Better sanitation key to improving children's health: World Bank report

It can help reduce diarrhoea prevalence by 47 per cent among children

By Kundan Pandey
Published: Friday 10 January 2014

75% of India’s surface water is polluted by human and agricultural waste and industrial effluents. Lack of sanitation is the key reason for child malnutrition, say recent reports

Better sanitation facilities can significantly help improve children’s health. A World Bank report, published on January 6, states that prevalence of diarrhoea can be reduced by 47 per cent among children if they are provided improved sanitation facilities at home as well as in their community.

The report, Sanitation and Externalities, analysed the data of 206,414 children under 48 months from the government’s District Level Household Survey 2007-08 to estimate how many of them had access to sanitation. They compared the data with the ratio of people with sanitation facilities in their villages.

The researchers found that as the quality of sanitation improved, so did its impact on health. Based on quality, they categorised sanitation facilities under open defecation, access to fixed-point defecation (such as pit latrine without slab, a hanging toilet or latrine over a pond or other surface water or a flush toilet that does not properly dispose of waste) and improved sanitation facilities, which include septic and pipe sewage which keep excreta completely separate from the environment. 

The average prevalence of diarrhoea among the children with little access to sanitation was 12.1 per cent. It reduced by 10 per cent after their houses had access to improved sanitation. The probability of diarrhoea reduced further when their entire community had access to improved sanitation facilities, because of reduced contact with human excreta.

The estimates indicate that there is visible improvement in the children’s health only until 30 per cent people in the village had access to sanitation facilities. Half of the potential total gains could be achieved when sanitation coverage is approximately 75 per cent of the village, the researchers noted.

Diarrhoea is the most common disease associated with poor water, sanitation and hygiene and contributes to 5.7 per cent of the global disease burden. Every year nearly 0.8 million children worldwide succumb to the disease. In 2010, about 11 per cent of the children who died from diarrhoea were under five. In their research, the report highlights that open defecation is practiced by an estimated 626 million people in India and it is said to be a major contributing factor to diarrhoea. Evidence, therefore, suggests that stopping open defecation and safely containing faeces with improved household sanitation can effectively break down the transmission of disease and improve health of children.


Sanitation and externalities: evidence from early childhood health in rural India

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