Household Environmental Factors: Health Implications Among Women and Children in India

Background and purpose: Diarrhea, acute respiratory health issues, and child mortality are prevalent among children under five years and women. These issues are significantly associated with household environmental factors, including household indoor air pollution, lack of sanitation facilities, and lack of access to clean drinking water sources. Yet, millions lack access to clean cooking energy and poor sanitation facilities. According to the World Health Organization, about 3.8 million people are estimated to die prematurely due to the illness associated with some exposure and effects of indoor household pollution, and 2.2 million deaths from acute diarrheal disease annually due to poor water consumption, sanitation, and hygiene. This study examines the association of comprehensive household environmental factors with health implications among children under five years and women and what factors contribute to enhancing the household environmental factors in India.

Method: The study was conducted using secondary data from the latest National Family Health Survey India (NFHS-5), conducted in 2019-20. The data was accessed from Demographic Health Survey (DHS) with approval. A total of 7,24,115 women and children’s cases across all the states in were included in the analysis. Bivariate logistic regression was performed to assess the association.

Results: The results show a significant association between household environmental factors and health implications among women and children, and the results are consistent with growing literature. Results demonstrate that neonatal mortality (OR=1.105, 95% CI=1.069, 1.141), infant mortality (1.094, 95% CI=1.043, 1.148), and child mortality (1.115, 95%CI=1.040, 1.197) are significantly associated with high exposure cooking fuels. Furthermore, acute respiratory infectious problems are less among women using improved cooking technologies (OR=0.739, 95% CI=.547, .999). The likelihood of anemia was less among women with moderate exposure to unclean cooking fuels (OR=1.045, 95%CI=.977, 1.004). Moreover, diarrheal prevalence and child mortality were assessed with other environmental factors. Findings revealed that diarrhea among children is significantly associated with unimproved drinking water sources (OR=1.072, CI=999, 1.149), lack of sanitation facilities (OR=1.109, 95%CI= 1.037, 1.185), and toilets shared with other families (OR=1.262, CI=1.189, 1.340). Furthermore, Neonatal mortality is strongly associated with unimproved drinking water sources (OR=1.31, 95%CI=1.241, CI=1.273) and household shared toilets with others (OR=1.22, CI=1.167, 1.274). Infant Mortality is associated with unimproved water quality sources (OR=1.089, 95%CI=1.016, 1.166), and child mortality is associated with unimproved water quality (OR=1.104, 95%CI=1.00, 1.219), and uncleaned household sanitation (OR=1.16, 95%CI=1.061, 1.271). In addition, the results suggest that household wealth index (OR=2.657, 95%CI=2.274, 3.104), husbands’ education (OR=1.208, 95% CI=1.024, 1.425), women own a mobile phone (OR=2.327, 95%CI=1.684, 3.215) are strongly associated with the adoption of cleaner cooking fuels.

Conclusion: The results show that household environmental factors are strongly associated with child mortality, diarrheal diseases among children, respiratory diseases, and anemic diseases among women. Although there have been massive interventions that focus on improving cooking energy, clean drinking water, and sanitation issues, yet health implications associated with these household environmental factors are alarming. There is a need for sustainable and inclusive program interventions, which need to be accelerated to achieve United Nations sustainable goals 6 and 7.