Introduction
Methods
Study setting
Data source
Sampling and data collection
Study variables
Outcome variables
Exposure variables
WASH factors | Type of variable & category | Survey question | Description |
---|---|---|---|
Toilet facility | Categorical data, categorised as “Improved”, “Unimproved” or “Open defecation” | What kind of toilet facility do members of your household usually use? (verify by observation) | Based on the WHO/UNICEF JMP definition, toilet facilities would be considered improved if they were any of the following types: flush/pour flush toilets to piped sewer systems, septic tanks, and pit latrines; ventilated improved pit (VIP) latrines; pit latrines with slabs; and composting toilets. Unimproved toilet facilities included: flush or pour-flush to elsewhere; pit latrine without a slab or open pit; bucket; hanging toilet og latrine. Other facilities, including households with no facility or use of bush/field, were considered open defecation. |
Source of drinking water | Categorical data, categorised as “Improved”, or “Unimproved” | What is the main source of drinking water for members of your household? | Improved drinking water sources include piped water, public taps, standpipes, tube wells, boreholes, protected dug wells and springs, and rainwater. Other sources of drinking water are regarded as unimproved. |
Child stool disposal | Binary data, categorised as “Safe” or “Unsafe” | The last time (NAME OF YOUNGEST CHILD living with the respondent) passed stool, what was done to dispose of the stool? | A child’s stool was considered to be disposed of “safely” when the child used a latrine/ toilet or child’s stool was put/rinsed into a toilet/latrine, whereas other methods were considered “unsafe”. |
Household flooring | Binary data, categorised as “Improved” or “Unimproved” | Observe the main material of the floor of the dwelling. Record observation | Household floors are considered to be unimproved if it is natural floor (earth/sand, dung), rudimentary floor (wood planks, palm/bamboo), and finished floor (parquet or polished wood, vinyl or asphalt strips/plastic tile, ceramic tiles, cement, carpet) were considered as improved. |
Time to obtain drinking water (round trip) | Categorical data, categorised as “On-premises”, “≤ 30 min round-trip fetching times”, “31–60 min round-trip fetching times”, and “ over 60 min round-trip fetching times” | How long does it take to go there, get water, and come back? | Time to obtain drinking water (round trip) was categorised as water on premises; up to 30 min, 31–60 min or over 60 min. |
Confounders/control variables
Statistical analysis
Results
Summary of descriptive statistics
Characteristics | Frequency | Weighted % | Stunting Prevalence (weighted %) | Wasting Prevalence (weighted %) |
---|---|---|---|---|
WASH Facility
| ||||
Latrine facility
| ||||
Improved | 3,795 | 11.4 | 9.3 | 8.7 |
Unimproved | 10,576 | 31.9 | 27.8 | 25.5 |
Open defecation | 18,783 | 56.6 | 62.9 | 65.8 |
Source of drinking water
| ||||
Improved | 20,356 | 61.4 | 35.6 | 37.5 |
Unimproved | 12,791 | 38.6 | 64.4 | 62.5 |
Child stool disposal
| ||||
Safe | 7,091 | 21.1 | 18.3 | 15.6 |
Unsafe | 26,546 | 78.9 | 81.7 | 84.4 |
Household flooring
‡
| ||||
Improved | 2,717 | 8.1 | 4.8 | 5.4 |
Unimproved | 31,736 | 91.9 | 95.2 | 94.6 |
Time to get water source
| ||||
On premise | 1,770 | 5.3 | 2.9 | 3.8 |
<=30 min | 19,545 | 58.3 | 60.1 | 57.7 |
31–60 min | 6,894 | 20.6 | 21.1 | 21.3 |
> 60 min | 5,327 | 15.9 | 15.9 | 17.2 |
Household drinking water service
| ||||
Basic drinking water service | 8,549 | 25.3 | 23.1 | 24.4 |
Limited drinking water service | 4,036 | 11.9 | 11.3 | 12.1 |
Poor drinking water service | 21,158 | 62.7 | 65.6 | 63.5 |
Combined sanitation facility
| ||||
Improved Water + Improved Sanitation | 2,342 | 7.1 | 5.1 | 4.6 |
Either one improved | 11,901 | 35.9 | 34.6 | 37.2 |
Unimproved Water + Unimproved Sanitation | 18,904 | 57.0 | 60.3 | 58.2 |
Child Factors
| ||||
Childhood infections
| ||||
Diarrhea
| ||||
Yes | 5,759 | 17.1 | 18.7 | 24.8 |
No | 27,938 | 82.9 | 81.3 | 75.2 |
Fever
| ||||
Yes | 6,853 | 20.3 | 21.4 | 28.1 |
No | 26,841 | 79.7 | 78.6 | 71.9 |
ARI
| ||||
Yes | 1,354 | 4.0 | 3.6 | 4.8 |
No | 32,389 | 96.0 | 96.4 | 95.2 |
Sex
| ||||
Male | 17,172 | 50.9 | 52.9 | 55.6 |
Female | 16,571 | 49.1 | 47.1 | 44.4 |
Age (months)
| ||||
0–5 | 3,436 | 10.2 | 3.4 | 13.4 |
6–11 | 3,565 | 10.6 | 5.7 | 16.7 |
12–17 | 3,561 | 10.5 | 9.7 | 16.3 |
18–23 | 3,001 | 8.9 | 10.5 | 10.8 |
≥ 24 to 59 months | 20,179 | 59.8 | 70.7 | 42.7 |
Birth order
| ||||
Firstborn | 6,005 | 17.8 | 16.8 | 15.5 |
2–4 | 14,547 | 43.1 | 42.4 | 42.0 |
5 or higher | 13,190 | 39.1 | 40.8 | 42.5 |
Birth interval
| ||||
< 33 months | 23,276 | 69.0 | 67.6 | 67.6 |
≥ 33 months | 10,467 | 31.0 | 32.4 | 32.4 |
Size of a child at birth
| ||||
Larger | 10,431 | 31.0 | 28.5 | 29.9 |
Average | 13,236 | 39.3 | 38.1 | 36.9 |
Small | 9,979 | 29.7 | 33.4 | 38.2 |
Currently breastfeeding
| ||||
Yes | 25,031 | 74.2 | 73.1 | 81.6 |
No | 8,712 | 25.8 | 26.9 | 18.4 |
Early initiation of breastfeeding
| ||||
Yes | 14,143 | 54.4 | 52.0 | 52.2 |
No | 11,848 | 45.6 | 48.0 | 47.8 |
Received measles
| ||||
Yes | 10,768 | 36.8 | 39.5 | 29.4 |
No | 18,501 | 63.2 | 60.5 | 70.6 |
Basic vaccine
| ||||
Yes | 5,608 | 19.4 | 20.3 | 15.1 |
No | 23,250 | 80.6 | 79.7 | 84.9 |
Parental factors
| ||||
Mother’s age
| ||||
< 18 | 278 | 0.8 | 0.8 | 1.0 |
18–24 | 7,818 | 23.2 | 22.0 | 23.8 |
25–34 | 17,123 | 50.7 | 50.8 | 48.4 |
≥ 35 | 8,524 | 25.3 | 26.4 | 26.4 |
Mother’s education
| ||||
No education | 24,596 | 72.9 | 77.6 | 79.3 |
Primary | 7,398 | 21.9 | 19.5 | 17.7 |
Secondary | 1,353 | 4.0 | 2.4 | 2.3 |
Higher | 396 | 1.2 | 0.5 | 0.7 |
Mother’s occupation
| ||||
Not working | 16,401 | 48.8 | 46.1 | 48.5 |
Non agriculture | 7,073 | 21.0 | 19.8 | 18.0 |
Agriculture | 10,164 | 30.2 | 34.1 | 33.5 |
ANC Visit
| ||||
None | 13,214 | 57.1 | 63.4 | 62.4 |
1–3 | 5,323 | 23.0 | 21.4 | 22.2 |
4+ | 4,587 | 19.9 | 15.2 | 15.4 |
Maternal BMI (kg/m2) | ||||
< 18.5 | 7,053 | 21.0 | 22.4 | 30.4 |
18.5 to 24.9 | 25,082 | 74.8 | 74.8 | 67.5 |
25 + | 1,411 | 4.2 | 2.8 | 2.1 |
Husband’s education
| ||||
No education | 17,834 | 54.2 | 59.5 | 62.6 |
Primary | 11,619 | 35.3 | 33.0 | 30.3 |
Secondary | 2,540 | 7.7 | 6.1 | 5.4 |
Higher | 886 | 2.7 | 1.4 | 1.7 |
Listening to radio
| ||||
Not at all | 22,157 | 65.7 | 69.0 | 71.8 |
Yes | 11,577 | 34.3 | 31.0 | 28.2 |
Watching television
| ||||
Not at all | 27,820 | 82.5 | 85.9 | 87.8 |
Yes | 5,901 | 17.5 | 14.1 | 12.2 |
Household Factors
| ||||
Wealth index
| ||||
Poor | 10,848 | 45.3 | 49.9 | 55.7 |
Middle | 4,998 | 20.9 | 21.2 | 20.9 |
Rich | 8,087 | 33.8 | 28.9 | 23.4 |
Household Size
| ||||
1–4 | 8,097 | 24.0 | 22.9 | 23.3 |
≥ 5 | 25,647 | 76.0 | 77.1 | 76.7 |
Community
level factors
| ||||
Residence
| ||||
Urban | 3,639 | 10.8 | 7.9 | 7.3 |
Rural | 30,104 | 89.2 | 92.1 | 92.7 |
Region
| ||||
Agrarian | 18,365 | 54.4 | 58.6 | 56.8 |
Pastoralist | 14,591 | 43.2 | 40.1 | 41.9 |
City | 787 | 2.4 | 1.3 | 1.3 |
Ecological Zone (meters in elevation )
@
(n = 34,058)
| ||||
< 1500 | 3,601 | 15.1 | 13.3 | 19.0 |
1500–2500 | 16,833 | 70.3 | 70.2 | 68.4 |
> 2500 | 3,498 | 14.6 | 16.5 | 12.6 |
Prevalence of stunting and wasting
Characteristics | Stunting (OR, 95%CI) | p-value | Wasting (OR, 95%CI) | p-value |
---|---|---|---|---|
WASH Facility
| ||||
Latrine facility
| ||||
Improved | 1 | 1 | ||
Unimproved | 1.61 (1.49,1.74) | p < 0.001 | 1.11 (0.98,1.26) | 0.087 |
Open defecation | 2.13 (1.98,2.29) | p < 0.001 | 1.78 (1.60,1.98) | p < 0.001 |
Source of drinking water
| ||||
Improved | 1 | 1 | ||
Unimproved | 1.39 (1.32,1.46) | p < 0.001 | 1.17 (1.09,1.25) | p < 0.001 |
Child stool disposal
| ||||
Safe | 1 | 1 | ||
Unsafe | 1.55 (1.46,1.64) | p < 0.001 | 1.50 (1.37,1.65) | p < 0.001 |
Household flooring
| ||||
Improved | 1 | 1 | ||
Unimproved | 2.82 (2.60,3.05) | p < 0.001 | 1.87 (1.65,2.11) | p < 0.001 |
Time to get a water source
| ||||
On-premise | 1 | 1 | ||
≤ 30 min | 2.80 (2.53,3.09) | p < 0.001 | 1.59 (1.37, 1.86) | p < 0.001 |
31–60 min | 2.82 (2.53, 3.14) | p < 0.001 | 1.78 (1.51,2.09) | p < 0.001 |
> 60 min | 2.76 (2.47, 3.08) | p < 0.001 | 2.06 (1.74,2.43) | p < 0.001 |
Household drinking water service
| ||||
Basic drinking water service | 1 | |||
Limited drinking water service | 1.25 (1.15,1.36) | p < 0.001 | 1.26 (1.12,1.43) | p < 0.001 |
Poor drinking water service | 1.42 (1.34,1.49) | p < 0.001 | 1.22 (1.12,1.33) | p < 0.001 |
Combined sanitation facility
| ||||
Improved Water + Improved Sanitation | 1 | 1 | ||
Either one improved | 2.19 (2.01,2.39) | p < 0.001 | 1.82 (1.58,2.09) | p < 0.001 |
Unimproved Water + Unimproved Sanitation | 2.57 (2.36,2.79) | p < 0.001 | 1.88 (1.64,2.15) | p < 0.001 |
Child Factors
| ||||
Childhood infections
| ||||
Diarrhea
| ||||
Yes | 1.25 (1.17,1.33) | p < 0.001 | 1.64 (1.51,1.79) | p < 0.001 |
No | 1 | 1 | ||
Fever
| ||||
Yes | 1.19 (1.13,1.26) | p < 0.001 | 1.56 (1.44,1.69) | p < 0.001 |
No | 1 | |||
ARI
| ||||
Yes | 0.92 (0.82,1.04) | 0.206 | 1.29 (1.09,1.53) | 0.002 |
No | 1 | 1 | ||
Sex
| ||||
Male | 1 | 1 | ||
Female | 0.89 (0.84,0.93) | p < 0.001 | 0.82 (0.76,0.87) | p < 0.001 |
Age (months)
| ||||
< 12 | 1 | 1 | ||
12–23 | 4.19 (3.85,4.55) | p < 0.001 | 0.89 (0.81,0.98) | 0.019 |
≥ 24 to 59 months | 5.43 (5.05,5.83) | p < 0.001 | 0.45 (0.42,0.49) | p < 0.001 |
Birth order
| ||||
First born | 1 | 1 | ||
2–4 | 1.13 (1.07,1.21) | p < 0.001 | 1.16 (1.05,1.28) | 0.003 |
5 or higher | 1.34 (1.25,1.43) | p < 0.001 | 1.35 (1.22,1.49) | p < 0.001 |
Birth interval
| ||||
< 33 months | 1 | 1 | ||
≥ 33 months | 1.15 (1.10,1.22) | p < 0.001 | 1.01 (0.94,1.09) | 0.695 |
Size of child at birth
| ||||
Larger | 1 | 1 | ||
Average | 1.11 (1.05,1.17) | p < 0.001 | 1.19 (1.09,1.30) | p < 0.001 |
Small | 1.46 (1.37,1.55) | p < 0.001 | 1.79 (1.63,1.95) | p < 0.001 |
Currently breastfeeding
| ||||
Yes | 1 | 1 | ||
No | 1.17 (1.11,1.23) | p < 0.001 | 0.69 (0.63,0.74) | p < 0.001 |
Early initiation of breastfeeding
| ||||
Yes | 1 | 1 | ||
No | 1.14 (1.08,1.20) | p < 0.001 | 1.04 (0.96,1.12) | 0.314 |
Received measles
| ||||
Yes | 1 | 1 | ||
No | 0.81 (0.77,0.85) | p < 0.001 | 1.61 (1.49,1.74) | p < 0.001 |
Basic vaccine
| ||||
Yes | 1 | 1 | ||
No | 0.94 (0.88,0.99) | 0.033 | 1.61 (1.46,1.78) | p < 0.001 |
Parental factors
| ||||
Mother’s age
| ||||
< 18 | 1 | 1 | ||
18–24 | 1.37 (1.04,1.79) | 0.023 | 0.71 (0.51,1.01) | 0.051 |
25–34 | 1.55 (1.18,2.03) | 0.001 | 0.64 (0.46,090) | 0.011 |
≥ 35 | 1.72 (1.31,2.26) | p < 0.001 | 0.69 (0.49,0.98) | 0.038 |
Mother’s education
| ||||
No education | 5.56 (4.36,7.09) | p < 0.001 | 2.70 (1.87,3.90) | p < 0.001 |
Primary | 3.79 (2.96, 4.85) | p < 0.001 | 1.91 (1.31, 2.78) | 0.001 |
Secondary | 1.85 (1.42, 2.41) | p < 0.001 | 1.24 (0.82, 1.87) | 0.306 |
Higher | 1 | 1 | ||
Mother’s occupation
| ||||
Not working | 1 | 1 | ||
Non agriculture | 0.95 (0.89,1.01) | 0.110 | 0.74 (0.67,0.81) | p < 0.001 |
Agriculture | 1.54 (1.46,1.63) | p < 0.001 | 1.02 (0.94, 1.11) | 0.541 |
ANC Visit
| ||||
None | 1 | 1 | ||
1–3 | 0.71 (0.66,0.76) | p < 0.001 | 0.84 (0.77,0.93) | p < 0.001 |
4+ | 0.48 (0.44,0.52) | p < 0.001 | 0.52 (0.47,0.58) | p < 0.001 |
Maternal BMI (kg/m2) | ||||
< 18.5 | 1 | 1 | ||
18.5 to 24.9 | 0.89 (0.84,0.94) | p < 0.001 | 0.55 (0.51,0.59) | p < 0.001 |
25 + | 0.37 (0.32,0.41) | p < 0.001 | 0.26 (0.21,0.32) | p < 0.001 |
Husband’s education
| ||||
No education | 1 | 1 | ||
Primary | 3.64 (3.17,4.19) | p < 0.001 | 1.82 (1.49,2.23) | p < 0.001 |
Secondary | 2.75 (2.38,3.18) | p < 0.001 | 1.24 (1.01,1.54) | 0.037 |
Higher | 1.69 (1.44,1.97) | p < 0.001 | 1.18 (0.94,1.49) | 0.148 |
Listening to radio
| ||||
Not at all | 1 | 1 | ||
Yes | 0.75 (0.72,0.79) | p < 0.001 | 0.66 (0.61,0.71) | p < 0.001 |
Watching television
| ||||
Not at all | 1 | 1 | ||
Yes | 0.52 (0.49,0.55) | p < 0.001 | 0.53 (0.47,0.58) | p < 0.001 |
Household factors
| ||||
Wealth index
| ||||
Poor | 1.71 (1.59,1.81) | p < 0.001 | 1.95 (1.76,2.16) | p < 0.001 |
Middle | 1.52 (1.39,1.65) | p < 0.001 | 1.52 (1.33,1.74) | p < 0.001 |
Rich | 1 | 1 | ||
Household Size
| ||||
1–4 | 0.86 (0.82,0.91) | p < 0.001 | 0.89 (0.82,0.97) | 0.006 |
≥ 5 | 1 | 1 | ||
Community-Level Factors
| ||||
Residence
| ||||
Urban | 1 | 1 | ||
Rural | 2.29 (2.14,2.46) | p < 0.001 | 1.61 (1.45,1.80) | p < 0.001 |
Region
| ||||
Agrarian | 1.91 (1.77,2.05) | p < 0.001 | 1.55 (1.38,1.74) | p < 0.001 |
Pastoralist | 1.78 (1.63,1.93) | p < 0.001 | 1.55 (1.37,1.76) | p < 0.001 |
City | 1 | 1 | ||
Ecological Zone (meters in elevation)
| ||||
< 1500 | 0.65 (0.58,0.73) | p < 0.001 | 2.01 (1.68,2.41) | p < 0.001 |
1500–2500 | 0.73 (0.66,0.82) | p < 0.001 | 1.23 (1.03,1.48) | p < 0.001 |
> 2500 | 1 | 1 |
WASH factors associated with stunting
Characteristics | Model 1 (AOR, 95%CI) | p-value | Model 2 (AOR, 95%CI) | p-value | Model 3 (AOR, 95%CI) | p-value | Model 4 (AOR, 95%CI) | p-value | Model 5 (AOR, 95%CI) | p-value | Model 6# (AOR, 95%CI) | p-value |
---|---|---|---|---|---|---|---|---|---|---|---|---|
WASH factors
a
| ||||||||||||
Latrine facility
| ||||||||||||
Improved | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
Unimproved | 1.08 (0.98,1.18) | 0.087 | 1.12 (1.01,1.26) | 0.048 | 1.03 (0.91,1.15) | 0.670 | 1.25 (1.08,1.45) | 0.002 | 1.21 (1.05,1.39) | 0.009 |
1.20 (1.05,1.39)
| 0.009 |
Open defecation | 1.34 (1.23,1.47) | p < 0.001 | 1.39 (1.24,1.56) | p < 0.001 | 1.21 (1.08,1.37) | 0.002 | 1.30 (1.11,1.52) | 0.001 | 1.29 (1.11,1.51) | 0.001 |
1.29 (1.11,1.51)
| 0.001 |
Source of drinking water
| ||||||||||||
Improved | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
Unimproved | 1.04 (0.99,1.10) | 0.100 | 1.04 (0.97,1.12) | 0.265 | 1.01 (0.93,1.08) | 0.879 | 0.91 (0.84,0.99) | 0.042 | 0.92 (0.84,1.01) | 0.06 |
0.91 (0.83,0.99)
| 0.041 |
Child stool disposal
| ||||||||||||
Safe | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
Unsafe | 1.08 (1.01,1.16) | 0.022 | 1.08 (0.98,1.18) | 0.092 | 0.98 (0.89,1.08) | 0.782 | 0.94 (0.85,1.05) | 0.302 | 0.94 (0.85,1.05) | 0.260 | 0.94 (0.85,1.04) | 0.282 |
Household flooring
| ||||||||||||
Improved | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
Unimproved | 1.85 (1.67,2.05) | p < 0.001 | 1.79(1.57,2.04) | p < 0.001 | 1.37 (1.19,1.58) | p < 0.001 | 1.38 (1.17,1.62) | p < 0.001 | 1.31 (1.10,1.55) | 0.002 |
1.32 (1.12,1.57)
| 0.001 |
Time to get water source
| ||||||||||||
On-premise | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
≤ 30 min | 1.67 (1.49,1.88) | p < 0.001 | 1.55 (1.33,1.82) | p < 0.001 | 1.28 (1.09,1.50) | 0.003 | 1.16 (0.97,1.37) | 0.097 | 1.09 (0.91,1.30) | 0.335 | 1.09 (0.91,1.29) | 0.338 |
31–60 min | 1.64 (1.45,1.86) | p < 0.001 | 1.49 (1.27,1.78) | p < 0.001 | 1.21 (1.02,1.44) | 0.030 | 1.09 (0.90,1.32) | 0.356 | 1.03 (0.85,1.24) | 0.789 | 1.02 (0.84,1.24) | 0.795 |
> 60 min | 1.56 (1.37,1.77) | p < 0.001 | 1.47 (1.24,1.74) | p < 0.001 | 1.18 (0.99,1.41) | 0.069 | 1.08 (0.89,1.31) | 0.448 | 1.04 (0.86,1.27) | 0.665 | 1.05 (0.86,1.27) | 0.618 |
Child Factors
| ||||||||||||
Childhood infections
| ||||||||||||
Diarrhea
| ||||||||||||
Yes | 1.22 (1.13,1.33) | p < 0.001 | 1.19 (1.09,1.30) | p < 0.001 | 1.14 (1.02,1.27) | 0.018 | 1.14 (1.02,1.27) | 0.018 | 1.16 (1.05,1.28) | 0.003 | ||
No | 1 | 1 | 1 | 1 | 1 | |||||||
Fever
| ||||||||||||
Yes | 1.14 (1.06,1.23) | p < 0.001 | 1.14 (1.06,1.24) | 0.001 | 1.07 (0.96,1.19) | 0.187 | 1.06 (0.96,1.18) | 0.223 | ||||
No | 1 | 1 | 1 | |||||||||
ARI
| ||||||||||||
Yes | 0.79 (0.67,0.94) | 0.008 | 0.80 (0.67,0.95) | 0.010 | 0.91 (0.76,1.08) | 0.275 | ||||||
No | 1 | 1 | 1 | |||||||||
Sex
| ||||||||||||
Male | 1 | 1 | 1 | 1 | 1 | |||||||
Female | 0.81 (0.76,0.86) | p < 0.001 | 0.79 (0.74,0.85) | p < 0.001 | 0.79 (0.73,0.85) | p < 0.001 | 0.79 (0.73,0.85) | p < 0.001 | 0.79 (0.72,0.85) | p < 0.001 | ||
Age (months)
| ||||||||||||
< 12 | 1 | 1 | 1 | 1 | 1 | |||||||
12–23 | 3.54 (3.09,4.06) | p < 0.001 | 3.66 (3.13,4.29) | p < 0.001 | 3.19 (2.61,3.90) | p < 0.001 | 3.17 (2.60,3.85) | p < 0.001 | 3.16 (2.59,3.84) | p < 0.001 | ||
≥ 24 to 59 months | 6.83 (5.93,7.87) | p < 0.001 | 7.51 (6.29,8.96) | p < 0.001 | 6.63 (5.32,8.27) | p < 0.001 | 6.52 (5.25,8.09) | p < 0.001 | 6.47 (5.21,8.02) | p < 0.001 | ||
Birth order
| ||||||||||||
Firstborn | 1 | 1 | 1 | 1 | 1 | |||||||
2–4 | 1.04 (0.95,1.14) | 0.382 | 0.90 (0.81,1.01) | 0.076 | 0.85 (0.75,0.96) | 0.011 | 0.86 (0.76,0.97) | 0.016 | 0.88 (0.78,0.98) | 0.032 | ||
5 or higher | 1.17 (1.05,1.30) | 0.004 | 0.95 (0.83,1.09) | 0.513 | 0.81 (0.70,0.94) | 0.005 | 0.81 (0.70,0.94) | 0.004 | 0.85 (0.75,0.96) | 0.009 | ||
Birth interval
| ||||||||||||
< 33 months | 1 | 1 | ||||||||||
≥ 33 months | 0.91 (0.83,0.98) | 0.023 | 0.91 (0.78,1.06) | 0.255 | ||||||||
Size of child at birth
| ||||||||||||
Larger | 1 | 1 | 1 | 1 | 1 | |||||||
Average | 1.21 (1.12,1.31) | p < 0.001 | 1.18 (1.09,1.28) | p < 0.001 | 1.23 (1.12,1.35) | p < 0.001 | 1.22 (1.11,1.34) | p < 0.001 | 1.22 (1.11,1.34) | p < 0.001 | ||
Small | 1.68 (1.55,1.82) | p < 0.001 | 1.63 (1.49,1.78) | p < 0.001 | 1.65 (1.48,1.83) | p < 0.001 | 1.64 (1.48,1.81) | p < 0.001 | 1.64 (1.48,1.82) | p < 0.001 | ||
Currently breast feeding
| ||||||||||||
Yes | 1 | 1 | 1 | 1 | 1 | |||||||
No | 0.70 (0.65,0.76) | p < 0.001 | 0.63 (0.58,0.69) | p < 0.001 | 0.61 (0.55,0.67) | p < 0.001 | 0.62 (0.55,0.68) | p < 0.001 | 0.62 (0.55,0.68) | p < 0.001 | ||
Early initiation of breastfeeding
| ||||||||||||
Yes | 1 | 1 | 1 | |||||||||
No | 1.04 (0.98,1.11) | 0.159 | 1.05 (0.98,1.12) | 0.153 | 1.02 (0.93,1.10) | 0.683 | ||||||
Received measles
| ||||||||||||
Yes | 1 | |||||||||||
No | 1.04 (0.95, 1.14) | 0.359 | ||||||||||
Basic vaccine
| ||||||||||||
Yes | 1 | |||||||||||
No | 1.01 (0.91,1.11) | 0.943 | ||||||||||
Parental factors
| ||||||||||||
Mother’s age
| ||||||||||||
< 18 | 1 | |||||||||||
18–24 | 0.80 (0.55,1.14) | 0.228 | ||||||||||
25–34 | 0.81 (0.56,1.16) | 0.252 | ||||||||||
≥ 35 | 0.77 (0.51,1.15) | 0.201 | ||||||||||
Mother’s education
| ||||||||||||
No education | 1.60 (1.12, 2.29) | 0.011 | 1.41 (0.96,2.04) | 0.074 | 1.51 (1.04,2.19) | 0.031 | 1.54 (1.06,2.24) | 0.022 | ||||
Primary | 1.39 (0.97,1.98) | 0.068 | 1.25 (0.87,1.81) | 0.219 | 1.35 (0.94,1.96) | 0.100 | 1.38 (0.96,1.99) | 0.080 | ||||
Secondary | 1.20 (0.83,1.73) | 0.316 | 1.12 (0.77,1.63) | 0.539 | 1.20 (0.83,1.75) | 0.336 | 1.21 (0.83,1.77) | 0.305 | ||||
Higher | 1 | 1 | 1 | 1 | ||||||||
Mother’s occupation
| ||||||||||||
Not working | 1 | 1 | 1 | 1 | ||||||||
Non agriculture | 1.02 (0.94,1.12) | 0.595 | 0.99 (0.89,1.11) | 0.975 | 1.01 (0.90,1.11) | 0.943 | 1.01 (0.90,1.11) | 0.958 | ||||
Agriculture | 1.18 (1.09,1.28) | p < 0.001 | 1.10 (0.99,1.23) | 0.058 | 1.07 (0.96,1.19) | 0.186 | 1.06 (0.96,1.18) | 0.235 | ||||
ANC Visit
| ||||||||||||
None | 1 | 1 | 1 | 1 | ||||||||
1–3 | 0.87 (0.80,0.95) | 0.002 | 0.93 (0.85,1.04) | 0.210 | 0.93 (0.84,1.03) | 0.151 | 0.93 (0.84,1.02) | 0.136 | ||||
4+ | 0.72 (0.65,0.79) | p < 0.001 | 0.74 (0.66,0.83) | p < 0.001 | 0.75 (0.67,0.83) | p < 0.001 | 0.74 (0.66,0.83) | p < 0.001 | ||||
Maternal BMI (kg/m2) | ||||||||||||
< 18.5 | 1 | 1 | 1 | 1 | ||||||||
18.5 to 24.9 | 0.95 (0.88,1.02) | 0.166 | 0.93 (0.85,1.01) | 0.105 | 0.92 (0.84,1.02) | 0.073 | 0.92 (0.84,1.01) | 0.072 | ||||
25 + | 0.81 (0.67,0.96) | 0.018 | 0.79 (0.65,0.96) | 0.017 | 0.79 (0.66,0.97) | 0.023 | 0.79 (0.65,0.96) | 0.020 | ||||
Husband’s education
| ||||||||||||
No education | 1.45 (1.15,1.83) | 0.001 | 1.51 (1.17,1.94) | 0.001 | 1.50 (1.17,1.92) | 0.001 | 1.50 (1.17,1.92) | 0.001 | ||||
Primary | 1.32 (1.05,1.65) | 0.017 | 1.39 (1.09,1.78) | 0.008 | 1.36 (1.07,1.74) | 0.011 | 1.37 (1.07,1.74) | 0.011 | ||||
Secondary | 1.09 (0.86,1.37) | 0.453 | 1.13 (0.88,1.46) | 0.336 | 1.15 (0.89,1.48) | 0.260 | 1.15 (0.89,1.48) | 0.264 | ||||
Higher | 1 | 1 | 1 | 1 | ||||||||
Husband’s occupation
| ||||||||||||
Not working | 0.69 (0.57,0.84) | p < 0.001 | 0.75 (0.61,0.93) | 0.009 | 0.75 (0.61,0.92) | 0.006 | 0.75 (0.61,0.93) | 0.008 | ||||
Agriculture | 1.04 (0.94,1.15) | 0.410 | 1.10 (0.98,1.24) | 0.088 | 1.07 (0.95,1.20) | 0.283 | 1.07 (0.95,1.21) | 0.241 | ||||
Non agriculture | 1 | 1 | 1 | 1 | ||||||||
Listening to radio
| ||||||||||||
Not at all | 1 | |||||||||||
Yes | 0.98 (0.91,1.06) | 0.669 | ||||||||||
Watching television
| ||||||||||||
Not at all | 1 | 1 | 1 | |||||||||
Yes | 0.87 (0.78,0.97) | 0.011 | 0.92 (0.82,1.03) | 0.147 | 0.93 (0.83,1.04) | 0.210 | ||||||
Household factors
| ||||||||||||
Wealth index
| ||||||||||||
Poor | 1.17 (1.04,1.31) | 0.009 | 1.19 (1.06,1.31) | 0.003 | 1.20 (1.07,1.35) | 0.002 | ||||||
Middle | 0.99 (0.87,1.13) | 0.936 | 1.01 (0.88,1.15) | 0.827 | 1.01 (0.89,1.15) | 0.828 | ||||||
Rich | 1 | 1 | 1 | |||||||||
Household Size
| ||||||||||||
1–4 | 0.93 (0.84,1.03) | 0.187 | 0.94 (0.85,1.04) | 0.240 | ||||||||
≥ 5 | 1 | 1 | ||||||||||
Community Level Factors
| ||||||||||||
Residence
| ||||||||||||
Urban | 1 | 1 | ||||||||||
Rural | 1.13 (0.94,1.35) | 0.181 | 1.15 (0.96,1.37) | 0.123 | ||||||||
Region
| ||||||||||||
Agrarian | 1.11 (0.96,1.28) | 0.176 | 1.12 (0.97,1.29) | 0.124 | ||||||||
Pastoralist | 1.08 (0.92,1.27) | 0.320 | 1.09 (0.93,1.28) | 0.276 | ||||||||
City administrations | 1 | 1 | ||||||||||
Ecological Zone
| ||||||||||||
< 1500 | 0.67 (0.58,0.78) | p < 0.001 | 0.67 (0.58,0.78) | p < 0.001 | ||||||||
1500–2500 | 0.75 (0.65,0.87) | p < 0.001 | 0.75 (0.65,0.87) | p < 0.001 | ||||||||
> 2500 | 1 | 1 |
WASH factors associated with wasting
Characteristics | Model 1 (AOR, 95%CI) | p-value | Model 2 (AOR, 95%CI) | p-value | Model 3 (AOR, 95%CI) | p-value | Model 4 (AOR, 95%CI) | p-value | Model 5 (AOR, 95%CI) | p-value | Model 6# (AOR, 95%CI) | p-value |
---|---|---|---|---|---|---|---|---|---|---|---|---|
WASH factors
a
| ||||||||||||
Latrine facility
| ||||||||||||
Improved | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
Unimproved | 0.93 (0.81,1.07) | 0.330 | 1.12 (1.01,1.24) | 0.024 | 1.05 (0.92,1.18) | 0.471 | 1.26 (1.09,1.45) | 0.001 | 1.03 (0.83,1.26) | 0.792 | 1.02 (0.83,1.24) | 0.873 |
Open defecation | 1.39 (1.21,1.59) | p < 0.001 | 1.31 (1.19,1.45) | p < 0.001 | 1.21 (1.06,1.37) | 0.004 | 1.30 (1.12,1.52) | 0.001 | 1.15 (0.93,1.42) | 0.206 | 1.15 (0.93, 1.42) | 0.182 |
Source of drinking water
| ||||||||||||
Improved | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
Unimproved | 0.98 (0.91,1.06) | 0.635 | 1.05 (0.99,1.12) | 0.089 | 1.01 (0.94,1.09) | 0.696 | 0.91 (0.84,0.99) | 0.039 | 0.84 (0.75,0.94) | 0.004 |
0.83 (0.73,0.93)
| 0.002 |
Child stool disposal
| ||||||||||||
Safe | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
Unsafe | 1.07 (0.96,1.19) | 0.208 | 1.14 (1.05,1.23) | 0.002 | 1.05 (0.95,1.16) | 0.310 | 0.96 (0.86,1.06) | 0.404 | 1.09 (0.94,1.26) | 0.233 | 1.09 (0.94,1.25) | 0.239 |
Household flooring
| ||||||||||||
Improved | 1 | 1 | 1 | 1` | 1 | 1 | ||||||
Unimproved | 1.40 (1.19,1.64) | p < 0.001 | 1.78 (1.58,2.00) | p < 0.001 | 1.37 (1.18,1.59) | p < 0.001 | 1.36 (1.15,1.60) | p < 0.001 | 0.99 (0.78,1.26) | 0.948 | 0.99 (0.78,1.25) | 0.957 |
Time to get water source
| ||||||||||||
On-premise | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
≤ 30 min | 1.11 (0.93,1.32) | 0.246 | 1.66 (1.45,1.91) | p < 0.001 | 1.26 (1.06,1.50) | 0.006 | 1.14 (0.97,1.36) | 0.114 | 1.14 (0.89,1.46) | 0.313 | 1.11 (0.86,1.42) | 0.412 |
31–60 min | 1.20 (0.99,1.45) | 0.059 | 1.55 (1.34,1.81) | p < 0.001 | 1.19 (0.99,1.43) | 0.054 | 1.07 (0.89,1.29) | 0.444 | 1.15 (0.88,1.50) | 0.313 | 1.14 (0.87,1.48) | 0.336 |
> 60 min | 1.37 (1.13,1.65) | 0.001 | 1.47 (1.26,1.71) | p < 0.001 | 1.18 (0.98,1.42) | 0.083 | 1.07 (0.88,1.29) | 0.483 | 1.24 (0.95,1.62) | 0.116 | 1.24 (0.95,1.62) | 0.112 |
Child factors
| ||||||||||||
Childhood infections
| ||||||||||||
Diarrhea
| ||||||||||||
Yes | 1.28(1.19,1.38) | p < 0.001 | 1.19 (1.09,1.31) | p < 0.001 | 1.34 (1.02,1.27) | 0.020 | 1.26 (1.09,1.44) | 0.001 | 1.27 (1.11,1.45) | p < 0.001 | ||
No | 1 | 1 | 1 | 1 | ||||||||
Fever
| ||||||||||||
Yes | 1.17 (1.09,1.26) | p < 0.001 | 1.14 (1.05,1.25) | 0.001 | 1.08 (0.97,1.20) | 0.135 | 1.25 (1.09,1.42) | 0.001 | 1.24 (1.09,1.41) | 0.001 | ||
No | 1 | 1 | 1 | 1 | ||||||||
ARI
| ||||||||||||
Yes | 0.83 (0.72,0.96) | 0.014 | 0.79 (0.67,0.95) | 0.011 | 0.91 (0.77,1.08) | 0.304 | ||||||
No | 1 | 1 | 1 | |||||||||
Sex
| ||||||||||||
Male | 1 | 1 | 1 | 1 | 1 | |||||||
Female | 0.84 (0.79,0.88) | p < 0.001 | 0.77 (0.72,0.83) | p < 0.001 | 0.78 (0.73,0.85) | p < 0.001 | 0.73 (0.65,0.81) | p < 0.001 | 0.73 (0.65,0.81) | p < 0.001 | ||
Age (months)
| ||||||||||||
< 12 | 1 | 1 | 1 | 1 | 1 | |||||||
12–23 | 3.60 (3.17,4.08) | p < 0.001 | 3.57 (3.05,4.19) | p < 0.001 | 3.17 (2.60,3.85) | p < 0.001 | 1.07 (0.85,1.35) | 0.548 | 1.08 (0.86, 1.36) | 0.508 | ||
≥ 24 to 59 months | 5.57 (4.91,6.31) | p < 0.001 | 7.38 (6.17,8.82) | p < 0.001 | 6.56 (5.28,8,14) | p < 0.001 | 0.67 (0.51,0.87) | 0.003 | 0.65 (0.50, 0.83) | 0.001 | ||
Birth order
| ||||||||||||
Firstborn | 1 | 1 | 1 | 1 | 1 | |||||||
2–4 | 1.05 (0.97,1.13) | 0.202 | 0.88 (0.79,0.98) | 0.032 | 0.85 (0.76,0.97) | 0.013 | 1.07 (0.91,1.25) | 0.392 | 1.10 (0.94,1.29) | 0.214 | ||
5 or higher | 1.15 (1.06,1.24) | p < 0.001 | 0.92 (0.79,1.05) | 0.214 | 0.82 (0.71,0.94) | 0.005 | 1.21 (1.02,1.43) | 0.024 | 1.28 (1.09,1.50) | 0.002 | ||
Size of child at birth
| ||||||||||||
Larger | 1 | 1 | 1 | 1 | 1 | |||||||
Average | 1.22 (1.14,1.31) | p < 0.001 | 1.19 (1.08,1.29) | p < 0.001 | 1.22 (1.10,1.34) | p < 0.001 | 1.14 (0.99,1.29) | 0.065 | 1.13 (0.99,1.29) | 0.055 | ||
Small | 1.63 (1.52,1.75) | p < 0.001 | 1.62 (1.48,1.77) | p < 0.001 | 1.64 (1.47,1.82) | p < 0.001 | 1.56 (1.36,1.79) | p < 0.001 | 1.58 (1.40,1.82) | p < 0.001 | ||
Currently breast feeding
| ||||||||||||
Yes | 1 | 1 | 1 | 1 | ||||||||
No | 0.83 (0.78,0.89) | p < 0.001 | 0.67 (0.61,0.73) | p < 0.001 | 0.61 (0.54,0.67) | p < 0.001 | 0.91 (0.78,1.06) | 0.238 | ||||
Received measles
| ||||||||||||
Yes | 1 | 1 | ||||||||||
No | 1.06 (0.98,1.15) | 0.116 | 0.96 (0.89,1.04) | 0.393 | ||||||||
Basic vaccine
| ||||||||||||
Yes | 1 | |||||||||||
No | 0.97 (0.89,1.06) | 0.569 | ||||||||||
Parental factors
| ||||||||||||
Mother’s age
| ||||||||||||
< 18 | 1 | |||||||||||
18–24 | 0.79 (0.55,1.14) | 0.206 | ||||||||||
25–34 | 0.82 (0.56,1.19) | 0.303 | ||||||||||
>=35 | 0.74 (0.50,1.08) | 0.121 | ||||||||||
Mother’s education
| ||||||||||||
No education | 1.84 (1.24,2.71) | 0.002 | 1.48 (1.02,2.16) | 0.037 | 1.18 (0.69,2.02) | 0.533 | ||||||
Primary | 1.66 (1.13,2.43) | 0.010 | 1.33 (0.93,1.93) | 0.116 | 1.05 (0.62, 1.77) | 0.847 | ||||||
Secondary | 1.38 (0.94,2.05) | 0.099 | 1.18 (0.81,1.72) | 0.377 | 0.81 (0.47, 1.39) | 0.445 | ||||||
Higher | 1 | 1 | 1 | |||||||||
Mother’s occupation
| ||||||||||||
Not working | 1 | 1 | 1 | 1 | ||||||||
Non agriculture | 1.02 (0.93,1.12) | 0.601 | 1.01 (0.91,1.12) | 0.887 | 0.86 (0.74, 1.01) | 0.054 | 0.84 (0.73,0.97) | 0.022 | ||||
Agriculture | 1.22 (1.12,1.33) | p < 0.001 | 1.11 (0.99,1.23) | 0.051 | 1.02 (0.89, 1.18) | 0.734 | 1.02 (0.89,1.17) | 0.738 | ||||
ANC Visit
| ||||||||||||
None | 1 | 1 | 1 | 1 | ||||||||
1–3 | 0.87 (0.79,0.94) | 0.002 | 0.93 (0.84,1.03) | 0.159 | 0.92 (0.81,1.04) | 0.214 | 0.90 (0.79,1.02) | 0.108 | ||||
4+ | 0.71 (0.64,0.79) | p < 0.001 | 0.74 (0.66,0.82) | p < 0.001 | 0.78 (0.67,0.91) | 0.002 | 0.74 (0.64,0.87) | p < 0.001 | ||||
Maternal BMI (kg/m2) | ||||||||||||
< 18.5 | 1 | 1 | 1 | 1 | ||||||||
18.5 to 24.9 | 0.96 (0.89,1.04) | 0.347 | 0.93 (0.85,1.02) | 0.116 | 0.64 (0.57,0.72) | p < 0.001 | 0.65 (0.58,0.73) | p < 0.001 | ||||
25 + | 0.79 (0.66,0.95) | 0.017 | 0.79 (0.65,0.96) | 0.019 | 0.39 (0.29,0.53) | p < 0.001 | 0.39 (0.28,0.52) | p < 0.001 | ||||
Husband’s education
| ||||||||||||
No education | 1.33 (1.04,1.69) | 0.019 | 1.51 (1.17, 1.93) | 0.001 | 1.06 (0.76, 1.47) | 0.738 | ||||||
Primary | 1.22 (0.96,1.54) | 0.103 | 1.38 (1.08,1.75) | 0.009 | 0.87 (0.62,1.21) | 0.411 | ||||||
Secondary | 0.99 (0.78,1.27) | 0.977 | 1.14 (0.89,1.47) | 0.289 | 1.12 (0.79, 1.57) | 0.508 | ||||||
Higher | 1 | 1 | 1 | |||||||||
Husband’s occupation
| ||||||||||||
Not working | 0.65 (0.52,0.80) | p < 0.001 | 0.75 (0.61,0.92) | 0.007 | 1.06 (0.81, 1.38) | 0.654 | 1.08 (0.83,1.40) | 0.571 | ||||
Agriculture | 1.01 (0.92,1.12) | 0.782 | 1.11 (0.99,1.24) | 0.066 | 1.16 (0.98, 1.36) | 0.077 | 1.16 (0.99, 1.35) | 0.062 | ||||
Non agriculture | 1 | 1 | 1 | 1 | ||||||||
Listening to radio
| ||||||||||||
Not at all | 1 | |||||||||||
Yes | 0.99 (0.91,1.07) | 0.820 | ||||||||||
Watching television
| ||||||||||||
Not at all | 1 | 1 | 1 | 1 | ||||||||
Yes | 0.84 (0.75,0.94) | 0.002 | 0.92 (0.82,1.03) | 0.152 | 0.78 (0.66,0.92) | 0.003 | 0.71 (0.61,0.84) | p < 0.001 | ||||
Household factors
| ||||||||||||
Wealth index
| ||||||||||||
Poor | 1.33 (1.13,1.56) | 0.001 | 1.35 (1.14,1.60) | p < 0.001 | 1.40 (1.18,1.66) | p < 0.001 | ||||||
Middle | 1.15 (0.95,1.38) | 0.143 | 1.24 (1.03,1.50) | 0.022 | 1.27 (1.05,1.53) | 0.012 | ||||||
Rich | 1 | 1 | 1 | 1 | ||||||||
Household Size
| ||||||||||||
1–4 | 0.94 (0.84,1.04) | 0.231 | ||||||||||
>=5 | 1 | |||||||||||
Community Level Factors
| ||||||||||||
Residence
| ||||||||||||
Urban | 1 | 1 | ||||||||||
Rural | 0.57 (0.44,0.72) | p < 0.001 | 0.58 (0.46,0.73) | p < 0.001 | ||||||||
Region
| ||||||||||||
Agrarian | 0.96 (0.79,1.17) | 0.711 | ||||||||||
Pastoralist | 0.95 (0.78,1.17) | 0.654 | ||||||||||
City administrations | 1 | |||||||||||
Ecological Zone
| ||||||||||||
< 1500 | 1.61 (1.30,1.99) | p < 0.001 | 1.61 (1.30,1.99) | p < 0.001 | ||||||||
1500–2500 | 1.18 (0.96,1.46) | 0.105 | 1.17 (0.96,1.45) | 0.115 | ||||||||
> 2500 | 1 | 1 |