Water, sanitation, and hygiene (WASH), environmental enteropathy, nutrition, and early child development: Making the links

Francis M. Ngure, Brianna M. Reid, Jean H. Humphrey, Mduduzi N. Mbuya, Gretel Pelto, Rebecca J. Stoltzfus

Research output: Contribution to journalArticlepeer-review

Abstract

There is scarce research and programmatic evidence on the effect of poor water, sanitation, and hygiene (WASH) conditions of the physical environment on early child cognitive, sensorimotor, and socioemotional development. Furthermore, many common WASH interventions are not specifically designed to protect babies in the first 3 years of life, when gut health and linear growth are established. We review evidence linking WASH, anemia, and child growth, and highlight pathways through which WASH may affect early child development, primarily through inflammation, stunting, and anemia. Environmental enteropathy, a prevalent subclinical condition of the gut, may be a key mediating pathway linking poor hygiene to developmental deficits. Current early child development research and programs lack evidence-based interventions to provide a clean play and infant feeding environment in addition to established priorities of nutrition, stimulation, and child protection. Solutions to this problem will require appropriate behavior change and technologies that are adapted to the social and physical context and conducive to infant play and socialization. We propose the concept of baby WASH as an additional component of early childhood development programs.

Original languageEnglish (US)
Pages (from-to)118-128
Number of pages11
JournalAnnals of the New York Academy of Sciences
Volume1308
Issue number1
DOIs
StatePublished - Jan 2014

Keywords

  • Anemia
  • Child development
  • Environmental enteropathy
  • Hygiene
  • Nutrition
  • Sanitation
  • Stunting
  • Water

ASJC Scopus subject areas

  • Neuroscience(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • History and Philosophy of Science

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