Under-five children diarrhea remains a major public health problem in resource-limited areas, including Ethiopia, due to multiple risk factors. This study aimed to identify individual and community-level risk factors affecting under-five children diarrhea (UFCD) in five districts of the Bench Maji Zone, southwestern Ethiopia. A community-based cross-sectional study was conducted from February to April 2018. A total of 826 households were recruited from five randomly selected districts using stratified sampling. A multivariable logistic regression model was fitted to identify risk factors associated with UFCD. The prevalence of UFCD in the study area was found to be 18.3%. Children less than six months of age are more at risk for diarrhea (95% CI for AOR2.5;1.23–4.90). Most probably initiating supplementary feedings before six months of age is one of the main risk factor for diarrhea (95% CI for AOR 0.65; 0.45–0.98). Similarly, mothers with low educational status (95% CI for AOR 0.30; 0.10–0.84), limited knowledge of mothers’ about diarrhea (95% CI for AOR 0.24; 0.15–0.40), absence of hand washing among mothers/caregivers at critical times (95% CI for AOR 4.6; 2.88–7.67), and sharing of the residence with domestic animals (95% CI for AOR 2.87, 1.75–4.67) were the predictors of UFCD at individual-level. Children living in semi pastoral areas (95% CI for AOR 0.22; 0.10–0.50) unvaccinated children for rotavirus prevention (95% CI AOR 5.22, 3.33–8.20), households obtaining water from unimproved sources (95% CI for AOR 2.53; 1.60–4.40), and households with unimproved latrine facilities (95% CI for AOR 0.60; 0.33–0.99) were the risk factors of UFCD at the community-level. The study revealed that UFCD is a critical health concern in southwestern Ethiopia, where integrated intervention approach at individual and community level could help to alleviate the problem. At individual level, behavioral change intervention on handwashing, exclusive breast-feeding before the age of six months, and awareness on diarrhea prevention methods are critical areas of intervention. Likewise, provision of safe and adequate water source combined with household water chlorination, and vaccination for rotavirus are interventions at community that need to be integrated with the individual-level of intervention. This could significantly contribute for the reduction of UFCD in the resource limited areas through intersectoral collaboration of the health and other sectors.

由于多种风险因素，五岁以下儿童腹泻仍然是包括埃塞俄比亚在内的资源有限地区的主要公共卫生问题。这项研究旨在确定影响埃塞俄比亚西南部Bench Maji区五个地区五岁以下儿童腹泻（UFCD）的个人和社区风险因素。2018年2月至2018年4月进行了一项基于社区的横断面研究。采用分层抽样方法，从五个随机选择的地区招募了826户家庭。拟合了多变量logistic回归模型来确定与UFCD相关的危险因素。研究区的UFCD患病率为18.3％。小于六个月的儿童有更大的腹泻风险（AOR2.5为95％CI； 1.23–4.90）。最有可能在六个月前开始补充喂养是腹泻的主要危险因素之一（95％CI的AOR为0.65； 0.45-0.98）。同样，受教育程度低的母亲（AOR为0.30的CI为95％； 0.10-0.84），母亲对腹泻的知识了解有限（AOR为0.24的CI为95％CI：0.15-0.40），母亲/护理人员在危急关头没有洗手UFCD的预测时间（AOR 4.6为95％CI； 2.88–7.67）以及与家畜共享的住所（AOR 2.87为95％CI，1.75-4.67）是个人层面UFCD的预测指标。居住在半牧区的儿童（95％CI的AOR 0.22； 0.10–0.50）未接种疫苗的儿童预防轮状病毒（95％CI的AOR 5.22，3.33-8.20），家庭从未经改善的水源取水（95％CI的AOR 2.53； 1.60） –4.40）和没有完善厕所设施的家庭（95％CI的AOR为0.60； 0.33-0。99）是社区一级UFCD的危险因素。研究表明，UFCD是埃塞俄比亚西南部的关键健康问题，在埃塞俄比亚西南部，在个人和社区层面采取综合干预方法可以帮助缓解这一问题。在个人层面，行为干预措施包括洗手，六个月前完全母乳喂养以及对腹泻预防方法的了解是干预的关键领域。同样，提供安全和充足的水源以及家庭用水加氯和轮状病毒疫苗接种是社区的干预措施，需要与个人干预措施结合起来。通过卫生部门和其他部门的部门间合作，这可以为减少资源有限地区的UFCD做出巨大贡献。