The Indian Journal of Nutrition and Dietetics

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Role of Water, Sanitation and Hygiene in Causing Severe Malnourishment among Children - Evidence from a Case-Controlled Study in Central Indian District


Affiliations
1 King George’s Medical University, Lucknow, U.P., India
2 Department of Community Medicine and Public Health, King George’s Medical University, Lucknow, U.P., India
     

   Subscribe/Renew Journal


This study was conducted with an aim to determine the Water, Sanitation and Hygiene (WASH) related practices in families having one or more severely malnourished child and comparing them with that of families with non-malnourished children as control. A community based unmatched case-control study was conducted involving 169 cases and 338 controls. Data on different practices related to water, sanitation, and hygiene followed by families of cases and controls were collected. The questions included source, storage and pre treatment of drinking water, hand washing practices, vector protection methods and method of disposing of various kinds of wastes. A multi variable analysis of selected variables was undertaken. The proportion of males and females among cases was 46.7 and 54.3% respectively. The proportion of families of cases and control which practised any kind of disinfection of drinking water was 38.5 and 78.1% respectively. Strongest factor which increased the odds of being severely malnourished were lack of water, disinfection before drinking, no hand washing before feeding a child, not using disinfectant solution for mopping the floor and defecating in the open. To counter severe malnutrition it is necessary need to broaden the focus and move from nutrition based intervention to include water, sanitation and hygienic practices into the prospect of malnutrition elimination.

Keywords

Water, Sanitation, Hygiene, Severe Malnutrition.
User
Notifications

  • BBC 2013; India ‘shamed’ by child malnutrition, says PM Singh http://www.bbc.com/news/world-asia-india-16481731 [ accessed 01 march 2016]

  • Government of India, Ministry of women and child development. available from http://icds-wcd.nic.in/icds/icds.aspx [ accessed 5th January 2016]

  • National Family Health Survey (NFHS-3) 2006. International Institute for Population Sciences (IIPS) and Macro International. Mumbai.

  • National Family Health Survey (NFHS-4) 2016. International Institute for Population Sciences (IIPS) and Macro International. Mumbai.

  • Dewey, K.G. and Mayers, D.R. Early child growth: how do nutrition and infection interact? Matern. Child Nutr., 2011, 7, 129–142.

  • De Pee, S. and Bloem, M.W. Assessing and communicating the impact of nutrition and health programs. In: Semba, R.D. Bloem, M.W. eds. Nutrition and health in developing countries. Totowa, NJ: Human Press, 2001, 483–506.

  • Christa, L., Fischer Walker, Igor Rudan, Li Liu, Harish Nair, Evropi Theodoratou, Zulfiqar A Bhutta, Katherine L O’Brien, Harry Campbell, Robert, E. Black ‘Global burden of childhood pneumonia and diarrhoea.’ The Lancet. 2013, 20, 1405-1416. doi: 10.1016/S0-1406736(13)60222-6.

  • Luby, S., Stephen, P., Agboatwalla, M., Feikin, D., Painter, J., Billhimer, W., Altaf, A. and Hoekstra Robert, M. “Effect of hand washing on child health: a randomised controlled trial” The Lancet, 2005, 366, 225–233 http://dx.doi.org/10.1016/S0140-6736(05)66912-7

  • Merchant, A.T., Jones, C. and Kiure, A. “Water and sanitation associated with improved child growth”. Eur. J. Clin. Nutr., 2003, 57, 1562–1568.

  • UNICEF 2003; Water Sanitation and Hygiene. Available from http://www.unicef.org/wash/index_hygiene.html

  • Dangour, A.D., Watson, L., Cumming, O., Boisson, S., Che, Y., Velleman, Y., Cavill, S., Allen, E. and Uauy, R. Interventions to improve water quality and supply, sanitation and hygiene practices, and their effects on the nutritional status of children. Cochrane Database of Systematic Reviews 2013. DOI: 10.1002/14651858.CD009382.pub2 http://doi.wiley.com/ 10.1002/14651858.CD009382.pub2

  • World Health Organisation (WHO 2008); Safer water, better health: Costs, benefits and sustainability of interventions to protect and promote health. Available at: http://whqlibdoc.who.int/publications/2008/9789241596435_eng.pdf [accessed January 2016]

  • Checkley, W., Gilman, R.H., Black, R.E., et al. Effect of water and sanitation on childhood health in a poor Peruvian peri-urban community. Lancet, 2004, 363, 112–118.

  • Community Led Total Sanitation Campaign (CLTS 2015) available from http://www.community led total sanitation.org/resources/results/taxonomy%3A44?search_fulltext=&page=50 (accessed 10th January 2016)

  • Meshram, I.I., Arlappa, N. and Balakrishna. N. Influence of feeding practices and associated factors on the nutritional status of infants in rural areas of Madhya Pradesh State, India. Asia Pac. J. Public Health, 2013. doi:10.1177/ 1010539513486174

  • Spears, D., Ghosh, A. and Cumming, O. Open defecation and childhood stunting in India: an ecological analysis of new data from 112 districts. PLoS ONE 2013, 8, 73784.

  • Rah, J.H., Cronin, A.A., Badgaiyan, B., et al. Household sanitation and personal hygiene practices are associated with child stunting in rural India: a cross-sectional analysis of surveys. BMJ Open 2015, 5, 005180. doi:10.1136/ bmjopen-2014-005180.

  • World Health Organization (WHO 2011). WHO child growth standards and the identification of severe acute malnutrition in infants and children A Joint Statement available from http://www.who.int/nutrition/publications/severemalnutrition/9789241598163_eng.pdf [accessed June 2015]

  • Government of Madhya Pradesh (Madhya Pradesh 2015) Department of Women and Child Development. ICDS available from http://mpwcdmis.gov.in/Profile/DistrictProfile.aspx last accessed 27th December 2015

  • World Health Organization (WHO 2004) – “Rapid Needs Assessments – Water Sanitation and Hygiene” South East Asia Region, New Delhi, India.

  • World Health Organization (WHO-2006b). WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation. Core questions on drinking-water and sanitation for household surveys.

  • World Health Organization (WHO 2009). “Water, sanitation and hygiene standards for schools in low-cost settings”. Geneva, Switzerland.


Abstract Views: 325

PDF Views: 1




  • Role of Water, Sanitation and Hygiene in Causing Severe Malnourishment among Children - Evidence from a Case-Controlled Study in Central Indian District

Abstract Views: 325  |  PDF Views: 1

Authors

Pavan Pandey
King George’s Medical University, Lucknow, U.P., India
Prashant Bajpai
Department of Community Medicine and Public Health, King George’s Medical University, Lucknow, U.P., India

Abstract


This study was conducted with an aim to determine the Water, Sanitation and Hygiene (WASH) related practices in families having one or more severely malnourished child and comparing them with that of families with non-malnourished children as control. A community based unmatched case-control study was conducted involving 169 cases and 338 controls. Data on different practices related to water, sanitation, and hygiene followed by families of cases and controls were collected. The questions included source, storage and pre treatment of drinking water, hand washing practices, vector protection methods and method of disposing of various kinds of wastes. A multi variable analysis of selected variables was undertaken. The proportion of males and females among cases was 46.7 and 54.3% respectively. The proportion of families of cases and control which practised any kind of disinfection of drinking water was 38.5 and 78.1% respectively. Strongest factor which increased the odds of being severely malnourished were lack of water, disinfection before drinking, no hand washing before feeding a child, not using disinfectant solution for mopping the floor and defecating in the open. To counter severe malnutrition it is necessary need to broaden the focus and move from nutrition based intervention to include water, sanitation and hygienic practices into the prospect of malnutrition elimination.

Keywords


Water, Sanitation, Hygiene, Severe Malnutrition.

References