Water, sanitation, and primary school attendance: a multi-level assessment of determinants of household-reported absence in Kenya

This cross-sectional analysis examined the influence of school and household water, sanitation, and hygiene (WASH) conditions on recent primary school absence in light of other individual, household, and school characteristics in western Kenya. School latrine cleanliness was the only school WASH factor associated with reduced odds of absence. The marginal effect of household characteristics, such as distance to water source, child involvement in water collection, and presence of a latrine, differed by gender. Demographic features were more important predictors of absence, suggesting that interventions to improve attendance must consider existing differentials attributable to gender, socio-economic status, and other household characteristics.