The Association of Sanitation, Birth History, and Nutritional Status on the Incidence of Diarrhea Among Children Under Five in Zambia, South Africa

Abstract

Sub-Saharan countries are known to have inadequate supplies of clean water and sanitation, thus increasing the risk of diarrhea. It is known that nutritional problems are also the cause of diarrhea. So how do these risk factors affect sub-Saharan countries? Therefore, the purpose of this study was to determine the relationship between sanitation, birth history, and nutritional status on the incidence of diarrhea in children under five in Zambia and the magnitude of the risk. The study design used was cross-sectional by utilizing secondary data from the 2018 Zambia Demographic and Health Survey available from the DHS program. The total sample was 6504 children under five with complete data, including diarrhea, socio-economic characteristics, birth history, anemia status, and anthropometry (BB and TB). The result was that as many as 15.6% of children under five experienced diarrhea in the last two weeks. Based on socio-economic level, education level was significantly related (p =0.000) with diarrhea where mothers who did not attend school were at risk of up to 1.542 times. The source of drinking water was significantly related to the incidence of diarrhea (p = 0.001), with a risk of 1.297 times. In nutritional status, only the variable BW/U (underweight) was found to be significantly related (p = 0.000), with a risk of 1.413 times. An interesting finding in the history of under-five births, namely that infants who were exclusively breastfed increased the incidence of diarrhea up to 2.5 times (p = 0.000). This study confirms the hypothesis that the incidence of diarrhea in children under five in Zambia is significantly influenced by the source of drinking water, the mother’s education level, history of BMI, and the nutritional status of BB/U or underweight. However, in the history of exclusive breastfeeding, diarrhea was more common in infants who were exclusively breastfed.