Table 1: Household water sanitation and handwashing practices and mean z-score for underweight, stunting and wasting among under-five children (n=2352).
Variables
|
Number (%)
|
Proportion of household with improved toilet, water purification practices and availability of soap and water
|
Household with improved sanitation
|
1781(75.7%)
|
Cluster sanitation coverage percentage [SD]
|
75.3 [32]
|
Household with practice of water purification
|
430 (18.3%)
|
Household with Soap and water available
|
882 (37.5%)
|
Nutritional Outcome Indicators
|
Mean [SD]
|
z-score for height-for-age
|
-1.52 [1.3]
|
z-score for weight-for-height
|
-0.65 [1.1]
|
z-score for weight-for-age
|
-1.33 [1.1]
|
Table 2: Under-five children z-score classification for underweight, stunting and wasting (n=2352)
Outcome indicators
|
Undernourished Children
N (%)
|
Adequately nourished Children
N (%)
|
z-score < -3
|
z-score between -3 to <- 2
|
Total
(z- score <-2)
|
z-score between -2 to +2
|
z-score greater than +2
|
Total
(z-score >-2)
|
Height-for-age (Stunting)
|
284 (12.1)
|
559 (23.8)
|
843 (35.8)
|
1489 (63.3)
|
20 (0.85)
|
1509 (64.2)
|
Weight-for-height (Wasting)
|
44 (1.9)
|
187 (8)
|
231 (9.8)
|
2092 (88.9)
|
29 (1.2)
|
2121 (90.2)
|
Weight-for-age (Underweight)
|
124 (5.3)
|
511 (21.7)
|
635 (27.0)
|
1710 (72.7)
|
7 (0.3)
|
1717 (73.0)
|
Table 3: Linear regression coefficient for association between WASH related variables and nutritional status indicators Z-scores of preschool, Nepalese children (n=2320)
WASH Outcomes
|
Height-for-age (β^, 95%CI)
|
Weight-for-height (β^, 95%CI)
|
Weight-for-age (β^, 95%CI)
|
|
Unadjusted
|
Adjusted
|
Unadjusted
|
Adjusted
|
Unadjusted
|
Adjusted
|
Sanitation Coverage
|
0.54 (0.35, 0.74)***
|
0.28 (0.001, 0.56) a,*
|
0.66 (0.50, 0.82)***
|
0.19 (-0.04, 0.42) a
|
0.78 (0.62, 0.94)***
|
0.30 (0.12, 0.48)a, **
|
Water
Purification
|
|
|
|
|
|
|
Yes
|
0.37 (0.16, 0.59)**
|
-0.02 (-0.24, 0.20) b
|
0.52 (0.38, 0.67)***
|
0.24 (0.07, 0.41)b, **
|
0.56 (0.38, 0.73)***
|
0.11 (-0.06, 0.28) b
|
No (Ref)
|
1
|
1
|
1
|
1
|
1
|
1
|
Water & Soap available
|
|
|
|
|
|
|
Yes
|
0.46 (0.32, 0.59)***
|
0.09 (-0.05, 0.22) c
|
0.29 (0.18, 0.40)***
|
0.13 (0.01, 0.24)c, *
|
0.47 (0.35, 0.58)***
|
0.15 (0.04, 0.25)c, **
|
No (Ref)
|
1 1
|
11
|
11
|
11
|
11
|
11
|
aAdjusted for child’s birth weight, child’s age, child’s sex wealth quintiles, use of clean fuel, sex of household head, ecological region, area of residence, women’s age, women marital status, women’s education, women’s smoking status, women’s BMI, ANC 4th visits, institutional delivery, frequency of watching TV, childhood diarrhea over past 2 weeks, household water purification practice and household water and soap availability.
bAdjusted for child’s birth weight, child’s age, child’s sex wealth quintiles, use of clean fuel, sex of household head, ecological region, area of residence, women’s age, women marital status, women’s education, women’s smoking status, women’s BMI, ANC 4th visits, institutional delivery, frequency of watching TV, childhood diarrhea over past 2 week, cluster sanitation coverage and household water and soap availability.
cAdjusted for child’s birth weight, child’s age, child’s sex wealth quintiles, use of clean fuel, sex of household head, ecological region, area of residence, women’s age, women marital status, women’s education, women’s smoking status, women’s BMI, ANC 4th visits, institutional delivery, frequency of watching TV, childhood diarrhea over past 2 weeks, cluster sanitation coverage and household water purification practice.
*p<0.05; **p<0.01; ***p<0.001
Table 4: Interaction between WASH related variables for childhood undernutrition (n=2320)
|
Height-for-age
|
Weight-for-height
|
Weight-for-age
|
Improved sanitation availability a
|
With
water purification
|
Without
water purification
|
p -value for interaction
|
With
water purification
|
Without
water purification
|
p -value for interaction
|
With
water purification
|
Without
water purification
|
p-value
for interaction
|
|
0.44
(-0.55, 1.43)
|
0.21
(-0.06, 0.48)
|
0.28
|
0.31
(-0.53, 1.15)
|
0.20
(-0.04, 0.44)
|
0.55
|
0.67
(-0.11, 1.45)
|
0.29
(0.11, 0.47)**
|
0.25
|
Water purification b
|
With soap and water
|
Without soap and water
|
|
With soap and water
|
Without soap and water
|
|
With soap and water
|
Without soap and water
|
|
|
0.07
(-0.21, 0.34)
|
-0.10
(-0.46, 0.26)
|
0.87
|
0.28
(0.05, 0.51)*
|
0.15
(-0.09, 0.38)
|
0.28
|
0.22
(0.02, 0.44)*
|
-0.05
(-0.27, 0.18)
|
0.16
|
Soap and water availability c
|
With improved sanitation
|
Without improved sanitation
|
|
With improved sanitation
|
Without improved sanitation
|
|
With improved sanitation
|
Without improved sanitation
|
|
0.69
(-0.07, 0.21)
|
0.07
(-0.36, 0.49)
|
0.39
|
0.14
(0.01, 0.27)*
|
0.04
(-0.24, 0.31)
|
0.36
|
0.15
(0.04, 0.26)**
|
0.08
(-0.25, 0.40)
|
0.97
|
aAdjusted for child’s birth weight, child’s age, child’s sex wealth quintiles, use of clean fuel, sex of household head, ecological region, area of residence, women’s age, women marital status, women’s education, women’s smoking status, women’s BMI, ANC 4th visits, institutional delivery, frequency of watching TV, childhood diarrhea over past 2 weeks and household water and soap availability.
b Adjusted for child’s birth weight, child’s age, child’s sex wealth quintiles, use of clean fuel, sex of household head, ecological region, area of residence, women’s age, women marital status, women’s education, women’s smoking status, women’s BMI, ANC 4th visits, institutional delivery, frequency of watching TV, childhood diarrhea over past 2 weeks and household sanitation availability.
c Adjusted for child’s birth weight, child’s age, child’s sex wealth quintiles, use of clean fuel, sex of household head, ecological region, area of residence, women’s age, women marital status, women’s education, women’s smoking status, women’s BMI, ANC 4th visits, institutional delivery, frequency of watching TV, childhood diarrhea over past 2 weeks and household water purification practice.
*p<0.05; **p<0.01; ***p<0.001
Table 5: Interaction between household water purification practices and area of residence on childhood stunting (n=2320)
Water purification practice
|
Height-for-age z-score
|
Urban
|
Rural
|
p-value for interaction
|
|
-0.14 (-0.41, 0.13) a
|
0.19 (-0.1, 0.5) a
|
0.02*
|
aAdjusted for child’s birth weight, child’s age, child’s sex wealth quintiles, use of clean fuel, sex of household head, ecological region, area of residence, women’s age, women marital status, women’s education, women’s smoking status, women’s BMI, ANC 4th visits, institutional delivery, frequency of watching TV, childhood diarrhea over past 2 week, cluster sanitation coverage and household water and soap availability.
*p<0.05