Authors:
, , , , , , , , , , , , , , , , , and
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Spears D , 2020. Exposure to open defecation can account for the Indian enigma of child height. J Dev Econ 146: 102277.
-
2.
Chakravarty I , Bhattacharya A , Das S , 2017. Water, sanitation and hygiene: The unfinished agenda in the World Health Organization South-East Asia Region. WHO South-East Asia J Public Health 6: 22.
-
3.
Chatterjee P , 2021. India’s child malnutrition story worsens. Lancet Child Adolesc Health 5: 319–320.
-
4.
Acharya Y , Luke N , Haro MF , Rose W , Russell PSS , Oommen AM , Minz S , 2019. Nutritional status, cognitive achievement, and educational attainment of children aged 8–11 in rural South India. PloS One 14: e0223001.
-
5.
Dewey KG , Begum K , 2011. Long-term consequences of stunting in early life: Long-term consequences of stunting. Matern Child Nutr 7: 5–18.
-
6.
Prado EL , Dewey KG , 2014. Nutrition and brain development in early life. Nutr Rev 72: 267–284.
-
7.
Horton S , 1999. Opportunities for investments in nutrition in low-income Asia. Asian Dev Rev 17: 246–273.
-
8.
Spears D , Lamba S , 2013. Effects of Early-Life Exposure to Sanitation on Childhood Cognitive Skills: Evidence from India’s Total Sanitation Campaign. Washington, DC: The World Bank.
-
9.
Humphrey JH , 2009. Child undernutrition, tropical enteropathy, toilets, and handwashing. Lancet 374: 1032–1035.
-
10.
Petri WA , Miller M , Binder HJ , Levine MM , Dillingham R , Guerrant RL , 2008. Enteric infections, diarrhea, and their impact on function and development. J Clin Invest 118: 1277–1290.
-
11.
Ercumen A et al., 2017. Animal feces contribute to domestic fecal contamination: Evidence from E. coli measured in water, hands, food, flies, and soil in Bangladesh. Environ Sci Technol 51: 8725–8734.
-
12.
Khan AY , Fatima K , Ali M , 2021. Sanitation ladder and undernutrition among under-five children in Pakistan. Environ Sci Pollut Res Int 28: 38749–38763.
-
13.
Spears D , Ghosh A , Cumming O , 2013. Open defecation and childhood stunting in India: An ecological analysis of new data from 112 districts. PloS One 8: e73784.
-
14.
Menon P , Headey D , Avula R , Nguyen PH , 2018. Understanding the geographical burden of stunting in India: A regression‐decomposition analysis of district‐level data from 2015–16. Matern Child Nutr 14: e12620.
-
15.
Singh S , Srivastava S , Upadhyay AK , 2019. Socio-economic inequality in malnutrition among children in India: An analysis of 640 districts from National Family Health Survey (2015–16). Int J Equity Health 18: 203.
-
16.
Srivastava S , Upadhyay AK , 2022. A success story of reduction in childhood stunting and underweight in India: Analysis of pooled data from three rounds of Indian demographic and health surveys (1998–2016). J Biosoc Sci 54: 106–123.
-
17.
Rah JH , Cronin AA , Badgaiyan B , Aguayo VM , Coates S , Ahmed S , 2015. Household sanitation and personal hygiene practices are associated with child stunting in rural India: A cross-sectional analysis of surveys. BMJ Open 5: e005180.
-
18.
Rahman MHU , Malik MA , Chauhan S , Patel R , Singh A , Mittal A , 2020. Examining the linkage between open defecation and child malnutrition in India. Child Youth Serv Rev 117: 105345.
-
19.
Singh P , Shah M , Bruckner TA , 2021. Child undernutrition following the introduction of a large-scale toilet construction campaign in India. J Nutr 151: 2455–2464.
-
20.
Hathi P , Haque S , Pant L , Coffey D , Spears D , 2017. Place and child health: The interaction of population density and sanitation in developing countries. Demography 54: 337–360.
-
21.
Chakrabarti S , Singh P , Bruckner T , 2020. Association of poor sanitation with growth measurements among children in India. JAMA Netw Open 3: e202791.
-
22.
Cameron L , Chase C , Haque S , Joseph G , Pinto R , Wang Q , 2021. Childhood stunting and cognitive effects of water and sanitation in Indonesia. Econ Hum Biol 40: 100944.
-
23.
Lai A , Velez I , Ambikapathi R , Seng K , Cumming O , Brown J , 2022. Risk factors for early childhood growth faltering in rural Cambodia: A cross-sectional study. BMJ Open 12: e058092.
-
24.
Headey D , Hoddinott J , Park S , 2016. Drivers of nutritional change in four South Asian countries: A dynamic observational analysis. Matern Child Nutr 12: 210–218.
-
25.
Zambrano LD , Levy K , Menezes NP , Freeman MC , 2014. Human diarrhea infections associated with domestic animal husbandry: A systematic review and meta-analysis. Trans R Soc Trop Med Hyg 108: 313–325.
-
26.
Kaur M , Graham JP , Eisenberg JNS , 2017. Livestock ownership among rural households and child morbidity and mortality: An analysis of demographic health survey data from 30 sub-Saharan African countries (2005–2015). Am J Trop Med Hyg 96: 741–748.
-
27.
Acharya Y , Yang D , Jones AD , 2021. Livestock ownership and anaemia in sub-Saharan African households. Public Health Nutr 24: 3698–3709.
-
28.
Neto UF , Scaletsky ICA , 2000. Escherichia coli infections and malnutrition. Lancet 356: S27.
-
29.
Ercumen A , Prottas C , Harris A , Dioguardi A , Dowd G , Guiteras R , 2020. Poultry ownership associated with increased risk of child diarrhea: Cross-sectional evidence from Uganda. Am J Trop Med Hyg 102: 526–533.
-
30.
Schmidt WP , Boisson S , Routray P , Bell M , Cameron M , Torondel B , Clasen T , 2016. Exposure to cows is not associated with diarrhoea or impaired child growth in rural Odisha, India: A cohort study. Epidemiol Infect 144: 53–63.
-
31.
International Institute for Population Sciences (IIPS) and ICF , 2017. National Family Health Survey (NFHS-4), 2015–16: India. Mumbai, India: International Institute for Population Sciences.
-
32.
Borker G , Eeckhout J , Luke N , Minz S , Munshi K , Swaminathan S , 2022. Wealth, Marriage, and Sex Selection. Available at: https://cpb-us-w2.wpmucdn.com/campuspress.yale.edu/dist/f/3899/files/2022/01/Wealth_Marriage_Sex_Selection.pdf. Accessed April 12, 2024.
-
33.
Vidmar SI , Cole TJ , Pan H , 2013. Standardizing anthropometric measures in children and adolescents with functions for egen: Update. Stata J 13: 366–378.
-
34.
World Health Organization , WHO Child Growth Standards: Length/Height-for-Age, Weight-for-Age, Weight-for-Length, Weight-for-Height and Body Mass Index-for-Age: Methods and Development. Available at: https://www.who.int/publications-detail-redirect/924154693X. Accessed April 20, 2023.
-
35.
Sharma S , 2015. Caste-based crimes and economic status: Evidence from India. J Comp Econ 43: 204–226.
-
36.
Luke N , Munshi K , 2011. Women as agents of change: Female income and mobility in India. J Dev Econ 94: 1–17.
-
37.
World Health Organization , 2017. Guidelines for Drinking-Water Quality, 4th Edition, Incorporating the 1st Addendum. Available at: https://www.who.int/publications-detail-redirect/9789241549950. Accessed April 21, 2023.
-
38.
Jayachandran S , Kuziemko I , 2011. Why do mothers breastfeed girls less than boys? Evidence and implications for child health in India. Q J Econ 126: 1485–1538.
-
39.
Borooah VK , 2004. Gender bias among children in India in their diet and immunisation against disease. Soc Sci Med 58: 1719–1731.
-
40.
Diamond‐Smith N , Luke N , McGarvey S , 2008. ‘Too many girls, too much dowry’: Son preference and daughter aversion in rural Tamil Nadu, India. Cult Health Sex 10: 697–708.
-
41.
Victora CG , de Onis M , Hallal PC , Blössner M , Shrimpton R , 2010. Worldwide timing of growth faltering: Revisiting implications for interventions. Pediatrics 125: e473–e480.
-
42.
Guldan GS , Zeitlin MF , Beiser AS , Super CM , Gershoff SN , Datta S , 1993. Maternal education and child feeding practices in rural Bangladesh. Soc Sci Med 36: 925–935.
-
43.
Vereecken CA , Keukelier E , Maes L , 2004. Influence of mother’s educational level on food parenting practices and food habits of young children. Appetite 43: 93–103.
-
44.
StataCorp , 2017. Stata Statistical Software: Release 15. College Station, TX: StataCorp LLC. Available at: https://www.stata.com/. Accessed April 13, 2024.
-
45.
Lowenstein C , Vasco K , Sarzosa S , Salinas L , Torres A , Perry MJ , Simmens SJ , Trueba G , Eisenberg JNS , Graham JP , 2020. Determinants of childhood zoonotic enteric infections in a semirural community of Quito, Ecuador. Am J Trop Med Hyg 102: 1269–1278.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1118 | 1118 | 31 |
| Full Text Views | 81 | 81 | 19 |
| PDF Downloads | 78 | 78 | 10 |
Open Defecation, Livestock Ownership, and Child Nutritional Status in India
Nancy Luke
Nancy Luke
Department of Sociology and Criminology, The Pennsylvania State University, University Park, Pennsylvania;
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Yubraj Acharya
Yubraj Acharya
Department of Health Policy and Administration, The Pennsylvania State University, University Park, Pennsylvania;
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Marco Faytong-Haro
Marco Faytong-Haro
Department of Sociology and Criminology, The Pennsylvania State University, University Park, Pennsylvania;
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Di Yang
Di Yang
Department of Health Policy and Administration, The Pennsylvania State University, University Park, Pennsylvania;
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Hongwei Xu
Hongwei Xu
Department of Sociology, Queens College-CUNY, New York, New York;
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Anu Mary Oommen
Anu Mary Oommen
Department of Community Health, Christian Medical College, Vellore, India;
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Winsley Rose
Winsley Rose
Department of Paediatrics, Christian Medical College, Vellore, India
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ABSTRACT.
South Asian children are among the most severely malnourished worldwide. One prominent hypothesis is that open defecation in the local area exposes children to human fecal pathogens that can cause diarrhea and malnutrition. Much of the existing research uses district-level measures of open defecation, which could mask important local-area variation. A second hypothesis is that animal fecal matter is a major source of exposure. This analysis tested these dual hypotheses using census data collected from 949 villages in Tamil Nadu, India, and a survey conducted in a random sample of 5,000 households in the same area. The final analytic sample consisted of 2,561 children aged 0–10 years. We estimated the association between the measures of village- and household-level open defecation, household livestock ownership, and child height-for-age Z-scores in a regression framework, controlling for potential confounders. Results revealed that village- and household-level open defecations are negatively associated with child height. There was an estimated difference of approximately 0.5 height-for-age Z-score between children living in villages with no open defecation and children in villages where all households practiced open defecation (P = 0.001) and a 0.2 Z-score difference between children living in households that practiced open defecation and those living in households that did not (P = 0.001). Livestock ownership was not associated with child height. Overall, the findings provide evidence on the centrality of open defecation in explaining persistent child malnutrition in India and the higher risk of exposure to human fecal pathogens compared with animal feces in the south Indian context.
- Supplemental Materials (PDF 190.11 KB)
Author Notes
Financial support:
Authors’ addresses: Nancy Luke, Department of Sociology and Criminology, The Pennsylvania State University, University Park, PA, E-mail: nkl10@psu.edu. Yubraj Acharya, Department of Health Policy and Administration, The Pennsylvania State University, University Park, PA, E-mail: yua36@psu.edu. Di Yang, The London School of Economics and Political Science, London, UK. Email: D.Yang21@lse.ac.uk. Marco Faytong-Haro, Universidad Espiritu Santo, Samborondon, Ecuador. Email: marco@laboratoriolide.org. Hongwei Xu, Department of Sociology, Queens College-CUNY, Flushing, NY, E-mail: Hongwei.Xu@qu.cuny.edu. Anu Mary Oommen, Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India, E-mail: anuoommen@cmcvellore.ac.in. Winsley Rose, Department of Paediatrics, Christian Medical College, Vellore, Tamil Nadu, India, E-mail: winsleyrose@cmc.vellore.ac.in.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Spears D , 2020. Exposure to open defecation can account for the Indian enigma of child height. J Dev Econ 146: 102277.
-
2.
Chakravarty I , Bhattacharya A , Das S , 2017. Water, sanitation and hygiene: The unfinished agenda in the World Health Organization South-East Asia Region. WHO South-East Asia J Public Health 6: 22.
-
3.
Chatterjee P , 2021. India’s child malnutrition story worsens. Lancet Child Adolesc Health 5: 319–320.
-
4.
Acharya Y , Luke N , Haro MF , Rose W , Russell PSS , Oommen AM , Minz S , 2019. Nutritional status, cognitive achievement, and educational attainment of children aged 8–11 in rural South India. PloS One 14: e0223001.
-
5.
Dewey KG , Begum K , 2011. Long-term consequences of stunting in early life: Long-term consequences of stunting. Matern Child Nutr 7: 5–18.
-
6.
Prado EL , Dewey KG , 2014. Nutrition and brain development in early life. Nutr Rev 72: 267–284.
-
7.
Horton S , 1999. Opportunities for investments in nutrition in low-income Asia. Asian Dev Rev 17: 246–273.
-
8.
Spears D , Lamba S , 2013. Effects of Early-Life Exposure to Sanitation on Childhood Cognitive Skills: Evidence from India’s Total Sanitation Campaign. Washington, DC: The World Bank.
-
9.
Humphrey JH , 2009. Child undernutrition, tropical enteropathy, toilets, and handwashing. Lancet 374: 1032–1035.
-
10.
Petri WA , Miller M , Binder HJ , Levine MM , Dillingham R , Guerrant RL , 2008. Enteric infections, diarrhea, and their impact on function and development. J Clin Invest 118: 1277–1290.
-
11.
Ercumen A et al., 2017. Animal feces contribute to domestic fecal contamination: Evidence from E. coli measured in water, hands, food, flies, and soil in Bangladesh. Environ Sci Technol 51: 8725–8734.
-
12.
Khan AY , Fatima K , Ali M , 2021. Sanitation ladder and undernutrition among under-five children in Pakistan. Environ Sci Pollut Res Int 28: 38749–38763.
-
13.
Spears D , Ghosh A , Cumming O , 2013. Open defecation and childhood stunting in India: An ecological analysis of new data from 112 districts. PloS One 8: e73784.
-
14.
Menon P , Headey D , Avula R , Nguyen PH , 2018. Understanding the geographical burden of stunting in India: A regression‐decomposition analysis of district‐level data from 2015–16. Matern Child Nutr 14: e12620.
-
15.
Singh S , Srivastava S , Upadhyay AK , 2019. Socio-economic inequality in malnutrition among children in India: An analysis of 640 districts from National Family Health Survey (2015–16). Int J Equity Health 18: 203.
-
16.
Srivastava S , Upadhyay AK , 2022. A success story of reduction in childhood stunting and underweight in India: Analysis of pooled data from three rounds of Indian demographic and health surveys (1998–2016). J Biosoc Sci 54: 106–123.
-
17.
Rah JH , Cronin AA , Badgaiyan B , Aguayo VM , Coates S , Ahmed S , 2015. Household sanitation and personal hygiene practices are associated with child stunting in rural India: A cross-sectional analysis of surveys. BMJ Open 5: e005180.
-
18.
Rahman MHU , Malik MA , Chauhan S , Patel R , Singh A , Mittal A , 2020. Examining the linkage between open defecation and child malnutrition in India. Child Youth Serv Rev 117: 105345.
-
19.
Singh P , Shah M , Bruckner TA , 2021. Child undernutrition following the introduction of a large-scale toilet construction campaign in India. J Nutr 151: 2455–2464.
-
20.
Hathi P , Haque S , Pant L , Coffey D , Spears D , 2017. Place and child health: The interaction of population density and sanitation in developing countries. Demography 54: 337–360.
-
21.
Chakrabarti S , Singh P , Bruckner T , 2020. Association of poor sanitation with growth measurements among children in India. JAMA Netw Open 3: e202791.
-
22.
Cameron L , Chase C , Haque S , Joseph G , Pinto R , Wang Q , 2021. Childhood stunting and cognitive effects of water and sanitation in Indonesia. Econ Hum Biol 40: 100944.
-
23.
Lai A , Velez I , Ambikapathi R , Seng K , Cumming O , Brown J , 2022. Risk factors for early childhood growth faltering in rural Cambodia: A cross-sectional study. BMJ Open 12: e058092.
-
24.
Headey D , Hoddinott J , Park S , 2016. Drivers of nutritional change in four South Asian countries: A dynamic observational analysis. Matern Child Nutr 12: 210–218.
-
25.
Zambrano LD , Levy K , Menezes NP , Freeman MC , 2014. Human diarrhea infections associated with domestic animal husbandry: A systematic review and meta-analysis. Trans R Soc Trop Med Hyg 108: 313–325.
-
26.
Kaur M , Graham JP , Eisenberg JNS , 2017. Livestock ownership among rural households and child morbidity and mortality: An analysis of demographic health survey data from 30 sub-Saharan African countries (2005–2015). Am J Trop Med Hyg 96: 741–748.
-
27.
Acharya Y , Yang D , Jones AD , 2021. Livestock ownership and anaemia in sub-Saharan African households. Public Health Nutr 24: 3698–3709.
-
28.
Neto UF , Scaletsky ICA , 2000. Escherichia coli infections and malnutrition. Lancet 356: S27.
-
29.
Ercumen A , Prottas C , Harris A , Dioguardi A , Dowd G , Guiteras R , 2020. Poultry ownership associated with increased risk of child diarrhea: Cross-sectional evidence from Uganda. Am J Trop Med Hyg 102: 526–533.
-
30.
Schmidt WP , Boisson S , Routray P , Bell M , Cameron M , Torondel B , Clasen T , 2016. Exposure to cows is not associated with diarrhoea or impaired child growth in rural Odisha, India: A cohort study. Epidemiol Infect 144: 53–63.
-
31.
International Institute for Population Sciences (IIPS) and ICF , 2017. National Family Health Survey (NFHS-4), 2015–16: India. Mumbai, India: International Institute for Population Sciences.
-
32.
Borker G , Eeckhout J , Luke N , Minz S , Munshi K , Swaminathan S , 2022. Wealth, Marriage, and Sex Selection. Available at: https://cpb-us-w2.wpmucdn.com/campuspress.yale.edu/dist/f/3899/files/2022/01/Wealth_Marriage_Sex_Selection.pdf. Accessed April 12, 2024.
-
33.
Vidmar SI , Cole TJ , Pan H , 2013. Standardizing anthropometric measures in children and adolescents with functions for egen: Update. Stata J 13: 366–378.
-
34.
World Health Organization , WHO Child Growth Standards: Length/Height-for-Age, Weight-for-Age, Weight-for-Length, Weight-for-Height and Body Mass Index-for-Age: Methods and Development. Available at: https://www.who.int/publications-detail-redirect/924154693X. Accessed April 20, 2023.
-
35.
Sharma S , 2015. Caste-based crimes and economic status: Evidence from India. J Comp Econ 43: 204–226.
-
36.
Luke N , Munshi K , 2011. Women as agents of change: Female income and mobility in India. J Dev Econ 94: 1–17.
-
37.
World Health Organization , 2017. Guidelines for Drinking-Water Quality, 4th Edition, Incorporating the 1st Addendum. Available at: https://www.who.int/publications-detail-redirect/9789241549950. Accessed April 21, 2023.
-
38.
Jayachandran S , Kuziemko I , 2011. Why do mothers breastfeed girls less than boys? Evidence and implications for child health in India. Q J Econ 126: 1485–1538.
-
39.
Borooah VK , 2004. Gender bias among children in India in their diet and immunisation against disease. Soc Sci Med 58: 1719–1731.
-
40.
Diamond‐Smith N , Luke N , McGarvey S , 2008. ‘Too many girls, too much dowry’: Son preference and daughter aversion in rural Tamil Nadu, India. Cult Health Sex 10: 697–708.
-
41.
Victora CG , de Onis M , Hallal PC , Blössner M , Shrimpton R , 2010. Worldwide timing of growth faltering: Revisiting implications for interventions. Pediatrics 125: e473–e480.
-
42.
Guldan GS , Zeitlin MF , Beiser AS , Super CM , Gershoff SN , Datta S , 1993. Maternal education and child feeding practices in rural Bangladesh. Soc Sci Med 36: 925–935.
-
43.
Vereecken CA , Keukelier E , Maes L , 2004. Influence of mother’s educational level on food parenting practices and food habits of young children. Appetite 43: 93–103.
-
44.
StataCorp , 2017. Stata Statistical Software: Release 15. College Station, TX: StataCorp LLC. Available at: https://www.stata.com/. Accessed April 13, 2024.
-
45.
Lowenstein C , Vasco K , Sarzosa S , Salinas L , Torres A , Perry MJ , Simmens SJ , Trueba G , Eisenberg JNS , Graham JP , 2020. Determinants of childhood zoonotic enteric infections in a semirural community of Quito, Ecuador. Am J Trop Med Hyg 102: 1269–1278.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1118 | 1118 | 31 |
| Full Text Views | 81 | 81 | 19 |
| PDF Downloads | 78 | 78 | 10 |