Thursday, September 5, 2019

Study says fetching water increases risk of childhood death

By Esther Nakkazi

Growing up in the city I did not fetch water but for the few times that I visited my lovely grandma (R.I.P Margaret Njakasi) I had to participate in the activity. It was very much for the younger children and maybe one adult who would carry a big (20 litres) jerrycan.

I loved the experience because it was time to play. The water source was downhill. We went in a group of about 6 from my grandma’s house and we would run all the way. We would quickly line up our water containers and run uphill in a queue and slide down sometimes soiling our clothes while some children did it on bare bottoms.

The time we had to spend depended on how enjoyable the ‘sliding’ was and pretty much of the time it was epic - the shouting when you were sliding to the bottom and the cheers plus the climb to go back up and come through again.

Now new research from the University of East Anglia in the UK says water fetching is associated with poor health outcomes for women and children and a higher risk of death.

Adults collecting water is associated with increased risk of childhood death, and children collecting water is associated with increased risk of diarrheal disease, says the study.

The study entitled ‘The association of water carriage, water supply and sanitation usage with maternal and child health. A combined analysis of 49 Multiple Indicator Cluster Surveys from 41 countries’ is published in the International Journal of Hygiene and Environmental Health on Tuesday, September 7, 2019.

The study links women collecting water to maternal health saying if a woman has to collect water chances of giving birth in a health care facility are reduced. The study found that women or girls who have to collect water have reduced uptake of antenatal care and increased odds of leaving young children under five alone for an hour or more.

Researchers studied health outcomes including the risk of child deaths, diarrhoea in children under five, low child weight and height, the number of women giving birth in a health care facility, the uptake of antenatal care and whether young children were being left alone for long periods.

Prof Paul Hunter, from UEA’s Norwich Medical School, the Principal Investigator said not much has been known about the health outcomes of fetching water. “We wanted to find out more about the health implications of fetching water, as well as the outcomes of using unsafe water supplies, inadequate access to improved sanitation – particularly in relation to the health of women and children,” he said.

The research, which involved more than 2.7 million people in 41 countries, is the first to analyse the relationships between water carriage, access to clean drinking water, sanitation and maternal and child health using the UNICEF multiple indicator cluster survey data.

Prof Hunter and his co-investigator Dr Jo Geere, from UEA’s School of Health Sciences, studied data from more than 2.7 million people in 41 low to middle-income countries, looking for associations between access to drinking water, sanitation and health.

Besides women who fetch water’s reduced chances of giving birth in a health care facility, they also have a low uptake of antenatal care and because they have to go to the water source they leave their children under five alone at home for over an hour or go with them. If they are left at home alone unsupervised the children get in trouble.

For the time it takes to walk to a water source, queue up, collect the water and return. Unsupervised children are likely to be at more risk of death from accidental injury or simply from reduced parental care when it is needed – for example during illness or when they are very young, said Dr. Jo Geere, a co-investigator to the study.

“Alternatively, if mothers take their young child with them to collect water, the route may be unsafe due to extreme environmental conditions, hazardous traffic, or interpersonal violence.

“Fetching water may also exacerbate under-nutrition which may inturn impact pregnancies and breastfeeding – increasing the risk of child mortality. And many of the studies we looked at reported fatigue and tiredness affecting water carriers,” said Dr. Geere.

The researchers also found that improving access to water and sanitation is associated with better health outcomes for women and children. This is consistent with another study from Ethiopia, which showed that when taps were installed closer to home, the monthly risk of child death was 50 percent lower among children of the women with access to the new taps.

“This really shows the difference that improved access to clean water makes,”” said Prof Hunter. “Living in a household without a flush toilet was associated with a 9-12 percent higher risk of child death than living in a household where members usually used flush toilets.

Having access to water in homes and having good sanitation led to big improvements to the health of women and children. As such children born into communities with improved sanitation were 12 per cent less likely to die than those born into communities with poor sanitation,” said Prof Hunter.

The research does not specify for how long you have to carry the water and in what way either on the head or lifting jerrycans.

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