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

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.

The recipe for success: how policy-makers can integrate water, sanitation and hygiene into actions to end malnutrition

At current rates of progress, the world will not meet the Sustainable Development Goals to end malnutrition by 2030. In this report, Action Against Hunger, WaterAid and SHARE assert that the integration of action on nutrition and WASH is fundamental to the recipe for success.

You can also read this related blog on the WaterAid website and watch a short video

Date: 28 September 2017

The effect of young children's faeces disposal practices on child growth: Evidence from 34 countries

The study by Valerie Bauza and Jeremy S. Guest looked at the relationship between child faeces disposal and child growth in low- and middle-income countries. You can read a more detailed abstract here. It was published in the Journal of Tropical Medicine and International Health is available for purchase from the Wiley Online Library

Date: 21 July 2017


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