were analyzed by multi-variable linear regression to understand the association between height-forage (HAZ), weight-for-height (WHZ) and weight-forage (WAZ) z-scores and WASH variables. Interactions between WASH variables, sex and area of residence on childhood nutritional status were also examined. Results: The mean z-score [standard deviation] for children's WAZ, HAZ and WHZ scores were − 1.33 [1.1], − 1.52 [1.3] and − 0.65 [1.1], respectively. A unit increase in cluster sanitation coverage was associated with an increase of 0.30 (95%CI: 0.12 to 0.48) for WAZ and 0.28 (95%CI: 0.001 to 0.56) for HAZ scores. Household water purification practice was associated with an increase of 0.24 (95%CI: 0.07 to 0.41) in WHZ score. Handwashing practice with water and soap was associated with an increase of 0.15 (95%CI: 0.04 to 0.25) in WAZ and 0.13 (95%CI: 0.01 to 0.24) in WHZ scores. The effect of water purification practice was higher for rural areas compared to urban settings for HAZ scores (p-value for interaction = 0.02). Conclusions: Consistent with findings from other countries in the South Asian region, findings of this study highlight the potential importance of good WASH practices, and therefore the potential of WASH interventions, to contribute to improved nutritional status in rural Nepal.

Correlation of Handwashing and Basic Household Sanitation Towards Nutritional Status of Toddler (Under 2 Years Old/ Baduta) in Bojonegoro District

“…variables, namely the habit of washing the hands of the mother/main caregiver and basic home sanitation and the nutritional status of toddler (under two years old). These results are in line with previous studies which also found no significant relationship between hand washing habits (Langford, Lunn dan Brick, 2011), sanitation (Sinharoy et al, 2016;Shrestha, Vicendese dan Erbas, 2020), and nutritional status. However, there are also several contradictory studies and actually found a significant correlation between hand washing habits (Shrestha, Vicendese dan Erbas, 2020) and sanitation (Raihan et al, 2017;van Cooten et al, 2019) and nutritional status.…”

The effect of access to water, sanitation and handwashing facilities on child growth indicators: Evidence from the Ethiopia Demographic and Health Survey 2016

“…However, the extent to which inadequate access and practices of WASH have been contributing to child growth failure remains inadequate understood. Challenges to interpret and synthesis study findings due to variations in methods used and study areas are limiting the provision of potential policy recommendations [20]. In addition, complex interaction among WASH components may also pose differential effect on child growth outcomes [9].…”

Prevalence of Stunting among 6-59 Months Children and its Association with Water, Sanitation and Hygiene Practice in Urban Slums of Kathmandu, Nepal

“…14 The availability of improved toilet, protected water source, purification of water, availability of handwashing station and similar health and hygiene behaviors have positive consequences on the nutritional status of the children. 17 Poor hygiene and sanitation lead to diarrhoeal disease. A case control study conducted in Nepal found that having diarrhea in children one or more times in past two months was 7.46 times higher risk of stunting as compared to normal children.…”