Beyond WASH: Testing Additional Connections Between Household Water Insecurity and Child Nutrition Outcomes in Multi-Country Contexts

Ecol Food Nutr. 2024 Jul-Aug;63(4):435-468. doi: 10.1080/03670244.2024.2366913. Epub 2024 Jun 18.

Abstract

This study identifies multiple pathways connecting household water insecurity with child nutrition. Using nationally representative samples for 18 countries, we examine the mediating role of child's dietary diversity as a function of household water status, while also accounting for sanitation. We construct a latent household water insecurity score (HWI) and use Structural Equation approach to model underlying pathways. HWI affected child's HAZ score and hemoglobin both directly and indirectly, with a mediation from child feeding alongside effects from sanitation. Broadening the conception of household water insecurity and accommodating the indirect effects of water could improve explanations of child under-nutrition.

Keywords: Anemia; dietary diversity; household water insecurity; nutrition; stunting.

MeSH terms

  • Child
  • Child Nutrition Disorders
  • Child Nutritional Physiological Phenomena
  • Child, Preschool
  • Diet
  • Family Characteristics*
  • Female
  • Humans
  • Infant
  • Male
  • Nutritional Status
  • Sanitation
  • Water Insecurity*
  • Water Supply