Sharma Anusha, Khanal Sudip, Thapa Milan, Sapkota Parash, Bhatta Anjali, Ojha Manaslu, Bhusal Rajan
School of Public Health, Patan Academy of Health Sciences, Lalitpur, Nepal.
Department of Public Health, Manmohan Memorial Institute of Health Sciences, Tribhuvan University, Kathmandu, Nepal.
BMC Public Health. 2025 May 20;25(1):1859. doi: 10.1186/s12889-025-23106-3.
Access to safe water, sanitation, and hygiene (WASH) is crucial for public health. However, women and marginalized communities in Nepal continue to face significant barriers. The Kumal community, a marginalized indigenous group traditionally known for pottery, experiences a disproportionate burden of preventable diseases like diarrhea. Due to geographical isolation, cultural practices, and limited resources, women have greater health, social, and economic impacts from inadequate water, sanitation, and hygiene services. Therefore, this study aims to assess WASH practices among women and explore factors associated with household diarrhea in the indigenous Kumal community of Nepal.
A community-based cross-sectional study was conducted from October 2022 to February 2023 among women aged 18 years and older who are mostly involved in WASH-related practices in the Kumal community of Rupa Rural Municipality, Nepal. A total of 194 Kumal households were systematically selected using a sampling frame of 325 households. Data was collected through interviews using a semi-structured questionnaire adapted from the WHO/UNICEF Joint Monitoring Program (JMP). Chi-square tests and logistic regression were performed to assess the associations between WASH practices and diarrhea prevalence, with a significance threshold set at p-value < 0.05 and 95% confidence intervals.
One-third of the participants reported at least one household member experiencing diarrhea in the past three months. Among children under 5 years, the prevalence of diarrhea was 41.7%. While 72.2% reported knowledge about preventive measures, only 1.5% knew the treatment of complications. Respondents with a monthly income of less than 15,000 NPR (AOR = 2.98, 95% CI: 1.42-6.23) and those who kept pigs as livestock (AOR = 4.44, 95% CI: 2.01-9.79) were significantly more likely to experience diarrhea than their respective counterparts. Those who washed their hands five times or less daily had a higher likelihood of experiencing diarrhea (AOR = 4.62, 95% CI: 1.96-10.87).
This study underscores the importance of WASH practices in preventing diarrhea in the Kumal community. It is crucial to address key factors like low income, livestock presence, and inadequate handwashing through targeted interventions to reduce diarrhea incidence and ultimately protect vulnerable populations.
获得安全的水、环境卫生和个人卫生（WASH）对于公众健康至关重要。然而，尼泊尔的妇女和边缘化社区仍然面临重大障碍。库马尔社区是一个边缘化的土著群体，传统上以制陶闻名，却承受着诸如腹泻等可预防疾病的不成比例的负担。由于地理隔离、文化习俗和资源有限，妇女因水、环境卫生和个人卫生服务不足而受到更大的健康、社会和经济影响。因此，本研究旨在评估尼泊尔土著库马尔社区妇女的WASH实践，并探讨与家庭腹泻相关的因素。
2022年10月至2023年2月，在尼泊尔鲁帕农村市库马尔社区对18岁及以上主要参与WASH相关实践的妇女进行了一项基于社区的横断面研究。使用325户家庭的抽样框架系统地选取了总共194户库马尔家庭。通过访谈收集数据，并使用了根据世界卫生组织/联合国儿童基金会联合监测计划（JMP）改编的半结构化问卷。进行卡方检验和逻辑回归以评估WASH实践与腹泻患病率之间的关联，显著性阈值设定为p值<0.05和95%置信区间。
三分之一的参与者报告称，在过去三个月中至少有一名家庭成员患腹泻。在5岁以下儿童中，腹泻患病率为41.7%。虽然72.2%的人报告了解预防措施，但只有1.5%知道并发症的治疗方法。月收入低于15000尼泊尔卢比的受访者（调整后比值比[AOR]=2.98，95%置信区间：1.42 - 6.23）以及饲养猪作为家畜的受访者（AOR = 4.44，95%置信区间：2.01 - 9.79）比各自的对照组患腹泻的可能性显著更高。那些每天洗手五次或更少的人患腹泻的可能性更高（AOR = 4.62，95%置信区间：1.96 - 10.87）。
本研究强调了WASH实践在预防库马尔社区腹泻方面的重要性。通过有针对性的干预措施解决低收入、饲养家畜和洗手不足等关键因素对于降低腹泻发病率并最终保护弱势群体至关重要。
