To gain further understanding of the interlinkages between poor water access, household food insecurity, and undernutrition among children, this study used a cross-sectional design with 474 female caretakers of children suffering from moderate acute malnutrition (MAM) to explore the relationship between limited access to water and diarrheal diseases among children, aged <5 years, experiencing MAM. The mean age of the caretakers was 28.50±6.88 years and that of their MAM children (sex ratio=0.7) was 17.79±9.59 months. The participants reported spending an average of 19.29±15.69 min for one trip to fetch water. A negative correlation was found between mean time spent fetching drinking water and hygiene and handwashing score (r=−0.141, p=0.003). Furthermore, the more severe the food insecurity status of a household, the farther the family member likely had to go to fetch for drinking water [F(2, 444)=8.64, p≤0.001]. Results from binary logistic regression showed that children from households practicing open defecation (p=0.008) and/or having inadequate hygiene practices (p=0.004) had increased odds of developing diarrhea. Therefore, ameliorating water access in households with MAM children could contribute to improvements in hygiene and sanitation attitudes with a subsequent increase in the effectiveness of nutrition interventions aiming at reducing acute malnutrition among children.

  • Wasting is a huge public health emergency in sub-Saharan Africa with 6.9% of children aged <5 years being affected.

  • The existence of relationships between the different forms of undernutrition and water, sanitation, and hygiene may contribute toward the persistency of children's poor nutritional status.

  • Children from households practicing open defecation or with poor hygiene practices have increased odds of having diarrhea.

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