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
Child height is an important indicator of human capital and human development, in large part because early life health and net nutrition shape both child height and adult economic productivity and health. Between 2005 and 2010, the average height of children under 5 in Cambodia significantly increased. What contributed to this improvement? Recent evidence suggests that exposure to poor sanitation - and specifically to widespread open defecation - can pose a critical threat to child growth. We closely analyze the sanitation height gradient in Cambodia in these two years.
This PLO article posits that although widely accepted as being one of the most important public health advances of the past hundred years, the contribution that improving sanitation coverage can make to child health is still unclear, especially since the publication of two large studies of sanitation in India which found no effect on child morbidity. The authors hypothesise that the value of sanitation does not come directly from use of improved sanitation but from improving community coverage.
Governments around the world have committed to end malnutrition by 2030. However, international and national nutrition plans and actions will fail if they don’t include all the ingredients for success. Evidence shows that scaling up nutrition-specific interventions to 90% coverage in 34 of the countries with the highest burden of child undernutrition, will only reduce stunting by 20%.
Stunting is a complex and enduring challenge with far-reaching consequences for those affected and society as a whole. To accelerate progress in eliminating stunting, broader efforts are needed that reach beyond the nutrition sector to tackle the underlying determinants of undernutrition. There is growing interest in how water, sanitation and hygiene (WASH) interventions might support strategies to reduce stunting in high-burden settings, such as SouthAsia and sub-SaharanAfrica.
Regional CLTS sharing and learning workshop, Sunday 10 January 2016: Innovative Bangladesh!
The traditional pre-SAN gathering of CLTS practitioners and enthusiasts brought together an interesting and eclectic group in Dhaka, with a notably large and welcome presence by the Afghanistan delegation. The focus of the first session was on innovation and new learning. While always difficult to focus the group’s attention tightly on new learning, several interesting new developments were highlighted.
Child stunting and anemia are intractable public health problems in developing countries and have profound short- and long-term consequences. The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial is motivated by the premise that environmental enteric dysfunction (EED) is a major underlying cause of both stunting and anemia, that chronic inflammation is the central characteristic of EED mediating these adverse effects, and that EED is primarily caused by high fecal ingestion due to living in conditions of poor water, sanitation, and hygiene (WASH).