Household-Level Water, Sanitation, Hygiene Conditions, and Child Growth, and their Relationship in Hawassa Zuriya District, Sidama, Ethiopia

Water, sanitation, hygiene (WaSH), and nutrition conditions demand integrated systematic investigations as they are interconnected entities of human livelihood. Connectedly, we assessed household-level WaSH conditions and child nutrition, and quantified their relationship. A cross-sectional study was conducted on randomly selected 604 households (HHs) and children from Hawassa Zuriya district (HZD) in the Sidama region of Ethiopia. Data were collected through questionnaire led interview, anthropometric measurements and observations. Descriptive and regression analyses were applied. About two-thirds of the HHs (65%) had access to basic drinking water source, while 33% to limited and 2% to unimproved. Half of the HHs (53%) had access to unimproved sanitation facility while a quarter (26%) to basic level and 13% possible to practice open defecation. Nearly all HHs (99%) had no hand washing facility. Stunting, underweight and wasting were at 39%, 22% and 12%, respectively. Longer in-house water storage [AOR=1.59(95%CI: 1.08, 2.33), p=0.019], and access to limited [AOR=1.78(95%CI: 1.16, 2.73) p=0.008] and unimproved [AOR=2.25(95%CI: 1.13, 4.52), p=0.02] sanitation facility increased odds of child stunting. WaSH and child growth gaps are widespread in HZD. Longer water storage and sanitation facility gaps are associated with stunting. Interventions and longitudinal analysis are demanded to better understand nexus and impact.