Background: In Benin, access to water, sanitation and hygiene (WASH) remains an issue. This study aims to provide an overview of household access to basic WASH services based on nationally representative data. Method: Secondary analyses were run using the ‘HOUSEHOLD’ dataset of the fifth Demographic and Health Survey 2017–2018. The dependent variables were household access to individual and combined basic WASH services. The characteristics of the household head and those related to the composition, wealth and environment of the household were independent variables. After a descriptive analysis of all study variables, multivariate logistic regression was performed to identify predictors of outcome variables. Results: The study included 14,156 households. Of these, 63.98% (95% CI = 61.63–66.26), 13.28% (95% CI = 12.10–14.57) and 10.11% (95% CI = 9.19–11.11) had access to individual basic water, sanitation and hygiene facilities, respectively. Also, 3% (95% CI = 2.53–3.56) of households had access to combined basic WASH services. Overall, the richest households and few, and those headed by people aged 30 and over, female and with higher levels of education, were the most likely to have access to individual and combined basic WASH services. In addition, disparities based on the department of residence were observed. Conclusion: The authors suggest a multifactorial approach that addresses the identified determinants.

Introduction: Sub-Saharan Africa has the highest under-five mortality rate and is among the regions where people have the least access to adequate Water, Sanitation, and Hygiene (WASH) services. The work aimed to investigate the effects of WASH conditions faced by children on under-five mortality in Sub-Saharan Africa.Methods: We carried out secondary analyses using the Demographic and Health Survey datasets of 30 countries in Sub-Saharan Africa. The study population consisted of children born within 5 years preceding the selected surveys. The dependent variable was the child’s status (1 = deceased versus 0 = alive) on the survey day. The individual WASH conditions in which children live were assessed in their immediate environment, i.e., at the level of their households of residence. The other explanatory variables were related to the child, mother, household, and environment. Following a description of the study variables, we identified the predictors of under-five mortality using a mixed logistic regression.Results: The analyses involved 303,985 children. Overall, 6.36% (95% CI = 6.24–6.49) of children died before their fifth birthday. The percentage of children living in households with access to individual basic WASH services was 58.15% (95% CI = 57.51–58.78), 28.18% (95% CI = 27.74–28.63), and 17.06% (95% CI = 16.71–17.41), respectively. Children living in households using unimproved water facilities (aOR = 1.10; 95% CI = 1.04–1.16) or surface water (aOR = 1.11; 95% CI = 1.03–1.20) were more likely to die before five than those coming from households with basic water facilities. The risk of under-five mortality was 11% higher for children living in households with unimproved sanitation facilities (aOR = 1.11; 95% CI = 1.04–1.18) than for those with basic sanitation services. We found no evidence to support a relationship between household access to hygiene services and under-five mortality.Conclusion: Interventions to reduce under-five mortality should focus on strengthening access to basic water and sanitation services. Further studies are needed to investigate the contribution of access to basic hygiene services on under-five mortality.

Background: Whether or not the Water, Sanitation and Hygiene (WASH) conditions in which children under five live determine their nutritional status is still under discussion. The work aimed to study the effects of household WASH conditions to which children under five are exposed on their nutritional status in Benin. Methods: The study utilized a cross-sectional design and consisted of secondary analyses using datasets from the fifth Demographic and Health Survey (DHS-V) conducted in Benin. Stunting, wasting and underweight were the dependent variables. The WASH conditions in which children live were evaluated in the immediate environment, i.e., at the level of their households. After describing the study variables, the relationships between the dependent variables and the exposures were checked using multivariate logistic regression. Data analysis was performed with Stata 15 and took into account the survey’s sampling design. Results: The prevalence of stunting, wasting and underweight was 31.15% (95% CI = 29.90-32.42), 4.79% (95% CI = 4.33–5.31) and 15.82% (95% CI = 14.92–16.76), respectively. The stunting odds were 1.35 (95% CI = 1.15–1.59) and 1.27 (95% CI = 1.01–1.59) times higher for children from households with no water and sanitation services, respectively, compared to children living in households with basic water and sanitation services. Children under five from households with no hygiene facilities and using limited hygiene services had 1.31 (95% CI = 1.05–1.63) and 1.35 (95% CI = 1.10–1.67) times the odds of being stunted, respectively, compared to children covered by basic hygiene facilities. There is no evidence of a significant relationship between household access to WASH and wasting in children under five. The odds of being underweight were 1.33 (95% CI = 1.02–1.72) times higher among children under five from households with limited hygiene facilities than among children from households with basic hygiene facilities. Conclusion: Interventions to fight malnutrition in children under five should include a WASH dimension.

Objective The paper aimed to study the association between household access to water, sanitation and hygiene (WASH) services and the occurrence of diarrhoea and acute respiratory infection among children under 5 years in Benin. Design We performed secondary analyses using Benin’s Fifth Demographic and Health Survey datasets. The dependent variables were diarrhoea and acute respiratory infection (yes=1, no=0). Among the independent variables were the household access to individual WASH services, grouped as follows: ‘basic’, ‘limited’, ‘unimproved’ and ‘no service’. Multivariate logistic regression was used to determine the association between household access to WASH services and the occurrence of diarrhoea and acute respiratory infection. Results from the multivariate logistic regression were presented using adjusted Odds Ratios (aORs) with 95% Confidence Intervals (95% CIs). Setting Benin. Participants Children under 5 years successfully surveyed during Benin’s Fifth Demographic and Health Survey. Outcome measures Diarrhoea and acute respiratory infection. Results In the current study, 12 034 children under 5 years met the selection criteria and were included in the analyses. The prevalence of diarrhoea and acute respiratory infection was 10.5% (95% CI=9.8% to 11.3%) and 2.9% (95% CI=2.5% to 3.4%), respectively. Children living in households without sanitation service, that is, practising open defecation (aOR=1.9, 95% CI=1.4 to 2.6), and with unimproved (aOR=1.9, 95% CI=1.3 to 2.7) and limited (aOR=1.5, 95% CI=1.1 to 2.2) services were more likely to have diarrhoea compared with children with basic sanitation services. Household access to WASH services was not associated with acute respiratory infection. Conclusion We suggest reinforcing household access to basic sanitation services to combat diarrhoea in children under 5 years. Further research is needed on the effects of WASH interventions on diarrhoea and acute respiratory infection in children under 5 years.

One of the priorities of the Immunization Agenda 2030 is to identify “zero-dose” children, and to adapt strategies in order to recover them. The study aimed to estimate the prevalence of “zero-dose” in children aged 12-23 months and determine the associated factors in Togo. This was a cross-sectional study which consisted in carrying out secondary analyzes of the databases of the Multiple Indicator Cluster Survey conducted in Togo in 2017. This study population consisted of children aged 12-23 months that had been successfully investigated during this survey. The dependent variable was the child's vaccination status (0 ="Vaccinated" vs 1 ="Zero-dose"). As for the explanatory variables, they were related to the child, the child’s mother, the household and the environment. Geospatial analyzes of child prevalence at “zero-dose” were performed using Arc GIS 10.5 software. Factors associated with “zero-dose” were identified through multivariate logistic regression. A total of 933 children under five were included in the study. The prevalence of “zero-dose” in children aged 12-23 months was 26.88% (95% CI= 23.50-30.55). We note that the factors associated with "zero-dose" in children aged 12-23 months in Togo were: the birth order of the child, the age, the level of education, the ethnicity, the religion of the head of household and the region of residence. Finally, our results can guide efforts to identify and reach children who have not received any vaccine. “Zero-dose” children can be avoided by joint interventions by the competent authorities at different levels, in particular parents, government authorities and technical and financial partners.

Introduction: With the end of the Millennium Agenda, the United Nations Member States adopted the Sustainable Development Agenda in 2015. This new agenda identifies 17 Sustainable Development Goals (SDGs) and 169 targets for 2030, including Water, Sanitation and Hygiene (WASH). Objective: To study the evolution of household access to WASH services over the last two decades in Benin and make projections for 2030. Methods: In this study, secondary analyses were performed using the datasets of the Demographic and Health Surveys in Benin from 2001 to 2017–2018. The statistical unit was the household. The achievement of the WASH SDGs targets was monitored through the proportion of households using individual basic WASH services, the proportion of households using surface water for drinking, and the proportion of households practising open defecation. The study generated Annual Percentage Changes (APCs) for outcome variables. Based on the APCs between 2001 and 2017–2018, projections were made for 2030. Results: From 2001 to 2017–2018, household access to individual basic WASH services increased from 50.54% to 63.98% (APC = +1.44%), 5.39% to 13.29% (APC = +5.62%), and 2.12% to 10.11% (APC = +9.92%), respectively. At the same time, the prevalence of surface water consumption and open defecation among households decreased from 10.54% to 5.84% (APC = -3.52%) and 67.03% to 53.91% (APC = -1.31%), respectively. If the trend observed between 2001 and 2017–2018 remains unchanged, the national coverage of households with basic individual WASH services would be 76.50%, 26.33% and 10.51%, respectively, by 2030. The prevalence of surface water consumption and open defecation among households would be 3.73% and 45.71%, respectively, by 2030. Conclusion: Benin achieved significant progress in household coverage of adequate WASH services over the last two decades. However, progress appears insufficient to achieve universal coverage of households with basic WASH services, and eliminate surface water consumption and open defecation by 2030. There is a need to strengthen research into the drivers of household access to adequate WASH services.