WASH’ Nutrition

KEY
MESSAGES
Chapter 2
Despite notable decline in infectious diseases, poor WASH conditions remain associated with a
significant proportion of deaths (both neonatal and post neonatal) and disease among children
under five.
The three main underlying causes of undernutrition, namely unsuitable or insufficient food
intake, poor care practices and disease, are directly or indirectly related to inadequate access to
water, sanitation and hygiene.
Inadequate WASH conditions facilitate ingestion of fecal pathogens which leads to diarrhea,
intestinal worms and environmental enteric dysfunction, the three key pathways from poor
WASH to undernutrition.
50% of undernourishment is associated with recurrent onsets of diarrhea. Frequent illness
impairs nutritional status and poor nutrition increases the risk of infection. This forms a “vicious
circle” of recurring sickness and further deterioration of nutritional status.
Other WASH-related diseases such as malaria, acute respiratory infections and neglected
tropical diseases such trachoma, dengue, chikungunya are known to be associated with
decreased immunity and undernutrition.
Improvements in drinking water, sanitation facilities and hygiene practices have positive effects
on disease reduction. WASH interventions have the potential to interrupt transmission of
pathogens, reduce disease burden and bring significant health and non-health benefits.
Beyond the impact on disease reduction, a growing base of evidence indicates that the WASH
environment can be critical in shaping children’s nutritional outcomes. This is especially true for
the effects of WASH conditions on stunting, while the impacts on wasting are still to be explored.
The evidence is sufficient to justify and support the integration of nutrition and WASH
interventions.
WASH’Nutrition
A practical guidebook
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