WaterAid’s ‘Caught Short’ report reveals how a lack of toilets and clean water are major contributors to malnutrition

26 July 2016
WaterAid/ Ronny Sen

India, the world’s second most populous nation, and a country with a well-known sanitation crisis has been named as having the greatest number of children in the world who are stunted. The new report, ‘Caught Short‘, from international development charity WaterAid, reveals 48 million children in India, or two in every five under five, are suffering from stunted growth, which affects their physical development as well as cognitive and emotional development.

Nigeria and Pakistan rank second and third with 10.3 and 9.8 million children stunted respectively. The Southeast Asian nation of Timor-Leste, and also one of the world’s newest countries, tops the list for having the highest percentage of children who are stunted, at 58%.

Stunting is a lifelong consequence of malnutrition in the first two years of a child’s life and is largely irreversible after that age. The report highlights that malnutrition is not just caused by a lack of food — the lack of access to a safe toilet, clean water and good hygiene practices play a major role too as repeated bouts of diarrhoea – often caused by dirty water and unhygienic environments – are directly linked to malnutrition.

Worldwide, some 650 million people in the world still do not have access to clean water and more than 2.3 billion do not have access to basic sanitation, with devastating results.

Some 140,000 children under five in India die each year of diarrhoeal diseases related to the lack of these basic services. And 50% of malnutrition cases are linked to infections, including chronic diarrhoea, caused by lack of safe water, sanitation and hygiene (WASH) including handwashing with soap.

WaterAid India’s Policy Manager (WASH in Health & Nutrition and WASH in Schools), Arundati Muralidharan, said:

Water, sanitation and hygiene are important determinants of nutrition. With open defecation rampant in India, frequent diarrhoea hinders the ability of children to absorb nutrients. India has made significant efforts to improve the nutritional status of children and women, but the beneficial impact of these efforts are threatened by poor WASH. For our children to be healthy and well-nourished, we need both nutrition specific interventions that get essential nutrients to children, as well as nutrition sensitive interventions on WASH.

Other key facts highlighted in the report include: 

  • Globally 159 million children under the age of 5 are stunted – one in four children of this age
  • Five or more cases of diarrhoea before two years of age can lead to stunting
  • Malnutrition costs 11% of GDP annually across Africa and Asia
  • India has made progress on reducing child stunting, from 48% of all children in 2006 to 39% in 2014
  • India has the highest concentration in the world of people practising open defecation. Research shows that high rates of open defecation have a strong correlation with increased rates of stunting, as faeces in the environment contaminate hands and surroundings, and spread disease and infection

WaterAid Chief Executive Barbara Frost said:

It is unacceptable that one child in every four around the world suffers from stunting. This not only makes children shorter for their age, but affects their emotional, social and cognitive development, meaning their lives and life chances are forever changed. Yet good food, the focus of most malnutrition programmes, will only get us halfway to the finishing line in addressing this crisis. We need to ensure governments make safe water, decent toilets and good hygiene a priority in efforts to end malnutrition.

The Nutrition for Growth summit on 4 August, just ahead of the Rio Olympics’ opening ceremony, will bring together world leaders and Olympians to highlight the importance of addressing malnutrition. These Olympians have reached their potential, but millions of children in the world will not, for the simple lack of good nutrition, clean water, decent toilets and a bar of soap.

Last September world leaders made commitments in the UN Global Goals to end hunger and malnutrition, and to reach everyone everywhere with clean water and sanitation, all by 2030.

As we approach the first anniversary of the signing of the Global Goals, WaterAid is calling on governments and donors to make ambitious investments in water, sanitation and hygiene for all, to help end malnutrition and improve the lives of millions of the world’s most vulnerable children.

To read the full report click here


For more information, please contact

Pragya Gupta, Media Officer, WaterAid India,  [email protected]