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Impatient Optimists: "What's the link between sanitation and health of a child?"

Learning Trip - Rural Sanitation Site Visit - Temeke Hamlet, Chiwata Village, Masasi District, Tanzania. Ms. Joyce Mrope demonstrates a hand washing station outside her home. 

March 29, 2012

Wash your hands! We heard it all the time as kids growing up and now we remind our own children regularly. We know hand washing can prevent disease. But can it also aid with healthy growth in young children? And what if you don’t have water? Then what do you do?

Results from a study on nutrition in India show there’s been a 20 percent reduction in underweight children who are under five years of age over the last seven years.

It’s a pretty impressive change. But the fascinating part is the implied link to water and sanitation.

The household study compared districts in the country that fell at the bottom of an index measuring child development to districts that came out on top.

Many of the findings are not surprising. The districts in the bottom tier were those with lower educational levels of mothers, less understanding of malnutrition, less immediate and less exclusive breastfeeding (meaning only 42 percent of mothers gave only breast milk for the first six months of their babies’ lives, the standard recommendation), and only 11 percent of mothers who reported washing hands with soap before a meal.

The most interesting part of the findings, however, is that the prevalence of child malnutrition—wasting, underweight, and stunting—was consistently higher in households without a toilet.

A child with poor nutrition in the first two years of life is at a disadvantage throughout his or her life, with impaired intellectual development, a reduced ability to fight disease, and slow physical growth they can never recuperate.

The complex interactions between sanitation, nutrition, and health are not well-understood, but intrinsically we know there is a link. It’s why we tell our children to wash their hands.

Now researchers have set out to prove that link scientifically.

Studies underway in Zimbabwe, Kenya, and Bangladesh are looking at the effects of different interventions on child growth and development. The trials test the independent and combined effects of improved water, sanitation, and hygiene interventions on the one hand, and improved feeding on the other.

The water, sanitation, and hygiene interventions include promotion of handwashing with soap, water treatment, and installation and promotion of latrines. The nutrition interventions include improved child feeding practices and daily provision of a nutrient supplement for children under two.

Back in India, there have been significant gains made in child nutrition, but there is still a lot of work to do to continue to improve the chances of a child getting a healthy, nutritious diet and growing up strong.

With evidence from the studies mentioned above, it is possible that even more effective interventions can be designed and implemented to continue the advances in both nutrition and sanitation. Soon, the words echoed to many children around the world, “Wash your hands!” will be further backed by science in an effort to ensure allchildren grow up healthy.

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