Water, sanitation and hygiene interventions to prevent diarrhoea
Diarrhoea remains a leading cause of death globally among children under five years of age. Diarrhoea contributes to nutritional deficiencies, reduced resistance to infections and impaired growth and development. Severe diarrhoea leads to fluid loss, and may be life-threatening, particularly in young children and people who are already malnourished or have impaired immunity.
Diarrhoea mostly results from lack of safe drinking-water, adequate sanitation and hygiene. A number of interventions are effective in preventing diarrhoeal diseases, thereby positively impacting the nutritional status of those most vulnerable. These are:
- Access to safe drinking water (e.g. water safety planning (the management of water from the source to tap); household water treatment and safe storage)
- Access to improved sanitation facilities
- Hand washing with soap at critical times (e.g. after toilet use and before the preparation of food)
Hygiene promotion, along with access to safe drinking water and adequate sanitation should be accessible by all.
WHO recommendations
Guidance information on drinking-water quality can be found in the document, Guidelines for drinking-water quality, fourth edition, under ‘WHO Documents’ below.
WHO documents
GRC-approved guidelines
Status: not currently available
Other guidance documents
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Guidelines for drinking-water quality, fourth edition
Publication date: 2011 -
Water safety plan manual (WSP manual): step-by-step risk management for drinking-water suppliers. Geneva
Publication date: 2009
Evidence
Related Cochrane reviews
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Hand washing promotion for preventing diarrhoea
Ejemot-Nwadiaro RI, Ehiri JE, Arikpo D, Meremikwu MM, Critchley JA.
Cochrane Database of Systematic Reviews. 2015; Issue 9. Art. No.: CD004265. - Summary of this review
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Podcast (Cochrane)
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Interventions to improve water quality and supply, sanitation and hygiene practices, and their effects on the nutritional status of children
Dangour AD, Watson L, Cumming O, Boisson S, Che Y, Velleman Y, et al.
Cochrane Database of Systematic Reviews. 2013; Issue 8. Art. No.: CD009382. -
Summary of this review
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Interventions to improve water quality for preventing diarrhoea
Clasen TF, Alexander KT, Sinclair D, Boisson S, Peletz R, Chang HH, et al.
Cochrane Database of Systematic Reviews 2015, Issue 10. Art. No.: CD004794. - Summary of this review
Other related systematic reviews
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Water, sanitation and hygiene for the prevention of diarrhoea
Cairncross S, Hunt C, Boisson S, Bostoen K, Curtis V, Fung ICH and Schmidt WP.
International Journal of Epidemiology. 2010; 39 suppl 1:i193-i205. -
Effectiveness and sustainability of water, sanitation, and hygiene interventions in combating diarrhoea
Waddington H & Snilstveit B.
Journal of Development Effectiveness. 2009; Vol.1 No3:295-335. -
Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis
Aiello AE, Coulborn RM, Perez V, and Larson EL. American Journal of Public Health. 2008; 98(8):1372–1381. -
Interventions to improve water quality for preventing diarrhoea: systematic review and meta-analysis
Clasen T, Schmidt WP, Rabie T, Roberts I, Cairncross S.
BMJ. 2007; 334(7597):782. -
Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis
Fewtrell l, Kaufmann RB, Kay D, Enanoria W, Haller L, Colford JM Jr .
The Lancet Infectious Diseases. 2005; Vol5, Issue1:42-52.
