Abstract

Background: Unsafe child feces disposal has compounding effects on children’s wellbeing, including a higher prevalence of diarrheal disease, environmental enteropathy, intestinal worms, and impaired growth. In Ethiopia and many other countries, still, there is a common misconception that children’s feces are not harmful, and not end up in a toilet. The study aims to determine the magnitude and factors associated with unsafe child feces disposal in Ethiopia.

Methods: The study is cross-sectional in nature and based on data from the population-based Ethiopian Demographic and Health Survey (EDHS). Data from the 1^st, 2^nd, 3^rd and 4^th rounds of EDHS conducted in the year 2000, 2005, 2011 and 2016, is used to carry out the analysis. Descriptive statistics were computed to illustrate the given data. Multivariable logistic regression was performed, adjusted odds ratio (AOR) with a 95% confidence interval (CI) were used to identify factors associated with unsafe child feces disposal.

Results: The pooled dataset contained information on 40,520 children younger than 5 years, male accounts 20,629 (50.9%). Overall, 77.7% (95%CI: 76.3-79.0) of children feces disposed of unsafely. In the multivariable logistic regression model, those mothers whose child was 13-24 months [AOR: 0.68, 95% CI: (0.60-0.78)] and ≥ 25 months [AOR: 0.66, 95% CI: (0.60-0.72)] were lower odds of unsafe child’s feces disposal. Children born into households having two or fewer children were 33% lower [AOR: 0.67, 95% CI: (0.56-0.79)] odds of unsafe child’s feces disposal than their counterparts. Additionally, the odds of unsafe feces disposal was higher [AOR: 1.11, 95%CI: (1.03-1.21)] among households having male children than those households having female children. The odds of disposing of feces unsafely among households having improved toilet facility was 76% lower [AOR: 0.24, 95% CI: (0.19-0.29)] that of households lacking such facilities. Being an urban resident, having improved drinking water facility, a high level of maternal and paternal education, paternal occupational status (work in non-agriculture), and maternal age (25-34 and ≥ 35 years) were factors associated with lower odds of unsafe child's feces disposal.

Conclusions: Three in four Ethiopian children feces disposed of unsafely. Unsafe child feces disposal is less prevalent among households that had improved water and toilet facility, those in urban areas, those with older children, those with a high level of maternal and paternal education, and those with a lower number of under-five children. There is a need for more attention to be paid to curtail the significant burden of unsafe child feces disposal in Ethiopia. It is also essential to explore opportunities to integrate child feces management into existing sanitation and hygiene efforts.

Keywords: Child feces disposal, Demographic and Health Survey, Ethiopia, Feces, Pooled data, Water Sanitation and Hygiene (WASH)