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Sudan's rate of child mortality, measured as the number of deaths per 1,000 live births, decreased from 106 in 2000 to 73 in 2012. However, child mortality in Sudan far exceeds the global rate of child mortality, which was 48 in 2012. Contributing to this disparity is diarrheal disease, which is a leading cause of preventable death in Sudan. In this paper, we will examine diarrheal disease among children under five in Sudan through an analysis of the 2000 Sudan Household Health Survey. We conduct a retrospective investigation of the region now officially known as the Republic of Sudan, focused on possible factors related to diarrheal disease in the year 2000. We hypothesize that having access to clean water, improved sanitation facilities—defined here as any kind of latrine—and improved nutritional status through nutrient supplementation would, while controlling for confounding variables, lead to a dramatic decrease in the disease susceptibility of Sudanese children. Additionally, we tested whether maternal education level could alter the effectiveness of clean water and sanitation access.
Our results indicate that availability of household sanitation facilities, access to clean water and better nutrition were all associated with a lower incidence of diarrhea. Maternal education level had an ambiguous effect. Somewhat surprisingly, we found that communities with relatively better levels of sanitation access had higher levels of diarrhea incidence. We conjecture that this finding is due to individuals acting in self-interest as people do not adequately care for communal facilities. These behaviors may have a damaging effect on shared resources and, consequently, turn communal facilities from being beneficial to detrimental.1