Nutritional gain associated with Water, Sanitation and Hygiene (WASH) access: An Analysis of Punjab

Abstract

Globally, undernutrition statistics are decreasing whereas in Pakistan, about half of the children under the age of 5 are exposed to the increasing concern of undernutrition. The progress on reducing undernutrition is rather slow in Pakistan despite significant reductions in poverty, which begs a question why Pakistan has been unable to make significant strides in improving nutrition indicators for children over the past few decades. Unimproved water, unimproved sanitation, and unhealthy hygienic practices are an important determinant for reducing undernutrition. Despite the recognized importance of the problem on national as well as international forums, research on determinants of undernutrition in Pakistan is scarce, especially in context of role of the sources of drinking water, toilet facilities and hand washing facilities. The objective of this study is to incorporate Water, Sanitation and Hygiene (WASH) variables to study their impact on undernutrition (stunting, wasting and undernutrition) in Punjab, the province with largest population in the country. The empirical analysis is based on the data from Multiple Indicator Cluster Survey (MICS) 2017-2018. Using the logistic and ordinal logistic regression analysis, the results indicate improved sanitation facility as one of the most significant determinants of undernutrition in Punjab. It is estimated that households that uses improved sanitation facility have lower rates of child being born stunted, wasted or underweight. It also highlights adequate food intake, education attainment, and birth in a health facility and child immunization as an important determinant to lower the rate of undernutrition in Punjab. The study concludes that, in addition to the interventions related to health and nutrition, improvement in sanitation access should be targeted by policy to improve nutrition status of the children in Punjab.