Relationship of stunting with water, sanitation, and hygiene (WASH) practices among children under the age of five: a cross-sectional study in Southern Punjab, Pakistan
Abstract Background Reasons for undernutrition are food insufficiency, impaired child care, limited access to healthcare, and maternal lack of health literacy. In addition, there are several environmental factors, such as drinking water quality, poor sanitation, and hygienic practices that can lead...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-023-17135-z |
| _version_ | 1797636640983744512 |
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| author | Munazza Batool Javeria Saleem Rubeena Zakar Muhammad Salman Butt Sanaullah Iqbal Shahroz Haider Florian Fischer |
| author_facet | Munazza Batool Javeria Saleem Rubeena Zakar Muhammad Salman Butt Sanaullah Iqbal Shahroz Haider Florian Fischer |
| author_sort | Munazza Batool |
| collection | DOAJ |
| description | Abstract Background Reasons for undernutrition are food insufficiency, impaired child care, limited access to healthcare, and maternal lack of health literacy. In addition, there are several environmental factors, such as drinking water quality, poor sanitation, and hygienic practices that can lead to poor nutritional status in children. The present study aimed to compare household-associated risk factors, including water, sanitation, and hygiene (WASH) practices of mothers, with children’s stunting under the age of five. Methods A face-to-face cross-sectional survey was conducted with mothers of children under the age of five in the Dera Ghazi Khan district in southern Punjab, Pakistan. World Health Organization criteria for stunting were used to identify the participants. A sociodemographic questionnaire was used to collect information from consented parents/guardians on children’s age, feeding, and WASH practices. Pearson’s chi-square, simple regression, and hierarchical regression models were applied for data analysis. Results A total of 204 mothers of children of both genders participated in this study. The children’s mean (SD) age was 15.67 (± 10.2) months, their weight was 5.44 (± 1.45) kg, their height was 67.69 (± 10.05), and their mid-upper arm circumference was 9.75 (± 1.30) cm. Children’s stunting was mild (z-score > -2) at 17.6%, moderate (z-score − 2 to -3) at 16.7%, and severe (z-score < -3) at 65.7% of participants. A simple regression model showed a strong association, r2 = 0.062, p = 0.013, with age as the most significant sociodemographic factor. The hierarchical regression model showed a combined value of r2 = 0.0128, p = 0.027, with hand pump and tank water as the significant source of drinking water that was related to stunting among children. Conclusion Stunting can be associated with several risk factors, including WASH parameters. This study concluded that children aged under five years are susceptible to stunting in southern Punjab, Pakistan. The contamination of hand pumps and tank water resources was found to be the major contributing factor to stunting. |
| first_indexed | 2024-03-11T12:37:57Z |
| format | Article |
| id | doaj.art-c1d0919d9d4d41a5a670361719e56d53 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-03-11T12:37:57Z |
| publishDate | 2023-11-01 |
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| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-c1d0919d9d4d41a5a670361719e56d532023-11-05T12:31:35ZengBMCBMC Public Health1471-24582023-11-012311710.1186/s12889-023-17135-zRelationship of stunting with water, sanitation, and hygiene (WASH) practices among children under the age of five: a cross-sectional study in Southern Punjab, PakistanMunazza Batool0Javeria Saleem1Rubeena Zakar2Muhammad Salman Butt3Sanaullah Iqbal4Shahroz Haider5Florian Fischer6Department of Public Health, University of the PunjabDepartment of Public Health, University of the PunjabDepartment of Public Health, University of the PunjabDepartment of Public Health, University of the PunjabDepartment of Food Science and Human Nutrition, University of Veterinary and Animal SciencesBakhtawar Amin Medical and Dental College MultanInstitute of Public Health, Charité – Universitätsmedizin BerlinAbstract Background Reasons for undernutrition are food insufficiency, impaired child care, limited access to healthcare, and maternal lack of health literacy. In addition, there are several environmental factors, such as drinking water quality, poor sanitation, and hygienic practices that can lead to poor nutritional status in children. The present study aimed to compare household-associated risk factors, including water, sanitation, and hygiene (WASH) practices of mothers, with children’s stunting under the age of five. Methods A face-to-face cross-sectional survey was conducted with mothers of children under the age of five in the Dera Ghazi Khan district in southern Punjab, Pakistan. World Health Organization criteria for stunting were used to identify the participants. A sociodemographic questionnaire was used to collect information from consented parents/guardians on children’s age, feeding, and WASH practices. Pearson’s chi-square, simple regression, and hierarchical regression models were applied for data analysis. Results A total of 204 mothers of children of both genders participated in this study. The children’s mean (SD) age was 15.67 (± 10.2) months, their weight was 5.44 (± 1.45) kg, their height was 67.69 (± 10.05), and their mid-upper arm circumference was 9.75 (± 1.30) cm. Children’s stunting was mild (z-score > -2) at 17.6%, moderate (z-score − 2 to -3) at 16.7%, and severe (z-score < -3) at 65.7% of participants. A simple regression model showed a strong association, r2 = 0.062, p = 0.013, with age as the most significant sociodemographic factor. The hierarchical regression model showed a combined value of r2 = 0.0128, p = 0.027, with hand pump and tank water as the significant source of drinking water that was related to stunting among children. Conclusion Stunting can be associated with several risk factors, including WASH parameters. This study concluded that children aged under five years are susceptible to stunting in southern Punjab, Pakistan. The contamination of hand pumps and tank water resources was found to be the major contributing factor to stunting.https://doi.org/10.1186/s12889-023-17135-zUnderweightUndernutritionImpaired growthDevelopmental delay |
| spellingShingle | Munazza Batool Javeria Saleem Rubeena Zakar Muhammad Salman Butt Sanaullah Iqbal Shahroz Haider Florian Fischer Relationship of stunting with water, sanitation, and hygiene (WASH) practices among children under the age of five: a cross-sectional study in Southern Punjab, Pakistan BMC Public Health Underweight Undernutrition Impaired growth Developmental delay |
| title | Relationship of stunting with water, sanitation, and hygiene (WASH) practices among children under the age of five: a cross-sectional study in Southern Punjab, Pakistan |
| title_full | Relationship of stunting with water, sanitation, and hygiene (WASH) practices among children under the age of five: a cross-sectional study in Southern Punjab, Pakistan |
| title_fullStr | Relationship of stunting with water, sanitation, and hygiene (WASH) practices among children under the age of five: a cross-sectional study in Southern Punjab, Pakistan |
| title_full_unstemmed | Relationship of stunting with water, sanitation, and hygiene (WASH) practices among children under the age of five: a cross-sectional study in Southern Punjab, Pakistan |
| title_short | Relationship of stunting with water, sanitation, and hygiene (WASH) practices among children under the age of five: a cross-sectional study in Southern Punjab, Pakistan |
| title_sort | relationship of stunting with water sanitation and hygiene wash practices among children under the age of five a cross sectional study in southern punjab pakistan |
| topic | Underweight Undernutrition Impaired growth Developmental delay |
| url | https://doi.org/10.1186/s12889-023-17135-z |
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