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Table 4 Adjusted odds ratio estimates on the effects of WASH and other factors on the prevalence of stunting among under-5 children, Ethiopia: 2000–2016

From: Association between water, sanitation and hygiene (WASH) and child undernutrition in Ethiopia: a hierarchical approach

Characteristics

Model 1

(AOR, 95%CI)

p-value

Model 2

(AOR, 95%CI)

p-value

Model 3

(AOR, 95%CI)

p-value

Model 4

(AOR, 95%CI)

p-value

Model 5

(AOR, 95%CI)

p-value

Model 6#

(AOR, 95%CI)

p-value

WASH factors a

            

Latrine facility

            

Improved

1

 

1

 

1

 

1

 

1

 

1

 

Unimproved

1.08 (0.98,1.18)

0.087

1.12 (1.01,1.26)

0.048

1.03 (0.91,1.15)

0.670

1.25 (1.08,1.45)

0.002

1.21 (1.05,1.39)

0.009

1.20 (1.05,1.39)

0.009

Open defecation

1.34 (1.23,1.47)

p < 0.001

1.39 (1.24,1.56)

p < 0.001

1.21 (1.08,1.37)

0.002

1.30 (1.11,1.52)

0.001

1.29 (1.11,1.51)

0.001

1.29 (1.11,1.51)

0.001

Source of drinking water

            

Improved

1

 

1

 

1

 

1

 

1

 

1

 

Unimproved

1.04 (0.99,1.10)

0.100

1.04 (0.97,1.12)

0.265

1.01 (0.93,1.08)

0.879

0.91 (0.84,0.99)

0.042

0.92 (0.84,1.01)

0.06

0.91 (0.83,0.99)

0.041

Child stool disposal

            

Safe

1

 

1

 

1

 

1

 

1

 

1

 

Unsafe

1.08 (1.01,1.16)

0.022

1.08 (0.98,1.18)

0.092

0.98 (0.89,1.08)

0.782

0.94 (0.85,1.05)

0.302

0.94 (0.85,1.05)

0.260

0.94 (0.85,1.04)

0.282

Household flooring

            

Improved

1

 

1

 

1

 

1

 

1

 

1

 

Unimproved

1.85 (1.67,2.05)

p < 0.001

1.79(1.57,2.04)

p < 0.001

1.37 (1.19,1.58)

p < 0.001

1.38 (1.17,1.62)

p < 0.001

1.31 (1.10,1.55)

0.002

1.32 (1.12,1.57)

0.001

Time to get water source

            

On-premise

1

 

1

 

1

 

1

 

1

 

1

 

≤ 30 min

1.67 (1.49,1.88)

p < 0.001

1.55 (1.33,1.82)

p < 0.001

1.28 (1.09,1.50)

0.003

1.16 (0.97,1.37)

0.097

1.09 (0.91,1.30)

0.335

1.09 (0.91,1.29)

0.338

31–60 min

1.64 (1.45,1.86)

p < 0.001

1.49 (1.27,1.78)

p < 0.001

1.21 (1.02,1.44)

0.030

1.09 (0.90,1.32)

0.356

1.03 (0.85,1.24)

0.789

1.02 (0.84,1.24)

0.795

> 60 min

1.56 (1.37,1.77)

p < 0.001

1.47 (1.24,1.74)

p < 0.001

1.18 (0.99,1.41)

0.069

1.08 (0.89,1.31)

0.448

1.04 (0.86,1.27)

0.665

1.05 (0.86,1.27)

0.618

Child Factors

            

Childhood infections

            

Diarrhea

            

Yes

  

1.22 (1.13,1.33)

p < 0.001

1.19 (1.09,1.30)

p < 0.001

1.14 (1.02,1.27)

0.018

1.14 (1.02,1.27)

0.018

1.16 (1.05,1.28)

0.003

No

  

1

 

1

 

1

 

1

 

1

 

Fever

            

Yes

  

1.14 (1.06,1.23)

p < 0.001

1.14 (1.06,1.24)

0.001

1.07 (0.96,1.19)

0.187

1.06 (0.96,1.18)

0.223

  

No

  

1

 

1

   

1

   

ARI

            

Yes

  

0.79 (0.67,0.94)

0.008

0.80 (0.67,0.95)

0.010

0.91 (0.76,1.08)

0.275

    

No

  

1

 

1

 

1

     

Sex

            

Male

  

1

 

1

 

1

 

1

 

1

 

Female

  

0.81 (0.76,0.86)

p < 0.001

0.79 (0.74,0.85)

p < 0.001

0.79 (0.73,0.85)

p < 0.001

0.79 (0.73,0.85)

p < 0.001

0.79 (0.72,0.85)

p < 0.001

Age (months)

            

< 12

  

1

 

1

 

1

 

1

 

1

 

12–23

  

3.54 (3.09,4.06)

p < 0.001

3.66 (3.13,4.29)

p < 0.001

3.19 (2.61,3.90)

p < 0.001

3.17 (2.60,3.85)

p < 0.001

3.16 (2.59,3.84)

p < 0.001

≥ 24 to 59 months

  

6.83 (5.93,7.87)

p < 0.001

7.51 (6.29,8.96)

p < 0.001

6.63 (5.32,8.27)

p < 0.001

6.52 (5.25,8.09)

p < 0.001

6.47 (5.21,8.02)

p < 0.001

Birth order

            

Firstborn

  

1

 

1

 

1

 

1

 

1

 

2–4

  

1.04 (0.95,1.14)

0.382

0.90 (0.81,1.01)

0.076

0.85 (0.75,0.96)

0.011

0.86 (0.76,0.97)

0.016

0.88 (0.78,0.98)

0.032

5 or higher

  

1.17 (1.05,1.30)

0.004

0.95 (0.83,1.09)

0.513

0.81 (0.70,0.94)

0.005

0.81 (0.70,0.94)

0.004

0.85 (0.75,0.96)

0.009

Birth interval

            

< 33 months

  

1

 

1

       

≥ 33 months

  

0.91 (0.83,0.98)

0.023

0.91 (0.78,1.06)

0.255

      

Size of child at birth

            

Larger

  

1

 

1

 

1

 

1

 

1

 

Average

  

1.21 (1.12,1.31)

p < 0.001

1.18 (1.09,1.28)

p < 0.001

1.23 (1.12,1.35)

p < 0.001

1.22 (1.11,1.34)

p < 0.001

1.22 (1.11,1.34)

p < 0.001

Small

  

1.68 (1.55,1.82)

p < 0.001

1.63 (1.49,1.78)

p < 0.001

1.65 (1.48,1.83)

p < 0.001

1.64 (1.48,1.81)

p < 0.001

1.64 (1.48,1.82)

p < 0.001

Currently breast feeding

            

Yes

  

1

 

1

 

1

 

1

 

1

 

No

  

0.70 (0.65,0.76)

p < 0.001

0.63 (0.58,0.69)

p < 0.001

0.61 (0.55,0.67)

p < 0.001

0.62 (0.55,0.68)

p < 0.001

0.62 (0.55,0.68)

p < 0.001

Early initiation of breastfeeding

            

Yes

  

1

 

1

 

1

     

No

  

1.04 (0.98,1.11)

0.159

1.05 (0.98,1.12)

0.153

1.02 (0.93,1.10)

0.683

    

Received measles

            

Yes

  

1

         

No

  

1.04 (0.95, 1.14)

0.359

        

Basic vaccine

            

Yes

  

1

         

No

  

1.01 (0.91,1.11)

0.943

        

Parental factors

            

Mother’s age

            

< 18

    

1

       

18–24

    

0.80 (0.55,1.14)

0.228

      

25–34

    

0.81 (0.56,1.16)

0.252

      

≥ 35

    

0.77 (0.51,1.15)

0.201

      

Mother’s education

            

No education

    

1.60 (1.12, 2.29)

0.011

1.41 (0.96,2.04)

0.074

1.51 (1.04,2.19)

0.031

1.54 (1.06,2.24)

0.022

Primary

    

1.39 (0.97,1.98)

0.068

1.25 (0.87,1.81)

0.219

1.35 (0.94,1.96)

0.100

1.38 (0.96,1.99)

0.080

Secondary

    

1.20 (0.83,1.73)

0.316

1.12 (0.77,1.63)

0.539

1.20 (0.83,1.75)

0.336

1.21 (0.83,1.77)

0.305

Higher

    

1

 

1

 

1

 

1

 

Mother’s occupation

            

Not working

    

1

 

1

 

1

 

1

 

Non agriculture

    

1.02 (0.94,1.12)

0.595

0.99 (0.89,1.11)

0.975

1.01 (0.90,1.11)

0.943

1.01 (0.90,1.11)

0.958

Agriculture

    

1.18 (1.09,1.28)

p < 0.001

1.10 (0.99,1.23)

0.058

1.07 (0.96,1.19)

0.186

1.06 (0.96,1.18)

0.235

ANC Visit

            

None

    

1

 

1

 

1

 

1

 

1–3

    

0.87 (0.80,0.95)

0.002

0.93 (0.85,1.04)

0.210

0.93 (0.84,1.03)

0.151

0.93 (0.84,1.02)

0.136

4+

    

0.72 (0.65,0.79)

p < 0.001

0.74 (0.66,0.83)

p < 0.001

0.75 (0.67,0.83)

p < 0.001

0.74 (0.66,0.83)

p < 0.001

Maternal BMI (kg/m2)

            

< 18.5

    

1

 

1

 

1

 

1

 

18.5 to 24.9

    

0.95 (0.88,1.02)

0.166

0.93 (0.85,1.01)

0.105

0.92 (0.84,1.02)

0.073

0.92 (0.84,1.01)

0.072

25 +

    

0.81 (0.67,0.96)

0.018

0.79 (0.65,0.96)

0.017

0.79 (0.66,0.97)

0.023

0.79 (0.65,0.96)

0.020

Husband’s education

            

No education

    

1.45 (1.15,1.83)

0.001

1.51 (1.17,1.94)

0.001

1.50 (1.17,1.92)

0.001

1.50 (1.17,1.92)

0.001

Primary

    

1.32 (1.05,1.65)

0.017

1.39 (1.09,1.78)

0.008

1.36 (1.07,1.74)

0.011

1.37 (1.07,1.74)

0.011

Secondary

    

1.09 (0.86,1.37)

0.453

1.13 (0.88,1.46)

0.336

1.15 (0.89,1.48)

0.260

1.15 (0.89,1.48)

0.264

Higher

    

1

 

1

 

1

 

1

 

Husband’s occupation

            

Not working

    

0.69 (0.57,0.84)

p < 0.001

0.75 (0.61,0.93)

0.009

0.75 (0.61,0.92)

0.006

0.75 (0.61,0.93)

0.008

Agriculture

    

1.04 (0.94,1.15)

0.410

1.10 (0.98,1.24)

0.088

1.07 (0.95,1.20)

0.283

1.07 (0.95,1.21)

0.241

Non agriculture

    

1

 

1

 

1

 

1

 

Listening to radio

            

Not at all

    

1

       

Yes

    

0.98 (0.91,1.06)

0.669

      

Watching television

            

Not at all

    

1

 

1

 

1

   

Yes

    

0.87 (0.78,0.97)

0.011

0.92 (0.82,1.03)

0.147

0.93 (0.83,1.04)

0.210

  

Household factors

            

Wealth index

            

Poor

      

1.17 (1.04,1.31)

0.009

1.19 (1.06,1.31)

0.003

1.20 (1.07,1.35)

0.002

Middle

      

0.99 (0.87,1.13)

0.936

1.01 (0.88,1.15)

0.827

1.01 (0.89,1.15)

0.828

Rich

      

1

 

1

 

1

 

Household Size

            

1–4

      

0.93 (0.84,1.03)

0.187

0.94 (0.85,1.04)

0.240

  

≥ 5

      

1

 

1

   

Community Level Factors

            

Residence

            

Urban

        

1

 

1

 

Rural

        

1.13 (0.94,1.35)

0.181

1.15 (0.96,1.37)

0.123

Region

            

Agrarian

        

1.11 (0.96,1.28)

0.176

1.12 (0.97,1.29)

0.124

Pastoralist

        

1.08 (0.92,1.27)

0.320

1.09 (0.93,1.28)

0.276

City administrations

        

1

 

1

 

Ecological Zone

            

< 1500

        

0.67 (0.58,0.78)

p < 0.001

0.67 (0.58,0.78)

p < 0.001

1500–2500

        

0.75 (0.65,0.87)

p < 0.001

0.75 (0.65,0.87)

p < 0.001

> 2500

        

1

 

1

 
  1. AOR (Adjusted Odds Ratio); COR (Crude Odds Ratio), WASH (Water, Sanitation, and Hygiene), LL: Log-likelihood
  2. Model 0: Empty model (-LL: -21703.816), ICC(%): 2.93, AIC: 43411.63, BIC: 43428.36
  3. Model 1: WASH variables only (-LL: -19976.364), ICC(%): 2.84, AIC: 39972.73, BIC: 40055.76
  4. Model 2: WASH + Child related factors (from model 0 with p < 0.20) (-LL: -12070.816)
  5. Model 3: WASH + Child related factors (from model 2 with p < 0.20) + Parental factors (from model 0 with p < 0.20) (-LL: -10882.449)
  6. Model 4: WASH + Child related factors (p < 0.20) + Parental factors (from model 0 with p < 0.20) + Household factors (-LL: -7718.3869)
  7. Model 5: WASH + Child related factors (p < 0.20) + Parental factors (from model 0 with p < 0.20) + Household factors (from model 4 with p < 0.2) + Community level factors (-LL: --7816.6514), ICC (%): 3.08; AIC: 15723.3, BIC: 16061.63
  8. Model 6: (final model): The final model includes only variables with a p < 0.2 from model 5. (-LL: --7830.3954), ICC (%): 3.0; AIC: 15744.79, BIC: 16060.62
  9. aVariables such as household drinking water service and combined sanitation facility were removed by the model due to multicollinearity
  10. # WASH factors significant associated with stunting (p < 0.05)
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