Effect of village income and household income on sanitation facilities, hygiene behaviours and child undernutrition during rapid economic growth in a rural cross-border area, Yunnan, China

Does sanitation infrastructure in rural areas affect migrant workers' health? Empirical evidence from China

Health is considered the most important factor for individual well-being and a country's sustainable development. Among the influential factors of population health, sanitary infrastructure, particularly sanitary toilets and innocuous-sanitary toilets, have already attracted attention. In recent years, to improve the overall health status of rural residents, the Chinese government has promoted the "toilet revolution" in rural areas to update and modernize the facilities of toilets. Given that migrant workers contribute significantly to China's economic growth, and that the migrant workers generally lived in rural areas before they moved to urban areas to find jobs, it is of great interest and importance to investigate the impacts of sanitary infrastructure in rural areas on the migrant workers. This study analyzes the spatial characteristic of rural sanitation facilities' implementation and looks for possible correlation between the health status of migrant workers and the implementation of sanitation facilities in their hometowns. Micro-survey data of migrant workers' health status from China Household Income Projects (CHIP) 2013 and macro-data of provincial economic factors are matched to provide a quality analysis. The analysis of the spatial distribution shows that there were significantly large gaps between the prevalence rates of sanitary toilets in provinces. Furthermore, the regression analysis indicates that the implementation of sanitary toilets and innocuous-sanitary toilets exhibits a positive effect on the overall health status of migrant workers, although the effects of the innocuous-sanitary toilets are greater. Moreover, the positive influences of both types of toilets on population health are higher in the provinces with relatively greater annual precipitation and higher average temperature.

Association between intestinal worm infection and malnutrition among rural children aged 9-11 years old in Guizhou Province, China

BACKGROUND

Intestinal worm infection adversely impacted child health and was one of the China's largest health burdens. However, yet little was known about associations between intestinal worm infection and malnutrition in school-aged children in rural China. This study aimed to fill into the gap.

METHODS

Data were from a survey of children aged 9-11 years old in Guizhou Province, China conducted in June 2013. Considering anemia and low intelligent quotient (IQ) as mediating factors, binomial logistic regression was used to estimate the associations of intestinal worm infection with thinness, underweight, and stunting. Moreover, the associations between socio-demographic factors and malnutrition were also explored.

RESULTS

Among 2179 children, part of children was infected by intestinal worm (41.85%). Stunting (28%), low memory IQ (87.52%), and low process IQ (62.59%) were highly prevalent in the sample. Socio-demographic factors were associated with thinness, underweight, stunting, low memory IQ, low process IQ, anaemia, and intestinal worm infection. Intestinal worm infection was associated with low IQ, anemia, and stunting. In addition, anemia and low IQ could not confound the other expected associations.

CONCLUSION

This study demonstrated the association between intestinal worm infections and stunting appeared to be largely mediated via low IQ. The study highlighted the importance of deworming and improving nutrition in the surveyed areas.

Housing Conditions Contribute to Underweight in Children: An Example From Rural Villages in Southeast Sulawesi, Indonesia

Objectives

The prevalence of underweight in children under 5 years of age is anomalously high in Konawe District, Southeast Sulawesi Province, Indonesia. This state of affairs may be related to poor housing conditions, such as limited access to clean water, the absence of a sanitary latrine, and the use of poor housing materials. Therefore, this study aimed to examine the effect of housing conditions on underweight in under-5 children in Konawe District.

Methods

This study was conducted in 2013 in 5 health centres in Konawe District, Southeast Sulawesi Province, and used a case-control study design. The study recruited 400 under-5 children, including 100 of whom were cases and 300 of whom were age-matched controls (1:3). Cases were underweight children, while the controls were children with a normal nutritional status. The independent variables were the availability and types of water and latrine facilities and housing materials (roof, wall, and floor). The statistical analysis used Cox regression.

Results

A lack of water availability (odds ratio [OR], 5.0; 95% confidence interval [CI], 2.7 to 9.5; p<0.001), a lack of latrine availability in the home (OR, 2.5; 95% CI, 1.5 to 4.0; p<0.001), and poor-quality roofing materials (OR, 1.7; 95% CI, 1.1 to 2.7; p<0.02) significantly contributed to underweight in children. In contrast, the walls and the floors did not contribute to under-5 year children being underweight (p=0.09 and p=0.71, respectively).

Conclusions

Sanitation facilities and roofing were identified as important factors to address in order to improve children’s nutritional status. Children’s health status was directly impacted by food intake via their nutritional status.

Child Health and Nutrition: Getting better and facing new challenges in China

BACKGROUND

Child healthcare practices in China over the last 60 years have extensively improved children's health and growth, yet new challenges lie ahead. This review aims to summarise the successful experiences and the newly identified problems in child healthcare in China.

METHOD

Information, available to the public, was obtained from Chinese databases and Chinese Government websites,chiefly the Chinese National Knowledge Infrastructure database, the Chinese Biomedical Literature database, the Ministry of Health website and the National working committee on children and Women website

RESULTS

During its poverty-stricken 1950s-1970s, China protected children's health mainly through prevention and control of common infectious diseases and severe malnutrition within a comprehensive healthcare system. After the subsequent 30 years of rapid socio-economic development, China has achieved great success in reducing childhood mortality rates and promoting child growth, meeting the Millennium Development Goal 4 targets and the WHO child growth standards. Meanwhile, new challenges for children's healthcare emerged, including: large disparities in the health, growth and nutritional status of children,and in the accessibility and quality of child healthcare, between urban and rural areas and across different regions of China; the nutritional and healthcare concerns of the fast-expanding population of migrant children and rural left-behind children; the burgeoning epidemic of childhood obesity in urban and economically developed areas; micronutrient deficiencies such as calcium, iron, zinc and vitamin A; and increasing prevalence of mental and behavioural disorders.

CONCLUSION

Under poor economic conditions, healthcare plays a key role in protecting children against diseases. With the development of social economy, new challenges present to healthcare services, specifically, to comprehensively promote and optimise childrens' health and nutrition.

Estimating the scope of household water treatment in low- and medium-income countries

For populations without reliable access to safe drinking water, household water treatment (HWT) provides a means of improving water quality and preventing disease. We extracted data on reported HWT practices from 67 national surveys and reports on the scope of HWT. An estimated 33.0% of the households (1.1 billion people) in these countries report treating their drinking water at home. The practice is widespread in the Western Pacific (66.8%) and Southeast Asia (45.4%) regions, and it is less common in the Eastern Mediterranean (13.6%) and Africa (18.2%). Boiling is the most dominant method with 21.0% of the study households (598 million people) using the method. Despite being at higher risk of waterborne disease because of lower coverage of improved water sources, African and rural households are less likely to practice HWT or use microbiologically adequate methods. Validation of the household surveys and further analysis of these data could help optimize HWT practices.