Association of both Water, Sanitation and Hygiene (WASH) and Infant and Young Child Feeding (IYCF) practices with childhood malnutrition in Lao PDR: a cross-sectional study of the 2017 Lao Social Indicator Survey II

Somphos Vicheth Som; Frank T Wieringa; Maiza Campos Ponce; Katja Polman; Prosper Dakurah; David Duncan; Janneke Blomberg; Sitthorot Rasphone; Marinka van der Hoeven

doi:10.1136/bmjopen-2023-073974

Association of both Water, Sanitation and Hygiene (WASH) and Infant and Young Child Feeding (IYCF) practices with childhood malnutrition in Lao PDR: a cross-sectional study of the 2017 Lao Social Indicator Survey II

Somphos Vicheth Som, Frank T Wieringa, Maiza Campos Ponce, Katja Polman, Prosper Dakurah, David Duncan, Janneke Blomberg, Sitthorot Rasphone, Marinka van der Hoeven

Eco-epidemiology

Research output: Contribution to journal › A1: Web of Science-article › peer-review

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Abstract

OBJECTIVE: We assessed whether Water, Sanitation and Hygiene (WASH) and Infant and Young Child Feeding (IYCF), either alone or combined, were associated with malnutrition among Lao People's Democratic Republic (Lao PDR) children aged 6 to <24 months.

DESIGN: This is a secondary analysis of the 2017 Lao Social Indicator Survey II (LSIS II), which used multistage probability proportional to size sampling. Logistic regression analyses were conducted with OR and its corresponding 95% CI.

SETTING: The LSIS II was conducted a nationwide household-based survey covering all 18 provinces in Lao PDR.

PARTICIPANTS: We had a total of 3375 children (weighted sample 3345) and 357 households with data on drinking water.

OUTCOME MEASURES: The outcomes of this study were stunting and wasting.

RESULTS: The prevalence of stunting and wasting was 28.9% and 10.1%, respectively. Even though households with access to a basic or improved water source were high (82.5%), over 83% of drinking water was contaminated with Escherichia coli. Access to improved sanitation, basic hygiene and adequate IYCF gave a significant lower risk of becoming stunted. The combined effect of these practices on stunting was (adjusted OR (AOR)=0.54; 95% CI=0.41 to 0.73) greater than each practice alone (improved sanitation: AOR=0.75; 95% CI=0.61 to 0.93; basic hygiene: AOR=0.69; 95% CI=0.57 to 0.83; adequate IYCF: AOR=0.79; 95% CI=0.64 to 0.98). Access to improved sanitation and adequate IYCF was associated with a significant lower risk for being wasted, and again the combined effect of these practices was (AOR=0.64; 95% CI=0.44 to 0.92) greater than each practice alone (improved sanitation: AOR=0.68; 95% CI=0.49 to 0.93 and adequate IYCF: AOR=0.66; 95% CI=0.47 to 0.92).

CONCLUSION: Given the strong associations with both stunting and wasting, and the added benefits when combining WASH and IYCF, there is a need of multisectoral interventions to reduce early childhood malnutrition in Lao PDR.

Original language	English
Article number	e073974
Journal	BMJ Open
Volume	13
Issue number	10
Number of pages	9
ISSN	2044-6055
DOIs	https://doi.org/10.1136/bmjopen-2023-073974
Publication status	Published - 2023

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Som, S. V., Wieringa, F. T., Campos Ponce, M., Polman, K., Dakurah, P., Duncan, D., Blomberg, J., Rasphone, S., & Hoeven, M. V. D. (2023). Association of both Water, Sanitation and Hygiene (WASH) and Infant and Young Child Feeding (IYCF) practices with childhood malnutrition in Lao PDR: a cross-sectional study of the 2017 Lao Social Indicator Survey II. BMJ Open, 13(10), Article e073974. https://doi.org/10.1136/bmjopen-2023-073974

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title = "Association of both Water, Sanitation and Hygiene (WASH) and Infant and Young Child Feeding (IYCF) practices with childhood malnutrition in Lao PDR: a cross-sectional study of the 2017 Lao Social Indicator Survey II",

abstract = "OBJECTIVE: We assessed whether Water, Sanitation and Hygiene (WASH) and Infant and Young Child Feeding (IYCF), either alone or combined, were associated with malnutrition among Lao People's Democratic Republic (Lao PDR) children aged 6 to <24 months.DESIGN: This is a secondary analysis of the 2017 Lao Social Indicator Survey II (LSIS II), which used multistage probability proportional to size sampling. Logistic regression analyses were conducted with OR and its corresponding 95% CI.SETTING: The LSIS II was conducted a nationwide household-based survey covering all 18 provinces in Lao PDR.PARTICIPANTS: We had a total of 3375 children (weighted sample 3345) and 357 households with data on drinking water.OUTCOME MEASURES: The outcomes of this study were stunting and wasting.RESULTS: The prevalence of stunting and wasting was 28.9% and 10.1%, respectively. Even though households with access to a basic or improved water source were high (82.5%), over 83% of drinking water was contaminated with Escherichia coli. Access to improved sanitation, basic hygiene and adequate IYCF gave a significant lower risk of becoming stunted. The combined effect of these practices on stunting was (adjusted OR (AOR)=0.54; 95% CI=0.41 to 0.73) greater than each practice alone (improved sanitation: AOR=0.75; 95% CI=0.61 to 0.93; basic hygiene: AOR=0.69; 95% CI=0.57 to 0.83; adequate IYCF: AOR=0.79; 95% CI=0.64 to 0.98). Access to improved sanitation and adequate IYCF was associated with a significant lower risk for being wasted, and again the combined effect of these practices was (AOR=0.64; 95% CI=0.44 to 0.92) greater than each practice alone (improved sanitation: AOR=0.68; 95% CI=0.49 to 0.93 and adequate IYCF: AOR=0.66; 95% CI=0.47 to 0.92).CONCLUSION: Given the strong associations with both stunting and wasting, and the added benefits when combining WASH and IYCF, there is a need of multisectoral interventions to reduce early childhood malnutrition in Lao PDR.",

author = "Som, {Somphos Vicheth} and Wieringa, {Frank T} and {Campos Ponce}, Maiza and Katja Polman and Prosper Dakurah and David Duncan and Janneke Blomberg and Sitthorot Rasphone and Hoeven, {Marinka van der}",

note = "FTX; DOAJ; (CC BY NC)",

year = "2023",

doi = "10.1136/bmjopen-2023-073974",

language = "English",

volume = "13",

journal = "BMJ Open",

issn = "2044-6055",

publisher = "BMJ Publishing Group",

number = "10",

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Som, SV, Wieringa, FT, Campos Ponce, M, Polman, K, Dakurah, P, Duncan, D, Blomberg, J, Rasphone, S & Hoeven, MVD 2023, 'Association of both Water, Sanitation and Hygiene (WASH) and Infant and Young Child Feeding (IYCF) practices with childhood malnutrition in Lao PDR: a cross-sectional study of the 2017 Lao Social Indicator Survey II', BMJ Open, vol. 13, no. 10, e073974. https://doi.org/10.1136/bmjopen-2023-073974

Association of both Water, Sanitation and Hygiene (WASH) and Infant and Young Child Feeding (IYCF) practices with childhood malnutrition in Lao PDR: a cross-sectional study of the 2017 Lao Social Indicator Survey II. / Som, Somphos Vicheth; Wieringa, Frank T; Campos Ponce, Maiza et al.
In: BMJ Open, Vol. 13, No. 10, e073974, 2023.

Research output: Contribution to journal › A1: Web of Science-article › peer-review

TY - JOUR

T1 - Association of both Water, Sanitation and Hygiene (WASH) and Infant and Young Child Feeding (IYCF) practices with childhood malnutrition in Lao PDR: a cross-sectional study of the 2017 Lao Social Indicator Survey II

AU - Som, Somphos Vicheth

AU - Wieringa, Frank T

AU - Campos Ponce, Maiza

AU - Polman, Katja

AU - Dakurah, Prosper

AU - Duncan, David

AU - Blomberg, Janneke

AU - Rasphone, Sitthorot

AU - Hoeven, Marinka van der

N1 - FTX; DOAJ; (CC BY NC)

PY - 2023

Y1 - 2023

N2 - OBJECTIVE: We assessed whether Water, Sanitation and Hygiene (WASH) and Infant and Young Child Feeding (IYCF), either alone or combined, were associated with malnutrition among Lao People's Democratic Republic (Lao PDR) children aged 6 to <24 months.DESIGN: This is a secondary analysis of the 2017 Lao Social Indicator Survey II (LSIS II), which used multistage probability proportional to size sampling. Logistic regression analyses were conducted with OR and its corresponding 95% CI.SETTING: The LSIS II was conducted a nationwide household-based survey covering all 18 provinces in Lao PDR.PARTICIPANTS: We had a total of 3375 children (weighted sample 3345) and 357 households with data on drinking water.OUTCOME MEASURES: The outcomes of this study were stunting and wasting.RESULTS: The prevalence of stunting and wasting was 28.9% and 10.1%, respectively. Even though households with access to a basic or improved water source were high (82.5%), over 83% of drinking water was contaminated with Escherichia coli. Access to improved sanitation, basic hygiene and adequate IYCF gave a significant lower risk of becoming stunted. The combined effect of these practices on stunting was (adjusted OR (AOR)=0.54; 95% CI=0.41 to 0.73) greater than each practice alone (improved sanitation: AOR=0.75; 95% CI=0.61 to 0.93; basic hygiene: AOR=0.69; 95% CI=0.57 to 0.83; adequate IYCF: AOR=0.79; 95% CI=0.64 to 0.98). Access to improved sanitation and adequate IYCF was associated with a significant lower risk for being wasted, and again the combined effect of these practices was (AOR=0.64; 95% CI=0.44 to 0.92) greater than each practice alone (improved sanitation: AOR=0.68; 95% CI=0.49 to 0.93 and adequate IYCF: AOR=0.66; 95% CI=0.47 to 0.92).CONCLUSION: Given the strong associations with both stunting and wasting, and the added benefits when combining WASH and IYCF, there is a need of multisectoral interventions to reduce early childhood malnutrition in Lao PDR.

AB - OBJECTIVE: We assessed whether Water, Sanitation and Hygiene (WASH) and Infant and Young Child Feeding (IYCF), either alone or combined, were associated with malnutrition among Lao People's Democratic Republic (Lao PDR) children aged 6 to <24 months.DESIGN: This is a secondary analysis of the 2017 Lao Social Indicator Survey II (LSIS II), which used multistage probability proportional to size sampling. Logistic regression analyses were conducted with OR and its corresponding 95% CI.SETTING: The LSIS II was conducted a nationwide household-based survey covering all 18 provinces in Lao PDR.PARTICIPANTS: We had a total of 3375 children (weighted sample 3345) and 357 households with data on drinking water.OUTCOME MEASURES: The outcomes of this study were stunting and wasting.RESULTS: The prevalence of stunting and wasting was 28.9% and 10.1%, respectively. Even though households with access to a basic or improved water source were high (82.5%), over 83% of drinking water was contaminated with Escherichia coli. Access to improved sanitation, basic hygiene and adequate IYCF gave a significant lower risk of becoming stunted. The combined effect of these practices on stunting was (adjusted OR (AOR)=0.54; 95% CI=0.41 to 0.73) greater than each practice alone (improved sanitation: AOR=0.75; 95% CI=0.61 to 0.93; basic hygiene: AOR=0.69; 95% CI=0.57 to 0.83; adequate IYCF: AOR=0.79; 95% CI=0.64 to 0.98). Access to improved sanitation and adequate IYCF was associated with a significant lower risk for being wasted, and again the combined effect of these practices was (AOR=0.64; 95% CI=0.44 to 0.92) greater than each practice alone (improved sanitation: AOR=0.68; 95% CI=0.49 to 0.93 and adequate IYCF: AOR=0.66; 95% CI=0.47 to 0.92).CONCLUSION: Given the strong associations with both stunting and wasting, and the added benefits when combining WASH and IYCF, there is a need of multisectoral interventions to reduce early childhood malnutrition in Lao PDR.

U2 - 10.1136/bmjopen-2023-073974

DO - 10.1136/bmjopen-2023-073974

M3 - A1: Web of Science-article

C2 - 37832981

SN - 2044-6055

VL - 13

JO - BMJ Open

JF - BMJ Open

IS - 10

M1 - e073974

ER -