Risk factors of diarrhoeal disease in under-five children among health extension model and non-model families in Sheko district rural community, Southwest Ethiopia: comparative cross-sectional study.

backgroundWorldwide diarrheal disease is the second leading cause of death in under-five year's children. In Ethiopia diarrhoea kills half million under-five children every year second to pneumonia. Poor sanitation, unsafe water supply and inadequate personal hygiene are responsible for 90% of diarrhoea occurrence; these can be easily improved by health promotion and education. The Ethiopian government introduced a new initiative health extension programme in 2002/03 as a means of providing a comprehensive, universal, equitable and affordable health service. As a strategy of the programme; households have been graduated as model families after training and implementing the intervention packages. Therefore the aim of the study was to assess risk factor of diarrheal disease in under-five children among health extension model and non-model families.

methodA community based comparative cross-sectional study design was employed in 2012 at Sheko district. Multi-stage sampling technique was employed to select 275 model and 550 non-model households that had at least one under-five children. Data was collected using structured questioner and/or checklist by trained data collectors. A summery descriptive, binary and multivariate logistic regression was computed to describe the functional independent predictors of childhood diarrhoea.

resultThe two weeks diarrhoea prevalence in under-five children among health extension model and non-model households were 6.4% and 25.5%, respectively. The independent predictors of childhood diarrhoea revealed in the study were being mothers can't read and write [OR: 1.74, 95% CI: (1.03, 2.91)], monthly family income earn less than 650 Birr [OR: 1.75, 95% CI: (1.06, 2.88)], mothers hand washing not practice at critical time [OR: 2.21, 95% CI: (1.41, 3.46)], not soap use for hand washing [OR: 7.40, 95% CI: (2.61, 20.96)], improper refuse disposal [OR: 3.19, 95% CI: (1.89, 5.38)] and being non-model families for the health extension programme [OR: 4.50, 95% CI: (2.52, 8.03].

conclusionThe level of diarrheal disease variation was well explained by maternal education, income, personal hygiene, waste disposal system and the effect of health extension programme. Thus encouraging families to being model families for the programme and enhancing community based behavioural change communication that emphasize on personal hygiene and sanitation should be strengthening to reduce childhood diarrhoea.