Publication: India: How Many Toilets Does It Take to Improve Health?
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2015-03
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2015-03
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Access to proper sanitation helps keep children healthy, but millions of people in the developing world still practice open defecation, putting children at risk. Diarrhea, which can result from the spread of fecal material into food or mouths, kills around 800,000 children under the age of five every year and leaves millions more malnourished and stunted. Whats the best way to create lasting change? Previous efforts often focused on encouraging individuals to invest in toilets for their households, but gains are limited if not everyone in the village does the same. One reason may be that sanitation has a communal element because even if only one family in a neighborhood practices open defecation, all families may be at risk of ingesting fecal matter. Sanitation therefore presents a unique challenge: If an individual family invests in a toilet, but their neighbors dont, are there still positive benefits? What proportion of households need to have improved sanitation for benefits to be seen across the whole village? And whats the impact in a village that goes from zero toilet use to full coverage? The World Bank is committed to helping countries develop the necessary infrastructure and practices to improve sanitation, reducing barriers families may face in raising healthy children. To better understand the impact of a whole village using improved sanitation – such as private toilets or pit latrines – compared with just a few people in the village having access to toilets, World Bank researchers analyzed a national survey database on more than 200,000 children younger than four years old in rural India. More than two-thirds of the people in the rural areas defecate in the open. The study found that diarrhea prevalence halved when sanitation coverage at community level is fully achieved. The study says that these results are mostly due to the positive spillover effects on everyones health that occurs when all (or the overwhelming majority of) households have toilets. The findings can help governments and development practitioners understand the importance of taking a communal approach to the problem.
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“World Bank. 2015. India: How Many Toilets Does It Take to Improve Health?. From Evidence to Policy;. © World Bank. http://hdl.handle.net/10986/22631 License: CC BY 3.0 IGO.”
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