Stunting: It’s not just about food

WASH&NutritionBy Yesenia Garcia, Communications Coordinator for 1,000 Days.

This post is part of our October 2013 series, “WASH & Nutrition: Partnering for a Healthier Future, ” produced in partnership with 1,000 Days. To read the entire series, click here.

About half of malnutrition worldwide can be attributed to poor water, sanitation and hygiene (WASH). Did you catch that? Food, or the lack thereof, is not the sole cause. Instead, half of malnutrition worldwide is the result of repeated bouts of exposure to harmful bacteria and infections. Poor sanitation and hygiene is associated with poor nutritional outcomes via different pathways, including diarrhea and gastro-intestinal disorders.

StuntingYet the role of hygiene, sanitation and water in preventing malnutrition—and in particular, stunted growth in children—is not well-understood by the broader global health and development communities. A number of recent studies have called attention to this “blind spot,” stressing the need for an integrated approach to improving nutrition that recognizes that food and diet alone will not make a substantial dent in reducing the number of stunted children worldwide.

The link between WASH and nutrition is evident when we look at India, where over half of all children are stunted. Recently published data has pointed to the widespread practice of open defecation as a cause for India’s high malnutrition. More than half of India’s population defecates in the open, exposing children to infections that reduce their ability to absorb nutrients. This stubborn cycle of disease and malnutrition plagues many communities and countries across the globe, and will not be broken without improved access to proper water, sanitation and hygiene.

While a continued focus on the nutritional intake of mothers and children is desperately needed, nutritious foods and healthy diets are just part of the solution to preventing stunted growth in children. Young children whose families and communities lack access to toilets, clean water and safe hygiene are susceptible to repeated, continuously debilitating bouts of diarrhea resulting in lowered ability to absorb nutrients and fight off infections, the result often being stunted growth.

To achieve significant and lasting reductions in child deaths and stunting, the linkages between nutrition and WASH need to be leveraged in order to better coordinate and integrate policy and program implementation The future of WASH and nutrition lies in the growing recognition that we must harmonize our efforts. Fortunately, we are already moving in this direction. The 1,000 Days Partnership comprises organizations that represent multiple sectors and works to further strengthen the linkages between all of our work. Furthermore, USAID’s nutrition strategy plans to prioritize both nutrition-specific and sensitive interventions, and calls for an established architecture in the U.S. government that enables coordination across sectors.

Without intensified focus on scaling up WASH interventions, continued progress toward ending preventable child deaths and decreasing rates of chronic malnutrition and stunting will be harder and costlier to achieve. It is time to eliminate this blind spot. To do so, we must move forward together.


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