Environmental Sanitation and Stunting in Children Under Five: An Integrative Literature Review
Keywords:
Child Malnutrition, Environmental Sanitation, Stunting, WASH Interventions, Diarrheal Disease, Low and Middle Income Countries, Hygiene BehaviorAbstract
Child malnutrition remains a global health priority, particularly in regions burdened by inadequate environmental sanitation. This narrative review aims to examine the relationship between environmental sanitation and child nutritional outcomes, focusing on children under five in low and middle income countries. A systematic literature search was conducted using PubMed, Scopus, and Google Scholar, incorporating predefined keywords and Boolean operators to identify empirical and theoretical studies published between 2010 and 2024. The findings reveal that improved sanitation facilities, handwashing behaviors, and water treatment are consistently associated with better child growth indicators, including reduced stunting and wasting. Diarrheal diseases and environmental enteric dysfunction are identified as key mediators in this relationship. Exposure to animal feces and poor waste management further exacerbate the risks. Socioeconomic and cultural factors, such as poverty and traditional beliefs, also influence sanitation practices and nutritional outcomes. Integrated interventions that combine WASH improvements with nutrition education and community led initiatives demonstrate significant potential to address child malnutrition holistically. This review underscores the urgent need for multisectoral policies and context specific research that address both environmental and behavioral determinants of malnutrition. Improving sanitation practices should be considered a central pillar in strategies aimed at enhancing child health outcomes globally.
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