Effects of household access to water, sanitation, and hygiene services on under-five mortality in Sub-Saharan Africa
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 S...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1136299/full |
| _version_ | 1797671350756704256 |
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| author | Nicolas Gaffan Alphonse Kpozehouen Cyriaque Degbey Cyriaque Degbey Yolaine Glele Ahanhanzo Moussiliou Noël Paraïso |
| author_facet | Nicolas Gaffan Alphonse Kpozehouen Cyriaque Degbey Cyriaque Degbey Yolaine Glele Ahanhanzo Moussiliou Noël Paraïso |
| author_sort | Nicolas Gaffan |
| collection | DOAJ |
| description | 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 unimproved 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. |
| first_indexed | 2024-03-11T21:14:04Z |
| format | Article |
| id | doaj.art-af996fa6c4aa4b43970f162d1f057b97 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-03-11T21:14:04Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-af996fa6c4aa4b43970f162d1f057b972023-09-29T05:39:09ZengFrontiers Media S.A.Frontiers in Public Health2296-25652023-04-011110.3389/fpubh.2023.11362991136299Effects of household access to water, sanitation, and hygiene services on under-five mortality in Sub-Saharan AfricaNicolas Gaffan0Alphonse Kpozehouen1Cyriaque Degbey2Cyriaque Degbey3Yolaine Glele Ahanhanzo4Moussiliou Noël Paraïso5Department of Epidemiology and Biostatistics, Regional Institute of Public Health, University of Abomey-Calavi, Ouidah, BeninDepartment of Epidemiology and Biostatistics, Regional Institute of Public Health, University of Abomey-Calavi, Ouidah, BeninDepartment of Environmental Health, Regional Institute of Public Health, University of Abomey Calavi, Ouidah, BeninUniversity Hospital Hygiene Clinic, National Hospital and University Centre Hubert Koutoukou Maga, Cotonou, BeninDepartment of Epidemiology and Biostatistics, Regional Institute of Public Health, University of Abomey-Calavi, Ouidah, BeninDepartment of Health Promotion, Regional Institute of Public Health, University of Abomey-Calavi, Ouidah, BeninIntroductionSub-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 unimproved 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.https://www.frontiersin.org/articles/10.3389/fpubh.2023.1136299/fullwatersanitationhygienedemographic and health surveychildunder-five mortality |
| spellingShingle | Nicolas Gaffan Alphonse Kpozehouen Cyriaque Degbey Cyriaque Degbey Yolaine Glele Ahanhanzo Moussiliou Noël Paraïso Effects of household access to water, sanitation, and hygiene services on under-five mortality in Sub-Saharan Africa Frontiers in Public Health water sanitation hygiene demographic and health survey child under-five mortality |
| title | Effects of household access to water, sanitation, and hygiene services on under-five mortality in Sub-Saharan Africa |
| title_full | Effects of household access to water, sanitation, and hygiene services on under-five mortality in Sub-Saharan Africa |
| title_fullStr | Effects of household access to water, sanitation, and hygiene services on under-five mortality in Sub-Saharan Africa |
| title_full_unstemmed | Effects of household access to water, sanitation, and hygiene services on under-five mortality in Sub-Saharan Africa |
| title_short | Effects of household access to water, sanitation, and hygiene services on under-five mortality in Sub-Saharan Africa |
| title_sort | effects of household access to water sanitation and hygiene services on under five mortality in sub saharan africa |
| topic | water sanitation hygiene demographic and health survey child under-five mortality |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1136299/full |
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