Abstract of Master’s Dissertation
No.1
CourseInternational Health Development (MPH)

NameKYAW THU

Determinants of safe stool disposal among children under five years in Myanmar
ThesisTitle

and its association with childhood diarrhoea: Secondary analysis of Myanmar
Demographic and Health Survey 2015-2016

Background: Proper child stool disposal is crucial to prevent the spread of faecal-oral diseases.
However, in Myanmar, people allegedly believe children's stools are not hazardous, overlook
managing them, and there are no studies regarding child stool disposal. Therefore, this studyaimed to explore the determinants of safe stool disposal among children under five years inMyanmar and the association between safe stool disposal and childhood diarrhoea.
Objectives: Two specific objectives of the study were to identify the factors associated withsafe stool disposal and to investigate the association between safe stool disposal and childhood
diarrhoea among children under five years in Myanmar.
Methods: With the authorization of the DHS program, using the Myanmar Demographic andHealth Survey (2015-2016) dataset, this analysis was conducted among 3498 children underfive years living with their mothers. Univariable and multivariable logistic regressions wereemployed in STATA to determine the factors associated with safe stool disposal and theassociation between safe stool disposal and childhood diarrhoea.
Results: The proportion of safe stool disposal among children was 62.44% (95%CI:60.2964.58). Among children who practised safe stool disposal, 9.42% (95%CI:7.94-11.14) and12.37% (95%CI:10.38-14.68) of children who practised unsafe stool disposal got diarrhoea.
Multivariable analysis for stool disposal revealed that children whose mothers were aged 15-24(AOR:0.68, 95%CI:0.52-0.88) and uneducated (AOR:0.65, 95%CI:0.47-0.89) and children
aged 0-5 months (AOR:0.18, 95%CI:0.12-0.26), 6-23 months (AOR:0.42, 95%CI:0.34-0.53),
breastfeeding children (AOR:0.50, 95%CI:0.40-0.62) and children who were from rural areas(AOR:0.72, 95%CI:0.56-0.94), coastal zones (AOR:0.29, 95%CI:0.21-0.41), hilly or
mountainous regions (AOR:0.55, 95%CI:0.41-0.74), dry zones (AOR:0.52, 95%CI:0.39-0.68),
poor families (AOR:0.73, 95%CI:0.58-0.93), families using unimproved toilets (AOR:0.75,95%CI:0.62-0.93), families with lack of water at handwashing places or no handwashing places(AOR:0.68, 95%CI:0.50-0.93) and large families (AOR:0.82, 95%CI:0.68-0.93) were lesslikely to practise safe stool disposal.

Abstract of Master’s Dissertation
No.2
CourseInternational Health Development (MPH)

NameKYAW THU

Multivariable analysis for diarrhoea ascertained that children who practised safe stool disposal
were less likely to develop diarrhoea (AOR:0.56, 95%CI:0.36-0.89), and the odds of diarrhoea
were higher among children who were aged 6-23 months (AOR:2.43, 95%CI:1.48-4.00),
children whose mothers were working (AOR:1.44, 95%CI:1.07-1.95), children who were fromhilly or mountainous areas (AOR:1.80, 95%CI:1.21-2.69), poor families (AOR:1.46,95%CI:1.08-1.97), families using piped water or rainwater (AOR:1.67, 95%CI:1.04-2.69),
families with only one child at home (AOR:1.60, 95%CI:1.16-2.20), and children whose wellbeing was decided by the mother or father alone (AOR:1.49, 95%CI:1.12-1.97). As safe stool
disposal interacted with breastfeeding, among children who practised safe stool disposal,
breastfeeding children had 2.05 odds of diarrhoea (95%CI:1.20-3.51), and non-breastfeedingchildren had 0.49 (95%CI:0.28-0.84).
Conclusion: The individual factors significantly associated with safe stool disposal werechildren under two, breastfeeding children, younger mothers, and uneducated mothers, while
the contextual features were large families, unimproved toilets, lack of water at handwashingplaces or no handwashing places, rural areas, and geographical zones. Safe stool disposal wasstrongly associated with childhood diarrhoea. To promote safe stool disposal and reducechildhood diarrhoea, sanitation programs in Myanmar should pay attention to child stool
disposal. Further longitudinal studies are recommended to determine the pathway andmagnitude of the association between safe stool disposal and childhood diarrhoea.
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