Diarrhoea remains one of the leading causes of death among children under five years old in Kenya, despite years of government efforts to reduce child mortality.

 In 2018 alone, nearly 1.5 million cases of diarrhoea were reported among children under five. This alarming statistic underscores the critical need for improved water, sanitation, and hygiene (WASH) services across the country.

Diarrhoeal diseases, including cholera, typhoid, and dysentery, thrive in areas with poor access to clean water and proper sanitation.

According to the latest report by the Kenya Institute for Public Policy Research and Analysis (KIPPRA), access to improved water and sanitation significantly reduces the prevalence of diarrhoea in children. However, disparities in WASH infrastructure, particularly between urban and rural areas, continue to pose a major challenge.

While 86.7% of households in urban areas like Nairobi have access to improved water sources, only 61.8% of rural households benefit from similar services.

In counties like Mandera and Bomet, access to clean water drops to as low as 28%.

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These rural communities often rely on unsafe water from rivers, ponds, or shallow wells, which are highly susceptible to contamination.

“Many households in rural areas face long distances to fetch water, and often the water is not safe for consumption,” the KIPPRA report noted.

The lack of proper sanitation is also a pressing issue, with open defecation still prevalent in some regions, further increasing the risk of waterborne diseases.

In Kenya, diarrhoea accounts for 31% of child mortality among children under the age of five. Despite being preventable, the disease continues to claim young lives, particularly in rural areas where WASH services are insufficient.

“Diarrhoeal diseases not only contribute to malnutrition and stunted growth but also burden the healthcare system, accounting for nearly 10% of outpatient visits,” said the report.

Maternal education is also a key factor in reducing diarrhoea prevalence. The KIPPRA study found that mothers with secondary education and above were more likely to adopt proper hygiene practices, such as handwashing, and to seek medical care for their children when needed.

However, in many rural communities, educational opportunities for women remain limited.

The KIPPRA report outlines several strategies that could significantly reduce the prevalence of diarrhoea in children under five. One of the key recommendations is increased investment in WASH infrastructure, especially in rural and marginalized communities.

“Providing piped water and building proper sanitation facilities should be prioritized by both national and county governments,” the report suggested.

Funding for these projects, however, has been limited. The report calls for a reduction in reliance on donor funding and an increase in domestic budget allocations to ensure the long-term sustainability of WASH services.

The report further recommends the expansion of community-driven WASH programs. Initiatives such as open defecation-free campaigns have been successful in some regions, but more needs to be done.

“These programs need to be scaled up, particularly in high-poverty areas, where access to proper sanitation and clean water is most lacking,” the report emphasized.

Despite progress in reducing child mortality rates over the past two decades, diarrhoea remains a persistent threat to the health of Kenya’s youngest citizens. In rural areas, where access to WASH services is severely lacking, children are at greater risk of contracting diarrhoeal diseases.

Experts stress that timely investments in WASH infrastructure and targeted educational programs, particularly for women, are critical in reversing this trend.

“As Kenya continues its efforts to reduce child mortality, addressing the root causes of diarrhoea—unsafe water, poor sanitation, and inadequate hygiene—must be a top priority. Without urgent action, millions of children will remain vulnerable to preventable diseases, and the dream of a healthier future for Kenya’s youngest generation may remain out of reach,” said the report.