Latrine access associated with improved health of rural Nepali children

Access to clean water and sanitation are crucial to assure the health of children in developing countries. When interventions to improve this access are provided, it is important that evaluations of their impact be conducted. We evaluated differences in health status of children living in households with and without access to a latrine in two low-caste villages of rural Nepal. Medical history and health status of family members were obtained from heads of households through personal interviews. Anthropometric measurements including height and weight were completed on children under the age of 12 and compared to 2000 CDC growth reference standards to obtain z-scores. Data were obtained on 579 children under age 12 living in 240 households. Younger children were more likely to be malnourished or stunted (p < .05) while gender was not associated with nutritional status. In households without access to latrines, 30.5% of children were severely malnourished compared 18.4% of those with access to latrines. Likewise, 24.2% of the children in households without latrines were severely stunted in contrast to 15.6% using latrines. Access to a household latrine, adjusted for gender, age, village, and household unit, reduced the risk of severe malnutrition by almost half (OR: 0.52, 95% CI: 0.31-0.87). Older parents were less likely to have children with severe stunting (OR: 0.97, 95% CI: 0.96-0.99) which may represent their greater experience or knowledge of healthy behaviors. Efforts to educate and improve access to sanitary conditions in rural Nepali communities are critically needed.