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Review
. 2021 Jul;17(3):e13202.
doi: 10.1111/mcn.13202. Epub 2021 May 14.

Leveraging water, sanitation and hygiene for nutrition in low- and middle-income countries: A conceptual framework

Eleonor Zavala  1 , Shannon E King  1 , Talata Sawadogo-Lewis  1 , Timothy Roberton  1
Affiliations
Review

Leveraging water, sanitation and hygiene for nutrition in low- and middle-income countries: A conceptual framework

Eleonor Zavala et al. Matern Child Nutr. 2021 Jul.

Abstract

In low- and middle-income countries (LMICs), access to water, sanitation and hygiene (WASH) is associated with nutritional status including stunting, which affects 144 million children under 5 globally. Despite the consistent epidemiological association between WASH indicators and nutritional status, the provision of WASH interventions alone has not been found to improve child growth in recent randomized control trials. We conducted a literature review to develop a new conceptual framework that highlights what is known about the WASH to nutrition pathways, the limitations of certain interventions and how future WASH could be leveraged to benefit nutritional status in populations. This new conceptual framework will provide policy makers, program implementors and researchers with a visual tool to bring into perspective multiple levels of WASH and how it may effectively influence nutrition while identifying existing gaps in implementation and research.

Keywords: child growth; hygiene; infections; nutritional status; sanitation; stunting; water supply.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Water, sanitation and hygiene (WASH) to nutrition conceptual framework
FIGURE 2
FIGURE 2
Water, sanitation and hygiene (WASH)‐related disease and nutritional status
FIGURE 3
FIGURE 3
Modes of transmission of pathogens from the environment to the host and disease consequences
FIGURE 4
FIGURE 4
Linkages between water, sanitation and hygiene (WASH) infrastructure and service levels to health behaviours and exposure to pathogens
FIGURE 5
FIGURE 5
Influence of context and role of capacity and human resources in water, sanitation and hygiene (WASH) systems
See this image and copyright information in PMC

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