Unsafe child feces disposal status in Ethiopia: what factors matter? analysis of pooled data from four demographic and health surveys

Abstract Background: Unsafe child feces disposal has compounding effects on children’s wellbeing. In Ethiopia and many other countries, still, there is a common misconception that children’s feces are not harmful, and not end up in a toilet. Objective: The study aims to determine the magnitude and factors associated with unsafe child feces disposal in Ethiopia. Methods: The study is cross-sectional in nature and the analysis was based on data from 1st to 4th rounds of the population-based Ethiopian Demographic and Health Survey (EDHS) conducted between 2000 and 2016. Descriptive statistics were computed to illustrate the given data. Multivariable logistic regression was performed, adjusted odds ratio (AOR) with a 95% confidence interval (CI) were used to identify factors associated with unsafe child feces disposal. Results: The pooled dataset contained information on 40,520 children younger than 5 years, male accounts 20,629 (50.9%). Overall, 77.7% (95%CI: 76.3-79.0) of children feces disposed of unsafely. In the multivariable logistic regression model, those mothers whose child was 13-24 months AOR: 0.68, 95% CI: (0.60-0.78) and ≥ 25 months AOR: 0.66, 95% CI: (0.60-0.72) were lower odds of unsafe child’s feces disposal. Children born into households having two or fewer children were 33% lower AOR: 0.67, 95% CI: (0.56-0.79) odds of unsafe child’s feces disposal than their counterparts. The odds of disposing of feces unsafely among households having improved toilet facility was 76% lower AOR: 0.24, 95% CI: (0.19-0.29) that of households lacking such facilities. Being an urban resident, having improved drinking water facility, a high level of maternal and paternal education, paternal occupational status (work in non-agriculture), and maternal age were factors associated with lower odds of unsafe child's feces disposal. Conclusions: Three in four Ethiopian children feces disposed of unsafely. Unsafe child feces disposal is less prevalent among households that had improved water and toilet facility, those in urban areas, those with older children, those with a high level of maternal and paternal education, and those with a lower number of under-five children. There is a need for more attention to be paid to curtail the significant burden of unsafe child feces disposal in Ethiopia.