Abstract
ObjectiveWe assessed whether Water, Sanitation and Hygiene (WASH) and Infant and Young Child Feeding (IYCF), either alone or combined, were associated with malnutrition among Lao People’s Democratic Republic (Lao PDR) children aged 6 to <24 months.DesignThis is a secondary analysis of the 2017 Lao Social Indicator Survey II (LSIS II), which used multistage probability proportional to size sampling. Logistic regression analyses were conducted with OR and its corresponding 95% CI.SettingThe LSIS II was conducted a nationwide household-based survey covering all 18 provinces in Lao PDR.ParticipantsWe had a total of 3375 children (weighted sample 3345) and 357 households with data on drinking water.Outcome measuresThe outcomes of this study were stunting and wasting.ResultsThe prevalence of stunting and wasting was 28.9% and 10.1%, respectively. Even though households with access to a basic or improved water source were high (82.5%), over 83% of drinking water was contaminated withEscherichia coli. Access to improved sanitation, basic hygiene and adequate IYCF gave a significant lower risk of becoming stunted. The combined effect of these practices on stunting was (adjusted OR (AOR)=0.54; 95% CI=0.41 to 0.73) greater than each practice alone (improved sanitation: AOR=0.75; 95% CI=0.61 to 0.93; basic hygiene: AOR=0.69; 95% CI=0.57 to 0.83; adequate IYCF: AOR=0.79; 95% CI=0.64 to 0.98). Access to improved sanitation and adequate IYCF was associated with a significant lower risk for being wasted, and again the combined effect of these practices was (AOR=0.64; 95% CI=0.44 to 0.92) greater than each practice alone (improved sanitation: AOR=0.68; 95% CI=0.49 to 0.93 and adequate IYCF: AOR=0.66; 95% CI=0.47 to 0.92).ConclusionGiven the strong associations with both stunting and wasting, and the added benefits when combining WASH and IYCF, there is a need of multisectoral interventions to reduce early childhood malnutrition in Lao PDR.
Funder
UNICEF Lao People’s Democratic Republic
Reference38 articles.
1. Micronutrient deficiencies among preschool-aged children and women of reproductive age worldwide: a pooled analysis of individual-level data from population-representative surveys
2. UNICEF, WHO, WORLD BANK . Levels and trends in child malnutrition UNICEF / WHO / World Bank group joint child malnutrition estimates key findings of the 2021 edition. World Heal Organ 2021:1–32.
3. Blössner M , Onis MD , World Health Organization . Malnutrition, Quantifying the health impact at national and local levels. Environ Burd Dis Ser 2005;12.
4. Khandelwal N , Mandliya J , Nigam K , et al . Determinants of motor, language, cognitive, and global developmental delay in children with complicated severe acute malnutrition at the time of discharge: an observational study from central India. PLoS One 2020;15:e0233949. doi:10.1371/journal.pone.0233949 Available: https://doi.org/10.1371/journal.pone.0233949
5. Long-Lasting Effects of Undernutrition