Sanitation and nutrition

In the scramble for attention in post-2015 development agenda discussions, WaterAid and the SHARE programme are highlighting the role of WASH in combating malnutrition. “A successful global effort to tackle under-nutrition must include WASH” is the headline in their new briefing note.

Mentioned in the note, and of special interest, is the forthcoming Cochrane review on “Interventions to improve water quality and supply, sanitation and hygiene practices, and their effects on the nutritional status of children” (DOI: 10.1002/14651858.CD009382).

In the wake of the WaterAid/SHARE briefing note, a new World Bank report on sanitation and stunting [1] is “getting a lot of attention from our nutrition colleagues”, says Eddy Perez of the Water and Sanitation Program (WSP) in an email.

It adds an important element for our advocacy work and it can also guide some programming decisions especially in targeting sanitation programs. […]   here are the headline messages:
1) Open defecation explains 54% of international variation in child height. In contrast, GDP only explains 29 percent.
2) A 20 percentage point reduction in open defecation is associated with a 0.1 standard deviation increase in child height, which is about 0.4 of a centimeter for a healthy four-year-old

[1] Spears, D., 2013. How much international variation in child height can sanitation explain? (Policy research working paper ; no. WPS 6351). Washington, DC, USA, World Bank. Available at:

For a related study on the impact of water and sanitation on malnutrition see:

Cuesta, J. (2007) Child malnutrition and the provision of water and sanitation in the Philippines. Journal of the Asia Pacific Economy, 12 (2), pp. 125-157. DOI: 10.1080/13547860701252298. Available at:

For economic impacts see:
SuSanA factsheet – Productive sanitation and the link to food security, April 2012. Available at:


One response to “Sanitation and nutrition

  1. The World Bank report by Dean Spears, linking open defecation to stunting, lead to a discussion on the opinion page of Indian newspaper The Hindu. D. Pradeep Kumar from Mavelikara, has this to say about the report:

    “Dean Spears’ argument that the height of Indian children is correlated to their and their neighbourhood’s access to toilets is curious and unconvincing. If child stunting is the fallout of open defecation, lakhs of children living near the railway tracks in India would be the shortest in the world.”

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