Robert Chambers (March 2009)
In India, a long economic boom has done little to reduce the vast number of cases of malnutrition and stunting in children, leaving them with mental and physical deficits that affect them for the rest of their lives. An emerging body of scientific studies suggest that many of the 162 million children under the age of 5 in the world who are malnourished are suffering less a lack of food than poor sanitation.
The purpose of this article was to obtain key inputs for the development of the first regional and global estimates of handwashing with soap following faecal exposure, in
view of updating the estimates of the burden of disease for the impact of this behaviour on diarrhoeal disease. The authors systematically reviewed the prevalence of the relevant hand dhygiene practices worldwide and updated the evidence linking hand hygiene practices to the prevention of diarrhoea. In both cases, they present adjusted estimates
The results of this analysis confirm the importance of improving water and sanitation in low- and middle-income settings for the prevention of diarrhoeal disease burden. The article also highlights the need for better data on exposure and risk reductions that can be achieved with provision of reliable piped water, community sewage with treatment and hand hygiene.
Divisions between communities, disciplinary and practice, impede understanding of how complex interventions in health and other sectors actually work and slow the development and spread of more effective ones. This hypothesis was tested by re-reviewing a Cochrane-standard systematic review (SR) of water, sanitation and hygiene (WASH) interventions’ impact on child diarrhoea morbidity: can greater understanding of impacts and how they are achieved be gained when the same papers are reviewed jointly from health and development perspectives?
More than 761 million people rely on shared sanitation facilities. These have historically been excluded from international sanitation targets, regardless of the service level, due to concerns about acceptability, hygiene and access. Prompted by a proposed change in such policy, this review was undertaken to identify and summarize existing evidence that compares health outcomes associated with shared sanitation versus individual household latrines.
The Cochrane Review on WASH and Childhood Undernutrition was launched in November 2013. This study was funded by DFID through the SHARE Research Consortium and provides a definitive synthesis of the current evidence relating improvements in drinking water, sanitation and hygiene (WASH) to childhood undernutrition.