Key resource: Re-framing Undernutrition: Faecally-Transmitted Infections and the 5 As (IDS Working Paper 450)

In this IDS Working Paper, Robert Chambers (CLTS Knowledge Hub, IDS) and Gregor von Medeazza (UNICEF) argue for a more inclusive framework for thinking about and dealing with undernutrition.  One concept is FTIs (faecally-transmitted infections).  This is designed to avoid the reductionisms of faecal-oral infections, waterborne diseases, and the focus on the diarrhoeas to the neglect of less dramatic and less measurable FTIs especially environmental enteropathy.  A second concept is the 5 As – availability and access which both have oral associations, and absorption, antibodies and allopath

Date: 31 October 2014

Reduction of stunting by CLTS in Mali: a case study to learn from

Mali is renowned as the location of the one of the few Community-Led Total Sanitation (CLTS) programmes that has managed to demonstrate a reduction in stunting from increased community-level sanitation coverage. There is much to learn and share from this programme, especially across the West and Central Africa region where similar sanitation challenges are faced and open defecation rates generally remain high.

Community-Level Sanitation Coverage More Strongly Associated with Child Growth and Household Drinking Water Quality than Access to a Private Toilet in Rural Mali

This article is an overview of a study that investigated the effect of community sanitation coverage versus individual household sanitation access on child health and drinking water quality. Using a census of 121 villages in rural Mali, the research team analysed the association of community latrine coverage (defined by a 200 meter radius surrounding a household) and individual household latrine ownership with child growth and household stored water quality.

Date: 11 July 2018

Effect of a community-led sanitation intervention on child diarrhoea and child growth in rural Mali: a cluster-randomised controlled trial

This article provides a brief overview of the method and findings from a cluster-randomised trial that was conducted in 2011-2013 in Koulikoro, Mali, to assess a government implemented Community-Led Total Sanitation (CLTS) programme’s effect on child health.

Date: 11 July 2018

Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Kenya: a cluster-randomised controlled trial

Poor nutrition and exposure to faecal contamination are associated with diarrhoea and growth faltering, both of which have long-term consequences for child health. This trial aimed to assess whether water, sanitation, handwashing, and nutrition interventions reduced diarrhoea or growth faltering.

Date: 26 February 2018

Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Bangladesh: a cluster randomised controlled trial

Diarrhoea and growth faltering in early childhood are associated with subsequent adverse outcomes. This trial aimed to assess whether water quality, sanitation, and handwashing interventions alone or combined with nutrition interventions reduced diarrhoea or growth faltering. Overall the trial found that nutrient counselling and supplementation modestly improved linear growth, but that there was no benefit to the integration of water, sanitation, and handwashing with nutrition.

Date: 26 February 2018

Toward a Hygienic Environment for Infants and Young Children: A Review of the Literature (WASHpals)

The USAID Water, Sanitation, and Hygiene Partnerships and Learning for Sustainability (WASHPaLS) project conducted a review of the scientific and grey literature, complemented by dozens of key informant interviews with researchers and field implementers, to synthesize the latest understanding of key pathways of fecal microbe ingestion by IYC and their links to diarrhea, EED, and poor nutrition and development outcomes.
Specifically, the review sought to:

Date: 21 February 2018

Sanitation boosts health, not stunted growth for Bangladeshi kids

Children born into housing compounds with improvements in drinking water quality, sanitation, and handwashing infrastructure were not measurably taller after two years compared to those born into compounds with more contamination, a new study suggests. Although children who received the interventions were significantly healthier overall, and despite mounting research over the last decade linking poor sanitation to stunted growth in children, sanitation improvements seemingly did nothing to improve growth and development.


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