Clean Water and Sanitation Reduce Childhood Malnutrition and Diarrhea

Malnutrition is a major health problem, especially in developing countries.  Water supply, sanitation, and hygiene, given their direct impact on infectious disease, especially diarrhea, are important for preventing malnutrition.  Both malnutrition and inadequate water supply and sanitation are linked to poverty. The impact of persistent diarrhea on nutrition-related poverty and the effect of malnutrition on susceptibility to infectious diarrhea are reinforcing elements of the same vicious cycle, especially amongst children in developing countries. The UNDP Human Development Report includes some illustrative numbers:  
  • Diarrhea, associated with unclean water and lack of sanitation, claims the lives of 1.8 million children under the age of 5. Globally, diarrhea kills more people than tuberculosis or malaria.
  • Water-related diseases cost 443 million school days each year, and children in poor health suffer from reduced cognitive potential. This hurts their prospects for future earnings and makes continuing poverty more likely.
  • The burden of disease linked to water and sanitation accounts for 60 million disability-adjusted life years lost annually, according to The WHO.

Malnutrition is not usually thought of as a Latin American problem.  But in much of Central America - notably El Salvador, Guatemala, Honduras, and Nicaragua – chronic child malnutrition is as prevalent as it is in Africa or South Asia. Also in Peru chronic malnutrition affects approximately 1 in 4 children under the age of 5 years.  In addition to poor physical growth, chronic malnutrition reduces children's cognitive development leading to lower productivity in adult life. This results have a negative social and economic impact on Peruvian society.  Reduced cognitive development limits the effects of education and reduces income potential and the likelihood to overcome poverty. According to research from The Johns Hopkins Bloomberg School of Public Health and other institutions, Peruvian children with inadequate water supplies and sanitation were found to be shorter and had more episodes of diarrhea.  In Peru the highest prevalence of diarrhea is found in rural Selva and Sierra; in rural and coastal areas children are less exposed to disease. Lead author of the Johns Hopkins study conducted in peri-urban area in Lima, William Checkley, MD, PhD, an associate in the Department of International Health, said that "The public health challenges of unsafe water and inadequate sanitation have plagued humanity for centuries, and will continue to do so unless governments make water and sanitation infrastructure improvements one of their first priorities. The poor in most of the developing world either pay more for their access to water or have to travel further distances to obtain water."  Several studies also reveal that better water supply alone does not guarantee full health benefits; findings underscore the importance of adequate sanitation facilities in developing countries to reduce childhood malnutrition and diarrhea.  Nearly one million of Lima’s eight million residents live in unofficial settlements or other areas which are not connected to the city’s water utility network and lack sanitation facilities.  It is estimated in these areas people pay 10 times more for access to water than richer areas in the country and three children out of them suffer from diarrhea.    

In order to raise the profile of malnutrition as a development issue in Peru, The World Bank organized a workshop on fighting chronic malnutrition on March10-11, in Lima.  Water and Sanitation Program participated in the fair. The leading newspaper, El Comercio, informed after the event that "during the International Meeting against Child Malnutrition, organized by the World Bank and the UN System agencies", the Presidents from the 25 regions in Peru "signed a commitment to jointly work to contribute to the success of the government's objective of reducing child malnutrition by 5 percentage points". The Bank has developed a comprehensive development project on preventing and fighting malnourishment.  WSP is supporting these efforts by providing technical assistance to the Government to improvie hygiene habits and water and sanitation services in the country.  WSP is among other project implementing The Public-Private Partnership for Handwashing in Peru to promote handwashing with soap to reduce diarrhea.  

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Katri Kontio
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