Environmental factors associated with diarrhoea prevalence among children under five years in Mathare informal settlement, Nairobi County

Abstract

Background: Diarrhea is the second leading cause of death globally among children under five. Nairobi County has reported 136,028  cases of diarrhearelated illnesses, with a large number occurring in informal settlements. This study assesses environmental factors  associated with diarrhea prevalence among children under five in Nairobi’s Mathare informal settlement.
Methods: This cross-sectional study employed both quantitative and qualitative data collection methods. The study was conducted in 13 villages of Mathare, targeting 218 main caregivers. A multistage sampling approach was used, combining purposive, stratified, and  simple random sampling. Descriptive statistics were used to analyze environmental factors.
Results: Among 173 caregivers surveyed, 88% were female, mostly aged 20-29 years. Nearly half (49%) had only primary education, and  95% earned 1,000 Kenyan shillings or less monthly, reflecting high poverty levels. Significant environmental factors associated with  diarrhea included water sources, sanitation practices, and waste disposal. Households using tap water had a 2.97- fold higher risk of  diarrhea compared to those relying on vendors. Poor waste disposal and lack of alternative water sources further exacerbated diarrhea incidence. Key informant interviews highlighted poor sanitation, overcrowding, and limited healthcare access as critical issues. Despite  public health efforts, there is a need for improved infrastructure, healthcare services, and community health support.
Conclusion: To reduce diarrhea prevalence in informal settlements, health programs should focus on improving environmental  conditions, particularly water supply and sanitation.