Health and sanitation

An assessment of the impact of water supply and sanitation interventions

July 14, 2010

Speaker: Dr. Thomas Clasen

Diarrhoeal diseases account for about 22% of child deaths around the world. It is the leading cause of death of children under the age of 5. Asia and Africa are the most affected regions with diarrhoea accounting for about 14 per cent of mortalities under the age of 5 in India.

Dr. Thomas Clasen, Lecturer at the London School of Hygiene and Tropical Medicine cited research at the Delhi seminar to show that diarrhoea was a result of not just contaminated water but also open defecation and poor sanitation. While treating water may improve water quality there wasn’t enough evidence about the accrued health gains. In such a situation “treating water at source may not be enough as water can get re-contaminated when stored at home” he said.
Dr. Clasen presented a case for Household Water Treatments (HWTS) which included using filters, chlorine tablets, sodium hydrochloride, and boiling water. However, low take-up and compliance over the long term remains a significant challenge in the adoption of HWTS. According to Dr. Clasen, a potential solution would be to target poor households with children and make interventions affordable or give them away free. “That’s where the health gains could be achieved”, he said.

Matthew Freeman, Research Assistant at the London School of Hygiene and Tropical Medicine, who also presented at the Delhi seminar emphasized that education and provision of basic infrastructure were key components of “Water Sanitation and Hygiene (WASH)” interventions in schools. “Increasing awareness about hygiene is as important as providing a latrine. WASH also has potential benefits in addressing gender and socio-economic barriers to schooling”, said Freeman.

Citing evidence from a study in China, Freeman highlighted a 60% reduction in diarrhoea among children after a school hand-washing program was implemented. Freeman also reiterated concerns about program sustainability and the slim evidence base on active uptake of WASH in schools. Financial resources, sufficient water, functional infrastructure, student and community engagement and support from school management are important factors in increasing program sustainability, he said.

Download Dr. Thomas Clasen’s presentation (5.5 MB)

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