Article type
Abstract
Background: The causes of anemia are multifaceted and context specific, characterized by a complex interplay between nutritional status, infections, environmental exposures, and various other factors.
Objectives: This report reviews the evidence on the impact of water, sanitation, and hygiene interventions on reducing anemia in low- and middle-income countries (LMICs). The review used the adapt, agree, and act framework based on the transtheoretical model for drawing causal linkages.
Methods: We conducted a systematic search, screen, coding, and critical appraisal process. A PubMed search and a hand search of relevant websites and journals was followed by screening of more than 781 titles and abstracts. Critical appraisal tools for quantitative and qualitative studies were used to assess confidence in the findings of the included studies. Screening, coding, and critical appraisal were all done in duplicate by two reviewers with a reconciliation step to settle disagreements.
Results: A total of three articles met the criteria for inclusion. The interventions focused on the provision of counseling and logistics to the target population. The themes for counseling included open defecation and hand washing; personal hygiene; and the treatment of water and clean surroundings through demonstrations, audio visual aids, and health education sessions. The logistics that were provided include hand washing stations, soap dispensers, soap bars, and latrine upgrades. The results show that the causal processes through WASH interventions impact on reducing anemia through improving the behavior related to hand washing and hygiene and sanitary practices. In addition, WASH interventions when combined with nutrition interventions amplify the impact of these interventions in improving behavior and thus result in the reduction in the anemia levels. Therefore, WASH interventions are to be considered as part of a long-term strategy for mitigating anemia across populations.
Conclusions: However, the evidence base is small, so additional research would help us learn more about the effectiveness of the policy.
Objectives: This report reviews the evidence on the impact of water, sanitation, and hygiene interventions on reducing anemia in low- and middle-income countries (LMICs). The review used the adapt, agree, and act framework based on the transtheoretical model for drawing causal linkages.
Methods: We conducted a systematic search, screen, coding, and critical appraisal process. A PubMed search and a hand search of relevant websites and journals was followed by screening of more than 781 titles and abstracts. Critical appraisal tools for quantitative and qualitative studies were used to assess confidence in the findings of the included studies. Screening, coding, and critical appraisal were all done in duplicate by two reviewers with a reconciliation step to settle disagreements.
Results: A total of three articles met the criteria for inclusion. The interventions focused on the provision of counseling and logistics to the target population. The themes for counseling included open defecation and hand washing; personal hygiene; and the treatment of water and clean surroundings through demonstrations, audio visual aids, and health education sessions. The logistics that were provided include hand washing stations, soap dispensers, soap bars, and latrine upgrades. The results show that the causal processes through WASH interventions impact on reducing anemia through improving the behavior related to hand washing and hygiene and sanitary practices. In addition, WASH interventions when combined with nutrition interventions amplify the impact of these interventions in improving behavior and thus result in the reduction in the anemia levels. Therefore, WASH interventions are to be considered as part of a long-term strategy for mitigating anemia across populations.
Conclusions: However, the evidence base is small, so additional research would help us learn more about the effectiveness of the policy.