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. 2024 Jul;20(3):e13642.
doi: 10.1111/mcn.13642. Epub 2024 Apr 2.

Children with disabilities lack access to nutrition, health and WASH services: A secondary data analysis

Isabel Rice  1 , Charles Opondo  2 , Lydia Nyesigomwe  3 , Daniel Ekude  3 , Julius Magezi  3 , Andrew Kalanzi  3 , Marko Kerac  1   4 , Julia Hayes  5 , Malia Robello  5 , Sarah Halfman  5 , Emily DeLacey  1   4   5
Affiliations

Children with disabilities lack access to nutrition, health and WASH services: A secondary data analysis

Isabel Rice et al. Matern Child Nutr. 2024 Jul.

Abstract

Malnutrition and disability are major global public health problems. Poor diets, inadequate access to nutrition/health services (NaHS), and poor water, sanitation and hygiene (WASH) all increase the risk of malnutrition and infection. This leads to poor health outcomes, including disability. To better understand the relationship between these factors, we explored access to NaHS and household WASH and dietary adequacy among households with and without children with disabilities in Uganda. We used cross-sectional secondary data from 2021. Adjusted logistic regression was used to explore associations between disabilities, access to NaHS, WASH and dietary adequacy. Of the 6924 households, 4019 (57.9%) reported having access to necessary NaHS, with deworming and vaccination reported as both the most important and most difficult to access services. Access to services was lower for households with children with disabilities compared to those without, after adjusting for likely confounding factors (Odds ratio = 0.70; 95% CI 0.55-0.89, p = 0.003). There is evidence of an interaction between disability and WASH adequacy, with improved WASH adequacy associated with improved access to services, including for children with disabilities (interaction odds ratio = 1.12, 95% CI: 1.02-1.22, p = 0.012). The proportion of malnourished children was higher among households with children with disabilities than households without it (6.3% vs. 2.4% p < 0.001). There are concerning gaps in access to NaHS services in Uganda, with households with children with disabilities reporting worse access, particularly for those with low WASH adequacy. Improved and inclusive access to NaHS and WASH needs to be urgently prioritized, especially for children with disabilities.

Keywords: WASH; child nutrition; dietary adequacy; disability; health access; nutrition and health services.

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Conflict of interest statement

E. D., J. H., L. N., D. E., J. M., A. K., M. R. and S. H. work for Holt International.

Figures

Figure 1
Figure 1
Data flow chart indicating the number of households included in the analysis.
Figure A1
Figure A1
Directed acyclic graph exploring the relationship between child disability and access to nutrition and health services with other factors green circles indicate an ancestor of the exposure on the causal pathway. White circles indicate adjusted variables. Purple arrows indicate a causal pathway. Pink circles indicate an ancestor of both the exposure and outcome, thus on the causal pathway.
See this image and copyright information in PMC

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