Childhood diarrhoea accounts for over 15% of all under-five deaths in Africa. The disease is exacerbated by social vulnerability. This study operationalizes social vulnerability by using three indicators: water poverty, sanitation and assets, to capture social disadvantage, which measures individual or community resources to prevent or mitigate health effects. We particularly investigated the relationship between childhood diarrhoea and risks emanating from multiple stressors: water poverty, poor sanitation and low wealth status, which define social vulnerability. Using data from the 2013/14 Malawi MDG Endline Survey (MMES), we fitted spatial models assuming that the combined effect of social vulnerability indicators, together with individual covariates, exhibit spatial correlation and heterogeneity on the outcome-diarrhoea status. Findings showed evidence of spatially varying risk imposed by social vulnerability indicators on childhood diarrhoea. We established a positive relationship between diarrhoea and water poverty, and negative association with poor sanitation and low wealth status. Spatial characterization of health effects of social vulnerability presents an important step towards targeted interventions in diarrhoea management. Our use of district level mapping provides for optimal planning and implementation, particularly, for the lowly placed individuals who are geographically located in high risk areas, since most decentralized decision making processes are made at this level.

儿童腹泻占非洲所有 5 岁以下儿童死亡人数的 15% 以上。社会脆弱性加剧了这种疾病。本研究通过使用三个指标来操作社会脆弱性：水贫困、卫生设施和资产，以捕捉社会劣势，衡量个人或社区资源以预防或减轻健康影响。我们特别调查了儿童腹泻与多种压力源产生的风险之间的关系：缺水、卫生条件差和财富状况低下，这些都定义了社会脆弱性。使用来自 2013/14 年马拉维千年发展目标终线调查 (MMES) 的数据，我们拟合了空间模型，假设社会脆弱性指标与个体协变量的综合影响在结果-腹泻状态上表现出空间相关性和异质性。调查结果表明，社会脆弱性指标对儿童腹泻施加的空间变化风险的证据。我们建立了腹泻与水贫困之间的正相关关系，以及与卫生条件差和低财富状况之间的负相关关系。社会脆弱性对健康影响的空间特征是朝着有针对性的腹泻管理干预迈出的重要一步。我们使用地区级别的映射提供了最佳的规划和实施，特别是对于地理上位于高风险地区的低位个人，因为大多数分散的决策过程都是在这个级别进行的。与卫生条件差和财富状况低下的负相关。社会脆弱性对健康影响的空间特征是朝着有针对性的腹泻管理干预迈出的重要一步。我们使用地区级别的映射提供了最佳的规划和实施，特别是对于地理上位于高风险地区的低位个人，因为大多数分散的决策过程都是在这个级别进行的。与卫生条件差和财富状况低下的负相关。社会脆弱性对健康影响的空间特征是朝着有针对性的腹泻管理干预措施迈出的重要一步。我们使用地区级别的映射提供了最佳的规划和实施，特别是对于地理上位于高风险地区的低位个人，因为大多数分散的决策过程都是在这个级别进行的。