Access to water, sanitation, and hygiene linked to height increase in young children

Parliamentary Yearbook reports on evidence from studies of children across several countries which suggests that access to water, sanitation and hygiene may boost growth in young children under the age of five years. The Cochrane Review identifies a height increase of 0.5cm.

The Cochrane Collaboration is an international network of over 31,000 people from over 120 countries who work together to help healthcare practitioners, policy makers, patients, their advocates and carers, make well-formed decisions about health care. It believes that global healthcare decision-making should be informed by high-quality, timely research evidence.  This independent and democratic organisation produces and disseminates evidence across all areas of health care. To this end, it has prepared over 5,000 formal reviews - known as the Cochrane Reviews - which have been published online in the Cochrane Database of Systematic Reviews. The reviews form part of The Cochrane Library. 

The London School of Hygiene and Tropical Medicine (LSHTM) and the international charity Wateraid have recently jointly carried out and authored a study for the Cochrane Review. The study examined how water, sanitation and hygiene - so called WASH interventions - impact on nutrition outcomes for children.

The background to the review - led by Dr Alan D Dangour, a public heath nutritionist from the LSHTM, states that 165 million children under the age of five years suffer from chronic undernutrition causing them to be short in height and 52 million suffer from acute undernutrition causing them to be very thin. This is important because poor growth in early life is known to increase the risks of illness and death in childhood.  The immediate causes of childhood undernutrition are cited as being inadequate dietary intake and infectious diseases such as diarrhoea. 

The aim of the review was to evaluate the effect of water, sanitation and hygiene on nutrition outcomes for children. This was done by compiling data WASH interventions and nutrition outcomes on nearly 10,000 children from studies of 14 countries. Data was collected from studies on low and middle-income countries where clean water and soap was not accessible relative to more developed countries.  This included Bangladesh, Ethiopia, Nigeria, Chile, Guatemala, Pakistan, Nepal, South Africa, Kenya and Cambodia.

The researchers found evidence that good sanitation resulted in a small increase (0.5cm) in height of children under five.  The authors believe that access to clean water and soap is likely to have led to the increase in height because of the reduction in microbiological and parasitic infestations in early childhood, which are know to negatively impact on growth.

The research was funded by the Department for International Development (DFID). According to the LSTMH website, Professor Tim Wheeler, Deputy Chief Scientific Adviser to the DFID, said:  “Failure to get the right nutrition in childhood can cause lifelong damage that cannot be undone.  This report provides further support to the idea that using clean water and soap remains one of the best ways to prevent contracting diarrhoea and stopping young children losing the essential nutrients vital for them to grow.”

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