Safe Drinking Water, Sanitation and Hygiene Services in Relation to Diarrhoea and Respiratory Tract Infections in Children in the Asia-Pacific Countries

Background: Despite substantial progress in the access to water, sanitation and hygiene (WASH) services, many low- and middle-income countries are still experiencing a high burden of childhood illness due to unsafe WASH services, such as diarrhea and acute respiratory infections (ARI). We aimed to analyse the association of household WASH services with diarrhea and ARI among children aged <5 years living in the Asia-Pacific countries.Methods: This study used the most recent Demographic and Health Survey datasets from 11 countries in the Asia-Pacific region, collected between 2015 to 2022. Both outcomes (diarrhea and ARI) were based on maternal/caregivers’ report. Logistic mixed effects models were fitted using the melogit function and performance of the fitted models compared. Each model was adjusted for child, maternal, household and cluster level factors.Results: A total of 303,004 and 294,728 children aged <5 years were included for diarrhea and ARI analysis, respectively. The prevalence of diarrhea and ARI was 9.98% (95% confidence interval [CI]: 9.87, 10.09) and 3.98% (95% CI: 3.91, 4.05), respectively. Lower odds of diarrhea was observed in households with drinking water from improved source (adjusted odds ratio [aOR] = 0.87; 95% CI: 0.83, 0.91), improved sanitation (aOR = 0.78; 95% CI: 0.76, 0.81) and basic handwashing facility (aOR = 0.92; 95% CI: 0.89, 0.95). Again, lower odds of ARI was observed in households with drinking water from improved source (aOR = 0.89; 95% CI: 0.83, 0.95), improved sanitation (aOR = 0.84; 95% CI: 0.80, 0.89) and basic handwashing facility (aOR = 0.88; 95% CI: 0.84, 0.93).Conclusions: This cross-sectional study highlights that household access to WASH services reduces diarrhea and ARI among under-five children in the Asia-Pacific countries. The findings highlight the importance of ensuring the internationally agreed goal of safe WASH services for all, which would yield major public-health returns.

Note:
Funding Declaration: None.

Conflict of Interests: None.

Keywords: water, sanitation, handwashing, diarrhea, acute respiratory infection, Children

Suggested Citation: Suggested Citation

Odo, Daniel Bogale and Shifti, Desalegn Markos and Thapa, Subash and Belachew, Sewunet Admasu and Hassen, Tahir Ahmed and Bizuayehu, Habtamu Mellie and Ahmed, Kedir Y. and Tegene, Teketo and Dadi, Abel F. and Seid, Abdulbasit and Mesfin, Yonatan and Kibrie, Getiye Dejenu and Ketema, Daniel Bekele and Kassa, Zemenu Yohannes and Bore, Meless G. and Zahid hossain, Mohammad, Safe Drinking Water, Sanitation and Hygiene Services in Relation to Diarrhoea and Respiratory Tract Infections in Children in the Asia-Pacific Countries. Available at SSRN: https://ssrn.com/abstract=4927433 or http://dx.doi.org/10.2139/ssrn.4927433