RESUMO
INTRODUCTION: Diarrhoeal disease is one of the major causes of childhood morbidity and mortality in India. It affects all ages, yet very few studies have been found regarding the young and older children affected by diarrhoea and its etiology. About 2.2 million deaths are attributed to diarrhoea alone in India every year. However, a large number of diarrhoeal cases may be avoided with proper sanitation and hygiene practices. The primary aim of this study was to assess the current water, sanitation, and hygiene (WASH) practises among mothers and diarrhoea among their children (6 months to 11 years) in rural households of the Mayurbhanj district, Odisha. Further, the association between WASH practises and childhood diarrhoeal disease was assessed. METHODS: A community-based cross-sectional survey was conducted among 430 mothers by using a pre-tested structured questionnaire adapted from previous studies. Data collection was done using the software Epicollect5 by the trained data collector. The data were further transformed to Statistical Package for Social Sciences (SPSS, IBM Corp., Armonk, NY) version 23 for analysis to find out potential risk factors. A multistage sampling technique was used to find subjects. RESULTS: Out of 430 households, 21.6% of respondents reported that their children were suffering from diarrhoea in the last two weeks from the day of the survey. Nearly 63.8% of respondents mentioned that they used to supply water as a principal source for household purposes. This study found that children of households near waste piles are more at risk of having diarrhoea than those households living far from the waste pile [AOR: 4.996; 95% CI: (2.173, 11.487)]. In the management of household wastes, households who are throwing waste here and there are 3.276 times more at risk of having diarrhoea than households who are managing the wastes by themselves by burning them outside the home [AOR: 3.276; 95%CI: (1.463, 7.042)]. In the disposal of child faeces, it was found that the household children's faeces disposed of in the garbage or dumping site are 2.438 times more at risk of having diarrhoea than those who are flushing the faeces in the latrine [AOR: 2.438; 95%CI: (1.284, 4.631)]. Also, using footwear less often was found to be highly associated with an increase in the incidence of diarrhoea (AOR: 1.634; 95% CI (.815, 3.276). CONCLUSION: Findings indicate that creating awareness about the benefits of proper management of household waste and using footwear on a regular basis is the priority to avoid childhood diarrhoea. Further, area-specific planning and programme allocation of resources is necessary to prevent childhood diarrhoea.
RESUMO
Universal access to safe sanitation is yet to be accomplished in India. Although Clean India Mission (named as "Swachh Bharat Mission (Gramin)" for rural India) claims that the sanitation coverage in rural India has increased from 39% to 100% of households from 2014 and 2019, yet open defaecation continues in India in large numbers. This article discusses the achievements on Swachh Bharat Mission (Gramin) and identifies the existing challenges that need to be acted on to achieve the success of India's Swachh Bharat Mission. We searched international database mainly Google scholar, Pubmed, Medline, Scopus, and Science direct using "Clean India," "Swachh Bharat," "Sanitation," "Open defecation," "Environmental heath," and "India" as search keywords in different combinations. In addition, websites of relevant United Nations (UN) agencies, Government of India and leading newspaper and national agencies were also searched manually for related publications and reports. In the last 5 years (2014-2019), significant efforts have been made for the Swachh Bharat Mission by creating various social movements and awareness program to improve toilet coverage throughout India. Over 100 million, latrines have been built as of the end of the first phase of Swachh Bharat Mission (Gramin) as on October 2, 2019 and all villages across the districts of India have been declared Open Defaecation Free. Still, nearly half of the rural population (52.1%) defecate in the open. Lack of piped water supply, poor construction of toilet substructures and misconception among people about toilet use remain as key challenges in the achievement of India's sanitation mission. Sanitation-related behavioral change and improvement in toilet facilities must be prioritized to ensure usage of built toilets and eventually can accelerate the universal access to sanitation and meet Sustainable Development Goals.