Burden and determinants of diarrhoea, and health seeking behaviour amongst under-five children in India: evidence from National Family Health Survey-5

Diarrhoeal diseases remain a significant public health concern globally, particularly among under-five children. Understanding the factors influencing diarrhoea prevalence and treatment practices is crucial for improving child health outcomes. Hence, this study aimed to assess the burden, determinants, and management practices of diarrhoeal diseases among under-five children in India. We conducted a secondary data analysis of NFHS-5, covering 707 districts across India. The survey employed a stratified two-stage sampling method, and analysis included 186 920 under-five children. Poisson regression was utilized for identifying determinants of diarrhoeal burden and health-seeking behaviour and reported as adjusted prevalence ratio with 95% confidence interval. Prevalence of diarrhoea in under-five children has decreased from 9.5% in 2015-16 to the current estimate of 7.5% in 2019-21. Health seeking behaviour for diarrhoea has changed from 76.2% in 2015-16 to 76.8% in 2019-21. Age, gender, birth weight, malnutrition, maternal age, and education level were significantly associated with diarrhoea prevalence. Geographical region and wealth index influenced health-seeking behaviour towards diarrhoeal illness. The study shows a marginal decline in the diarrhoeal prevalence among children under-five years in India. Key determinants identified highlight the critical areas where targeted interventions are urgently needed.