June J. Cheng|Corinne J. Schuster?Wallace|Susan Watt|K. Bruce Newbold|Andrew Mente
An ecological quantification of the relationships between water, sanitation and infant, child, and maternal mortality
McMaster University|United Nations University Institute for Water, Environment, and Health|United Nations University Institute for Water, Environment, and Health|McMaster University|McMaster University
water sanitation access known related newborn child maternal health study attempts quantify relationships globally using countrylevel data much improving access water sanitation influence infant child maternal mortalitydata 193 countries abstracted global databases world bank unicef linear regression used outcomes underfive mortality rate infant mortality rate imr results presented events per 1000 live births ordinal logistic regression used compute odds ratios outcome maternal mortality ratio mmrunderfive mortality rate decreased 117 95ci 108126 deaths per 1000 p 0001 every quartile increase population water access adjustments confounders similar relationship quartile increase sanitation access underfive mortality rate decrease 166 95ci 111132 deaths per 1000 p 0001 improved water access also related imr imr decreasing 114 95ci 105123 deaths per 1000 p 0001 increasing quartile access improved water source significance relationship retained quartile improvement sanitation access decrease imr 166 95ci 111132 deaths per 1000 p 0001 estimated odds ratio increased quartile water access significantly associated increased quartile mmr 058 95ci 039086 p 0008 corresponding odds ratio sanitation 052 95ci 032085 p 0009 suggesting better water sanitation associated decreased mmrour analyses suggest access water sanitation independently contribute child maternal mortality outcomes world seriously address millennium development goals reducing child maternal mortality improved water sanitation accesses key strategies