Assessing the impact of water, sanitation and hygiene (wash) on diarrheal disease and malnutrition among children under-five in Chad

Water, sanitation and hygiene (WASH) are pivotal in order to improve health outcomes and overall quality of life. More than 25 diseases are transmitted by poor and inadequate WASH conditions, killing more than two million people each year, including more children than Acquired Immune Deficiency Syndrome (AIDS), tuberculosis, and malaria combined. Internationally, poor WASH conditions are the primary reasons for diarrheal disease, which result in morbidity and mortality among children under the age of five. Moreover, diarrhea is a major cause of malnutrition and has a cyclical relationship with malnutrition. The burden of disease resulting from poor WASH conditions lies heavily upon sub-Saharan Africa (46% of global DALYs). Chad, a sub-Saharan African country, has the second highest under-five mortality rate in the world at approximately 123.20 deaths per 1000 live births, as well as the highest rate of under-five mortality due to diarrhea (499 deaths per 100,000). The purpose of this study was to use secondary data to assess the relationship between improved versus unimproved household WASH sources and diarrheal disease incidence among children under the age of five in Chad. A parallel purpose of this study was to assess the relationship between improved versus unimproved household WASH sources and the incidence of malnutrition among children under the age of five in Chad. Using nationally representative data from Chad from two time periods (2004-2005 and 2014-2015), the researcher used logistic regression analysis to answer three research questions and test three hypotheses. No evidence was found for effects of the usage of improved household water sources and sanitation facilities on the incidence of diarrhea, both in 2004-2005 and 2014-2015 periods. However, the researcher found that specific types of water sources led to increased incidences of diarrhea in 2014-2015, whereas specific sanitation facility types led to decreased incidences of diarrhea. Also, in 2014-2015, the researcher found that having access to improved water sources and sanitation facilities significantly reduced malnutrition incidence.