BackSanitation can improve early cognitive development: World Bank
The study suggests that low-cost rural sanitation strategies can support children's cognitive development
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New Delhi: Access to improved sanitation can increase cognition in children, according to a new World Bank study that observed India’s efforts to combat open defecation.
Fifty three percent of Indian households, around 600 million people, defecate in the open without using a toilet or latrine, according to a 2012 report by the World Health Organization and UN Children’s Fund.
The study looked at the effects on childhood cognitive achievement of early life exposure to India’s Total Sanitation Campaign (TSC), a national-scale government programme that encouraged local governments to build and promote the use of inexpensive pit latrines from 2001 to 2012.
Currently, more than 2.5 billion people worldwide lack access to toilets, and a billion people defecate in the open. The paper estimates the effect of the TSC on Indian children’s cognitive skills by matching test score data on six year olds’ academic achievements with government data on TSC programme intensity early in their lives, focusing on the first three years of the implementation between 2001 to 2003.
“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 recognize letters and simple numbers on learning tests than those who were not," said Dean Spears, lead author of the paper in a press release published on Monday. “The study suggests that low-cost rural sanitation strategies such as India’s Total Sanitation Campaign can support children’s cognitive development."
But activists are questioning the way such campaigns are implemented on the ground. “Under the Total Sanitation Campaign, many so-called toilets have been constructed by the government, but it has not given any focus to community mobilization or spreading awareness regarding the importance of toilets," says Rajive Ranjan from the Water, Sanitation and Hygiene Institute (WASHi), which has been working for sanitation capacity building in India.
Ranjan, who has been working on sanitation projects in villages of Bihar, added that it sometimes takes his team nearly six months to convince a community to use toilets, but such efforts are not made by the government campaigns. “Constructing toilets is not enough," he said.
The authors of the study concluded that open defecation, which spreads diseases, is an important threat to the human capital of developing countries, and that a programme accessible to countries where sanitation development capacity is lower could improve average cognitive skills.
The study comes in the wake of a recent UN study which suggested that open defecation was also the cause for stunted growth in children. In 2013, a study titled How Much International Variation in Child Height Can Sanitation Explain?, the World Bank revealed that open defecation can statistically account for most of the differences across poor countries in average child height.
The World Bank study explained that because the same factors that promote physical development in early life also encourage children’s cognitive development, diseases caused by poor sanitation have been associated with the lack of cognitive achievement.
Every year 400,000 children die of diarrhoea in India which continues to have the largest diarrhoeal burden in the world, and 88% of diarrhoea deaths are linked to incomplete water and sanitation service provision. Rural development minister Jairam Ramesh recently said that India would take another 8-10 years to ensure it’s free of open defecation.
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