Abstract
Program interventions like access to improved water supply, sanitation and hygiene do not have a systematic response to the aggregate health outcomes. Therefore, this is an attempt at recognising the concept of level sensitivity while verifying the association between prevalence of diarrhoea in under-five children in a district and its corresponding coverage of improved water supply and sanitation and hygiene. Information obtained in the DLHS—4 including 275 districts from 19 states and 2 union territories of India forms the database for this analysis. Universal access to safe drinking water, improving coverage of sanitation in a district beyond 71 percent across the country and beyond 78 percent among the non-south DLHS districts, has the potential to realise reductions in the prevalence of diarrhoea in under-five children in a district. The effect of improved sanitation seems to work synergistically with these indicators only at better levels of prevalence of diarrhoea in under-five children in a district. This offers lessons for the Clean India Mission in terms of universalising access to safe water and coverage up to three-fourths of households with sanitation in a district for the positive externalities to manifest in reduced prevalence of diarrhoea in under-five children.
Highlights
Water, Sanitation and Hygiene (WaSH) are three basic dimensions of Public Health and any compromise in them has adverse consequences on health
This exercise offers an explanation of the three components namely; access to improved water supply, improved sanitation and female education gain statistical salience or significance, conditioned by the level of outcome of prevalence of diarrhoea in under-five children
It is observed that improved sanitation has an effect only beyond the 40th percentile point of levels of diarrhoea prevalence in a district while female literacy and access to improved water supply gain salience above the 20th percentile point
Summary
Sanitation and Hygiene (WaSH) are three basic dimensions of Public Health and any compromise in them has adverse consequences on health. 71 percent of the people have access to safe drinking water in the premises, and 68 percent have access to basic sanitation services [1]. Hygiene is shaped by individual factors such as practices, beliefs, norms and educational status of caregivers of children and contextually by prevailing norms, e.g., access to safe drinking water and sanitation. Improvements in WaSH have an impact in reducing the incidence of diarrhoea and other intestinal infections. Availability and use of water along with hygiene practices reduces the risk of respiratory, skin and eye infections.
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