Community Improved Sanitation Coverage and Childhood Stunting [SAR23]

The study was conducted by Rose E. Donohue, Rachael Church, Shireen Assaf, and Benjamin K. Mayala, and was supported by the United States Agency for International Development (USAID) through The DHS Program. The report's objectives were to analyze the association between community-improved sanitation coverage and childhood stunting, and to identify the geographic areas with the highest and lowest levels of sanitation coverage and childhood stunting. The study used data from the 2018 Demographic and Health Surveys (DHS) in Nigeria and Zambia, and employed geospatial modeling and multilevel regression analysis to examine the relationship between sanitation coverage and childhood stunting. The study found that community-improved sanitation coverage was associated with a lower prevalence of childhood stunting in both Nigeria and Zambia. In Nigeria, the study found that for every 10% increase in community-improved sanitation coverage, the prevalence of childhood stunting decreased by 1.4%. In Zambia, the study found that for every 10% increase in community-improved sanitation coverage, the prevalence of childhood stunting decreased by 2.1%. The study also found that the geographic areas with the highest levels of sanitation coverage and lowest levels of childhood stunting were located in the southern regions of Nigeria and Zambia. In contrast, the geographic areas with the lowest levels of sanitation coverage and highest levels of childhood stunting were located in the northern regions of Nigeria and Zambia. The study's findings suggest that improving community sanitation coverage is an important strategy for reducing childhood stunting in Nigeria and Zambia. The study's results also highlight the need for targeted interventions to improve sanitation coverage in areas with low levels of coverage and high levels of childhood stunting. The study used a geospatial modeling approach to analyze the relationship between sanitation coverage and childhood stunting. The study's geospatial modeling process involved the use of a stacked generalization approach, which combined the results of multiple models to produce a final estimate of the relationship between sanitation coverage and childhood stunting. The study also used multilevel regression analysis to examine the relationship between sanitation coverage and childhood stunting. The study's multilevel regression analysis involved the use of individual-level and community-level measures to examine the relationship between sanitation coverage and childhood stunting. The study's results are presented in a series of maps and tables that depict the geographic distribution of sanitation coverage and childhood stunting in Nigeria and Zambia. The study's maps show the proportion of clusters in each region classified by their community-improved sanitation coverage, and the prevalence of childhood stunting in each region. The study's tables present the results of the multilevel regression analysis, which examined the association between community-improved sanitation coverage and childhood stunting in Nigeria and Zambia. The study's tables also present the results of the geospatial modeling analysis, which examined the relationship between sanitation coverage and childhood stunting in Nigeria and Zambia.