Scaling up rural sanitation : investing in the next generation - growing tall and smart with toilets : stopping open defecation improves children's height in Cambodia

Open defecation within a community harms the physical and cognitive development of children, even children living in households that use toilets themselves. Frequently digesting feces due to poor sanitation can cause diarrhea, malnutrition, and stunted growth-and thus impact negatively on a child's cognitive development. Experiencing these health hazards at young ages can ultimately limit one's earning potential later in life. In addition to the use of health services, mother and child nutrition practices and care, the immediate disease environment shapes early life health and ultimately a child's achievement later in life. Thus, elimination of open defecation makes a sensible priority for policy makers that are concerned with the next productive generation. This brief shows, the level of open defecation in a community is associated with shorter children in Cambodia. Moreover, the level of open defecation in a community is more important for a child's development than whether the child's household itself openly defecates. By looking at the change in defecation levels and average child height between 2005 and 2010 within Cambodian provinces, the study is able to show that improvements in sanitation access played a substantial role in increasing average child height over the same five years. [author abstract]