An investigation of water and sanitation risk factors associated with childhood diarrhoeal morbility in Kibera, Nairobi Kenya
Muthee, Veronica Mukuhi
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Diarrhoeal diseases are still some of the leading causes of morbidity and mortality and are responsible for approximately 1.6 million of the 11 million yearly deaths, of the under fives worldwide. Although mortality rates have been reduced drastically, morbidity rates remain high. The associations of water supply and sanitation, with childhood diarrhoeal morbidity while considering specific indicators have not been clearly established. A better understanding is therefore warranted particularly in regard to burden of health among the under fives in terms of ill health and appalling quality of life. The main objective of this study was to investigate water and sanitation risk factors associated with childhood diarrhoeal morbidity in Kibera, Nairobi and the inadequate water and sanitation related coping mechanisms. Data on health outcome and the determinants (proximate) of childhood diarrhoeal diseases was based on a two-week recall, selfreporting of ill health by respondents (373 child care takers) using systematic and snowballing sampling. The study variables included income earning, education levels, household family size, water source, water storage conditions, per capita water consumption, accessibility to and sharing of latrines. Data was obtained by trained interviewers using, sanitary survey, semi-precoded questionnaires and spot check observation sheets. The Statistical Package for Social Sciences (SPSS) software (version 12 for windows) was used for data analysis. The findings of the study indicated that period prevalence of diarrhoea two weeks preceding the study was 37.8%. The frequency of diarrhoea was significantly higher among households with low income (p=0.036) and in homes with high crowding indices (p=0.095). Results indicated that diarrhoea morbidity among the under fives was significantly lower among households paying to use a latrine (p=0.023). The major conclusion derived from the study findings was that inadequate water and sanitation in Kibera undoubtedly results in higher prevalence of childhood diarrhoeal morbidity. This is compounded by inappropriate hygiene behaviours, overcrowding and poverty which predispose children to the risk of diarrhoeal illnesses. The main pro-poor policy implication of this study includes increasing access to water and sanitation in the informal settlements while the short-term solution to reducing diarrhoea include effective education programs that emphasize on hygiene. The study recommends a further research on the use of water guard to measure its effectiveness, appropriateness, affordability and ease of use in treating drinking water.