Effects of Community-Led Total Sanitation (CLTS) Boosting and Household Factors on Latrine Ownership in Siaya County, Kenya.

Community-led total sanitation (CLTS) is a widely used approach for enhancing sanitation practices. However, the impact of boosted CLTS on household latrine ownership has not been adequately evaluated. This study aims to investigate the factors associated with latrine possession among households, with a specific focus on single and CLTS-boosting implementation. A community-based repeated cross-sectional study was conducted in Siaya County, Kenya, involving 512 households at the baseline and 423 households at the follow-up. Data were analyzed using the mixed-effects logistic regression model. At the baseline, latrine possession was significantly associated with CLTS implementation (adjusted OR [aOR]: 3.01; 95% confidence interval [CI]: 1.41-6.44), literacy among households (aOR: 1.83; 95% CI: 1.12-2.98) and higher socioeconomic status (SES) (second level: aOR: 2.48; 95% CI:1.41-4.36, third level: aOR: 3.11; 95% CI: 1.76-5.50, fourth level: aOR: 10.20; 95% CI: 5.07-20.54). At follow-up, CLTS boosting (aOR: 7.92; 95% CI: 1.77-35.45) and a higher SES were associated with increased latrine ownership (second level: aOR: 2.04; 95% CI: 0.97-4.26, third level: aOR: 7.73; 95% CI: 2.98-20.03, fourth level: aOR: 9.93; 95% CI: 3.14-28.35). These findings highlight the significant role played by both single and CLST boosting in promoting universal latrine ownership and empowering vulnerable households to understand the importance of sanitation and open defecation-free practices.

Improvement of Dietary Diversity and Attitude toward Recommended Feeding through Novel Community Based Nutritional Education Program in Coastal Kenya-An Intervention Study.

Community-based nutritional intervention to improve the practice of dietary diversity and child nutrition by community health workers (CHWs) involving Nyumba Kumi as small neighborhood units (SNUs) in communities has not yet been explored. This study was conducted in two villages in rural Kenya between 2018 and 2019. In total, 662 participants (control vs. intervention: n = 339 vs. n = 323) were recruited. The intervention group received education on maternal and child nutrition and follow-up consultations. The custom-tailored educational guidelines were made based on Infant and Young Child Feeding and the mother and child health booklet. The educational effects on household caregivers' feeding practice attitude and child nutritional status were analyzed using multiple linear regression. After the intervention, a total of 368 household caregivers (187 vs. 181) and 180 children (113 vs. 67) were analyzed separately. Between the groups, no significant difference was found in their background characteristics. This study successfully improved the dietary diversity score (ß = 0.54; p < 0.01) and attitude score (ß = 0.29; p < 0.01). The results revealed that the interventions using CHWs and SNUs were useful to improve dietary diversity and caregivers' attitudes toward recommended feeding. This research has the potential to be successfully applied in other regions where child undernutrition remains.

Correlates of exclusive breastfeeding practices in rural and urban Niger: a community-based cross-sectional study.

Background: Exclusive breastfeeding (EBF) can prevent death and disease among young children. The proportion of EBF is low in Niger. This study aimed to identify the prevalence and correlates of exclusive breastfeeding. Methods: We conducted a community-based cross-sectional study in urban and rural areas of Niger among mothers of infants under 7 months old. We used a structured questionnaire to investigate breastfeeding practices, sociodemographic factors, and health service use. We used multivariate analysis to explore the correlates of EBF since birth. Results: The study involved 234 urban and 283 rural mothers. Colostrum was almost universally given to newborns (98.7% [231/234] urban and 97.9% [277/283] rural) and many mothers started breastfeeding within an hour of giving birth (69.2% [162/234] and 90.5% [256/283]). The proportion of EBF since birth in urban and rural areas was 15.8% (37/234) and 54.4% (154/283), respectively. Among mothers who had ceased EBF, proportion of prelacteal feeding was 85.3% (168/197) in urban areas and 62.0% (80/129) in rural areas, while 93.4% (183/196) and 72.7% (88/121) had stopped EBF within 1 week after birth respectively. The median duration of EBF was 1 week in urban and 2 months in rural areas. In urban areas, EBF was more likely in mothers with infants 3 months old or younger (Adjusted Odds Ratio [AOR] 2.78; 95% Confidence Interval 95% [CI] 1.07, 7.21) and problems with delivery including Caesarean section (AOR 3.60; 95% CI 1.17, 11.01). In rural areas, lower socioeconomic status (AOR 1.89; 95% CI 1.12, 3.18), early initiation of breastfeeding (AOR 4.04; 95% CI 1.50, 10.83) and delivery assisted by a traditional birth attendant (AOR 3.49; 95% CI 1.37, 8.89) were correlated with exclusive breastfeeding. Conclusions: Exclusive breastfeeding was uncommon. Most mothers ceased EBF within 1 week after birth. Adequate information about EBF by health professionals around delivery seems to encourage its use. To encourage EBF in Niger, it is important to educate health professionals, including traditional birth attendants, and enable them to discuss the practice with mothers through individual counselling or group education.