Work

Effectiveness of stand-alone and multi-component water, sanitation and hygiene interventions to reduce mortality in childhood: a network meta-analysis

Year: 2025

Type: article

Abstract: Mortality in childhood constitutes the vast majority of the global burden of disease due to diarrhoea and respiratory infection. We employ a multi-component network meta-analysis to evaluate the comparative effectiveness of WASH interventions implemented as stand-alone interventions or as multicomponent intervention packages, in reducing all-cause mortality in childhood in endemic disease circumstances in low- and middle-income countries. We find that interventions providing water supplies are most consistently associated with reductions in all-cause mortality in childhood. Furthermore, when initial water supplies are improved, hygiene and sanitation interventions are also more effective. However, we find that behaviour change WASH intervention packages are less effective than stand-alone interventions and that there are no synergies between interventions. These findings caution against the implementation of multicomponent behavioural intervention packages and favour prioritising approaches that improve water supply conditions first. We highlight conflicting behavioural change as a potential cause of the absence of synergies in WASH intervention packages.

Source: Nature Water

DOI: 10.1038/s44221-025-00484-x

Authors: Edoardo Masset, Hugh Sharma Waddington

Institutions: National Institute of Economic and Social Research, London School of Hygiene & Tropical Medicine

Language: English

Topic: Child Nutrition and Water Access

Subfield: Nutrition and Dietetics

Field: Nursing

Domain: Health Sciences

SDGs: Good health and well-being, Clean water and sanitation

Open Access status: hybrid

Estimated APC paid: $12,690