Association of access to water, sanitation and handwashing facilities with undernutrition of children below 5 years of age in Bangladesh: evidence from two population-based, nationally representative surveys
Objective To examine the association between household access to water, sanitation and handwashing (WaSH) facilities and child undernutrition in Bangladesh.Design, setting and participants Cross-sectional study of children less than 5 years using data collected from the 2019 Multiple Indicator Clust...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/6/e065330.full |
| _version_ | 1797813926746914816 |
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| author | Md Mehedi Hasan Chowdhury Abdullah Al Asif Alina Barua Archis Banerjee Md Abul Kalam Abdul Kader Tasnuva Wahed Mohammad Wali Noman Aminuzzaman Talukder |
| author_facet | Md Mehedi Hasan Chowdhury Abdullah Al Asif Alina Barua Archis Banerjee Md Abul Kalam Abdul Kader Tasnuva Wahed Mohammad Wali Noman Aminuzzaman Talukder |
| author_sort | Md Mehedi Hasan |
| collection | DOAJ |
| description | Objective To examine the association between household access to water, sanitation and handwashing (WaSH) facilities and child undernutrition in Bangladesh.Design, setting and participants Cross-sectional study of children less than 5 years using data collected from the 2019 Multiple Indicator Cluster Survey (MICS) and the 2017–2018 Bangladesh Demographic and Health Survey (BDHS).Outcome measures Stunting, wasting and underweight, defined as a Z-score <−2 SD for height-for-age, weight-for-height and weight-for-age, respectively. We applied hierarchical multiple binary logistic regression models.Results Among 30 514 children 0–59 months, there was a high prevalence of child undernutrition (MICS: 28.0% stunted, 9.8% wasted, 22.6% underweight; BDHS: 30.8% stunted, 8.4% wasted, 21.7% underweight). Most children came from households lacking basic sanitation (MICS: 39.1%, BDHS: 55.3%) or handwashing facilities (MICS: 43.8%, BDHS: 62.6%). Children from households without access to WaSH facilities experienced the highest rates of undernutrition. Exposure-specific adjusted logistic regression models showed that a lack of access to improved water sources was associated with greater odds of wasting (MICS: adjusted OR (AOR) 1.36, 95% CI 1.00 to 1.85, p<0.05); basic sanitation facility with higher rates of stunting (MICS: 1.13, 1.04 to 1.23, p<0.01) and underweight (BDHS: 1.18, 1.02 to 1.37, p<0.05); and a lack of handwashing facilities with stunting (BDHS: 1.27, 1.10 to 1.48, p<0.01) and underweight (MICS: 1.10, 1.01 to 1.19, p<0.05). In fully adjusted models, no basic sanitation facility was associated with higher odds of stunting (MICS: AOR 1.12, 1.03 to 1.22, p<0.01) and a lack of handwashing facilities with higher odds of underweight (BDHS: AOR 1.30, 1.10 to 1.54, p<0.01;MICS: AOR 1.09, 1.01 to 1.19, p<0.05).Conclusion These findings demonstrate a significant association between poor household WaSH facilities and high prevalence of child undernutrition. Improving WaSH may help reduce child undernutrition in Bangladesh. |
| first_indexed | 2024-03-13T07:59:54Z |
| format | Article |
| id | doaj.art-336dfb3169434129a553c24a879c6445 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-13T07:59:54Z |
| publishDate | 2023-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-336dfb3169434129a553c24a879c64452023-06-01T22:00:07ZengBMJ Publishing GroupBMJ Open2044-60552023-06-0113610.1136/bmjopen-2022-065330Association of access to water, sanitation and handwashing facilities with undernutrition of children below 5 years of age in Bangladesh: evidence from two population-based, nationally representative surveysMd Mehedi Hasan0Chowdhury Abdullah Al Asif1Alina Barua2Archis Banerjee3Md Abul Kalam4Abdul Kader5Tasnuva Wahed6Mohammad Wali Noman7Aminuzzaman Talukder85 Institute for Social Science Research, The University of Queensland, Indooroopilly, Queensland, AustraliaLearning and Reflection Unit, Helen Keller International, Dhaka, BangladeshLearning and Reflection Unit, Helen Keller International, Dhaka, BangladeshLearning and Reflection Unit, Helen Keller International, Dhaka, BangladeshLearning and Reflection Unit, Helen Keller International, Dhaka, BangladeshLearning and Reflection Unit, Helen Keller International, Dhaka, BangladeshLearning and Reflection Unit, Helen Keller International, Dhaka, BangladeshLearning and Reflection Unit, Helen Keller International, Dhaka, BangladeshLearning and Reflection Unit, Helen Keller International, Dhaka, BangladeshObjective To examine the association between household access to water, sanitation and handwashing (WaSH) facilities and child undernutrition in Bangladesh.Design, setting and participants Cross-sectional study of children less than 5 years using data collected from the 2019 Multiple Indicator Cluster Survey (MICS) and the 2017–2018 Bangladesh Demographic and Health Survey (BDHS).Outcome measures Stunting, wasting and underweight, defined as a Z-score <−2 SD for height-for-age, weight-for-height and weight-for-age, respectively. We applied hierarchical multiple binary logistic regression models.Results Among 30 514 children 0–59 months, there was a high prevalence of child undernutrition (MICS: 28.0% stunted, 9.8% wasted, 22.6% underweight; BDHS: 30.8% stunted, 8.4% wasted, 21.7% underweight). Most children came from households lacking basic sanitation (MICS: 39.1%, BDHS: 55.3%) or handwashing facilities (MICS: 43.8%, BDHS: 62.6%). Children from households without access to WaSH facilities experienced the highest rates of undernutrition. Exposure-specific adjusted logistic regression models showed that a lack of access to improved water sources was associated with greater odds of wasting (MICS: adjusted OR (AOR) 1.36, 95% CI 1.00 to 1.85, p<0.05); basic sanitation facility with higher rates of stunting (MICS: 1.13, 1.04 to 1.23, p<0.01) and underweight (BDHS: 1.18, 1.02 to 1.37, p<0.05); and a lack of handwashing facilities with stunting (BDHS: 1.27, 1.10 to 1.48, p<0.01) and underweight (MICS: 1.10, 1.01 to 1.19, p<0.05). In fully adjusted models, no basic sanitation facility was associated with higher odds of stunting (MICS: AOR 1.12, 1.03 to 1.22, p<0.01) and a lack of handwashing facilities with higher odds of underweight (BDHS: AOR 1.30, 1.10 to 1.54, p<0.01;MICS: AOR 1.09, 1.01 to 1.19, p<0.05).Conclusion These findings demonstrate a significant association between poor household WaSH facilities and high prevalence of child undernutrition. Improving WaSH may help reduce child undernutrition in Bangladesh.https://bmjopen.bmj.com/content/13/6/e065330.full |
| spellingShingle | Md Mehedi Hasan Chowdhury Abdullah Al Asif Alina Barua Archis Banerjee Md Abul Kalam Abdul Kader Tasnuva Wahed Mohammad Wali Noman Aminuzzaman Talukder Association of access to water, sanitation and handwashing facilities with undernutrition of children below 5 years of age in Bangladesh: evidence from two population-based, nationally representative surveys BMJ Open |
| title | Association of access to water, sanitation and handwashing facilities with undernutrition of children below 5 years of age in Bangladesh: evidence from two population-based, nationally representative surveys |
| title_full | Association of access to water, sanitation and handwashing facilities with undernutrition of children below 5 years of age in Bangladesh: evidence from two population-based, nationally representative surveys |
| title_fullStr | Association of access to water, sanitation and handwashing facilities with undernutrition of children below 5 years of age in Bangladesh: evidence from two population-based, nationally representative surveys |
| title_full_unstemmed | Association of access to water, sanitation and handwashing facilities with undernutrition of children below 5 years of age in Bangladesh: evidence from two population-based, nationally representative surveys |
| title_short | Association of access to water, sanitation and handwashing facilities with undernutrition of children below 5 years of age in Bangladesh: evidence from two population-based, nationally representative surveys |
| title_sort | association of access to water sanitation and handwashing facilities with undernutrition of children below 5 years of age in bangladesh evidence from two population based nationally representative surveys |
| url | https://bmjopen.bmj.com/content/13/6/e065330.full |
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