Improved sanitation facilities are associated with higher body mass index and higher hemoglobin concentration among rural Cambodian women in the first trimester of pregnancy
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Multiple factors contribute to undernutrition in Cambodian women. Our aim was to determine if type of household sanitation facility was associated with body mass index (BMI) and hemoglobin (Hb) concentration among pregnant women. Women (N = 544) from 75 villages in Kampong Chhnang Province had their height, weight, and Hb measured (HemoCue Hb 201+) in the first trimester. Sociodemographic and household characteristics were collected. Multivariable linear and logistic regression models were used for analyses. Approximately 40% (N = 221) of women reported primarily using an ‘improved’ sanitation facility (closed pit latrine) and ∼60% (N = 323) used ‘non-improved’ facilities (open defecation). Mean ± standard deviation (SD) BMI was higher among women with improved versus non-improved facilities (19.9 ± 3.0 kg/m2 versus 19.4 ± 2.3 kg/m2; P = 0.01). Mean ± SD Hb concentration was also higher among women with improved versus non-improved facilities (118 ± 12 g/L versus 114 ± 14 g/L; P = 0.001). Anemia prevalence (Hb < 110 g/L) was higher among women with non-improved facilities (34% versus 25%; P = 0.04). An improved sanitation facility was a positive predictor of BMI (β = 0.57 kg/m2; 95% confidence interval [CI] = 0.10, 1.04) and Hb concentration (β = 2.94 g/L; 95% CI = 0.53, 5.35), adjusting for age, parity, household size, village, gestation week, source of drinking water, and iron folic acid supplementation. Poor sanitation was associated with lower BMI and Hb concentration among pregnant Cambodian women. This warrants multisectoral approaches involving the health, nutrition, water, and sanitation sectors to effectively improve maternal health in Cambodia.
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Studies in Cambodia and India have observed associations between women's access to sanitation facilities and body mass index (BMI); studies have also examined associations between sanitation or water and anemia.
“Studies in Cambodia [290] and India [248] have observed associations between women's access to sanitation facilities and body mass index (BMI).Studies have also examined associations between sanitation (Cambodia [290]) or water (Uganda [278]) and anemia.”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [290]
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Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis
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- Authors
- Janmohamed, A., Karakochuk, C. D., McLean, J., & Green, T. J.
- Affiliations
- University of British Columbia (CA)
- South Australian Health and Medical Research Institute, Women's and Children's Hospital, North Adelaide, Australia.
- Venue
- The American Society of Tropical Medicine and Hygiene
- Published
- 2016-11-02
- Volume
- 95
- Issue
- 5
- Pages
- 1211-1215
- ISSN
- 0002-9637 (ISSN-L)
- 1476-1645
- PMC
- PMC5094240
- OpenAlex
- W2516206573
- Cited by
- 15
- References
- 16
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 2 · 2022: 3 · 2021: 2 · 2020: 1 · 2019: 3 · 2018: 1
- FWCI
- 1.39
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Tropical Medicine and Hygiene (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Public Health and Nutrition
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Keywords
- household sanitation, improved sanitation, body mass index, hemoglobin levels, anemia, pregnant women, malnutrition, open defecation, maternal health, rural Cambodia, iron and folic acid supplementation
- MeSH terms
- Adult, Body Height, Body Weight, Cambodia, Cross-Sectional Studies, Family Characteristics, Female, Folic Acid, Hemoglobins, Humans, Iron, Nutritional Status, Pregnancy, Pregnancy Trimester, First, Rural Population, Sanitation, Socioeconomic Factors, Toilet Facilities, Body Mass Index, Prevalence, Multivariate Analysis, Cluster Analysis, Linear Models, Logistic Models, Randomized Controlled Trials as Topic, Anemia, Iron-Deficiency, Iron, Dietary, Dietary Supplements, Young Adult, Drinking Water
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