Empirical Analysis of the Association Between Household Water Access and Child Stunting in North West Nigeria

Chronic undernutrition manifesting as stunting is the dominant form of child malnutrition in north-western Nigeria, and safe household water access is theorised as a key environmental determinant through its influence on diarrhoeal disease frequency and absorptive capacity. This study empirically examined the association between household water access and stunting in children under five in Kano State, North West Nigeria. A cross-sectional analytical study was conducted in Kano Municipal and Garun Mallam LGAs, enrolling 480 children aged 6 to 59 months through multistage cluster sampling. Anthropometric data were collected using WHO standardised protocols, and stunting was defined as height-for-age z-score below minus two standard deviations. Household water access was assessed using the JMP improved source classification and supplemented with source-point water quality testing using a portable E. coli testing kit. Covariates included maternal education, dietary diversity, household food security, and sanitation status. Logistic regression with adjustment for clustering was applied. Results showed a stunting prevalence of 43.8 percent. Household access to an improved water source was associated with a 31 percent reduction in stunting odds (OR 0.69; 95 percent CI 0.52 to 0.91; p < 0.05) after adjustment. E. coli contamination of improved sources was present in 38.4 percent of households, attenuating the water-stunting relationship. Maternal education showed the strongest independent protective effect. The study provides empirical evidence that water quality at the point of use must supplement source improvement for nutritional impact, recommending household water treatment promotion in stunting reduction programmes.