Tag Archives: child mortality

Water and Sanitation to Reduce Child Mortality: the Impact and Cost of Water and Sanitation Infrastructure

Water and Sanitation to Reduce Child Mortality: the Impact and Cost of Water and Sanitation Infrastructure, 2011. I. Gunther, World Bank.

(Link to full-text)

Using household survey data, this paper estimates the mortality impact of improved water and sanitation access in order to evaluate the potential contribution of water and sanitation investment toward achieving the child mortality targets defined in Millennium Development Goal 4. The authors find that the average mortality reduction achievable by investment in water and sanitation infrastructure is 25 deaths per 1,000 children born across countries, a difference that accounts for about 40 percent of the gap between current child mortality rates and the 2015 target set in the Millennium Development Goals. According to the estimates, full household coverage with water and sanitation infrastructure could lead to a total reduction of 2.2 million child deaths per year in the developing world. Combining this analysis with cost data for water and sanitation infrastructure, the authors estimate that the average cost per life-year saved ranges between 65 and 80 percent of developing countries’ annual gross domestic product per capita. The results suggest that investment in water and sanitation is a highly cost-effective policy option, even when only the mortality benefits are taken into consideration. Taking into account the additional expected benefits, such as reduced morbidity, time spending, and environmental hazards, would further increase the benefit-cost ratio.

Global deaths from diarrhoea, malaria, AIDS declining, study predicts

Book coverUnder-five child mortality from diarrhoeal diseases, which was 1.7 million in 2005, is expected to fall to just over half a million by 2030 and around 130,000 in 2060, a new study [1] predicts.

The study notes that headway is being made in fighting communicable diseases such as diarrhoea, malaria and AIDS. At the global level disease burdens are shifting from communicable diseases to chronic ones such as cancer, diabetes and heart disease.

Continue reading

South Africa, Cape Town: basic services needed to save babies

Toddler Sanele Qaqa should have been running around his home by now. Instead, his family is grieving his death, which could have been prevented. Sanele, the youngest of six children, died in March [2009], just two weeks ahead of his second birthday.

[…] A shocking 37 city children younger than five died of diarrhoea in February, March and April [2009] – deaths that could easily have been avoided. In 2005, more than 100 children, most of them from poverty-stricken areas, died, statistics show.

But health officials are making headway in the war on this disease. According to the Department of Health, the main contributors to the death rate are lack of access to potable water, and inadequate sanitation, sewerage services, and hygiene practices. The deaths earlier this year were largely concentrated in informal settlements where access to clean water was limited.

[Cape Town] has said that although it spends R10-million a year installing sanitation infrastructure, it is costing it R60m a year to repair infrastructure that has been damaged.

Broken toilets, stagnant pools of dirty water and human waste are common in informal settlements. These are the conditions in which disease thrives.

[Sanele Qaqa died on 28 March 2009, two days after falling ill]. One week earlier, on March 17, one-year-old Unabantu Mali died, tied to the back of his grandmother, as she made the two-hour walk home after allegedly being turned away from three health-care centres at which she had sought help for the boy, who had diarrhoea. A probe later cleared the facilities of wrongdoing.

Sanele was one of 3 586 children admitted to hospital for diarrhoea in the past year. Provincial health department spokeswoman Faiza Steyn said there was no accurate picture of deaths from diarrhoea that occurred outside hospitals.

[…] Of the 37 children who died, four had malnutrition and 12 were HIV-positive. Dehydration was the direct cause of the deaths of 14 of the children, said Steyn.

[…] According to Jaco Muller, of the City of Cape Town’s water and sanitation department, the capital expenditure for these services was R23m, while operating expenditure was R80m. The city has 223 informal settlements. The number of toilets needed was 27 052. In May, there were 2 078. The required number of standpipes providing potable water was 5 148, compared with the 4 402 that were in place.

“If all families were to have ready access to clean potable water, the risk of contamination would be considerably reduced,” said Steyn. “The risk would be further reduced if water was stored in clean containers that were cleaned regularly.”

While 37 deaths in three months is high, the mortality rate has improved since 2005, when more than 100 children in the metropole died. The provincial and city health departments have tried to curb the number of deaths through, among other things, awareness campaigns.

From April 1, [2010], a new vaccine is to be introduced that can reduce the incidence and severity of diarrhoea.

Source: Esther Lewis and Lavern De Vries, Cape Argus / Mercury & Independent Online, 05 Oct 2009

Child undernutrition, tropical enteropathy, toilets, and handwashing

The impact of sanitation and hygiene on child mortality and health has been underestimated, contends Dr Jean Humphrey in The Lancet of 19 September 2009 [free registration required].

“Of the 555 million preschool children in developing countries, 32% are stunted and 20% are underweight. Child underweight or stunting causes about 20% of all mortality of children younger than 5 years of age and leads to long-term cognitive deficits, poorer performance in school and fewer years of completed schooling, and lower adult economic productivity.”

“A key cause of child undernutrition is a subclinical disorder of the small intestine known as tropical enteropathy”, Dr. Humphrey states, which “is caused by faecal bacteria ingested in large quantities by young children living in conditions of poor sanitation and hygiene”. “Provision of toilets and promotion of handwashing after faecal contact could reduce or prevent tropical enteropathy and its adverse effects on growth”. “The primary causal pathway from poor sanitation and hygiene to undernutrition is tropical enteropathy and not diarrhoea”.

Dr. Humphrey concludes that “that prevention of tropical enteropathy, which afflicts almost all children in the developing world, will be crucial to normalise child growth, and that this will not be possible without provision of toilets”.

Full reference:

Humphrey, J.H. (2009). Child undernutrition, tropical enteropathy, toilets, and handwashing. The Lancet ; vol. 374, no. 9694 ; p. 1032-1035. doi:10.1016/S0140-6736(09)60950-8

In an earlier WHO study, the authors estimated that 860 000 deaths per year in children under five years of age were “caused directly and indirectly by malnutrition induced by unsafe water, inadequate sanitation and insufficient hygiene”. This raises the total number of children that die every year as a result of unsafe water, inadequate sanitation or insufficient hygiene to 2.2 million instead of the 1.4 million usually quoted.

Full reference:

Pruss-Ustun, A.; Bos, R.; Gore, F. and Bartram, J. (2008). Safer water, better health : costs, benefits and sustainability of interventions to protect and promote health. Geneva, Switzerland, World Health Organization (WHO). Read the full report [PDF file].

Africa – Poor sanitation claimed some 780,000 children last year

Accra, July 6, GNA – Some 780,000 African children, under age five, died of diarrhoea last year due to inadequate access to safe water and sanitation, WaterAid research has shown.

It estimates a yearly 15 billion-dollar economic cost to the continent if the Millennium Development Goal (MDG) targets for water and sanitation are not met.

In a press release received by GNA on Monday, Mr Stephen Ntow, Country Representative of WaterAid, Ghana, expressed disquiet over the fact that African leaders had failed to act upon a pledge to address the situation at last year’s African Union Summit.

“Last year’s Summit marked a breakthrough as African leaders raised water and sanitation to the top of the political agenda by signing the Sham El-Sheik and eThekwini commitments to accelerate progress towards the water and sanitation goals,” he said, but expressed shock that little action had been done to address the situation.

Mr Ntow said the number of children that died of diarrhoea were a stark indication of the human cost of insufficient investment and called for immediate and pragmatic steps to reverse the sad trend.

“Diarrhoea is a major health crisis facing Africa. It is the second biggest killer of under-fives, yet neither governments nor donors are paying enough attention to this deadly disease,” he said.

“African leaders must implement and independently monitor the Sham El-Sheik and eThekwini commitments on water and sanitation as well as collaborate with international counterparts including the G8 in order to mobilize international efforts to support African commitments especially in areas that border on water and sanitation,” Mr Ntow said.

Source – Modern Ghana

The Case for Sanitation: Government failure to tackle global child mortality

Every year 9.7 million children die before reaching their fifth birthday. A new WaterAid report “Tacking the silent killer: The case for sanitation” asserts that improved sanitation could bring the single greatest reduction in these child deaths.

WaterAid’s report reveals that the current statistics on child mortality may be underestimating how many child deaths are attributable to poor sanitation. According to the report inadequate sanitation may be the biggest killer of children under the age of five, yet no governments are prioritising the issue, instead sanitation is the most neglected of all the Millennium Development Goal (MDG) sectors.

The report, released at the G8 Hokkaido summit in Japan, explores how the sanitation sector is being chronically and institutionally neglected by donors and developing country governments alike, resulting in as many as 2.4 million easily preventable child deaths a year; double the number of people killed worldwide in road traffic accidents.

Read more: WaterAid, 07 Jul 2008

East Asia – Over 200,000 children die in water-borne diseases in East Asia

BALI, Indonesia, Feb. 26 — Over 200,000 children died in East Asia per year and a half of them were in Indonesia, due to water-borne diseases such as diarrhea, the World Bank said here Tuesday.

Almud Weitz, regional team Leader of WB’s Water and Sanitation Program in East Asia and the Pacific, said that the diseases were caused by poor sanitation.

“The number of children die per year is about 200,000 in east Asia. That is a lot. Over 100,000 of them are in Indonesia,” she said at a Media Workshop here.

The leader said that the fatality related with the lack of access to sanitation, which affects 800 million to one billion people in the region.

The countries which signed the declaration of the Millennium Development Goals (MDGs) have agreed to halve the number of people who do not get access to sanitation by 2015, according to Weitz.

However, Weitz said that basically the sanitation statistic in East Asia including Indonesia, was not so bad to start for improvement, compared with other region.

The United Nations has declared that this year is as the year of sanitation. Indonesia is one the four most populated countries in the world, with over 240 million population.

Source – Xinhua