The Relationship of Water, Sanitation, and Hygiene on Stunting In Children Under Five: A Systematic Review
Main Article Content
Abstract
Introduction: Stunting, a nutritional deficiency in children, remains a global concern. This study aimed to explore the relationship between water, sanitation, and hygiene (WASH) components and stunting in children under five. Materials and methods: A systematic review was conducted with sources from three databases, Scopus, PubMed, and CINAHL, used various combinations of keywords related to “water, sanitation, hygiene”, "WASH", and “growth disorders” or “stunting” or “stunted”. Inclusion criteria were published between 2019 and 2024, available in English or Indonesian, focused on families with children under five years old, and investigated the relationship between water, sanitation, and hygiene (WASH) factors with stunting in children. The articles were analysed using the PRISMA guidelines to ensure a comprehensive and systematic approach. Results: The review process involved screening titles and abstracts and a full-text review of potential studies. Of 389 articles, only 14 met the inclusion criteria of the study. Water components (access to clean water, water quality, and storage), sanitation components (facilities and sanitation status, disposal, and management of the sanitation), hygiene components (hygiene practice and handwashing, especially before eating and after using the toilet, handwashing with soap or ash and water, handwashing with water), environment components (household floor), and individual characteristics (knowledge and awareness of WASH) are associated with stunting in children under-five. Conclusion: This systematic review confirmed a relationship between various WASH factors and childhood stunting. Improving access to clean water, sanitation, and hygiene can significantly reduce stunting prevalence and improve child health and well-being.
Downloads
Article Details
References
United Nations. Transforming our world: The 2030 agenda for sustainable development. New York: United Nations, Department of Economic and Social Affairs. 2015;
World Health Organization. Improving nutrition outcomes with better water, sanitation and hygiene: practical solutions for policies and programmes. 2015;
Rahmadhita K. Stunting Problems and Prevention. Jurnal Ilmiah Kesehatan Sandi Husada. 2020;11(1):225–9. doi: 10.35816/jiskh.v10i2.253
WHO. Levels and trends in child malnutrition: key findings of the 2020 edition. UNICEF/WHO/World Bank Group joint child malnutrition estimates. World Health Organization; 2020.
WHO. The UNICEF/WHO/WB Joint Child Malnutrition Estimates (JME) group released new data for 2021. World Health Organization; 2021.
WHO. Levels and trends in child malnutrition child malnutrition: UNICEF/WHO/World Bank Group Joint Child Malnutrition Estimates: Key findings of the 2023 edition. World Health Organization; 2023.
Otsuka Y, Agestika L, Widyarani, Sintawardani N, Yamauchi T. Risk Factors for Undernutrition and Diarrhea Prevalence in an Urban Slum in Indonesia: Focus on Water, Sanitation, and Hygiene. Am J Trop Med Hyg. 2019;100(3):727–32. doi: 10.4269/ajtmh.18-0063
UNICEF, WHO. Progress on household drinking water, sanitation and hygiene 2000–2022: special focus on gender. New York; 2023. Available from: https://washdata.org
Gaffan N, Kpozehouen A, Degbey C, Ahanhanzo YG, Paraïso MN. Effects of the level of household access to water, sanitation and hygiene on the nutritional status of children under five, Benin. BMC Nutr. 2023;9(1):95. doi: 10.1186/s40795-023-00751-8
Walker CLF, Walker N, Black RE. Updating the assumptions on the impact of household water, sanitation and hygiene interventions on diarrhea morbidity in young children. J Glob Health. 2022;12. doi: 10.7189/jogh.12.08003
Mudadu Silva JR, Vieira LL, Murta Abreu AR, de Souza Fernandes E, Moreira TR, Dias da Costa G, et al. Water, sanitation, and hygiene vulnerability in child stunting in developing countries: a systematic review with meta-analysis. Public Health. 2023;219:117–23. doi: 10.1016/j.puhe.2023.03.024
Sahiledengle B, Petrucka P, Kumie A, Mwanri L, Beressa G, Atlaw D, et al. Association between water, sanitation and hygiene (WASH) and child undernutrition in Ethiopia: a hierarchical approach. BMC Public Health. 2022;22(1):1943. doi: 10.1186/s12889-022-14309-z
Ademas A, Adane M, Keleb A, Berihun G, Tesfaw G. Water, sanitation, and hygiene as a priority intervention for stunting in under-five children in northwest Ethiopia: a community-based cross-sectional study. Ital J Pediatr. 2021;47(1):174. doi: 10.1186/s13052-021-01128-y
Kwami CS, Godfrey S, Gavilan H, Lakhanpaul M, Parikh P. Water, Sanitation, and Hygiene: Linkages with Stunting in Rural Ethiopia. Int J Environ Res Public Health. 2019;16(20). doi: 10.3390/ijerph16203793
Saaka M, Saapiire FN, Dogoli RN. Independent and joint contribution of inappropriate complementary feeding and poor water, sanitation and hygiene (WASH) practices to stunted child growth. J Nutr Sci. 2021;10:e109. doi: 10.1017/jns.2021.103
Gizaw Z, Yalew AW, Bitew BD, Lee J, Bisesi M. Stunting among children aged 24-59 months and associations with sanitation, enteric infections, and environmental enteric dysfunction in rural northwest Ethiopia. Sci Rep. 2022;12(1):19293. doi: 10.1038/s41598-022-23981-5
Soe TK, Laohasiriwong W, Sornlorm K, Mahato RK. Safely managed sanitation practice and childhood stunting among under five years old children in Myanmar. PLoS One. 2023;18(11):e0290600. doi: 10.1371/journal.pone.0290600
Lin J, Feng XL. Exploring the impact of water, sanitation and hygiene (WASH), early adequate feeding and access to health care on urban-rural disparities of child malnutrition in China. Matern Child Nutr. 2023;19(4):e13542. doi: 10.1111/mcn.13542
Batool M, Saleem J, Zakar R, Butt MS, Iqbal S, Haider S, et al. Relationship of stunting with water, sanitation, and hygiene (WASH) practices among children under the age of five: a cross-sectional study in Southern Punjab, Pakistan. BMC Public Health. 2023;23(1):2153. doi: 10.1186/s12889-023-17135-z
Shrestha SK, Vicendese D, Erbas B. Water, sanitation and hygiene practices associated with improved height-for-age, weight-for-height and weight-for-age z-scores among under-five children in Nepal. BMC Pediatr. 2020;20(1):134. doi: 10.1186/s12887-020-2010-9
Lee C, Lakhanpaul M, Stern BM, Sarkar K, Parikh P. Associations between the household environment and stunted child growth in rural India: a cross-sectional analysis. UCL Open Environ. 2021;3:e014. doi: 10.14324/111.444/ucloe.000014
Ainy FN, Susanto T, Susumaningrum LA. The relationship between environmental sanitation of family and stunting among underfive children: A cross-sectional study in the public health center of Jember, Indonesia. Nursing Practice Today. 2021 Apr 11; doi: 10.18502/npt.v8i3.5932
Jubayer A, Islam MdH, Nayan MdM. Child-sensitive water, sanitation, and hygiene composite score and its association with child nutritional outcomes in St. Martin’s Island, Bangladesh. SAGE Open Med. 2022;10:205031212210959. doi: 10.1177/20503121221095966
Kuddus MA, Sunny AR, Sazzad SA, Hossain M, Rahman M, Mithun MH, et al. Sense and Manner of WASH and Their Coalition With Disease and Nutritional Status of Under-five Children in Rural Bangladesh: A Cross-Sectional Study. Front Public Health. 2022;10:890293. doi: 10.3389/fpubh.2022.890293
Artharini OM, Bumi C, Noveyani, Adistha Eka. Correlation Between Wash and Stunting in Toddlers in Jember Regency. Jurnal Ilmu Kesehatan Masyarakat. 2022;13(3):278–91. doi: 10.26553/jikm.2022.13.2.278-291
Mshida HA, Kassim N, Mpolya E, Kimanya M. Water, Sanitation, and Hygiene Practices Associated with Nutritional Status of Under-Five Children in Semi-Pastoral Communities Tanzania. Am J Trop Med Hyg. 2018;98(5):1242–9. doi: 10.4269/ajtmh.17-0399
Pickering AJ, Davis J. Freshwater Availability and Water Fetching Distance Affect Child Health in Sub-Saharan Africa. Environ Sci Technol. 2012;46(4):2391–7. doi: 10.1021/es203177v
McGuinness SL, O’Toole J, Barker SF, Forbes AB, Boving TB, Giriyan A, et al. Household Water Storage Management, Hygiene Practices, and Associated Drinking Water Quality in Rural India. Environ Sci Technol. 2020;54(8):4963–73. doi: 10.1021/acs.est.9b04818
Rah JH, Sukotjo S, Badgaiyan N, Cronin AA, Torlesse H. Improved sanitation is associated with reduced child stunting amongst Indonesian children under 3 years of age. Matern Child Nutr. 2020;16(S2). doi: 10.1111/mcn.12741
Wolf J, Hubbard S, Brauer M, Ambelu A, Arnold BF, Bain R, et al. Effectiveness of interventions to improve drinking water, sanitation, and handwashing with soap on risk of diarrhoeal disease in children in low-income and middle-income settings: a systematic review and meta-analysis. The Lancet. 2022;400(10345):48–59. doi: 10.1016/S0140-6736(22)00937-0
Grace K, Davenport F, Funk C, Lerner AM. Child malnutrition and climate in Sub-Saharan Africa: An analysis of recent trends in Kenya. Applied Geography. 2012;35(1–2):405–13. doi: 10.1016/j.apgeog.2012.06.017
Vilcins D, Sly PD, Jagals P. Environmental Risk Factors Associated with Child Stunting: A Systematic Review of the Literature. Ann Glob Health. 2018;84(4):551–62. doi: 10.9204/aogh.2361
Ilham SNP, Rahayuwati L, Witdiawati W, Pramukti I, Ramdhanie GG. The Correlation Between Demographic Characteristics With Wash Practices In Stunting Locus. Journal of Nursing Care. 2023;6(1). doi: https://doi.org/10.24198/jnc.v6i1.44393
Liem S, Marta DrRF, Panggabean ProfDr phil. H. Sanitation Behavior and Risk of Stunting: Understanding the Discourse of a Public Service Announcement. Jurnal The Messenger. 2019;11(2):168. doi: 10.26623/themessenger.v11i2.1317
Irza D, Rahayuwati L, Witdiawati, Susanti RD, Yamin A. Relationship Between Family Income And Availability Of Basic Sanitation In Stunting Locus. Journal of Nursing Care (1411-156X). 2023;6(2):134–43. doi: https://doi.org/10.24198/jnc.v6i2.44412
World Health Organization. Reducing Stunting in Children: Target: 40% Reduction in the Number of Children Under-5 Who are Stunted. WHO: Geneva. 2018;
Rahmadi A, Bertalina B, Sudarmi S, Aprina A. Education on Nutrition, Sanitation, and IYCF to Increase Mother’s Knowledge in Lokus Stunting Village. Jurnal Aisyah : Jurnal Ilmu Kesehatan. 2022;7(2). doi: 10.30604/jika.v7i2.890
Rohmah M. Parental Knowledge and Personal Hygiene Practices Associated with Stunting Incidence in Children 24-60 Months Old in Mlarak Village. Journal for Research in Public Health. 2023;5(1):42–9.