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Artigo em Inglês | MEDLINE | ID: mdl-31600942


Stunting is a global burden affecting nearly 160 million children younger than five years of age. Whilst the linkages between nutrition and stunting are well recognized, there is a need to explore environmental factors such as water and sanitation, which may influence feeding practices and result in potential infection pathways. This paper explores the linkages between stunting and water, sanitation and hygiene (WASH) factors in Ethiopia, which is a relatively understudied context. The research draws upon baseline data for children under the age of five from 3200 households across four regions in Ethiopia as part of a wider study and integrated program led by the United Nations Children's Fund (UNICEF). Using World Health Organization (WHO) z-scoring, the average stunting rate in the sample is 47.5%. This paper also takes into account demographic and social behavioural factors such as the age, gender of children, and gender of the primary caregiver, in addition to handwashing behaviour and drinking water facilities. The evidence recommends efforts to improve handwashing behaviour for mothers and children with a focus on access to clean water. Higher stunting rates with an increase in the age of children highlight the need for continued interventions, as efforts to improve nutrition and WASH behaviours are most effective early on in promoting long-term health outcomes for children.

Transtornos do Crescimento/epidemiologia , Desinfecção das Mãos , Higiene , Saneamento , Abastecimento de Água , Criança , Pré-Escolar , Etiópia/epidemiologia , Características da Família , Comportamento Alimentar , Feminino , Humanos , Masculino , Mães , Estado Nutricional , População Rural , Água
Artigo em Inglês | MEDLINE | ID: mdl-30261590


We examine factors associated with the use of basic water supply and sanitation services as part of an integrated community-based nutrition programme which included a drinking water, sanitation and hygiene (WaSH) intervention and emphasise findings related to health risk perceptions. Data were collected from 2658 households in four regions in Ethiopia with a cross-sectional survey in WaSH intervention areas, as well as in control areas, where the intervention was not implemented. The data were analysed using bivariate and multivariable regression analysis. Awareness of health risk factors related to inadequate WaSH was high in the programme area. The use of basic water and sanitation services was associated with several health risk perceptions: Perceiving water quality as good increased the odds of using basic water services as opposed to believing the water quality was poor (OR 3.94; CI 3.06⁻5.08; p ≤ 0.001). Believing that drinking unsafe water was the main cause for diarrhoea increased the odds of using basic water services (OR 1.48; CI 1.20⁻1.81; p ≤ 0.001). In the WaSH intervention group, the use of basic sanitation was more likely than in the control group. The use of basic sanitation was associated with households who had previously received sanitation training, as opposed to such who had not (OR 1.55; CI 1.22⁻1.97; p ≤ 0.001). Perceiving dirty space as the main cause of diarrhoea (OR 1.81; CI 1.50⁻2.19; p ≤ 0.001), and privacy when using a latrine (OR 2.00; CI 1.67⁻2.40; p ≤ 0.001), were associated with higher odds of using basic sanitation. Households that indicated a disadvantage of owning a latrine was maintenance costs were less likely to use basic sanitation (OR 0.49; CI 0.38⁻0.63; p ≤ 0.001). Risk perceptions were important determinants of use of basic services. The findings point to risk perceptions motivating the application of positive WaSH-related and health-protective ours. This suggests that well-designed health risk communication strategies may be effective for engaging households in healthy WaSH behaviour.

Água Potável , Conhecimentos, Atitudes e Prática em Saúde , Prática de Saúde Pública , Saneamento/estatística & dados numéricos , Abastecimento de Água/estatística & dados numéricos , Estudos Transversais , Diarreia/prevenção & controle , Etiópia , Características da Família , Feminino , Comportamentos de Risco à Saúde , Humanos , Higiene , Masculino , Propriedade , Percepção , Fatores de Risco , População Rural/estatística & dados numéricos , Fatores Socioeconômicos , Fatores de Tempo , Toaletes/estatística & dados numéricos , Água , Qualidade da Água
Trop Med Int Health ; 21(11): 1403-1419, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27546207


OBJECTIVES: To review and synthesise the available evidence on the effectiveness of interventions targeting unsafe child faeces disposal in reducing this behaviour and improving child health in low- and middle-income countries. METHODS: PubMed and EMBASE were systematically searched. Studies meeting the inclusion criteria were reviewed and key information on study methodologies and outcomes were extracted. RESULTS: A total of 1048 articles were screened, and eight studies representing five countries were included for the review. Three were randomised controlled trials, and five were prospective cohort studies. There was wide variability across studies in the definition of 'safe disposal' of child faeces. Six studies reported the change in child faeces disposal practices associated with safe child faeces disposal interventions. However, only one study found a significant improvement in this behaviour. Two of the six studies that evaluated the health impact of delivered interventions found significant reductions in childhood diarrhoea associated with safe faeces disposal practices, and one study reported a positive effect on child growth and ascariasis. Only one study was identified that delivered a single intervention solely focused on safe child faeces disposal. Unfortunately, this study did not investigate the impact of this intervention on child health. CONCLUSIONS: There are major methodological limitations in studies that assessed the impact of safe child faeces disposal interventions. The health impact of these interventions is inconclusive because the quality of the current evidence is poor. Randomised controlled trials are urgently needed to assess the impact of safe faeces disposal interventions on child health.

Países em Desenvolvimento , Fezes , Saneamento/métodos , Criança , Humanos