ASSESSING THE EFFECT OF HOUSEHOLD ACCESS TO WATER SANITATION AND HYGIENE FACILITIES ON CHILDHOOD UNDERNUTRITION IN THE BOLGATANGA MUNICIPALITY OF THE UPPER EAST REGION OF GHANA

Abstract

Background: Childhood undernutrition is a disease of public health concern in developing countries and has been found to be associated with poor water, sanitation, and hygiene practices. Objective: This study sought to assess the effect of household access to WASH services on childhood undernutrition in the Bolgatanga Municipality of the Upper East Region of Ghana. This study adopted Amartya Sen and Martha Nussbaum's capability approach and social cognitive theory frameworks to explain how inadequate WASH access can lead to childhood undernutrition. Methodology: A cross-sectional study design involving 19 health facilities was conducted. The study sample included 422 mother-baby pairs who attended selected health facilities for Child Welfare Clinic services. A simple random sampling technique using the lottery method was used to select participants for this study. A standard questionnaire was used to obtain primary data, whereas a checklist was used to extract secondary data from maternity booklets. Data was analyzed using STATA IC version 17. Results: The prevalence of childhood undernutrition in the study sample was 48.5% (95% CI: 43.5- 53.5). About 28.5% (95% CI: 23.9-33.1) of the children had stunted growth, 20.8% (95% CI: 16.6-24.9) were wasted, while 11.3% (95% CI: 8-14.6) were found to be underweight. Children from households with insufficient sanitation facilities were 2.2 times more likely to be stunted compared to children from households with sufficient sanitation services (AOR: 2.20, 95% CI: 1.21 - 4.02, P-value = 0.010). Children from households with unimproved sanitation services were 3.25 times more likely to be underweight compared to children residing in households with improved sanitation services (AOR: 3.25, 95% CI: 1.22 - 8.68, P-value = 0.018). This study found no statistically significant relationship between household access to WASH facilities and childhood wasting. Conclusion: The study found that inadequate sanitation and hygiene practices contribute to childhood stunting and underweight. I recommend that the Bolgatanga Municipal Health Directorate should design and implement integrated programs that address both WASH and nutrition to tackle the interconnected issues of poor sanitation and undernutrition.