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Table 5 Trend in WASH, IYCF and child disease prevention and management in the Karnali Zone of Nepal after controlling for confoundersa, 2009-2015

From: The impact of unconditional child cash grant on child malnutrition and its immediate and underlying causes in five districts of the Karnali Zone, Nepal – A trend analysis

Variables 2009 (Ref.) Dolpa AOR(95%CI) Jumla AOR (95%CI) Mugu AOR(95%CI) Humla AOR(95%CI) Kalikot AOR(95%CI) Karnali Zone AOR(95%CI)
2013 2015 2013 2015 2013 2015 2013 2015 2013 2015 2013 2015
Water and sanitation
‘Unimproved’ drinking water sources b 1 0.05***
(0.03-0.07)
0.13***
(0.09-0.18)
0.27**
(0.12-0.61)
1.08
(0.57-2.07)
1.26
(0.88-1.80)
0.60
(0.33-1.09)
1.99**
(1.34-2.94)
0.24***
(0.15-0.40)
0.08***
(0.05-0.125)
0.22***
(0.16-0.30)
0.36***
(0.30-0.42)
0.29***
(0.24-0.34)
‘Inadequate’ water treatment method b 1 2.05***
(1.38-3.04)
12.61***
(7.69-20.66)
1.15
(0.62-2.14)
0.91
(0.54-1.53)
2.53*
(1.24-5.17)
0.46*
(0.22-0.96)
0.89
(0.55-1.45)
0.94
(0.56-1.57)
1.24
(0.64 -2.40)
1.12
(0.64-1.95)
1.76***
(1.40-2.23)
1.85***
(1.47-2.33)
‘Unimproved’ sanitation facilities b 1 0.37***
(0.26-0.53)
0.02***
(0.02-0.03)
0.01***
(0.01-0.02)
0.06***
(0.04-0.10)
0.01***
(0.003-0.01)
0.00***
(0.00-0.00)
0.06***
(0.04-0.09)
0.02***
(0.01-0.03)
0.02***
(0.01-0.03)
0.02***
(0.01-0.03)
0.04***
(0.04-0.05)
0.02***
(0.02-0.03)
‘Unsanitary’ disposal of children’s faeces b 1 0.15***
(0.11-0.21)
0.12***
(0.09-0.16)
0.13***
(0.09-0.19)
0.15***
(0.11-0.21)
0.21***
(0.15-0.28)
0.14***
(0.09-0.21)
0.51***
(0.39-0.66)
0.18***
(0.13-0.24)
0.04***
(0.02-0.05)
0.06***
(0.04-0.08)
0.18***
(0.16-0.21)
0.13***
(0.11-0.15)
IYCF Practices
Early initiation of breastfeeding b 1 4.54***
(2.81-7.33)
1.67*
(1.11-2.51)
1.12
(0.64-1.95)
1.94**
(1.18-3.17)
0.57**
(0.38-0.86)
1.00
(0.53-1.90)
0.46***
(0.31-0.69)
0.73
(0.45-1.16)
3.09***
(1.95-1.90)
1.71**
(1.17-2.51)
1.17
(0.97-1.40)
1.28**
(1.06-1.55)
Bottle feeding b 1 1.47
(0.57-3.78)
8.25***
(3.75-18.16)
8.92**
(1.75-45.05)
40.00***
(7.54-153.20)
13.86***
(5.24-36.68)
19.75***
(6.43-60.70)
8.64***
(2.67-28.00)
29.39***
(9.02-95.73)
5.49***
(2.33-12.94)
2.47*
(1.07-5.69)
11.47***
(6.56-20.04)
24.72***
(14.22-42.97)
Prevalence
Diarrhoea b 1 0.83
(0.54-1.26)
0.35***
(0.23-0.52)
0.57
(0.32-1.02)
0.39***
(0.24-0.64)
4.27***
(2.43-7.51)
5.94***
(2.64-13.35)
0.82
(0.54-1.24)
0.60*
(0.38-0.94)
2.60**
(1.42-4.75)
1.50
(0.90-2.50)
1.11
(0.91-1.36)
0.80*
(0.66-0.98)
Pneumonia b 1 1.83**
(1.18-2.82)
3.06***
(2.02-4.63)
3.11***
(1.69-5.73)
9.53***
(5.48-16.58)
1.26
(0.76-2.09)
0.52
(0.25-1.12)
1.52
(0.96-2.40)
4.03***
(2.48-6.54)
1.06
(0.59-1.90)
3.41***
(2.10-5.56)
1.79***
(1.46-2.21)
2.79***
(2.28-3.42)
Fever b 1 0.81
(0.54-1.21)
1.20
(0.82-1.75)
0.96
(0.54-1.71)
1.10
(0.68-1.80)
1.23
(0.74-2.05)
1.38
(0.65-2.91)
1.19
(0.79-1.80)
1.84**
(1.18-2.88)
1.29
(0.74-2.25)
2.70***
(1.67-4.27)
1.07
(0.88-1.30)
1.42***
(1.17-1.72)
Action taken
Sought advice b 1 2.44***
(1.79-3.32)
1.46*
(1.09-1.94)
1.89**
(1.30-2.73)
2.04***
(1.47-2.82)
1.98***
(1.37-2.87)
2.93)***
(1.77-4.85
2.01***
(1.51-2.67)
2.69***
(1.99-3.64)
2.60***
(1.77-3.81)
5.06***
(3.63-7.04)
1.93***
(1.68-2.23)
2.55***
(2.21-2.93)
More fluid b 1 5.08***
(2.03-12.72)
1.66
(0.64-4.33)
1.15
(0.39-3.34)
3.17*
(1.32-7.60)
3.43*
(1.08-10.93)
2.00
(0.48-8.31)
1.22
(0.57-2.61)
1.23
(0.56-2.68)
1.91
(0.72-5.10)
2.03
(0.87-4.75)
2.37***
(1.57-3.58)
2.32***
(1.54-3.48)
More food# 1 6.32**
(1.69-23.74)
3.63
(0.94-14.04)
1.99
(0.47-8.43)
3.29
(0.90-12.07)
13.10*
(1.61-106.37)
12.95*
(1.09-153.58)
0.46
(0.10-2.19)
1.06
(0.27-4.19)
1.00
(0.08-11.95)
4.34
(0.50-37.87)
2.59**
(1.37-4.92)
2.55**
(1.36-4.79)
More breastfeeding b 1 4.26***
(2.33-7.80)
3.14***
(1.83-5.37)
77.03*** (a)
(29.37-202.03)
21.21***
(10.16-44.26)
2.25*
(1.14-4.47)
1.23
(0.48-3.14)
1.39
(0.81-2.39)
2.84***
(1.58-5.10)
9.77***
(4.22-22.63)
7.38***
(3.53-15.45)
4.19***
(3.22-5.45)
3.91 ***
(3.03-5.05)
Prevention
Deworming b 1 4.20***
(2.24-7.87)
1.58
(0.85-2.65)
0.92
(0.37-2.32)
0.85
(0.37-1.93)
0.06***
(0.03-0.14)
0.29
(0.08-1.07)
2.14*
(1.18-3.89)
6.35***
(2.99-13.49)
0.78
(0.39-1.53)
1.01
(0.54-1.90)
0.93
(0.69-1.24)
1.39*
(1.03-1.88)
Iodised salt b 1 1.34
(0.84-1.83)
5.42***
(3.46-8.49)
0.90
(0.53-1.55)
1.71
(0.95-3.09)
1.65**
(1.24-2.19)
3.51***
(2.22-5.54)
0.77
(0.55-1.08)
3.56***
(2.09-6.08)
0.49***
(0.36-0.66)
0.68**
(0.53-0.87)
0.90
(0.77-1.05)
1.67***
(1.42-1.96)
  1. AOR adjusted odds ratio, CI confidence interval, Ref reference. b Two-level GLMMs with binominal link; # Two-level GLMMs with Poisson link
  2. aAdjusted for child age and gender, father and mother’s educational attainment, household wealth index, caste/ethnicity, expected food shortage, family size, and clustering of children within wards
  3. (a) The large AOR and its 95%CI are due to small sample sizes and the variance in data at each measurement time
  4. *p<0.05; ** p<0.01; ***p<0.001