Socio-health vulnerabilities and diarrheal disease risks in rural Burkina Faso: A livelihoods approach

Rural populations have lower rates of access to adequate drinking water and sanitation than their urban counterparts, particularly in sub-Saharan Africa. This situation puts these populations at risk of diarrheal diseases, the severity of which is modulated by factors related to socio-health vulnerabilities. We used the livelihoods framework and its capital-based approach to study socio-health vulnerabilities in rural Burkina Faso. The objective was to identify the most vulnerable households and compare results at village and health area levels. A quantitative and spatial survey was conducted on 272 households in the municipality of Boussouma (Bagré, Centre-East region of Burkina Faso). Bivariate analyses, multiple correspondence analyses (MCA) and ascending hierarchical classification were used to identify socio-health vulnerability profiles. 43% of households, reported at least one episode of diarrhea among their members during the 12 months prior to the survey. A total of 24 variables were retained for MCA, broken down into four capitals: physical capital (type of water resource, quantity, accessibility and distance, functionality of hydraulic structures), financial capital (means of transport and financial capacity to pay for water), human capital (access to sanitation, hygiene measures, and population knowledge) and social capital (social behaviors concerning water points and rules of access). Five socio-health vulnerability profiles were identified and spatialized. The least vulnerable profiles are affected by human capital deficiencies, and the most vulnerable by a combination of deficiencies in the four capitals dominated by physical capital. Targeted WASH interventions, installation of drinking water points, access to water and health care, construction of sanitation infrastructure to eradicate open defecation and, strengthened hygiene awareness campaigns, could considerably reduce socio-health vulnerabilities. However, access to drinking water, sanitation and health care depends on households characteristics (financial resources, knowledge, practices) and structural and political inequalities that shape access, which constitute embedded power relations, as our study reveals.