Prevalence and associated risk factors of diarrhea in under-five children among health extension model and non-model kebeles in Getta district , Southern Ethiopia: A Community-based comparative cross-sectional study

Abstract

Introduction: Worldwide diarrheal disease is the second leading cause of death in under-five year’s children. In Ethiopia diarrhea kills half million under-five children every year second to pneumonia. Poor sanitation, unsafe water supply and inadequate personal hygiene are responsible for 88% of diarrhea occurrence; these can be easily improved by health promotion and education. The Ethiopian government introduced a new initiative health extension program in 2002/03 as a means of providing a comprehensive, universal, equitable and affordable health service. As a strategy of the program; households have been graduated as model families after training and implementing the intervention packages. Objective: To assess the Prevalence and Associated Risk factors of diarrhea in under-five children among health extension model and non-model kebeles in Getta District, SNNPR. Method: A community based comparative cross-sectional study design was employed. Multi-stage sampling technique was employed to select 365 model and 365 non-model households. Data was collected using structured questionnaire and checklist by trained data collectors. Each questionnaire was coded, entered and cleaned using epi data version 3.1 and SPSS version 23 statistical packages were used for data analysis. Binary and Multivariate logistic regression was computed to describe the functional independent predictors of childhood diarrhea. Result: A total of 718 (363 household from Health Extension Model Kebeles and 355 from Non-Model Kebeles) participants were enrolled in the study making a response rate of 98%. The prevalence of diarrhea in under-five children among model and non-model kebeles were 9.9 %( (95% CI: (6.9, 13.2)) and 23.7% %, (95% CI: (19.4, 28.2)), respectively. The independent predictors of childhood diarrhea revealed in the study were being non-model for the health extension program (AOR=2.545; 95%CI: 1.553-4.172), absence of latrine (AOR=3.074; 95%CI: 1.612-5.860), improper child stool disposal (AOR=2.195; 95%CI: 1.323-3.643), maternal history of diarrhea (AOR=2.316; 95%CI: 1.287-4.168) and unimmunized children for Rota vaccine (AOR=2.449; 1.483-4.043). Conclusion and recommendation: The prevalence of childhood diarrhea was high among non-model families. The variation in the level of diarrheal morbidity was well explained by the effect of health extension program (being non-model), absence of latrine, improper child stool disposal, maternal history of diarrhea and child immunization for Rota vaccine. The district health office should do better to improve services i.e. vaccination, latrine presence at household level and proper utilization, proper refuse disposal and the model household training need to be scaled up in order to decrease under-five diarrheas in the community.