Discussion Paper No. 339 of 2024 on The Role of Water, Sanitation, and Hygiene in Diarrhoea Prevention Among Children Under the Age of Five Years in Kenya

Abstract

This study examined the effect of access to improved sources of water, sanitation, and hygiene (WASH) on the probability of reducing diarrhoeal among children under the age of five years (under-five children) in Kenya. Differential effects were estimated for urban and rural areas. Diarrhoea is one of the causes of morbidity and mortality among children under-five years globally. In 2018, Kenya reported nearly 1.5 million diarrhoeal cases among under-five children. The study estimated probit models using the Kenya Integrated Household Budget Survey (KIHBS) 2015/16 data to assess diarrhoea prevalence controlling for other contributing factors. Access to improved sources of water and sanitation plays a preventive role in diarrhoea prevalence among under-five children. Access to improved water sources and sanitation significantly reduces the probability of households with under-five children reporting a prevalence of diarrhoea compared to those with access to unimproved water sources. Other factors such as large households, high monetary poverty levels, and low levels of maternal education significantly contribute to an increased probability of diarrhoea prevalence in under-five children. The findings indicate that enhancing access to improved water and sanitation is a key factor in reducing the probability of diarrhoea prevalence among under-five children. Education for all is a key strategy, and expanding the ongoing efforts to readmit teenage mothers to school is commendable. It is also important for the government with support from stakeholders to enhance targeted WASH investments in rural areas and urban informal settlements with high poverty rates in piped water systems; scale up small-scale/pilot WASH interventions and innovations that have had good outcomes; and support an enabling environment for more market-based innovations such as water and sanitation lending by financial institutions for the development of water and sanitation infrastructure. From the review of overarching institutional issues, the national and county governments need to improve coordination of WASH interventions through collaborative planning, prioritize funding for sanitation and hygiene services to reduce reliance on donor support, and develop robust maintenance plans to facilitate timely repair/rehabilitation of WASH infrastructure