Water, sanitation and hygiene interventions to prevent diarrhoea
Persistent diarrhoea is the second leading cause of death globally among children under five years old – second only to pneumonia. It can also contribute to nutritional deficiencies, reduced resistance to infections, impaired growth and development. More than half of child deaths due to diarrhoea are associated with malnutrition.
Lack of access to safe, clean drinking-water and basic sanitation, as well as poor hygiene cause nearly 90% of all deaths from diarrhoea. A number of interventions are effective in preventing diarrhoeal diseases and thereby positively impacting the nutritional status of those most vulnerable. These are:
- improved water supply
- water safety planning (the management of water from the source to tap)
- household water treatment and safe storage
- improved sanitation facilities
- hygiene education (e.g. hand washing after toilet use and before the preparation of food).
WHO documents
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Guidelines for drinking-water quality, fourth edition
Status: published
Publication year: 2011
Approved by the WHO Guidelines Review Committee -
Water safety plan manual (WSP manual): step-by-step risk management for drinking-water suppliers. Geneva
Status: published
Publication year: 2009
Evidence
Cochrane reviews
- Interventions to improve water quality and supply, sanitation and hygiene practices, and their effects on the nutritional status of children (intervention protocol)
- Interventions to improve water quality for preventing diarrhoea
- Hand washing for preventing diarrhoea
Systematic reviews
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Water, sanitation and hygiene for the prevention of diarrhoea
Cairncross S et al.
International Journal of Epidemiology, 2010, 39:i193–i205 doi: 10.1093/ije/dyq035 -
Water, sanitation and hygiene interventions to combat childhood diarrhoea in developing countries [pdf 989kb]
Waddington H et al.
The International Initiative for Impact Evaluation (3ie), 2009 -
Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis
Aiello AE et al.
American Journal of Public Health, 2008, 98(8):1372–1381 doi:10.2105/AJPH.2007.124610 -
Interventions to improve water quality for preventing diarrhoea: systematic review and meta-analysis
Clasen T et al.
BMJ, 2007, 334(7597):782 doi: 10.1136/bmj.39118.489931.BE -
Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis
Fewtrell L et al.
The Lancet Infectious Diseases, 2005, 5(1):42–52 doi:10.1016/S1473-3099(04)01253-8