ArticleBMC public health2022
Neighbors' use of water and sanitation facilities can affect children's health: a cohort study in Mozambique using a spatial approach.
Article in BMC public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 4 citations in OpenAlex.
- Effects of climatic factors on rotavirus infection in Bangladesh: a time series analysis and future projections.Global health action · 2026Article
- Behavioral patterns in latrine use and handwashing in rural western Kenya: Age, time of day, and the role of perceived safety.PloS one · 2026Article
- Access to Water, Sanitation, and Hygiene (WASH) practices and their associations with waterborne diseases and malnutrition in Ibrahim Kodbuur District, Hargeisa, Somaliland: a cross-sectional study.BMC public health · 2025Article
- The Well-Being of Slum Dwellers Are Associated With WaSH-Related Factors: A Cross-Sectional Study From India.Health science reports · 2025Article
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Authors and funding
11 authors at 5 institutions in 6 countries.
Funding
Abstract
backgroundImpact evaluation of most water, sanitation and hygiene (WASH) interventions in health are user-centered. However, recent research discussed WASH herd protection - community WASH coverage could protect neighboring households. We evaluated the effect of water and sanitation used in the household and by household neighbors in children's morbidity and mortality using recorded health data.
methodsWe conducted a retrospective cohort including 61,333 children from a district in Mozambique during 2012-2015. We obtained water and sanitation household data and morbidity data from Manhiça Health Research Centre surveillance system. To evaluate herd protection, we estimated the density of household neighbors with improved facilities using a Kernel Density Estimator. We fitted negative binomial adjusted regression models to assess the minimum children-based incidence rates for every morbidity indicator, and Cox regression models for mortality.
resultsHousehold use of unimproved water and sanitation displayed a higher rate of outpatient visit, diarrhea, malaria, and anemia. Households with unimproved water and sanitation surrounded by neighbors with improved water and sanitation high coverage were associated with a lower rate of outpatient visit, malaria, anemia, and malnutrition.
conclusionHousehold and neighbors' access to improve water and sanitation can affect children's health. Accounting for household WASH and herd protection in interventions' evaluation could foster stakeholders' investment and improve WASH related diseases control. Distribution of main water and sanitation facilities used during study period.
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