Better sanitation boosts children's test scores, decreases stunting - study

Astrid Zweynert, Nov 19, 2013

Access to improved sanitation can increase cognition in children, according to a new World Bank study, the latest research to link stunting and open defecation.

More than 2.5 billion people worldwide lack access to toilets, and one billion people practice open defecation.

"Effects of Early-Life Exposure to Sanitation on Childhood Cognitive Skills", released ahead of the first official U.N. World Toilet Day on Nov. 19, studied the effects on childhood cognitive achievement of early life exposure to India’s Total Sanitation Campaign, a national government programme that encouraged local governments to build and promote use of inexpensive pit latrines.

“Our research showed that six-year-olds who had been exposed to India’s sanitation programme during their first year of life were more likely to recognise letters and simple numbers on learning tests than those who were not,” said lead author Dean Spears. “This is important news -- the study suggests that low-cost rural sanitation strategies such as India’s Total Sanitation Campaign can support children's cognitive development.”

The results also suggest that open defecation -- going outside without using a toilet or latrine -- is an important threat to the human capital of developing countries, the World Bank said in a statement.

“Open defecation lies at the root of many development challenges, as poor sanitation and lack of access to toilets impact public health, education, and the environment,” said Jaehyang So, manager of the World Bank's water and sanitation programme. 

"This recent study joins a growing body of evidence indicating that open defecation harms infants and stunts the growth of young bodies and minds.”

A World Bank working paper released earlier this year found that children exposed to more fecal germs don’t grow as tall as other children with less exposure. 

Children in India are shorter, on average, than children in Africa who are poorer, on average, a paradox called "the Asian enigma," which has received much attention from economists.  Studies indicate a 5 year-old girl in India to be around 0.7 cm shorter than her counterpart in sub-Saharan Africa, the World Bank said. 

Studies have shown physical height is an important economic variable reflecting health and human capital. However, differences in average height across developing countries are not well explained by differences in wealth, according to the report.