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Lack of community-level improved sanitation causes stunting in rural villages of Lao PDR and Vietnam

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conference contribution
posted on 2018-02-12, 15:10 authored by Maria Quattri, Susanna Smets
Increasing evidence indicates that inadequate sanitation is among the underlying causes of stunting. Stunted children are not only shorter than average: their cognitive development and chances to become productive adults are also affected. Poor sanitation, especially open defecation, still prevails in rural communities of Lao PDR, while unimproved sanitation showed no improvement in rural Vietnam during the past decade (although open defecation has declined rapidly). The poorest living in remove villages of Lao PDR and rural mountainous regions of Vietnam suffer the most from unimproved sanitation and stunting. Our analysis shows that community-level unimproved sanitation causes stunting in rural Vietnam and Lao PDR, regardless of whether a child household uses improved toilets. Thus, policies, programmatic interventions and incentives would best focus on community-wide (rather than household) outcomes and behavioural change. Targeted support for the poor might be a complementary element to ensure their inclusion.



  • Architecture, Building and Civil Engineering

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  • Water, Engineering and Development Centre (WEDC)

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QUATTRI, M. and SMETS, S., 2014. Lack of community-level improved sanitation causes stunting in rural villages of Lao PDR and Vietnam. IN: Shaw, R.J., Anh, N.V. and Dang, T.H. (eds). Sustainable water and sanitation services for all in a fast changing world: Proceedings of the 37th WEDC International Conference, Hanoi, Vietnam, 15-19 September 2014, 7pp.


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This work is made available according to the conditions of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence. Full details of this licence are available at: https://creativecommons.org/licenses/by-nc-nd/4.0/

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This is a conference paper. This paper has previously been given the alternative title of "Lack of community-level improved sanitation is associated with stunting in rural villages of Lao PDR and Vietnam".

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