Effects of household access to water, sanitation, and hygiene services on under-five mortality in Sub-Saharan Africa

Frontiers in Public Health

Public Health

Cyriaque Degbey¹  Yolaine Glele Ahanhanzo²  Alphonse Kpozehouen²  Nicolas Gaffan²  Moussiliou Noël Paraïso³ 

[1] Department of Environmental Health, Regional Institute of Public Health, University of Abomey Calavi, Ouidah, Benin;University Hospital Hygiene Clinic, National Hospital and University Centre Hubert Koutoukou Maga, Cotonou, Benin;Department of Epidemiology and Biostatistics, Regional Institute of Public Health, University of Abomey-Calavi, Ouidah, Benin;Department of Health Promotion, Regional Institute of Public Health, University of Abomey-Calavi, Ouidah, Benin;

关键词: water;    sanitation;    hygiene;    demographic and health survey;    child;    under-five mortality;    household;    Sub-Saharan Africa;   

DOI  :  10.3389/fpubh.2023.1136299

 received in 2023-01-02, accepted in 2023-03-22,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionSub-Saharan Africa has the highest under-five mortality rate and is among the regions where people have the least access to adequate Water, Sanitation, and Hygiene (WASH) services. The work aimed to investigate the effects of WASH conditions faced by children on under-five mortality in Sub-Saharan Africa.MethodsWe carried out secondary analyses using the Demographic and Health Survey datasets of 30 countries in Sub-Saharan Africa. The study population consisted of children born within 5 years preceding the selected surveys. The dependent variable was the child’s status (1 = deceased versus 0 = alive) on the survey day. The individual WASH conditions in which children live were assessed in their immediate environment, i.e., at the level of their households of residence. The other explanatory variables were related to the child, mother, household, and environment. Following a description of the study variables, we identified the predictors of under-five mortality using a mixed logistic regression.ResultsThe analyses involved 303,985 children. Overall, 6.36% (95% CI = 6.24–6.49) of children died before their fifth birthday. The percentage of children living in households with access to individual basic WASH services was 58.15% (95% CI = 57.51–58.78), 28.18% (95% CI = 27.74–28.63), and 17.06% (95% CI = 16.71–17.41), respectively. Children living in households using unimproved water facilities (aOR = 1.10; 95% CI = 1.04–1.16) or surface water (aOR = 1.11; 95% CI = 1.03–1.20) were more likely to die before five than those coming from households with basic water facilities. The risk of under-five mortality was 11% higher for children living in households with limited sanitation facilities (aOR = 1.11; 95% CI = 1.04–1.18) than for those with basic sanitation services. We found no evidence to support a relationship between household access to hygiene services and under-five mortality.ConclusionInterventions to reduce under-five mortality should focus on strengthening access to basic water and sanitation services. Further studies are needed to investigate the contribution of access to basic hygiene services on under-five mortality.

【 授权许可】

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Copyright © 2023 Gaffan, Kpozehouen, Degbey, Ahanhanzo and Paraïso.