What is the issue?
- Various studies found there is a link between sanitation and stunting. Click here to know more about the issue
- India has much implications from the sanitation studies.
What are the links between Sanitation and stunting?
- Stunting (low height for age) is driven by multiple factors, one of which is inflammation.
- Inflammation is a normal biological response of body tissues to stimuli such as disease-causing bacteria (pathogens).
- But ironically repeated exposure to high doses of bacteria that are not linked with diseases or diarrhoea also cause inflammation.
- Children living in poor hygiene conditions are regularly exposed to high doses of bacteria that will not cause diarrhoea.
- Inflammation down regulates growth factors, and thus impairs normal growth in children.
What are reason behind rejection of the sanitation study?
- Studies about sanitation has been conducted in lower and middle income (LAMI) countries.
- It had attracted considerable traction among health, nutrition and social researchers and policymakers around the world.
- Water, Sanitation and Hygiene (WaSH) trials in countries like Kenya and Bangladesh ended, disappointingly, with no palpable reduction in stunting among children.
- When the effect of poor sanitation is obviously passing on from one generation to the other, it might take at least a generation to adopt WaSH interventions before their outcomes can be seen.
- Therefore, short-term trials like the ones in Kenya and Bangladesh are bound to show little or no effect.
What are the implications for India?
- In India open defecation remains a persistent problem despite sustained and concerted efforts under the Swachh Bharat Abhiyan (SBA) campaign over the last few years.
- About 52% of rural India still defecates in the open, India must understand SBA campaign is beyond mere construction of toilets.
- Unlike in other countries taken for study, India has a large baseline of ODF (over 50% of open defecation against 1% in Bangladesh) even small improvements can demonstrate significant and palpable changes.
- The difference in prevalence of open defecation in urban (7%) and rural (52%) India is large and the figures of stunting are much lower in urban children than among their rural counterparts.
- This difference may not necessarily establish the cause-and-effect relationship but it certainly indicates that toilets and sanitation are important factors associated with stunting.
How Bangladesh managed sanitation woes?
- It is indeed true that mere building of toilets cannot prompt people to use them as there are a lot of social, cultural and behavioural aspects attached to it.
- Bangladesh has managed to bring down open defecation to less than 1% by 2016, from a whopping 42%, in 2006.
- A huge chunk of public and charity money was spent on building toilets, and campaign volunteers slogged to change public attitudes and habits.
- Children were used literally as whistle-blowers and agents of change while door-to-door campaigns were carried out.
- It was done in a dogged campaign in mission mode supported by 25% of the country’s overall development budget.
Source: The Hindu
