‘More toilets don’t lead to better health’

After more than two years, they found that the health of children in the villages with latrines had not improved. Diarrhoea rates were virtually the same. So was the prevalence of parasitic worms that can cause stunting and mental impairment. Children in villages with latrines had not grown faster than children in those without, nor had they even gained more weight.

The authors, whose work was published by The Lancet this month, could not fully explain the failure of latrine building to do more good. Some households did not use the latrines consistently, they said — compliance was particularly bad among men and children. Many users who had to clean themselves with their hands did not wash their hands with soap afterward. And animal feces lying around may have caused problems.

If building latrines does so little, an editorial comment with the article said, it may make more sense to spend money on clean water, encouraging hand-washing, vaccines against rotavirus and other diarrhoeal diseases, or treating diarrhoea with oral rehydration and zinc.

Cause & effect

Study covers 100 villages in Odisha, India, with a total of 51,000 inhabitants

Large latrines were built in half of them. Focus on households with young children

After more than two years, it was found that the health of children in the villages with latrines had not improved

Diarrhoea rates were virtually the same

Prevalence of parasitic worms that can cause stunting and mental impairment also remained the same. Also these children had not grown faster than those without the latrines.