Improving Health Through Education & Better Sanitation
Every year more than 1.3 million children die globally due to diarrheal diseases (WHO, 2013). Diarrhea is a water-borne disease which is caused due to presence of pathogens (bacteria, parasites or viruses) either in the food or water consumed by children or in the water used by them for washing and other purposes. Unhygienic and unclean conditions are more conducive to the proliferation of diarrhea causing bacteria as compared to cleaner surroundings.
The incidence of the disease is particularly high in developing countries where 2.2 million children face death due to diarrhea each year (WHO, 2013). In Pakistan, on average a child under the age of five experiences five episodes of diarrhea annually (Biloo & Ahmed, 1997). The government of Pakistan collaborated with UNICEF and WHO in 1980 and launched a program to reduce the severity of diarrhea by introducing the Oral Rehydration Therapy. Despite the efforts of the government, diarrhea continues to be one of the leading causes of death amongst children below the age of five in Punjab, Pakistan.
Our empirical investigation using MICS 2011-12 dataset shows that the household’s source of water is not significantly related to the incidence of diarrhea since the quality of water supplied by the government and underground water vary from region to region. Moreover, children tend to drink water from various sources outside their households which can also be a contributory factor to the incidence of the disease. Secondly, we find that male children are more susceptible to diarrhea. This could be because male children tend to spend more time outside their houses and hence they consume water from a variety of places. Thirdly, improper sanitation facilities such as those that imply open disposal of waste create environments that are highly conducive to the proliferation of diarrhea causing agents. Additionally, children from households that share toilets with other households tend to be more prone to diarrhea. Fourthly, an increase in the education level of the mother decreases the probability of child contracting diarrhea as with education the mother becomes more aware of importance of good hygiene habits which are vital for the prevention of diarrhea. The results further indicate that children from households that are rigorous in terms of hand washing are less likely to be infected with the disease as a household that stresses upon hand washing tends to be more concerned about hygiene than other households. Lastly, children from households without refrigerators tend to have a higher incidence of diarrhea because either these households buy contaminated ice from local vendors and street hawkers to cool their drinking water, or these households are poorer households with unhygienic or insanitary facilities for storing water.
Consequently, the key policy recommendations stemming from this research indicate that, first and foremost, efforts need to be geared towards heightening awareness amongst households regarding the importance of hygiene and the health implications of neglect in this regard. This can be done by increasing the enrollment of children in schools where they are formally taught about hygiene in tandem with the launch of awareness campaigns such as television advertisements and door-to-door distribution of pamphlets containing relevant information. Female education needs to receive utmost attention since time and again, this has been revealed to have far reaching consequences for the entire household. To emphasize, we find that while the household head’s education has no impact on child health, the mother’s education can bring diarrheal morbidity down significantly. Secondly, people should be made informed of the importance of proper disposal of waste materials as improper, open disposal of human waste provides an excellent breeding ground for pathogens and increases the incidence of diarrhea. Thirdly, the health department should curb local street hawkers from selling contaminated ice to people from the low income groups. Instead, the government should set up registered sale points for this purpose in summers and hence regulate the quality of water used by these vendors to make ice. Fourth, the government should allocate a greater proportion of the budget to the development and improvement of sanitation facilities.
While the importance of safe drinking water is undeniable, we urge the provincial government to direct more investment into sanitation and lay down sewerage pipelines so that more households are encouraged to install proper toilet facilities. The government should ensure that the sewerage pipes are closed and are installed at a safe distance from the clean water pipes. Moreover, government should carry out intensive awareness campaigns to spread information on the importance of hygiene and proper sanitation facilities. Improved sanitation facilities and inculcation of hygienic practices such as regular hand washing and proper disposal of waste could significantly decrease the incidence of diarrhea. These measures adopted in unison throughout the country together with the active involvement of all stakeholders can be expected to bring Pakistan a step closer to achieving the Millennium Development Goals by 2015.
References
Arif, A., & Naheed, R. (2012). Socioeconomic determinants of diarrheal morbidity in Pakistan. Academic Research International , 490-518.
Biloo, A., & Ahmed, T. (1997). Child Survival Part II. Community Medicine and Public Health , 89-96.
George, R. (2008). The Big Necessity: The Unmentional World of Human Waste and Why it Matters. New York: Macmillan.
UN. (2010). The Millennium Development Goals Report. United Nations Publications , 6-76.
WHO. (2013, 2 2). Media Centre Diarrheal disease. Retrieved 5 24, 2013, from WHO|Diarrheal Disease: http://www.who.int/mediacentre/factsheets/fs330/en/
Disclaimer: The views expressed here are those of the authors and do not necessarily represent the views of the Institute of Development and Economic Alternatives