Meta-analysis shows community-level access to sanitation facilities benefits child health

Meta-analysis shows community-level access to sanitation facilities benefits child health

Researchers estimate 1 billion people live without access to a sanitation facility, such as a toilet or a latrine, which increases the risk of fecal-borne disease spreading within their communities. Children are particularly vulnerable, with millions dying from diarrheal disease each year. Children who do survive diarrheal disease are more likely to be malnourished or experience stunted growth and anemia.

Population-level survey data indicate that children with access to a household latrine are less likely to die from diarrhea than those without. However, there has been a gap in research as to the health outcomes of children living in communities with disparate access to latrines.

In new study, Dave Larsen and colleagues conducted a meta-analysis of previously conducted surveys to investigate health outcomes for children living in communities with different levels of access to sanitation facilities. The researchers pooled 301 health surveys conducted between 1990 and 2015 that included data on sanitation access for more than 1 million children in 93 countries. The outcomes measured included growth stunting among children 12 to 59 months old, anemia among children under 5 years, and diarrhea within the two weeks just prior to survey. Community-level sanitation access was calculated as the proportion of households that had access to any latrine.

“Community-level sanitation access had different effects on child health depending on whether a child lived in a household with its own latrine.” Children living in households with a latrine were less likely to experience growth stunting, anemia and diarrhea if they lived in communities with 100 percent sanitation access than if they lived in communities with less than 30 percent access. Children living in households without a latrine had lower odds of stunting or anemia in they lived in communities with some sanitation access (1 to 30 percent) than with 0 percent. Increasing the proportion of community-level access (60 to 99 percent) to sanitation did reduce the odds of anemia among children, but did not decrease the risk of stunting and diarrhea among children.

The findings indicate that poor community-level access to sanitation facilities is a significant risk factor for child morbidity and mortality. Improving access to latrines at the community level is integral to achieving the United Nations’ Sustainable Development Goals 3 and 6, which aim to end preventable child deaths and achieve universal access to clean water and sanitation facilities by 2030.

Reference: Larsen DA, Grisham T, Slawsky E, Narine L (2017) An individual-level meta-analysis assessing the impact of community-level sanitation access on child stunting, anemia, and diarrhea: Evidence from DHS and MICS surveys. PLoS Negl Trop Dis 11(6): e0005591.

Image Credit: Andy Prinsen, Akros


Sara Kassabian is the Social Media Programs Manager at PLOS, where she spends a lot of time writing and editing content for different digital platforms, as well as managing social media strategy and editorial operations for the PLOS Blogs Network ( Sara is a former journalist who completed her MS in Global Health at the University of California San Francisco (UCSF), where her research focused on the prioritization of maternal and newborn health in global health policy. She can be reached by email at and on Twitter @sarakassabian.

Leave a Reply

Your email address will not be published. Required fields are marked *