valentineghanem-bit/wash-child-health-ghana-261districts

Spatial ML mediation analysis: WASH determinants of childhood diarrhoea and under-five mortality across Ghana 261 districts. DHS 2022 + GSS 2021 Census + Baron-Kenny mediation with 1000-bootstrap CIs # WASH Determinants of Child Health, Ghana 261 Districts: A Spatial Machine-Learning Mediation Analysis **Author:** Valentine Golden Ghanem | Ghana COCOBOD Cocoa Clinic, Accra, Ghana **ORCID:** 0009-0002-8332-0220 **Affiliation:** Ghana COCOBOD Cocoa Clinic, Accra, Ghana **Reporting standard:** STROBE · RECORD-Spatial · TRIPOD+AI **Date:** 2026 **Status:** Manuscript in preparation --- ## 1. Abstract This study quantifies the direct and indirect (diarrhoea-mediated) pathways through which water, sanitation, and hygiene (WASH) access affects under-five mortality (U5MR) across Ghana's 261 health districts. Spatial autocorrelation analysis reveals strong clustering of U5MR (Global Moran's I = 0.83, p DHS data accessed under standard DHS Programme Data Use Agreement. No individual participant data redistributed. --- ## 5. Key Findings | Metric | Value | |--------|-------| | U5MR Global Moran's I | 0.83 (z = 20.69, p **Tip:** The dashboard works fully offline once downloaded. The poster is print-ready at A0 (841 × 1189 mm). --- ## 9. Reporting Standard This study follows the **STROBE** (Strengthening the Reporting of Observational Studies in Epidemiology) reporting guideline for observational ecological studies. Machine learning components follow **TRIPOD+AI**; spatial statistical components follow **RECORD-Spatial**. --- ## 10. Ethical Statement This study analyses publicly released aggregate data from the Ghana Demographic and Health Survey 2022 (ICF International) and the Ghana Statistical Service 2021 Population and Housing Census. No individual participant data were accessed. All inputs are de-identified district and regional summary statistics. Ethical review was not required for analysis of publicly available aggregate statistics; DHS data were accessed under the standard DHS Programme Data Use Agreement. --- ## 11. Citation **APA:** Ghanem, V. G. (2026). *WASH Determinants of Child Health, Ghana 261 Districts: A Spatial Machine-Learning Medi …