SynthesisBMC public health2026
Association between water, sanitation, and hygiene (WASH) practices and childhood stunting in low- and middle-income countries: a systematic review and meta-analysis.
Synthesis in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Core Elements of the Stunting Prevention Model to Improve Adolescents' Quality of Life.Journal of multidisciplinary healthcare · 2026Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionChildhood stunting remains a major public health challenge in low- and middle-income countries (LMICs). Inadequate water, sanitation, and hygiene (WASH) conditions contribute to recurrent infections and chronic undernutrition; however, evidence regarding which specific WASH components most strongly influence stunting remains inconsistent. This study aimed to systematically evaluate the association between WASH practices and childhood stunting in LMICs.
methodsWe conducted a systematic review and meta-analysis following PRISMA 2020 guidelines. PubMed, Scopus, Web of Science, Cochrane Library, Epistemonikos, EBSCOhost, and Google Scholar were searched up to July 2025. Observational studies from LMICs assessing associations between WASH practices and childhood stunting were included. Study quality was evaluated using the Newcastle-Ottawa Scale. Random-effects meta-analyses were used to pool odds ratios (ORs) with 95% confidence intervals, with publication bias and sensitivity analyses performed.
resultsSixteen studies involving 36,574 children were included. Improved water quality (OR = 0.39; 95% CI: 0.18-0.87) and water accessibility (OR = 0.69; 95% CI: 0.49-0.98) were significantly associated with lower odds of stunting, whereas drinking water source and household water treatment were not. Among sanitation indicators, improved sanitation facility type (OR = 0.71; 95% CI: 0.53-0.94) and environmental sanitation (OR = 0.05; 95% CI: 0.00-0.64) were significantly associated with lower odds of stunting, while toilet access, safe disposal of child feces, and garbage disposal showed no consistent associations. Hygiene practices were also associated with lower odds of stunting, particularly hand hygiene (OR = 0.54; 95% CI: 0.30-0.98) and family hygiene (OR = 0.40; 95% CI: 0.21-0.74), whereas general hygiene was not significantly associated with stunting. Substantial heterogeneity was observed across several outcomes.
conclusionsSeveral WASH components were associated with lower odds of childhood stunting in LMICs, with more consistent evidence for drinking water quality, water accessibility, and sanitation facility type. Findings for other components were inconsistent. Given substantial heterogeneity and the observational nature of included studies, these results should be interpreted cautiously, and further research is needed to establish causal relationships.
trial registrationPROSPERO CRD420251145998.
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