Lado Emmanuel Pitia Zacharia, Awiti Japheth Osotsi, Mwai Daniel
Department of Economics, University of Juba, Juba, SSD.
Department of Economics, University of Nairobi, Nairobi, KEN.
Cureus. 2025 Apr 7;17(4):e81829. doi: 10.7759/cureus.81829. eCollection 2025 Apr.
South Sudan has higher rates of under-five morbidity and mortality compared to other countries in the African region. Diarrhea is one of the major causes of death among children under five, both globally and in South Sudan. One of the main factors contributing to diarrheal infections, especially among young children, is the source of drinking water. This paper aims to establish the effect of drinking water sources on diarrheal morbidities among children under five in South Sudan.
Using the Second South Sudan Household Survey data, the study employed a logistic regression model to gauge the effect of drinking water sources on the health of under-five children in South Sudan. In the investigation, under-five child health was proxied by diarrheal infection in under-five children. To account for potential endogeneity and unobserved heterogeneity in the model, the research employed the two-stage residual inclusion (2SRI) procedure and control function approach, respectively.
The outcomes show that out of the sample of 6,307 children, 1,561 (24.75%) had diarrhea two weeks before the survey, and 1,567 (24.85%) belonged to households using improved drinking water sources. The logistic regression result shows that the drinking water sources variable has an average marginal effect (AME) of about -0.04 and a Z-statistic of -2.72 (P-value = 0.006). This means an improved drinking water source reduces the probability of diarrheal infections among children under five. The control variables comprising the residence of the under-five children and gender of the under-five children have been weakly significant at 10%. The residence of the under-five has a coefficient of about 0.02 with a Z-statistic of 1.65 (P-value = 0.099), while the gender of the under-five child has a coefficient of about -0.02 with a Z-statistic of -1.87 (P-value = 0.062). Since the P-values are greater than 0.05, the two variables are considered to have no effect on diarrheal infections among children under five years of age. The other control variables, namely water treatment, education of head of household, mother's age, number of under-five children, under-five child age, wealth score, and time spent on fetching water, were all insignificant.
Given the result of the study, it can be concluded that drinking water sources significantly determine diarrheal illnesses among children under the age of five in South Sudan. Therefore, the population needs to use potable water sources that are protected and monitored. Furthermore, additional efforts are needed to ensure access to clean water for all citizens. Providing safe drinking water from improved sources would help reduce the prevalence of diarrheal diseases and improve overall public health in the country. The strength of the investigation is that it includes a large, diverse sample of 6,307 children from all ten of the country states with different access to water sources, ensuring the findings are generalizable to a broader population. This large sample size helps account for regional variations in water quality and infrastructure, increasing the reliability and external validity of the study's results. However, the research has limitations, highlighting the necessity for a new study utilizing updated data (when available) and a composite index between drinking water sources and sanitation.
与非洲地区其他国家相比,南苏丹五岁以下儿童的发病率和死亡率更高。腹泻是全球和南苏丹五岁以下儿童死亡的主要原因之一。导致腹泻感染的主要因素之一,尤其是在幼儿中,是饮用水源。本文旨在确定饮用水源对南苏丹五岁以下儿童腹泻发病率的影响。
该研究使用第二次南苏丹家庭调查数据,采用逻辑回归模型来衡量饮用水源对南苏丹五岁以下儿童健康的影响。在调查中,五岁以下儿童的健康状况通过五岁以下儿童的腹泻感染情况来衡量。为了解决模型中的潜在内生性和未观察到的异质性问题,研究分别采用了两阶段残差纳入(2SRI)程序和控制函数方法。
结果显示,在6307名儿童的样本中,1561名(24.75%)在调查前两周患有腹泻,1567名(24.85%)属于使用改善饮用水源的家庭。逻辑回归结果表明,饮用水源变量的平均边际效应(AME)约为-0.04,Z统计量为-2.72(P值=0.006)。这意味着改善饮用水源可降低五岁以下儿童腹泻感染的概率。包括五岁以下儿童的居住地和五岁以下儿童的性别在内的控制变量在10%的水平上具有微弱的显著性。五岁以下儿童的居住地系数约为0.02,Z统计量为1.65(P值=0.099),而五岁以下儿童的性别系数约为-0.02,Z统计量为-1.87(P值=0.062)。由于P值大于0.05,这两个变量被认为对五岁以下儿童的腹泻感染没有影响。其他控制变量,即水处理、户主教育程度、母亲年龄、五岁以下儿童数量(应为“五岁以下儿童数量”)、五岁以下儿童年龄、财富得分和取水时间,均不显著。
根据研究结果,可以得出结论,饮用水源显著决定了南苏丹五岁以下儿童的腹泻疾病。因此,民众需要使用受保护和监测的饮用水源。此外,还需要做出额外努力,以确保所有公民都能获得清洁水。提供来自改善水源的安全饮用水将有助于降低腹泻疾病的患病率,并改善该国的整体公共卫生状况。该调查的优势在于,它包括了来自该国所有十个州的6307名儿童的大型多样样本,这些儿童获得水源的情况各不相同,确保了研究结果能够推广到更广泛的人群。这个大样本量有助于考虑水质和基础设施的区域差异,提高研究结果的可靠性和外部有效性。然而,该研究存在局限性,这凸显了利用更新数据(如有)以及饮用水源与卫生设施之间的综合指数进行新研究的必要性。 (注:原文中“number of under-five children”重复出现且表述有误,翻译时按正确理解翻译为“五岁以下儿童数量”)