Better toilets may not mean better health Kounteya Sinha London: WORLDS LARGEST SANITATION DRIVE MAY NOT IMPROVE INDIAS HEALTH INDICATORS The worlds biggest sanitation programme, being run in India, will reduce the shameful practice of open defecation in the country but may not improve the countrys abysmal health indicators, according to a study by an international group of scientists. The study comes at a time when PM Narendra Modi has launched the Swachh Bharat Abhiyan with great fanfare. Once some families were provided with covered toilets, the researchers looked at whether practising hygienic sanitation improved their health. To everyones surprise, the researchers found no evidence to conclude that the intervention protected against diarrhoea in children younger than five years: seven-day prevalence of reported diarrhoea was 8.8% in the intervention group (data from 1,919 children) and 9.1% in the control group (1,916 children). Defecating in a toilet with water did not reduce prevalence of parasitic worms that are transmitted via soil and can hinder physical growth and impair cognitive functions in children. There was also no impact on child weight or height -measures of nutritional status. Lead author of the study , professor Thomas Clasen from Emory University , Atlanta and the London School of Hygiene and Tropical Medicine in the UK, said, “Many householders do not always use the latrines.This, combined with continued exposure from poor hygiene, contaminated water and unsafe disposal of child faeces may explain the lack of a health impact.“ More Indians have a cellphone than a covered toilet.Around 62.6 crore people in the country dont have access to a toilet close to their house and consequently practice open defecation. The sanitation intervention delivered under the terms of the governments Total Sanitation Campaign -the worlds largest sanitation initiative -provided almost 25,000 individuals in rural India with access to a latrine. However, a study to be published in the British medical journal Lancet on Friday , involving 100 villages, shows that it did not reduce exposure to faecal pathogens or decrease the occurrence of diarrhoea, parasitic worm infections or child malnutrition. This randomized trial involved 9,480 households in 100 rural villages in Odisha comprising either achild younger than four years or a pregnant woman. Households in 50 villages were randomly assigned to receive the sanitation intervention in early 2011; control villages received the intervention after a 14-month surveillance period. The intervention increased the average proportion of households in a village with a latrine from 9% to 63%, compared to an increase of 8% to 12% in control villages. Worldwide, around 2.5 billion people lack access to basic sanitation facilities such as a latrine, a third of whom live in India. Two-thirds of the 1.1 billion people who practice open defecation and a quarter of the 1.5 million who die every year from diarrhoeal diseases caused by poor hygiene and sanitation also live in India. Trying to explain why the intervention did not help bring down Indias abysmally high diarrhoea rates, the researchers suggest a number of possible explanations including insufficient coverage and inconsistent use of latrines, or that a lack of handwashing with soap or animal faeces could also be contributing to the disease burden. Dr Stephen Luby , research deputy director at the Centre for Innovation in Global Health, Stanford University , said, “This rigorous assessment is important, because it provides the best evidence so far for the uncomfortable conclusion that well-funded, professionally delivered sanitation programmes, even when they reach coverage levels that are quite commendable for largescale interventions, do not necessarily improve health.“ The United Nations had recently said that the number of people forced to resort to open defecation remains a widespread health hazard and a global scandal. For the full report, log on to http:timesofindia
Posted on: Fri, 10 Oct 2014 05:42:45 +0000
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