Chapter 3 THE POWER OF WASH
Why Sanitation Matters for Nutrition
Dean Spears and Lawrence Haddad
SUMMARY Water, sanitation, and hygiene can have a profound effect on health and nutrition. A growing base of evidence on the link between sanitation, child height, and well-being has come at an opportune time, when the issue of sanita- tion and nutrition in developing countries has moved to the top of the post-2015 development agenda.
T
he year 2014 was an exciting time for nutrition research and policy action related to water, sanitation, and hygiene, or WASH. In terms of research, during the past year, a wide range of studies began
to converge on evidence that WASH can be critical in shaping key nutrition outcomes, such as child height, one of the most important measures of a popula- tion’s well-being. Te evidence regarding the nutritional consequences of sanita- tion was particularly strong,1 especially for open defecation without using a toilet or latrine, which is the focus of this chapter. Te importance of WASH for nutrition should come as no surprise. Research-
ers have long known that nutritional outcomes reflect “net nutrition”: the nutri- tional resources that, aſter what is consumed by activity or disease, are absorbed and available to the body to support growth. Poor sanitation, and deficient WASH more generally, expose growing children to germs that cause disease and prevent children’s bodies from puting their diets to the best possible use. Tis is why WASH has long been part of the United Nations Children’s Fund (UNICEF) conceptual model of child nutrition. In 2014, the issue of sanitation and nutrition also moved to the front of the
development policy agenda. Sanitation now seems to be a global priority: end- ing open defecation is near the top of the world’s post-2015 goals for sustainable development. Tis is particularly true for India—a country where half of all children are stunted2 and a country home to half of the world’s population of the one billion people worldwide who, according to UNICEF-World Health Organi- zation (WHO) statistics, defecate in the open. India has made the rapid elimina- tion of open defecation a policy priority.
Dean Spears is executive director of R.I.C.E. and visiting economist, Centre for Development Economics, Delhi School of Economics, India. Lawrence Haddad is senior research fellow, Poverty, Health, and Nutrition Division, International Food Policy Research Institute.
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