A multilevel analysis of individual and contextual factors associated with the practice of safe disposal of children's faeces in sub-Saharan Africa.

<h4>Background</h4>Over the years, sanitation programs over the world have focused more on household sanitation, with limited attention towards the disposal of children's stools. This lack of attention could be due to the misconception that children's stools are harmless. The c...

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Autores principales: Abdul-Aziz Seidu, Bright Opoku Ahinkorah, Kwaku Kissah-Korsah, Ebenezer Agbaglo, Louis Kobina Dadzie, Edward Kwabena Ameyaw, Eugene Budu, John Elvis Hagan
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spelling oai:doaj.org-article:b51489b774c14cf6a605c16015ffce162021-12-02T20:18:52ZA multilevel analysis of individual and contextual factors associated with the practice of safe disposal of children's faeces in sub-Saharan Africa.1932-620310.1371/journal.pone.0254774https://doaj.org/article/b51489b774c14cf6a605c16015ffce162021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0254774https://doaj.org/toc/1932-6203<h4>Background</h4>Over the years, sanitation programs over the world have focused more on household sanitation, with limited attention towards the disposal of children's stools. This lack of attention could be due to the misconception that children's stools are harmless. The current study examined the individual and contextual predictors of safe disposal of children's faeces among women in sub-Saharan Africa (SSA).<h4>Methods</h4>The study used secondary data involving 128,096 mother-child pairs of under-five children from the current Demographic and Health Surveys (DHS) in 15 sub-Saharan African countries from 2015 to 2018. Multilevel logistic analysis was used to assess the individual and contextual factors associated with the practice of safe disposal of children's faeces. We presented the results as adjusted odds ratios (aOR) at a statistical significance of p< 0.05.<h4>Results</h4>The results show that 58.73% (57.79-59.68) of childbearing women in the 15 countries in SSA included in our study safely disposed off their children's stools. This varied from as high as 85.90% (84.57-87.14) in Rwanda to as low as 26.38% (24.01-28.91) in Chad. At the individual level, the practice of safe disposal of children's stools was more likely to occur among children aged 1, compared to those aged 0 [aOR = 1.74; 95% CI: 1.68-1.80] and those with diarrhoea compared to those without diarrhoea [aOR = 1.17, 95% CI: 1.13-1.21]. Mothers with primary level of education [aOR = 1.42, 95% CI: 1.30-1.5], those aged 35-39 [aOR = 1.20, 95% CI: 1.12-1.28], and those exposed to radio [aOR = 1.23, 95% CI: 1.20-1.27] were more likely to practice safe disposal of children's stools. Conversely, the odds of safe disposal of children's stool were lower among mothers who were married [aOR = 0.74, 95% CI: 0.69-0.80] and those who belonged to the Traditional African Religion [aOR = 0.64, 95% CI: 0.51-0.80]. With the contextual factors, women with improved water [aOR = 1.13, 95% CI: 1.10-1.16] and improved toilet facility [aOR = 5.75 95% CI: 5.55-5.95] had higher odds of safe disposal of children's stool. On the other hand, mothers who lived in households with 5 or more children [aOR = 0.89, 95% CI: 0.86-0.93], those in rural areas [aOR = 0.86, 95% CI: 0.82-0.89], and those who lived in Central Africa [aOR = 0.19, 95% CI: 0.18-0.21] were less likely to practice safe disposal of children's stools.<h4>Conclusion</h4>The findings indicate that between- and within-country contextual variations and commonalities need to be acknowledged in designing interventions to enhance safe disposal of children's faeces. Audio-visual education on safe faecal disposal among rural women and large households can help enhance safe disposal. In light of the strong association between safe stool disposal and improved latrine use in SSA, governments need to develop feasible and cost-effective strategies to increase the number of households with access to improved toilet facilities.Abdul-Aziz SeiduBright Opoku AhinkorahKwaku Kissah-KorsahEbenezer AgbagloLouis Kobina DadzieEdward Kwabena AmeyawEugene BuduJohn Elvis HaganPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0254774 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Abdul-Aziz Seidu
Bright Opoku Ahinkorah
Kwaku Kissah-Korsah
Ebenezer Agbaglo
Louis Kobina Dadzie
Edward Kwabena Ameyaw
Eugene Budu
John Elvis Hagan
A multilevel analysis of individual and contextual factors associated with the practice of safe disposal of children's faeces in sub-Saharan Africa.
description <h4>Background</h4>Over the years, sanitation programs over the world have focused more on household sanitation, with limited attention towards the disposal of children's stools. This lack of attention could be due to the misconception that children's stools are harmless. The current study examined the individual and contextual predictors of safe disposal of children's faeces among women in sub-Saharan Africa (SSA).<h4>Methods</h4>The study used secondary data involving 128,096 mother-child pairs of under-five children from the current Demographic and Health Surveys (DHS) in 15 sub-Saharan African countries from 2015 to 2018. Multilevel logistic analysis was used to assess the individual and contextual factors associated with the practice of safe disposal of children's faeces. We presented the results as adjusted odds ratios (aOR) at a statistical significance of p< 0.05.<h4>Results</h4>The results show that 58.73% (57.79-59.68) of childbearing women in the 15 countries in SSA included in our study safely disposed off their children's stools. This varied from as high as 85.90% (84.57-87.14) in Rwanda to as low as 26.38% (24.01-28.91) in Chad. At the individual level, the practice of safe disposal of children's stools was more likely to occur among children aged 1, compared to those aged 0 [aOR = 1.74; 95% CI: 1.68-1.80] and those with diarrhoea compared to those without diarrhoea [aOR = 1.17, 95% CI: 1.13-1.21]. Mothers with primary level of education [aOR = 1.42, 95% CI: 1.30-1.5], those aged 35-39 [aOR = 1.20, 95% CI: 1.12-1.28], and those exposed to radio [aOR = 1.23, 95% CI: 1.20-1.27] were more likely to practice safe disposal of children's stools. Conversely, the odds of safe disposal of children's stool were lower among mothers who were married [aOR = 0.74, 95% CI: 0.69-0.80] and those who belonged to the Traditional African Religion [aOR = 0.64, 95% CI: 0.51-0.80]. With the contextual factors, women with improved water [aOR = 1.13, 95% CI: 1.10-1.16] and improved toilet facility [aOR = 5.75 95% CI: 5.55-5.95] had higher odds of safe disposal of children's stool. On the other hand, mothers who lived in households with 5 or more children [aOR = 0.89, 95% CI: 0.86-0.93], those in rural areas [aOR = 0.86, 95% CI: 0.82-0.89], and those who lived in Central Africa [aOR = 0.19, 95% CI: 0.18-0.21] were less likely to practice safe disposal of children's stools.<h4>Conclusion</h4>The findings indicate that between- and within-country contextual variations and commonalities need to be acknowledged in designing interventions to enhance safe disposal of children's faeces. Audio-visual education on safe faecal disposal among rural women and large households can help enhance safe disposal. In light of the strong association between safe stool disposal and improved latrine use in SSA, governments need to develop feasible and cost-effective strategies to increase the number of households with access to improved toilet facilities.
format article
author Abdul-Aziz Seidu
Bright Opoku Ahinkorah
Kwaku Kissah-Korsah
Ebenezer Agbaglo
Louis Kobina Dadzie
Edward Kwabena Ameyaw
Eugene Budu
John Elvis Hagan
author_facet Abdul-Aziz Seidu
Bright Opoku Ahinkorah
Kwaku Kissah-Korsah
Ebenezer Agbaglo
Louis Kobina Dadzie
Edward Kwabena Ameyaw
Eugene Budu
John Elvis Hagan
author_sort Abdul-Aziz Seidu
title A multilevel analysis of individual and contextual factors associated with the practice of safe disposal of children's faeces in sub-Saharan Africa.
title_short A multilevel analysis of individual and contextual factors associated with the practice of safe disposal of children's faeces in sub-Saharan Africa.
title_full A multilevel analysis of individual and contextual factors associated with the practice of safe disposal of children's faeces in sub-Saharan Africa.
title_fullStr A multilevel analysis of individual and contextual factors associated with the practice of safe disposal of children's faeces in sub-Saharan Africa.
title_full_unstemmed A multilevel analysis of individual and contextual factors associated with the practice of safe disposal of children's faeces in sub-Saharan Africa.
title_sort multilevel analysis of individual and contextual factors associated with the practice of safe disposal of children's faeces in sub-saharan africa.
publisher Public Library of Science (PLoS)
publishDate 2021
url https://doaj.org/article/b51489b774c14cf6a605c16015ffce16
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