Three hundred thirty four (74.2%) and 75(22.5%) of the households had latrine and hand washing facility respectively. Majority of the latrine facility of the households were 304(91%) private and 330(98.8) of them were not improved type and 72(21.3%) of the households had unclean latrine or feces seen around the hole of pit latrine. Most of the households 232(51.6%) disposes their waste material properly. 230(51.1%) of the households use improved type of water source and 118(26.2%) of the households take 30 minute or more to fetch water. 170(37.8%) of the households treat their drinking water at home (Table 2)

Majority of the respondents give their child 410(91%) other food in addition to BF. Most of the respondents 243(59.3%) were prepare gruel and 239(58.3%) of the respondents feed their children using their hand. Most of the respondents 209(46.4) wash their hand using water only (Table 3).

Two hundred thirty one (51.3%) of the children were females with the majority of the children 161(35.8%) were in the age group of 12-24 months. The mean age of the children was 24.55(±13.63 SD) months. 263(58.4%) and 285(73.5%) of the children receive Rota and measles virus vaccine respectively. In this study, 128(28.4%) of the children had experience diarrhea in the two weeks period preceding the study (Table 4).

In the bivariate analysis number of under five children in the household, household family size, occupation of mother, education of the fathers, occupation of fathers, place of Residence, religion, average family monthly income were found to be significantly associated with under-five diarrhea. The odds of having diarrhea in household with tow and less number of under five children were 4.18 times less likely than the odds in household with more than two under five children (COR: 0.239, 95% CI (0.152-0.375)) children who live in the household of five or less family size were 1.83 times less likely prone to diarrhea when compared to those children live in the household greater than five family member (COR: 0.545, 95% CI (0.347-0.857)). Children of fathers who completed primary education were less probable to have diarrhea compared to children of mothers who were illiterate (COR: 0.69, 95% CI(0.45-1.06)). Likewise children of fathers who were secondary and above educational status were more than three times less likely to experience diarrhea compared to children of mothers who were illiterate (COR: 0.28, 95% CI(0.11-.71)). Children from households of urban community were about 1.5 times less likely to have diarrhea compared to children of rural community households (COR: 0.67, 95% CI (0.37, 1.234)). Children of house hold whose income more than one thousand were less likely to develop diarrhea compared to children of household whose income were one thousand and less birr per month (COR: 0.387, 95% CI(0.245,0.611)).Children of mothers whose occupation house wife were four times more likely to experience diarrhea as compared Children of mothers whose occupation were government employee. Children of mothers whose occupation were farmer three times more likely to have diarrhea compared to government employee Likewise children of mothers whose occupation were merchant two times more likely to have diarrhea compared to government employee. In this study Educational status of the mother, Age of mothers category, Occupation of fathers, Marital status, Ethnicity, Relation of respondents to child and Monthly income of family were not showed significant association with under five diarrhea (Table 5)

Households’ environmental variables and their relationship with under-five diarrhea were assessed on the bivariate analysis. But latrine availability, feces seen in the pit hole, hand washing facility, refuse disposal method, time to fetch water from source, home water treatment, number of rooms and animals live in same house were found to be significantly associated with under-five diarrheal morbidity.

Children from household who had no latrine were 3 times more likely to experience diarrhea compared to children from household who had latrine(COR: 2.91, 95% CI(1.86,4.54)). Children from household who had clean latrine/ faces not seen around the pit or on the floor of latrine were 1.5 times less likely to experience diarrhea compared to children from household who had not clean latrine/ feces seen around the pit or on the floor of latrine (COR: 0.65, 95% CI(0.37,1.14)). Children from households had no hand washing facilities were five times more likely prone for diarrhea compared to those children of households who had hand washing facilities(COR: 5.18, 95% CI(0.19,0.53)). Children from households experience improper waste disposal were 2.2 times more likely to develop diarrhea compared to those children of household who dispose waste properly(COR: 2.22, 95% CI(1.46,3.38)). Children from households who take below 30 minute to get water from source were four times less likely to develop diarrhea compared to those children of household get water after walking more than 30 minute (COR: 0.262, 95% CI(0.17,0.41)). Children from households who treat water before using were less likely to develop diarrhea compared to those children from households who didn’t treat water before using(COR: 0.52, 95% CI(0.33,0.82)). Children of households use improved water source were three times less likely to experience diarrhea compared to children from households who use unimproved water source (COR: 0.32, 95% CI(0.19,0.53)). Children of households had one room house were 3.5 times more likely to experience diarrhea compared to those children of house hold who had house of more than two rooms(COR: 3.6, 95% CI(1.74,7.41)). likewise children of household had house of two rooms were 1.7 times more likely to develop diarrhea compared to those children of house hold who had house of more than two rooms [COR: 1.69, 95% CI(0.98,2.897)), and child of house hold live with animal in the same house were four times more likely to develop diarrhea compared to those children of house hold live in separated room from animal(COR: 3.9, 95% CI(2.52,6.04)) (Table 6).

In the bivariate analysis, current breast feeding status, type of food the child take (Powder milk and gruel), eating unwashed fruit, eating uncooked food, prepare child food separately, utensil washing methods, methods of child feeding, hand washing before food preparation, hand washing before food serving, hand washing after visiting latrine, and hand washing after cleaning of child bottom were the behavioral variables that showed significant association with under-five diarrheal morbidity.

Children who partially breast feeding were 4.5 times more likely to develop diarrhea when compared to children exclusively breast feed(COR: 4.5, 95% CI(1.53,13.21)). Similarly children who didn’t breast feeding were three times more likely to develop diarrhea when compared to children exclusively breast feed (COR: 3.44, 95% CI(1.18,10.08)). Children usually taking gruel type of food were 1.5 times less likely compared to children eating other type of food (COR: 0.64, 95% CI(0.416,0.98)). But child cow milk and adult type of food were not showed any significant association with under-five diarrheal morbidity. Children who didn’t ate unwashed food were two times less likely to develop compared to those children who ate unwashed fruit (COR: 0.49, 95% CI(0.32,0.76)). Children used to eat uncooked food were two times more likely to develop diarrhea compared to those children not used to eat uncooked food (COR: 2.02, 95% CI(1.2,3.39)). Children of mothers who prepare their children food in separately were two times less likely to develop diarrhea compared to children of mothers prepare children food together with the family (COR: 0.42, 95% CI(0.27,0.65)). Children of mother who used only water to wash utensil were 1.5 times more likely to develop diarrhea compared to children of mothers who used soap and water(COR: 1.58, 95% CI(1.01,2.48)). Children of mother who wash their hand before food preparing were six times less likely to develop diarrhea compared to children of mothers who were not wash their hand before food preparing(COR: 0.158, 95% CI(0.098,0.254)). Children of mother who wash their hand before food serving were two times less likely to develop diarrhea compared to children of mothers who were not wash their hand before food serving (COR: 0.49, 95% CI(0.32,0.76)). Children of mother who wash their hand after visiting latrine were three times less likely to develop diarrhea compared to children of mothers who were not wash their hand after visiting latrine (COR: 0.29, 95% CI(0.19, 0.44)). Children of mother who wash their hand after cleaning bottom of children were four times less likely to develop diarrhea compared to children of mothers who were not their hand after cleaning bottom of children (COR: 0.24, 95% CI(0.14,0.40)). But hand washing before eating was not show significant association with under five children diarrhea. Children of mothers/care takers who wash their hand using water and soap/ash were 1.5 times less likely to develop diarrhea compared to those children of mothers/care takers who wash their hand with water only (COR: 0.69, 95% CI(0.46,1.04)). Children who received Rota vaccine were two times less likely prone to diarrheal diseases compared to children not received rata vaccine(COR: 0.43, 95% CI(0.28,0.65)). Similarly those children received measles vaccine were four times less likely prone to diarrheal diseases compared to children not received Rota vaccine(COR: 0.26, 95% CI(0.16,0.42)). Length of breast feeding, age at supplementary food and method of children feeding were not show significant association with under five children diarrhea. (Table 7)

In the bivariate analysis any possible confounders were not controlled and assessing the independent effects of the covariates was difficult. So, an enter method of binary logistic regression technique was used to assess the independent effects of explanatory variables on under five diarrhea. To avoid excessive number of variables and unstable estimate in the final model, only variables with P-value less than 0.2 in the bivariate analysis were taken in the multivariate analysis. Model fit was checked by Hosmer-Lemeshow goodness-of-fit test statistics.

The multivariate binary logistic regression analysis identified that number of under five children in the family, utilization of latrine, time from the source of water, home based water treatment, number of rooms in the home, animal live in the same house with the family, type of food child take, hand washing before food preparation, and mothers/care takers hand washing method had significant association with the occurrence of under-five diarrhea. The odds of having diarrhea in household with tow and less number of under five children were 3.7 times less likely than the odds in household with more than two under five children (AOR: 0.268, 95% CI(.08,0.90)).According to this study, children of household who had clean latrine/faces not seen around the pit or on the floor of latrine was 3.4 times less likely to develop diarrhea compared to those clean latrine/faces seen around the pit or on the floor of latrine(AOR: 0.298, 95% CI(0.097,0.92)). Time take less than 30 minuet to fetch water from source was 16.7 times less likely to develop diarrhea compared to time take more than 30 minutes to fetch water from source to home (AOR: 0.046, 95% CI(0.01,0.22)). children in the households who treat water before drinking were 1.9 times less likely to had diarrhea compared to children in the households who do not treat water at home before using (AOR = 0.15, 95% CI: (0.04, 0.62). The odds of under five years of age children who live in house with one room had 6.01 times more risk of diarrhea as compared to the odds of children who live in house with more than two rooms ((AOR = 6.01, 95% CI(1.01,36.01)). Children living with animals in the same house were more likely to develop diarrhea compared to children live in the house separately from animals (AOR: 8.31, 95% CI(2.46,28.06)). Children who take gruel type of food were four times less likely to develop diarrhea as compared to children taking other type of food (AOR: 0.24, 95% CI(0.07,0.81))(Table 8)