Impact of Drinking Water and Sanitation Facilities on Child Mortality in Sierra Leone

Water, sanitation, and hygiene (WASH) are viewed as key contributors to the high rates of under-5 child deaths in sub-Saharan Africa. In one of the countries in the region, Sierra Leone, there was an absence of studies on the potential impacts of WASH on child mortality. The purpose of this quantitative study was to examine how variables related to access to toilet facilities and safe drinking water in rural and urban areas of Sierra Leone impact child mortality. Secondary data from the United Nations Children's Fund 2017 Multiple Indicator Cluster Survey (N = 18,006) were analyzed as part of this cross-sectional study. The impact of demographic variables on child mortality was also assessed. The theoretical framework was Bronfenbrenner’s socioecological model, which focuses on how the characteristics of individuals, communities, organizations, the environment, and public policy affect health. The analysis involved binary logistic regression. With child mortality as the independent variable and yes as the reference category, wealth index had a statistically significant association with a p-value of less than .001 and 95% confidence interval (CI) between .827 and .915 for the first and second research questions. Area also showed a statistically significant association with a p-value of .003. It had a CI of 1.075 to 1.428. The third research question showed statistical significance as well with the wealth index variable (p = < .001, 95% CI [.816, .921]). The findings reinforce that demographic interventions are an important part of life, specifically in early childhood and development. The findings may inform positive social change in the development of policy specifically focused on wealth groups and areas that show the most need for interventions geared toward preventing child mortality.