The health impacts of poor sanitation are numerous. However, recent RCTs have drawn attention to the fact that the potential pathways of infection are similarly plentiful and interwoven.
To disrupt these pathways and improve health outcomes, S&H programmes need to go beyond eliminating open defecation and work across sectors to clean up the whole environment. This includes:
- Safe disposal of animal and human faeces (including children’s);
- Effective and safely managed pit emptying or faecal sludge management (FSM);
- Good water management/cleanliness;
- Handwashing with soap at critical times throughout the day;
- Creating clean play spaces for children (see below).
As children are amongst the most vulnerable to faecally-transmitted infections (FTIs), it is important to minimise their exposure to pathogens. This requires radically cleaning their environment, for example by: promoting the importance of wearing of shoes when children start walking; providing clean play areas and/or easily cleanable play mats, toys and teething objects which reduce their contact with soil, animal and human excreta; and encouraging the containment or penning of animals in the home.