Analyzing Effect of WASH Practices and District‑Level Spatial Effects on Acute Respiratory Infections and Diarrhoea Among Under‑Five Children in India

Abstract

The United Nations sustainable development goal 6 (UN SDG-6) emphasizes equitable access to safe and affordable drinking water, sanitation, and hygiene (WASH) for all by 2030. Lack of WASH is health hazardous and hinders children’s physical and educational development due to the frequent exposure to childhood illnesses. Previous researches from Africa have found strong linkages between WASH practices and childhood chronic undernutrition and related morbidities like diarrhoea, and acute respiratory infection (ARI). Furthermore, according to the National Health Profile of India, Report 2019, mortality from diseases among children is 27.2% for ARI and 10.5% for acute diarrhoea. The current study utilizes a Bayesian geoadditive modeling framework to explain the district-level spatial heterogeneity in cases of diarrhoea and ARI in India and simultaneously analyzes the effects of WASH practices and other socioeconomic covariates. The study results suggests that most districts situated in India’s north and central regions had higher chances of ARI and diarrhoea and, cases of diarrhoea may reduce with the improved toilet facilities. Nevertheless, female children are less prone to ARI and Diarrhoea, whereas, stunted and wasted children are more susceptible to Diarrhoea only; young women with low education level are more likely to have children down with both the diseases. On the other hand, Hindu and ST have less while SC children have more chances of being sick with ARI and diarrhoea. Finally, the study may suggest to have an effective intervention of the Government for the identified regions of country with a high burden of ARI and Diarrhoea and a need for strategies for behavioural change in the people towards health and hygiene.