Unimproved water, sanitation, and hygiene (WASH) and common childhood illness in Myanmar: evidence from a nationally representative survey

Abstract Background Inadequate Water, Hygiene and Sanitation (WASH) is one of the major risk factors of common childhood illness - namely, diarrhea, cough, fever, and acute respiratory infection, in many Southeast Asian countries. This study aims to analyze the relationship between WASH-related indicators and common childhood illnesses; cough, fever and diarrhea among under-five children in Myanmar. Methods The data of 4,815 under-fives was extracted from the first Myanmar Demographic and Health Survey 2015-16. Chi-square test was used to determine association between WASH and sociodemographic variables and each common childhood illness. The bivariate logistic regression was used to obtain the unadjusted odds of cough, fever, and diarrhea for each wash indicator, i.e., Unimproved toilet, access to unsafe water, and unsafe feces disposal. Further multivariate regression was employed and adjusted odd ratios were obtained of each common childhood illness after accounting for all wash indicators. Results Among under-five children, 16.2% suffered from cough, 16% suffered from fever, and 10.4% from diarrhea. Unimproved toilet facility was associated with cough (Adjusted Odds Ratio (AOR) 1.15, 95% CI:0.86, 1.22), and fever (AOR 1.03, 95% CI:0.86,1.23) among children. Children from households practicing unimproved child feces disposal had 21%, 18%, and 52% higher odds of experiencing cough (95% CI:1.12, 1.31), fever (95% CI: 0.99,1.29), and diarrhea (95% CI:1.21, 1.68), respectively. A combination of unimproved water, toilet and child feces disposal facilities was associated with cough (AOR 1.34, 95% CI:1.03, 1.73), fever (AOR 1.12, 95% CI:0.86, 1.19) and diarrhea (AOR 1.18, 95% CI:0.95, 1.29). Conclusion Inadequate improved WASH significantly contributed to common childhood illnesses among children in Myanmar. Findings suggest that WASH interventions should be targeted to the poor and rural areas where the prevalence of both childhood illnesses and unimproved WASH facilities were reportedly high.