Food, water, and sanitation insecurities: Complex linkages and implications for achieving WASH security

Area of Science:

• Public Health
• Environmental Health
• Global Health

Background:

• Food, water, and sanitation insecurities are complex issues extending beyond mere availability and access.
• These insecurities interact, leading to significant biological and psychological consequences.
• Existing water, sanitation, and hygiene (WASH) interventions have shown limited impact on child growth and health in recent trials.

Purpose of the Study:

• To highlight the complexity of combined food, water, and sanitation insecurities.
• To advocate for a more comprehensive understanding of WASH security.
• To propose integrated interventions for improved global health outcomes.

Main Methods:

• Critical review of existing research on resource insecurities.
• Analysis of findings from large-scale randomized controlled trials (RCTs) in Bangladesh, Kenya, and Zimbabwe.
• Examination of the interplay between individual, social, economic, and environmental factors.

Main Results:

• Randomized controlled trials (RCTs) in Bangladesh, Kenya (WASH Benefits), and Zimbabwe (SHINE) showed no significant effect of WASH interventions on linear growth.
• Evidence regarding the impact of WASH interventions on enteropathogen burden and diarrhea risk in young children is mixed.
• The risks associated with multiple resource insecurities are dynamic and context-dependent.

Conclusions:

• A comprehensive understanding of WASH security, integrating food, water, and sanitation, is crucial.
• Interventions must address myriad transmission pathways and co-occurring diseases for improved health.
• Transformative WASH approaches are needed to address the complexity of combined resource insecurities.