reporting that the effect of WASH interventions on stunting was greatest in children aged 0-24 months, in an individual participant data sub-group analysis (Dangour et al., 2013b). Identifying dominant faecal-oral exposure pathways for young children when they are most vulnerable to the deleterious effects of contaminated environments is the first step in identifying those WASH interventions that are likely to be most efficacious. One recent study used structured observation of mother-child couples in Zimbabwe to assess faecal-oral exposure among young children and highlighted the risks associated with the consumption of soil geophagia and animal waste in peri-domestic areas (Ngure et al., – – 2013). A number of recent studies in Mali (Touré et al., 2013, Touré et al., 2011) and in Bangladesh (Islam et al., 2013) have also highlighted the risk to this age group posed by often highly contaminated weaning or complementary food. There has been growing concern, too, about the safe disposal of children’s faeces, which is generally not disposed of safely, as it is often considered to be less pathogenic than that of adults although the reverse may be true (Brown, 2003). WASH interventions that target critical exposure points for children should be prioritized within broader WASH programmes that seek to influence growth outcomes, and be promoted alongside relevant nutrition-specific priorities, such as improving Infant and Young Child Feeding (IYCP)(WHO and UNICEF, 2003). Such WASH interventions might logically include infant food hygiene - the safe preparation, storage and reheating of infant foods -,
reporting that the effect of WASH interventions on stunting was greatest in children aged 0-24 months, in an individual participant data sub-group analysis (Dangour et al., 2013b). Identifying dominant faecal-oral exposure pathways for young children when they are most vulnerable to the deleterious effects of contaminated environments is the first step in identifying those WASH interventions that are likely to be most efficacious. One recent study used structured observation of mother-child couples in Zimbabwe to assess faecal-oral exposure among young children and highlighted the risks associated with the consumption of soil – geophagia – and animal waste in peri-domestic areas (Ngure et al., 2013). A number of recent studies in Mali (Touré et al., 2013, Touré et al., 2011) and in Bangladesh (Islam et al., 2013) have also highlighted the risk to this age group posed by often highly contaminated weaning or complementary food. There has been growing concern, too, about the safe disposal of children’s faeces, which is generally not disposed of safely, as it is often considered to be less pathogenic than that of adults although the reverse may be true (Brown, 2003). WASH interventions that target critical exposure points for children should be prioritized within broader WASH programmes that seek to influence growth outcomes, and be promoted alongside relevant nutrition-specific priorities, such as improving Infant and Young Child Feeding (IYCP)(WHO and UNICEF, 2003). Such WASH interventions might logically include infant food hygiene - the safe preparation, storage and reheating of infant foods -,
Cumming%20%26%20Cairncross%20%28WASH%20%26%20Stunting%29%20REVIEWER%20COMMENTS%20ADDRESSED%202_clean.docx