Effect of safe water delivery plus water and sanitation hygiene behavior change communication on diarrheal disease prevalence among children under 5 years in a slum setting in Nairobi, Kenya: a quasi-experimental study
| dc.contributor.author | Izudi, Jonathan | |
| dc.contributor.author | Muchiri, Evans | |
| dc.contributor.author | Musyoka, Dennis | |
| dc.contributor.author | Simiyu, Sheillah | |
| dc.contributor.author | Tumwebaze, Innocent K. | |
| dc.contributor.author | Mbaya, Nelson | |
| dc.contributor.author | Sidze, Estelle | |
| dc.contributor.author | Musau, Kelvin | |
| dc.contributor.author | Abajobir, Amanuel | |
| dc.date.accessioned | 2025-11-11T16:52:08Z | |
| dc.date.available | 2025-11-11T16:52:08Z | |
| dc.date.issued | 2025-10-28 | |
| dc.description.abstract | Background Diarrheal diseases are prevalent among children under five years of age in slum areas. We evaluated the effect of safe water delivery plus water, sanitation, and hygiene (WASH)-Behavior Change Communication (WASH-BCC on diarrheal disease prevalence among children under 5 years in a slum setting in Nairobi, Kenya. Methods We designed a quasi-experimental study, with the intervention as safe water delivery plus WASH-BCC. The intervention arm consisted of 2 slum villages that received safe water plus WASH-BCC, while the comparison arm comprised 2 slum villages that did not receive the intervention. The primary outcome was diarrheal disease in a child under five years of age in the past 2 weeks in both study arms, defined as the passage of ≥ 3 watery stools in the past 24 h. Data were collected at the baseline and endline from a random sample of eligible households in the villages. Propensity score weighting was used to achieve similarity in measured covariates between both arms. Binary logistic regression analysis, adjusting for propensity-score weights, was utilized to estimate the causal effect of the intervention, reported as odds ratio (OR) and 95% confidence interval (CI). Results We analyzed data from 1,876 participants in a 1:1 ratio and found 382 (20.4%) children under five years of age had diarrheal disease at the endline. Diarrheal disease prevalence declined in the intervention villages (33.3% baseline vs. 23.5% endline) but increased in the comparison villages (15.7% baseline vs. 17.5% endline). We found a 31% decline in diarrheal disease in the intervention villages relative to the comparison villages (OR 0.69, 95% CI 0.55–0.86). In a difference-in-differences analysis, the decline was 11.4%. The findings remained robust in a sensitivity analysis. Conclusion The intervention significantly reduced diarrheal disease prevalence in children under five years of age in the slum setting. Therefore, there is a need to expand the intervention to the remaining areas to reduce diarrheal disease morbidity and mortality. | |
| dc.identifier.citation | Izudi, J., Muchiri, E., Musyoka, D., Simiyu, S., Tumwebaze, I. K., Mbaya, N., ... & Abajobir, A. (2025). Effect of safe water delivery plus water and sanitation hygiene behavior change communication on diarrheal disease prevalence among children under 5 years in a slum setting in Nairobi, Kenya: a quasi-experimental study. BMC Public Health, 25(1), 3641. | |
| dc.identifier.issn | 1471-2458 | |
| dc.identifier.uri | https://dir.muni.ac.ug/handle/20.500.12260/798 | |
| dc.language.iso | en | |
| dc.publisher | Springer Nature | |
| dc.subject | Access to safe water | |
| dc.subject | Behavior change communication | |
| dc.subject | Diarrheal disease | |
| dc.subject | Slum | |
| dc.subject | Kenya | |
| dc.title | Effect of safe water delivery plus water and sanitation hygiene behavior change communication on diarrheal disease prevalence among children under 5 years in a slum setting in Nairobi, Kenya: a quasi-experimental study | |
| dc.type | Article |