Abstract:
Introduction: Diarrhea is the second most prevalent cause of death in children under the age of five and 
affects around 1.7 billion children worldwide every year, killing an estimated 525 000 people. Similar to 
this, diarrheal disease is the biggest public health problem in Sub-Saharan African countries. Of those 
developing Sub-Saharan African countries, Ethiopia notably contributes to the high burden of diarrheal 
disease and mortality. However, to the knowledge of the investigator, there are no studies made regarding 
under-five children’s diarrheal diseases and its association with food hygiene practice in the rural areas of 
Harari Region. 
Objective: To assess the prevalence of diarrhea among under five children and its association with food 
hygiene practice among households of rural kebeles of Harari Region, Ethiopia April 30- May 20,2023. 
Methods: A community- based cross-sectional study design was carried out. The source population of 
these study was all households of rural kebeles and the study population were households from 
selected woredas and kebeles of rural areas of Harari Region during the study period. And the 
final sample size of the study was 581.Multi stage sampling procedure was employed to draw the
study units and structured questionnaire was used for data collection then Data was entered Epi Data 3.1
and analyzed using SPSS version 22 statistical software. Bivariate and multivariate analysis were used by 
using binary logistic regression to determine the association between independent variables and the 
outcome variable. In this study, P-value < 0.05 was considered as a cutoff point to declare a result as 
statistically significant.
Result: The two-week prevalence of diarrhea among children under-five was 27.5%(95% CI, 23.7–
31%).Marital status (Divorced)[AOR= 26.264 95%CI (1.745-395.213)],monthly income(≤1000)[AOR= 
4.507 95%CI (2.769-7.335)], use of separate utensil for raw and cooked food [AOR= 1.607 95%CI 
(1.004-2.574)], mother’s use of well covered water container [AOR= 2.322 95%CI (1.327-4.064)], 
attitude towards food hygiene [AOR= 0.541 95% CI (0.338-0.867)], food hygiene practice [AOR= 4.167 
95% CI (2.432-7.138)], hand washing at critical time [AOR= 3.903 95% CI (1.647-9.249)], and latrine 
availability[AOR= 5.064 95% CI (1.647-9.249)] were statistically associated with prevalence of diarrhea 
among under-five children.
Conclusion and recommendation: In this study prevalence of diarrhea is high as compared to other 
studies. And Food hygiene practice and practice of hand washing at critical time should be increased by 
health education in order to reduce prevalence of diarrhea among under five children.