Determinants of Diarrhea in Under-Five Children Among Health Extension Model and Non-Model Families in Wama Hagelo District, West Ethiopia: Community-Based Comparative Cross-Sectional Study

Figures & data

Table 1 Socio-Demographic and Economic Characteristics of Model and Non-Model Families in Wama Hagelo Woreda, East Wollega, Oromia, Ethiopia, 2019

Variables	Categories	HH HEP Implementation Status
		Model (%)	Non-Model (%)
Residence of respondents	Urban	9 (3.5%)	9 (3.5%)
	Rural	248 (96.5%)	246 (96.5%)
Respondent's relation with children in HH	Mother	255 (99.2%)	251 (98.4%)
	Other	2 (0.8%)	4 (1.6%)
Age category of respondents	15–19	0 (0.0%)	9 (3.5%)
	20–24	42 (16.3%)	38 (14.9%)
	25–29	78 (30.4%)	82 (32.2%)
	30–34	57 (22.2%)	57 (22.4%)
	35+	25 (9.7%)	9 (3.5%)
Marital status	Single	0 (0%)	1 (0.4%)
	Ever married	257 (96.9%)	254 (99.6%)
Religion of respondents	Orthodox	92 (35.8%)	74 (29.0%)
	Muslim	23 (8.9%)	31 (12.2%)
	Protestant	138 (53.7%)	134 (52.5%)
	Other	4 (1.6%)	16 (6.3%)
Ethnicity	Oromo	244 (94.9%)	219 (85.9%)
	Amharic	5 (1.9%)	15 (5.9%)
	Other	8 (3.1%)	21 (8.2%)
Educational level of caretaker	Illiterates	90 (35.2%)	115 (45.1%)
	Write and read only	15 (5.8%)	40 (15.7%)
	Grade 1–8	110 (42.8%)	71 (27.8%)
	Grade 9–12 and above	42 (16.3%)	29 (11.4%)
Occupation of respondents	Housewife	113 (44.0%)	121 (47.5%)
	Farmer	115 (44.7%)	87 (34.1%)
	Merchant	26 (10.1%)	38 (14.9%)
	Employ in private	3 (1.2%)	9 (3.6%)
Whether father or mother of child alive	Both parents alive	247 (96.1%)	237 (92.9%)
	Either alive	7 (2.7%)	16 (6.3%)
	Both parents died	3 (1.2%)	2 (0.8%)
Educational level of child’s father	Illiterates	44 (17.5%)	70 (30.2%)
	Write and read only	22 (8.8%)	11 (4.7%)
	Grade 1–8	91 (36.3%)	79 (34.1%)
	Grade 9–12 and above	94 (37.5%)	72 (31.0%)
Average family size	≤5	165 (64.2%)	97 (38.0%)
	>5	92 (35.8%)	158 (62.0%)
Family monthly income	≤1000	80 (31.1%)	158 (62.0%)
	1001–2000	69 (26.8%)	65 (25.5%)
	2001–3000	47 (18.3%)	23 (9.0%)
	>3000	61 (23.7%)	9 (3.5%)

Table 2 Environmental Risk Factors for Diarrhea Among U5C of Model and Non-Model Families in Wama Hagelo Woreda, Oromia, Ethiopia, 2019

Variables	Categories	HH HEP Implementation Status
		Model (%)	Non-Model (%)
Types of water sources for drinking	Improved sources	248 (96.5%)	201 (78.8%)
	Unimproved sources	9 (3.5%)	54 (21.2%)
Time taken to reach water sources in min	≤15 min	189 (73.5%)	170 (66.7%)
	>15 min	68 (26.5%)	85 (33.3%)
Household level water treatment	Do not treat	102 (39.7%)	206 (80.8%)
	Treat at home	155 (60.3%)	49 (19.2%)
Washing hands with water and soap at critical times	Yes	250 (97.3%)	164 (64.3%)
	No	7 (2.7%)	91 (35.7%)
Amount of water used in liters per person per day	<7.5 L	185 (72.0%)	195 (76.5%)
	≥7.5 L	72 (28.0%)	60 (23.5%)
Washing hands with water and soap	Wash at all critical time	188 (74.9%)	82 (50.3%)
	Wash soap partially	63 (25.1%)	81 (49.7%)
HH using latrine	Yes	257 (100.0%)	215 (84.3%)
	No		40 (15.7%)
Availability of hand washing facility near latrine	No hand washing facility	12 (4.7%)	62 (29.0%)
	Only water available	12 (4.7%)	51 (23.8%)
	All facilities available	233 (90.7%)	102 (47.2%)
Type of latrine	Improved	257 (100.0%)	106 (49.3%)
	Unimproved		109 (50.7%)
Distance between latrine and drinking water sources	<30 m	48 (18.7%)	51 (20.0%)
	≥30 m	209 (81.3%)	204 (80.0%0
Availability of solid-waste disposal system	Yes	233 (90.7%)	87 (34.1%)
	No	24 (9.3%)	168 (65.9%)
Availability of liquid-waste disposal system for HH use	Yes	101 (39.3%)	14 (5.5%)
	No	156 (60.7%)	241 (94.5%)

Table 3 Child Health Care Practice of Model and Non-Model Families in Wama Hagelo Woreda, Oromia, Ethiopia, 2019

Variables	Categories	HH HEP Implementation Status
		Model (%)	Non-Model (%)
Number of U5C in HH	1	148 (57.6%)	134 (52.5%)
	≥2	109 (42.4%)	121 (47.5%)
Sex of index child	Male	118 (45.9%)	117 (45.9%)
	Female	139 (54.1%)	138 (54.1%)
Age of index child	0–6 months	29 (11.3%)	26 (10.2%)
	7–11 months	64 (24.9%)	52 (20.4%)
	12–23 months	68 (26.5%)	41 (16.1%)
	24–59 months	96 (37.4%)	136 (53.3%)
Place of childbirth	Health facility	255 (99.2%)	213 (83.5%)
	Home	2 (0.8%)	42 (16.5%)
Time at initiation of breastfeeding	Before 1 hour	237 (92.2%)	214 (83.9%)
	1–8 hours	15 (5.8%)	30 (11.8%)
	8 hours – 3 days	5 (1.9%)	11 (4.3%)
EBF status	EBF	248 (96.5%)	182 (71.4%)
	Not EBF	9 (3.5%)	73 (28.6%)
Age at complementary feeding initiation	Age 6 month	145 (61.7%)	47 (19.7%)
	Before 6 month	9 (3.8%)	70 (29.4%)
	After 6 month	81 (34.5%)	121 (50.8%)
Types of complementary feeding	From variety of food	197 (87.6%)	101 (58.0%)
	Not from variety of food	28 (12.4%)	73 (42.0%)
Safety of child feeding method	With spoon/cup	199 (88.4%)	116 (66.3%)
	With hand	26 (11.6%)	59 (33.7%)
Rotavirus vaccination status	Vaccinated	250 (98.0%)	212 (85.1%)
	Not vaccinated	5 (2.0%)	37 (14.9%)
Measles vaccination	Vaccinated	210 (98.1%)	171 (81.8%)
	Not vaccinated	4 (1.9%)	38 (18.2%)
Vitamin A supp. in last six months	Received	179 (77.5%)	137 (60.4%)
	Not received	52 (22.5%)	90 (39.6%)
Deworming status in the last six months	Received	88 (80.0%)	75 (54.3%)
	Not received	22 (20.0%)	63 (45.7%)
Diarrhea in under-five children	Yes	20 (7.8%)	71 (27.8%)
	No	237 (92.2%)	184 (72.2%)
Measles infection in the last 4 weeks	Experienced	0 (0.0%)	0 (0.0%)
	Not experienced	257 (100%)	255 (100%)

Figure 1 Prevalence of diarrhea among under-five-year-old children in health extension model and non-model families in Wama Hagelo woreda 2019.

Notes:

All surveyed households.

Families with diarrhea among U5C.

Table 4 Predictors of Childhood Diarrhea Among Under-Five Children in Model and Non-Model Families in Wama Hagelo Woreda, East Wollega, Oromia, Ethiopia, 2019

Model Families
Variables	Categories	Diarrhea Status		COR (95% CI)	AOR (95% CI)
		Yes, n (%)	No, n (%)
Household health extension program implementation	Non-model HH	71 (27.8%)	184 (72.2%)	1	1
	Model HH	20 (7.8%)	237 (92.2%)	4.6 (2.7–7.8)	2.4 (1.15, 5.00)*
Residence of respondents	Urban	1 (0.4%)	8 (3.1%)	1	1
	Rural	19 (7.4%)	229 (89.1%)	0.7 (0.2, 12.7)	1.5 (0.9, 7.9)
Family size	≤5	11 (4.%)	154 (60%)	1	1
	>5	9 (3.5%)	83 (32.3%)	1.5 (1.1, 3.8)	1.04 (0.3, 3.4)
Types of source of water for drinking	Improved	16 (6.2%)	232 (90%)	1	1
	Unimproved	4 (1.6%)	5 (2.0%)	11.6 (2.71, 77.70)	5.5 (2.15, 97.7)*
Storage of water for drink in house	Stored in jerry can	16 (6.2%)	236 (91.8%)	1	1
	Stored in pot	4 (1.6%)	1 (0.4%)	59 (6.23, 59.24)	1.5 (0.12, 8.6)
Time taken to reach water source	<15 min	12 (4.7%)	177 (69%)	1	1
	≥15 min	8 (3.1%)	60 (23.3%)	2 (0.7, 5.0)	3.1 (0.71, 13.7)
Household water treatment method	Do not treat	7 (2.7%)	95 (37%)	1	1
	Treat at home	13 (5.1%)	142 (55.3%)	1.2 (0.5, 3.2)	4.2 (0.6, 16.44)
No. of U5C in household	1	10 (3.9%)	138 (53.7%)	1	1
	≥2	10 (3.9%)	99 (38.5%)	1.4 (0.6, 3.5)	2.2 (0.5, 8.2)
Place of childbirth	Health facility	19 (7.4%)	231 (90.0%)	1	1
	Home	1 (0.4%)	6 (0.8%)	2 (1.5, 13.2)	0.21 (0.1, 0.87)
Rotavirus vaccination status	Vaccinated	16 (6.3%)	228 (91.8%)	1	1
	Not vaccinated	4 (1.6%)	6 (0.4%)	8.5 (6.2, 554.5)	49.8 (4.18, 94.8)*
Vitamin A supp. in last six months	Received	11 (4.8%)	168 (72.7%)	1	1
	Not received	6 (2.6%)	46 (20.0%)	2 (0.7, 5.7)	2.6 (0.9.5)
Non-model families
Residence of respondents	Urban	4 (1.6%)	5 (2%)	1	1
	Rural	67 (26.3%)	179 (70.2%)	2.1 (1.7, 7.2)	2.2 (0.0, 3.1.0)
Family size	≤5	25 (9.8%)	72 (28.2%)	1	1
	>5	46 (18%)	112 (44%)	1.2 (0.7, 2.1)	5.2 (1.7, 17.6)*
Types of source of water for drinking	Improved sources	36 (14.1%)	165 (64.7%)	1	1
	Unimproved	35 (13.6%)	19 (7.5%)	18 (3.7, 90)	7.2 (1.6, 13.2)*
Storage of water for drink in house	Stored in jerry can	28 (11%)	183 (71.8%)	1	1
	Stored in pot	43 (17%)	1 (0.4%)	28 (7.2, 112)	2 (0.95, 8.76)
Time taken to reach water source in minutes	<15 min	43 (17%)	127 (49.8%)	1	1
	≥15 min	28 (11%)	37 (22.4%)	1.5 (0.82, 2.6)	1.6 (0.5, 4.9)
Household water treatment method	Do not treat	65 (25.5%)	141 (55.3%)	1	1
	Treat at home	6 (2.4%)	43 (17%)	0.3 (0.1, 0.7)	0.6 (0.1, 2.8)
	Use partially	44 (17.3%)	47 (18.4%)	4.8 (2.6, 8.5)	0.8 (0.2, 3.6)
Family using latrine	Yes	39 (15.3%)	176 (69%)	1	1
	No	32 (12.5%)	8 (3.1%)	18 (7.7, 42.2)	6.0 (1.8, 20.6)*
No. of U5C in household	1	20 (7.8%)	114 (44.7%)	1	1
	≥2	51 (20%)	70 (27.5%)	4.2 (2.3, 7.6)	2.3 (0.8, 7.1)
Rotavirus vaccination status	Vaccinated	37 (15%)	175 (70.3%)	1	1
	Not vaccinated	33 (13.3%)	4 (1.6%)	39 (13.3, 116.9)	10.9 (2.87, 41.05)*
Vitamin A supp. in last six months	Received	26 (11.5%)	111 (49%)	1	1
	Not received	38 (16.7%)	52 (23%)	3.2 (1.7, 5.7)	3.2 (1.4, 7.2)*

Note: *Statistically significant variables in multivariable logistic regression.