Association of childhood undernutrition with water supply, sanitation and hygiene interventions in Kersa and Omo Nada districts of Jimma Zone, Ethiopia: A case-control study

Abstract Objective: This study aimed to describe the association of childhood undernutrition with water supply, sanitation, and hygiene interventions in Kersa and Omo Nada districts of the Jimma Zone, Ethiopia.Design: A case-control study design was undertaken from December 2018 to January 2019.Setting: Kersa and Omo Nada districts of the Jimma Zone, Ethiopia.Subjects: 128 cases and 256 controls were randomly selected from malnourished and well-nourished children, respectively.Outcome measures: Bodyweight, length/height, mid-upper arm circumference and presence of edema of the children were measured according to the WHO references. Then, the nutritional status of children was identified as case or control using cutoff points recommended by the WHO based on the Z-score, edema, and MUAC values recorded.Results: A total of 378 children were included in this study, with a response rate of 98.44%. Undernutrition was significantly increased among children who delayed breastfeeding initiation (AOR=2.60; 95% CI: 1.02-6.65), diarrhea (AOR=9.50; 95% CI: 5.19-17.36), living with households indexed as the poorest (AOR=2.57; 95% CI: 1.09-6.07) and defecated in a pit latrine without slab/open pit (AOR=2.49; 95% CI: 1.17-5.30), and sometimes practiced hand washing at the critical times (AOR=2.52; 95% CI: 1.10-5.75) compared with their counterparts. However, lactating during the survey (AOR=0.35; 95% CI: 0.18-0.71) and collection and disposal of under-five children feces elsewhere (AOR = 0.08; 95% CI: 0.01-0.75) significantly reduced the likelihood of undernutrition.Conclusions: Early initiation of exclusive breastfeeding, diarrhea prevention, the use of improved latrine, and always handwashing practices at critical times could be important variables to improve the nutritional status of children.