Effect of Water, Sanitation and Hygiene Educational Intervention on Incidence of Diarrhea and Childhood Stunting Among Under Five Children in Bule Hora Wereda, Southern Ethiopia

Background: Childhood malnutrition and diarrhea remains life-threatening, yet these conditions are preventable. Water, Sanitation, and Hygiene (WASH) interventions are among the most effective measures against diarrhea and stunting. Objective: To evaluate the effect of WASH education intervention on incidence of diarrhea and childhood stunting among under-five children in Southern Ethiopia. Methods: A Community based cluster randomized controlled trial was conducted in Bule Hora Woreda, West Guji Zone, Southern Ethiopia from November 1, 2024 - April 30, 2025. A total sample of 26 clusters (13 intervention groups and 13 control groups) were randomly selected and assigned to the intervention and control groups. Diarrhea incidence was measured through caregiver reporting of diarrheal episodes over 2 weeks for 6 month. Stunting was assessed using standardized anthropometry and calculated height-for-age Z-scores based on WHO growth standards. Generalized estimating equation with log link Poisson distribution family was used to assess the effect of intervention after adjusting for potential confounders.

* A household that have at least one child aged 6-59 months living in the home * Not a model household