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The WHO and UNICEF Joint Monitoring Programme (JMP) Indicators for Water Supply, Sanitation and Hygiene and Their Association with Linear Growth in Children 6 to 23 Months in East Africa

Author

Listed:
  • Hasina Rakotomanana

    (Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078, USA)

  • Joel J. Komakech

    (Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078, USA)

  • Christine N. Walters

    (Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078, USA)

  • Barbara J. Stoecker

    (Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078, USA)

Abstract

The slow decrease in child stunting rates in East Africa warrants further research to identify the influence of contributing factors such as water, sanitation, and hygiene (WASH). This study investigated the association between child length and WASH conditions using the recently revised WHO and UNICEF (United Nations Children’s Fund) Joint Monitoring Programme (JMP) indicators. Data from households with infants and young children aged 6–23 months from the Demographic and Health Surveys in Burundi, Ethiopia, Kenya, Malawi, Rwanda, Tanzania, Uganda, and Zambia were used. Associations for each country between WASH conditions and length-for-age z-scores (LAZ) were analyzed using linear regression. Stunting rates were high (>20%) reaching 45% in Burundi. At the time of the most recent Demographic and Health Survey (DHS), more than half of the households in most countries did not have basic or safely managed WASH indicators. Models predicted significantly higher LAZ for children living in households with safely managed drinking water compared to those living in households drinking from surface water in Kenya (β = 0.13, p < 0.01) and Tanzania (β = 0.08, p < 0.05) after adjustment with child, maternal, and household covariates. Children living in households with improved sanitation facilities not shared with other households were also taller than children living in households practicing open defecation in Ethiopia (β = 0.07, p < 0.01) and Tanzania (β = 0.08, p < 0.01) in the adjusted models. All countries need improved WASH conditions to reduce pathogen and helminth contamination. Targeting adherence to the highest JMP indicators would support efforts to reduce child stunting in East Africa.

Suggested Citation

  • Hasina Rakotomanana & Joel J. Komakech & Christine N. Walters & Barbara J. Stoecker, 2020. "The WHO and UNICEF Joint Monitoring Programme (JMP) Indicators for Water Supply, Sanitation and Hygiene and Their Association with Linear Growth in Children 6 to 23 Months in East Africa," IJERPH, MDPI, vol. 17(17), pages 1-14, August.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:17:p:6262-:d:405328
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    References listed on IDEAS

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    1. Dean Spears & Arabinda Ghosh & Oliver Cumming, 2013. "Open Defecation and Childhood Stunting in India: An Ecological Analysis of New Data from 112 Districts," PLOS ONE, Public Library of Science, vol. 8(9), pages 1-1, September.
    2. Dean Spears, 2012. "How much international variation in child height can sanitation explain?," Working Papers 1438, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing..
    3. Smith, Lisa C. & Haddad, Lawrence, 2015. "Reducing Child Undernutrition: Past Drivers and Priorities for the Post-MDG Era," World Development, Elsevier, vol. 68(C), pages 180-204.
    4. Leonor Rodríguez & Elsa Cervantes & Rocío Ortiz, 2011. "Malnutrition and Gastrointestinal and Respiratory Infections in Children: A Public Health Problem," IJERPH, MDPI, vol. 8(4), pages 1-32, April.
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