Does The Effect Of Water And Sanitation Vary By Maternal Education On Childhood Diarrhea Among Under Five Children In Mecha District West Gojjam Ethiopia

BACKGROUND: Diarrhoeal disease is widely recognized as a major cause of child morbidity andrnmortality in many developing countries, particularly in sub-Saharan Africa including Ethiopia. Whilerna good living environment, comprising safe water and latrine facilities, is essential in reducing thernrisk, it is unclear if the disadvantage associated with untreated water and lack of latrine facilities arernthe same for all children. Since diarrhea is transmitted through a variety of agents, we argue that otherrnparentally provided inputs combined with water and latrine facilities in determining a child’srnvulnerability.rnOBJECTIVES: The study assesses the effects of drinking water and latrine facilities on the risk ofrnchildhood diarrhoea among under five children and as well whether they vary by maternal education.rnMETHODS: a community based cross-sectional study was carried out on February, 2009 with a totalrnsample size of 768 households that had at least one under-five child, which was randomly selectedrnfrom the ten rural kebeles and one urban kebele that was found in Mecha Woreda, West Gojjam,rnEthiopia. Information on the households' socio-economic, environmental and behaviouralrncharacteristics was collected using structured, pre-tested questionnaire by trained data collectors.rnDiarrhoeal morbidity occurrence among under-five children during the two weeks preceding the timernof the interview was registered to determine prevalence. Logistic regression model was employed tornexamine the significance of environmental factors and level of mother’s education in preventingrnchildhood diarrhoea.rnRESULT: The findings of this study showed that the overall prevalence of diarrhoea in under-fivesrnwas 18.0%. Multivariate logistic regression analysis showed that children of less educated mothersrnhad more than fivefold higher odds of having diarrhoea than their higher educated counterparts. In thernanalysis maternal education, mother’s history of recent diarrhea, availability of latrine facility,rnduration of breast feeding and age of the child had a significant association after adjusting otherrnvariables. The highest risk was found in households without improved water source and latrinesrnfacilities. When these variables stratified by maternal education, however, it became evident thatrnchildren whose mothers were less educated were the most vulnerable in the absence of water andrnlatrine facilities.rnCONCLUSION AND RECOMMENDATION: Highly educated mothers protect their childrenrnagainst diarrhea much better under poor environmental condition than their less educatedrncounterparts. There were interaction effects of water with maternal education and sanitation withrnmaternal education on childhood diarrhea. Thus effective educational programs that emphasize onrnhygiene and good home management practices and encouraging female school enrolment should bernstrengthen to reduce childhood diarrhoea morbidity.rnVI

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