Underweight associated with water, sanitation, and hygiene among women of reproductive age in Arba Minch Health and Demographic Surveillance Site, Southern Ethiopia

Ethiopia is one of the sub-Saharan African countries where underweight among women of reproductive age is high, and it is predisposing to low birth weight, preterm birth, and reduced resistance to infections. Poor water, sanitation, and hygiene (WASH) and drinking water polluted with disease-causing microorganisms lead to undernutrition. Therefore, this study aimed to assess the association between WASH and underweight among women of reproductive age at Arba Minch Health and Demographic Surveillance Site (HDSS), Southern Ethiopia. A community-based cross-sectional study was conducted at Arba Minch HDSS, South Ethiopia, from April to May 2022. Women of reproductive age were included in the study. Data were collected using a pre-tested questionnaire and checklist. Multivariate analysis was conducted to assess the association separately for WASH indicators with underweight status of the women by adjusting for sociodemographic characteristics. Adjusted Odds Ratio (AOR) with a 95% confidence interval was used to assess the association. The prevalence of underweight and overweight/obesity among women of reproductive age was 7.82% (95% CI: 5.60, 10.81) and 12.32% (95% CI: 9.50, 15.83), respectively. Latrine hygiene and use were significantly associated with being underweight. The odds of being underweight among those who use clean latrine were 0.43 (95% CI: 0.20, 0.92) compared to those who use unclean latrine or do not have toilet facilities. The utilization of clean latrine facilities is negatively associated with being underweight among women of reproductive age. From WASH components, latrine utilization and keeping the latrine clean to use need to get focused on reducing the risk of being underweight among women of reproductive age. The prevalence of underweight, overweight, and obesity was 7.82% (95% CI: 5.60, 10.81) and 12.32% (95% CI: 9.50, 15.83), respectively. The odds of being underweight among those who use clean latrine were reduced by 57% (AOR = 0.43; 95% CI: 0.20, 0.92) compared to those who use unclean latrine or do not have toilet facilities. Latrine utilization and keeping the latrine clean to use need to be focused on reducing the risk of being underweight among women of reproductive age.image