Hygiene and health-seeking behaviours of households as predictors of nutritional insecurity among preschool children in urban slums in Ethiopia: the case of Addis Ababa

Abstract

The objective of the study was to establish hygiene and health-seeking practices most likely to be predictors of nutritional insecurity among children living in slums. A cross-sectional study was conducted from March to May 1997 comparing 192 households with and 192 without malnourished children. All the households with children in the 3 - 36-month age group were identified. Using underweight (weight-for-age) as an indicator of nutritional insecurity, the households were classified into two groups, namely nutritionally secure and insecure households Subsequently, sampling frames for each set of households were established and used to select the study households randomly. Four slums in Addis Ababa, Ethiopia, constituted the study sites. The results indicated that there was not a significant difference between secure and insecure households with regard to prevalence of immunisation and dietary (food withholding) habits during episodes of diarrhoea. After adjusting (by means of logistical regression) for covariates, six household behaviours were established as having the power to predict exposure to childhood natritional insecurity in urban slums of Ethiopia. The presence of children's faeces inside the house, failure to have diarrhoea treated at a health facility, prolonged storage of cooked foods (beyond 24 hours), feeding children with unwashed hands, and poor handling of drinking water and foods are risk factors that can predict nutritional insecurity. Advice with a view to achieving sustainable behaviour change in households, namely good personal and household hygiene practices and increased utilisation of health facilities is recommended as being essential in addressing challenges to nutritional insecurity and in optimising the success of public health programmes.