Nutrition Supplement Distribution Analysis
"While WASH alone will not
eliminate stunting, it does
have the potential to
accelerate progress on
eliminating stunting as a
critical component of
comprehensive strategies."
Maternal & Child
Maternal & Child Nutrition Nutrition
Review Article
DOK: 103311/12258
Can water, sanitation and hygiene help eliminate stunting?
Current evidence and policy implications
Oliver Cumming and Sandy Cairncross
Dva of
Abstract
Corty of
feat Dan andand
make a significant contribution to edixing the p
Stunting is a complex and enduring challenge with far-reaching consequences for those affected and society as a
whole. To accelerate progress in eliminating stunting, becoder efforts are needed that reach beyond the nutrition
sector to tackle the underlying determinants of undermatition. There is growing interest in how water, sanitation
and hygiene (WASH) interventions might s
port strategies to reduce
o stunting in high-burden settings, such as
South Asia and sub-Saharan A
n Africa. This review article considers two broad questione (1) can WASH intervention
and (2) can WASH in-
be delivered to
conditions have a significant detrimental elect on child p
d growth and development resulting
from sustained exposure to enteric pathogen but also due to wider social and economic mechar Realing
the potential of WASH to reduce stunting requires a redoubling of efforts to achieve unmersal access to these ser
vices in envisaged under the Sustainable Development Goals. It may also require new or modified WASH strategies
that po beyond the scope of traditional interventions to spectically address exposure pathways in the first 2 years of
life when the process of stunting is concentrated.
gests that poor WASH their effect dull red
terventions be
Keyword sanitation, water, stunting, child nutrition, child public bealth, early growth
Deportment of Deco Facilty of dion Tropical case London School of Higene and
Dapical Medicine, London UK. Ek divecomm
Introduction
This article was inspired by the Stop Standing Conder
ence held in Delhi last year to comene actors from mid
tiple countries and sectors to address a shared concenc
the enduring and seemingly intractaNe challenge of
childhood stunting in South Asia. Hspe progress has
been made in much of the South Asia region in extend
ing healthcare, education and economic opportunity,
und these investments have brought dramatic improve
mends in maternal and child mortality, in school retention
rates and in overall economic output. Despite this
able progress, the prevalence of childhood stunting in
South Asia remains high with profound aequences
for those children affected increasing their suscepity
to infectious disease morbidity and mortality, diminishing
their future educational achievements and reducing their
economic productivity in later life. The failure to address
stunting in South Asia, and other high burden regions
stands to undermine progress in other sectors and trap-
ping future generations is poverty and ill health
Stunting is a complex problem as depicted by various
conceptual frameworks, focused on 'child malnutrition
(UNKEF 1990 matemal and child undernutrition
(Back in 2013) and food and nutrition security
(Grower al 2000). The causes of stunting are multifacto
tial and inter-linked spanning biological, social and cavi
ronmental spheres Water, sanitation and hypicne
(WASH) the focus of this paper, feature at various level
in these frameworks with varying degrees of proximity to
the outcome of stunting, as immediate or proximate risk
factors but also as more distant causes or determinants of
stunting For example, different aspects of WASH hone
been plisbly linked to all four pillars' of the food
and nutrition security framework (Cumming et al in
press food availability, through water as a resource
0306 The Aun Mama&C Non poblebed by Way & Se1ad Mam & Chit Now (36, 12 Sep 11-
This in an open access artide under the terms of the Chrative Conanens Anibution Lime, which permits debut and reprod
sion in any mod provided the original sopper
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