Trend and predictors of unsafe child stool disposal in Ethiopia (2000-2016): pooled evidence from demographic and health survey

Abstract Background Exposure to children's stool may present a greater health risk. But, in many settings including Ethiopia children's stools often considered not harmful, and do not end up in a toilet. Even those with access to sanitation facilities often fail to use them for disposal of child feces. Importantly, Ethiopia ranked among the worst third of 38 African countries whose children feces are safely disposed of.Therefore, the study aims to determine the pooled prevalence of unsafe disposal of children's stools in Ethiopia, the predictive factors associated with it and finally it examines the trend of child stool disposal in Ethiopia.Methods The pooled data for this study obtained from the demographic and health survey (DHS) done in Ethiopia between 2000 and 2016. Descriptive statistics were computed to illustrate the given data. Binary multivariable logistic regression was employed to identify the predictors of unsafe child stool disposal.Results The pooled data contained 26,014 children's with their mother, which were included in the study. Of these, 76.1% (95%CI: 74.7-77.5) of them were unsafe child stool disposal. The trend confirms that the prevalence of unsafe child stool disposal was falling from 90.8% in 2000, to 80.4% in 2005, 65.0% in 2011, and 63.1% in 2016. In the adjusted multivariable model, being male gender [AOR: 1.15, 95%CI (1.04-1.27)], child age (children aged 13–24 months [AOR: 0.71, 95%CI (0.62-0.80)]; children aged ≥ 25 months [AOR: 0.71, 95%CI (0.61-0.81)]), mother age (mother aged 25-34 years [AOR: 0.69, 95%CI (0.61-0.79); mother aged >=35 years [AOR: 0.71, 95%CI(0.61-0.83)]), mother's working status [AOR: 0.81, 95%CI (0.72-0.91)], mother's education [AOR: 2.61, 95%CI (1.69-4.01)], residence [AOR: 2.27, 95%CI (1.79-2.89)], latrine type [AOR: 3.23, 95%CI (2.75-3.79)], and media exposure [AOR: 1.52, 95%CI (1.34-1.73)] remained strong predictors of unsafe child stool disposal.Conclusion In Ethiopia, almost three in four children's stool disposed unsafely, and maternal education and working status, children age,and type of sanitation facility were found to be predictive of unsafe child stool disposal. Thus, it is necessary to strengthen efforts focusing on child stool disposal behavioral to reduce the significant burden of unsafe child stool disposal and through careful consideration of these identified factors.