title: Examining the relationship between socio-economic status, WASH practices and wasting.
abstract: Childhood wasting is a global problem and is significantly more pronounced in low and middle income countries like Bangladesh. Socio Economic Status (SES) and Water, Sanitation and Hygiene (WASH) practices may be significantly associated with wasting. Most previous research is consistent about the role of SES, but the significance of WASH in the context of wasting remains ambiguous. The effect of SES and WASH on weight for length (WHZ) is examined using a Structural Equation Model (SEM) to explicitly describe the direct and indirect role of WASH in the context of SES.A nationally representative survey of 10,478 Bangladeshi children under 5 were examined. An expert defined SEM was used to construct latent variables for SES and WASH. The SEM included a direct pathway from SES to WHZ and an indirect pathway from SES to WHZ via WASH along with regression of relevant covariates on the outcome WHZ and the latent variables. Both SES (p<0.01) and WASH (p<0.05) significantly affect WHZ. SES (p<0.01) also significantly affects WASH. Other structural components showed that child's age (p<0.01) affects WHZ and types of residence (p<0.01) affects SES. WASH practices at least partially mediate the association between SES and wasting status. WASH and SES are both significantly associated with WHZ.
authors.affiliation: Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Mohammad Jyoti
authors.initials: MJ
authors.lastname: Raihan
authors.affiliation: Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Fahmida Dil
authors.initials: FD
authors.lastname: Farzana
authors.affiliation: James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.
authors.forename: Sabiha
authors.initials: S
authors.lastname: Sultana
authors.affiliation: Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Md Ahshanul
authors.initials: MA
authors.lastname: Haque
authors.affiliation: Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Ahmed Shafiqur
authors.initials: AS
authors.lastname: Rahman
authors.affiliation: Helen Keller International, Dhaka, Bangladesh.
authors.forename: Jillian L
authors.initials: JL
authors.lastname: Waid
authors.affiliation: Fogarty International Center/National Institutes of Health, Bethesda, MD, United States of America.
authors.forename: Ben
authors.initials: B
authors.lastname: McCormick
authors.affiliation: Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Nuzhat
authors.initials: N
authors.lastname: Choudhury
authors.affiliation: Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.|James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.
authors.forename: Tahmeed
authors.initials: T
authors.lastname: Ahmed
mesh_terms: D000367:Age Factors; D001459:Bangladesh; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006235:Hand Disinfection / Q000592:standards*; D006801:Humans; D006920:Hygiene / Q000592:standards*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012499:Sanitation / Q000592:standards*; D012923:Social Class; D060753:Water Quality / Q000592:standards*; D014881:Water Supply / Q000592:standards*