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Abstract Introduction In less developed countries, including the Gambia, childhood diarrhea is one of the leading causes of serious illness and death among children. Studies on wider determinants of behaviors in medical treatment seeking for diarrheal illnesses in poor resource settings are limited. However, the challenges are continuing and, there is a gap in research work about it in the Gambia. Therefore, the rationale of this study was to assess the individual and community level factors of medical treatment-seeking behaviors for childhood diarrhea among mothers in the Gambia. Methods Data from the 2019–20 Gambia demographic and health survey were used in this study, which was based on secondary data analysis. A total of 1,403 weighted samples of under-five children’s mothers were included in the study for diarrhea medical treatment-seeking behaviors. Because of the hierarchical nature of the data, a multi-level logistic regression model was applied to identify individual and community-level factors that may influence mothers’ medical treatment-seeking behaviors of diarrhea. Data were analyzed using multilevel logistic regression analysis. In the multivariable multilevel logistic regression analysis, variables were judged significantly linked with medical treatment-seeking behavior of diarrhea if their p-value was less than 0. 05. Results Medical treatment-seeking behaviors for diarrhea were discovered in 62.24% (95% CI: 59.67,64.74) of mothers of under five children. Being a female child has shown odds of (AOR = 0.79, (CI 95%: (0.62,0.98)) times less treatment-seeking behavior than the counterparts. Moreover, compared to mothers whose children were of average size, those whose children were smaller, and larger than average at birth were more likely to seek out pediatric medical treatment (AOR = 1.53, 95% CI (1.08–2.16), and (AOR = 1.31, 95% CI (1.01,1.169)) respectively. On the other side, mothers who have exposure to listening to the radio, and heard about oral rehydration have shown an odds of (AOR = 1.34, CI 95%, (1.05,1.72)), (AOR = 2.21, CI 95%, (1.14,4.30)), being from the middle, and rich household wealth have also shown (AOR = 2.15, CI 95%, (1.32,3.51)), and (AOR = 1.92, (CI 95%, (1.11,3.32)), a child with cough, and fever (AOR = 1.44, CI 95%, (1.09,1.89)), and (AOR = 1.73, CI 95%, (1.33,2.25)) were individual-level factors that have shown association statistically with the outcome variable. Similarly, regarding community level factors mothers who had a postnatal checkup, and those from the Kerewan region have revealed more odds of (AOR = 1.48, CI 95%, (1.08,2.02)), and (AOR = 2.99, CI 95%, (1.32,6.78)) times significantly with treatment seeking behavior of mothers respectively. Conclusion Diarrhea medical treatment-seeking behavior was found low. Hence, it remains among the top public health challenges in the Gambia. Strengthening mothers’ healthcare-seeking behavior and skills on home remedies, and childhood illnesses, advocating mass media exposure, assisting financially disadvantaged mothers, and postnatal checkups after delivery will enhance medical treatment-seeking behavior. Furthermore, coordinating with regional states, and designing timely policies and interventions are highly advisable in the country.

Abstract Background Children’s stool disposal is often overlooked in sanitation programs of any country. Unsafe disposal of children’s stool makes children susceptible to many diseases that transmit through faecal-oral route. Therefore, the study aims to examine the magnitude of unsafe disposal of children’s stools in India, the factors associated with it and finally its association with childhood diarrhea. Methods Data from the third round of the National Family Health Survey (NFHS-3) conducted in 2005–06 is used to carry out the analysis. The binary logistic regression model is used to examine the factors associated with unsafe disposal of children’s stool. Binary logistic regression is also used to examine the association between unsafe disposal of children’s stool and childhood diarrhea. Result Overall, stools of 79% of children in India were disposed of unsafely. The urban-rural gap in the unsafe disposal of children’s stool was wide. Mother’s illiteracy and lack of exposure to media, the age of the child, religion and caste/tribe of the household head, wealth index, access to toilet facility and urban-rural residence were statistically associated with unsafe disposal of stool. The odds of diarrhea in children whose stools were disposed of unsafely was estimated to be 11% higher (95% CI: 1.01–1.21) than that of children whose stools were disposed of safely. An increase in the unsafe disposal of children’s stool in the community also increased the risk of diarrhea in children. Conclusion We found significant statistical association between children’s stool disposal and diarrhea. Therefore, gains in reduction of childhood diarrhea can be achieved in India through the complete elimination of unsafe disposal of children’s stools. The sanitation programmes currently being run in India must also focus on safe disposal of children’s stool.

Background: Children's stool disposal is often overlooked in sanitation programs of any country. Unsafe disposal of children's stool makes children susceptible to many diseases that transmit through faecal-oral route. Therefore, the study aims to examine the magnitude of unsafe disposal of children's stools in India, the factors associated with it and finally its association with childhood diarrhea.Methods: Data from the third round of the National Family Health Survey (NFHS-3) conducted in 2005-06 is used to carry out the analysis. The binary logistic regression model is used to examine the factors associated with unsafe disposal of children's stool. Binary logistic regression is also used to examine the association between unsafe disposal of children's stool and childhood diarrhea.Result: Overall, stools of 79% of children in India were disposed of unsafely. The urban-rural gap in the unsafe disposal of children's stool was wide. Mother's illiteracy and lack of exposure to media, the age of the child, religion and caste/tribe of the household head, wealth index, access to toilet facility and urban-rural residence were statistically associated with unsafe disposal of stool. The odds of diarrhea in children whose stools were disposed of unsafely was estimated to be 11% higher (95% CI: 1.01-1.21) than that of children whose stools were disposed of safely. An increase in the unsafe disposal of children's stool in the community also increased the risk of diarrhea in children.Conclusion: We found significant statistical association between children's stool disposal and diarrhea. Therefore, gains in reduction of childhood diarrhea can be achieved in India through the complete elimination of unsafe disposal of children's stools. The sanitation programmes currently being run in India must also focus on safe disposal of children's stool. [ABSTRACT FROM AUTHOR]