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Factors associated with rural-urban safe disposal of children stools in Ghana
Martin Wiredu Agyekum1, Florence Esi Nyieku2, Sylvia Boamah Yeboah3
1Institute for Educational Research and Innovation Studies (IERIS), University of Education, Winneba, Ghana. mwagyekum@uew.edu.gh.
Insights
Safe disposal of young children's stools remains a significant public health challenge in Ghana, with only 22% of households practicing safely. Tailored rural and urban strategies are crucial for ending open defecation by 2030.
Area of Science:
- Environmental Health
- Public Health
- Pediatrics
Background:
- Poor sanitation and unsafe child stool disposal contribute to disease burden in low- and middle-income countries.
- Infant and toddler stools present a higher public health risk compared to adult stools.
- Existing research in Sub-Saharan Africa and Ghana lacks focus on distinct rural and urban factors influencing child stool disposal.
Purpose of the Study:
- To examine factors independently associated with safe child stool disposal in rural and urban areas of Ghana.
- To inform strategies for achieving Sustainable Development Goal targets for ending open defecation by 2030.
Main Methods:
- Utilized data from the sixth round of the Ghana Multiple Indicator Cluster Survey (MICS) in 2017/18.
- Analyzed a sub-sample of 3,476 children under two years old and their caregivers' stool disposal practices.
- Employed binary logistic regression to identify significant factors associated with safe stool disposal.
Main Results:
- Overall, only 22% of households practiced safe disposal of stools for children under two.
- Safe disposal rates were higher in rural areas (26%) compared to urban areas (16%).
- In urban settings, child's age, sex, and caregiver's marital status were significant. In rural settings, child's age, caregiver listening to radio, and access to improved toilet facilities were significant.
Conclusions:
- Safe child stool disposal practices are alarmingly low in Ghana.
- Distinct policy approaches are required for urban and rural areas to improve child stool disposal.
- Targeted interventions are necessary to meet Sustainable Development Goals for sanitation.
Introduction:
The burden of children's disease in many low-and middle-income countries is associated with poor sanitation, including unsafe disposal of children's stool. Infants and toddler stools pose a greater public health risk than adults. Studies on stool disposal in Sub-Saharan Africa (SSA) and Ghana have focused on prevalence, patterns, and associated factors. Nevertheless, these studies have not focused on factors that independently influence rural and/or urban child stool disposal. This study, therefore, examines factors associated with safe child stool disposal in rural areas separately from urban areas towards Ghana's readiness for ending open defaecation by 2030.
Methodology:
We examined young children's faecal disposal drawing on the sixth round of the nationally-representative Ghana Multiple Indicator Cluster Survey (MICS) conducted in 2017/18. This study was restricted to children under two years, yielding a sub-sample of 3,476. Responses of caregivers or mothers who disposed of children less than two years faecal matter, their characteristics in addition to the child's age in months were analysed. A binary logistic regression was used to examine the factors associated with the safe disposal of young children's stools.
Results:
In the aggregated data, only 22% of households, regardless of their residence, dispose of their young children less than two years stools safely. From the disaggregated data, the rural analysis shows that 26% of young children's stools were safely disposed of, compared to 16% in the urban analysis. The urban analysis shows that the child's age, sex and caregiver's marital status were significantly associated with safe disposal of stools. On the other hand, child's age, caregiver listening to radio and household access to improved toilet facilities were significant in the rural analysis.
Conclusion:
The safe practice of stool disposal was very low. The results of this study show that urgent and different policies and strategies are needed to address child stool disposal in urban residences compared to rural residences if we are to meet SDG targets of ending open defaecation.
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