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Water, sanitation, and hygiene (WASH), environmental enteropathy, nutrition, and early child development: making the links
Author(s) -
Ngure Francis M.,
Reid Brianna M.,
Humphrey Jean H.,
Mbuya Mduduzi N.,
Pelto Gretel,
Stoltzfus Rebecca J.
Publication year - 2014
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/nyas.12330
Subject(s) - sanitation , psychological intervention , early childhood , context (archaeology) , environmental health , hygiene , child development , malnutrition , medicine , socioemotional selectivity theory , psychology , developmental psychology , psychiatry , biology , paleontology , pathology
There is scarce research and programmatic evidence on the effect of poor water, sanitation, and hygiene (WASH) conditions of the physical environment on early child cognitive, sensorimotor, and socioemotional development. Furthermore, many common WASH interventions are not specifically designed to protect babies in the first 3 years of life, when gut health and linear growth are established. We review evidence linking WASH, anemia, and child growth, and highlight pathways through which WASH may affect early child development, primarily through inflammation, stunting, and anemia. Environmental enteropathy, a prevalent subclinical condition of the gut, may be a key mediating pathway linking poor hygiene to developmental deficits. Current early child development research and programs lack evidence‐based interventions to provide a clean play and infant feeding environment in addition to established priorities of nutrition, stimulation, and child protection. Solutions to this problem will require appropriate behavior change and technologies that are adapted to the social and physical context and conducive to infant play and socialization. We propose the concept of baby WASH as an additional component of early childhood development programs.