Environmental Health and Child Survival

Description

Each year, millions of children in developing countries fall sick and die from diseases caused by polluted air, contaminated water and soil, and poor hygiene behavior. Repeated infectious also contribute to malnutrition in children, and subsequently impacts future learning and productivity. This book analyzes the linkages between malnutrition and environmental health, and assesses the burden of disease on young children, and its economic costs.

Sujets

• Environment
• Health

Informations

• Publié par: world-bank-publications
• Publié le: 16 juin 2008
• Nombre de lectures: 31
• EAN13: 9780821372364
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

Environmental
Health and
Child Survival
Epidemiology, Economics, Experiences
ENVIRONMENT AND DEVELOPMENTEnvironmental Health and Child SurvivalENVIRONMENT
AND
DEVELOPMENT
A fundamental element of sustainable development is environmental sustain-
ability. Hence, this series was created in 2007 to cover current and emerging
issues in order to promote debate and broaden the understanding of environ-
mental challenges as integral to achieving equitable and sustained economic
growth. The series will draw on analysis and practical experience from across
the World Bank and from client countries. The manuscripts chosen for publi-
cation will be central to the implementation of the World Bank’s Environment
Strategy, and relevant to the development community, policy-makers, and
academia. Topics addressed in this series will include environmental health,
natural resources management, strategic environmental assessment, policy instru-
ments, and environmental institutions.
Also in this series:
International Trade and Climate Change: Economic, Legal, and Institutional
Perspectives
Poverty and the Environment: Understanding Linkages at the Household Level
Strategic Environmental Assessment for Policies: An Instrument for Good GovernanceEnvironmental Health
and
Child Survival
Epidemiology, Economics,
Experiences © 2008 The International Bank for Reconstruction and
Development/The World Bank
1818 H Street, NW
Washington, DC 20433
Telephone [phone]
Internet www.worldbank.org
E-mail feedback@w
All rights reserved.
1 2 3 4 :: 11 10 09 08
This volume is a product of the staff of the International Bank for
Reconstruction and Development / The World Bank. The findings, inter-
pretations, and conclusions expressed in this volume do not necessarily
reflect the views of the Executive Directors of The World Bank or the
governments they represent.
The World Bank does not guarantee the accuracy of the data included
in this work. The boundaries, colors, denominations, and other informa-
tion shown on any map in this work do not imply any judgement on the
part of The World Bank concerning the legal status of any territory or the
endorsement or acceptance of such boundaries.
RIGHTS AND PERMISSIONS
The material in this publication is copyrighted. Copying and/or transmit-
ting portions or all of this work without permission may be a violation of
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For permission to photocopy or reprint any part of this work, please
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All other queries on rights and licenses, including subsidiary rights,
should be addressed to the Office of the Publisher, The World Bank,
1818 H Street NW, Washington, DC 20433, USA; fax: [phone];
e-mail: [e-mail].
ISBN-13: 978-0-8213-7236-4
eISBN-13: 978-0-8213-7237-1
DOI: 10.1596/978-0-8213-7236-4
Library of Congress Cataloging-in-Publication Data
Environmental health and child survival : epidemiology, economics, expe-
riences.
p. ; cm. — (Environment and development)
Includes bibliographical references and index.
ISBN 978-0-8213-7236-4
1. Environmentally induced diseases in children--Developing countries. 2.
Malnutrition in children--Developing countries. I. World Bank. II. Series:
Environment and development (Washington, D.C.)
[DNLM: 1. Child, Preschool. 2. Environmental Health. 3. Cost of Illness.
4. Developing Countries. 5. Disorders of Environmental Origin. 6.
Malnutrition. WA 30.5 E605 2008]
RJ383.E583 2008
618.92'98--dc22
2008022136
Cover photo:
World Bank Photo Library
Cover design:
Auras Design, Silver Spring, MarylandCONTENTS
xi Acknowledgments
xiii Abbreviations and Acronyms
CHAPTER 1
1 Introduction
4Objectives
5 Audience
5 A Primer on Environmental Health
6 A Primer on Malnutrition
7 Content and Organization
PART I
15 Epidemiology
CHAPTER 2
17 Environmental Health, Malnutrition, and Child Health
18 Environmental Factors, Exposure, and Transmission Pathways
19 Vicious Cycle of Infections and Malnutrition
23 Environmental Role in Early Childhood Health
28 Averting Cognition and Learning Impacts
30 Key Messages
30 Note
CHAPTER 3
31 How Environmental Health Supplements Other
Child Survival Strategies
32 Adding Value to Health Systems
38 Adapting Environmental Management Programs
39 Adjusting Infrastructure Strategies
43 Key Messages
43 Notes
PART II
45 Economics
CHAPTER 4
47 How Large Is the Environmental Health Burden?
48 Burden of Disease
51 Environmental Health Burdens
58 Areas for Future Research
vvi CONTENTS
59 Key Messages
59 Notes
CHAPTER 5
61 Estimating the Environmental Health Burden and
Costs at the Country Level
61 Existing Practice in Environmental Health Valuation
62 Building New Estimates for Environmental Health Costs
64 Case Studies of Ghana and Pakistan
66 Results for Ghana and Pakistan
77 Conclusion
79 Next Steps
81 Key Messages
81 Notes
PART III
83 Experiences
CHAPTER 6
85 Approaches to Environmental Health
86 History of Environmental Health
88 Agenda Falling through the Cracks
90 Environmental Health Experiences in Developing Countries
97 Understanding the Enabling Environment
100 Governance and Institutional Implications
104 Institutional Requirements for Successful Environmental
Health Governance
109 A Critical Moment
109 Key Messages
110 Note
CHAPTER 7
111 Conclusion
111 Contributions of This Report
113 Next Steps
Appendixes
117 APPENDIX A: Technical Review of Cohort Studies
117 Background
118 Search Strategy and Selection Criteria
118 Findings and Discussion
122 Experimental Evidence from Deworming
123 Conclusions
125 Notes
141 APPENDIX B: Review of Studies on Nutritional
Status and Education
145 Diarrhea and EducationCONTENTS vii
145 Conclusions
146 Note
147 APPENDIX C: New Estimates for Burden of Disease from Water,
Sanitation, and Hygiene
151 APPENDIX D: Computing Country-Level Environmental Health
Burden of Disease
151 Mortality
160 Education
170 Notes
173 APPENDIX E: Methodological Aspects of Assessing Environmental
Health Burden of Disease
173 From Relative Risks to Attributable Fractions
176 Dealing with Biased Estimates of Relative Risk
177 Notes
179 APPENDIX F: Monetary Valuation of the Cost of Environmental
Health Risks
181 Note
183 References
201 Index
Boxes
2 1.1 What Is Environmental Health?
22 2.1 Impact of Diarrhea on Child Malnutrition:
Evidence from Research
25 2.2 Overweight Mothers Carrying Underweight Children
50 4.1 Why 50 Percent? Supporting Evidence from
Recent Cohort Studies
54 4.2 Revisiting the “Asian Enigma”
56 4.3 The Mills-Reincke Phenomenon
65 5.1 Basic Indicators for Ghana and Pakistan
75 5.2 Attributable Fractions and Burden of Disease
When Multiple Risk Factors Are Present
80 5.3 How Policy-Makers Should Interpret These Results
87 6.1 Combating Disease through Improved Milk
92 6.2 Mexico: Multisectorality through a Diagonal Approach
93 6.3 Thailand’s National Nutrition Program
95 6.4 Ethiopia: The Toilet Revolution
97 6.5 Vietnam’s Dengue Program
101 6.6 Atrophy of Environmental Health Functions in India
102 6.7 Institutional Evolution of Environmental Health:
The Case of Ethiopia
Figures
19 2.1 The F-Diagram: Transmission Routes for Infection
20 2.2 Relationship between Nutrition and Infection viii CONTENTS
24 2.3 Environmental Health Inputs and Health Outcomes
in the Child’s Life Cycle
27 2.4 The Window of Opportunity for Addressing Undernutrition
32 3.1 Range of Preventive Activities in Child Survival
52 4.1 The Health Effects of Environmental Risks Factors
53 4.2 Water-Related (WSH plus WRM) Burden of Disease in
Children under Five Attributable to Environmental Risk Factors
by WHO Region, 2002
55 4.3 Mills-Reincke Ratios for Subregions
63 5.1 Cost of Environmental Health Risks
70 5.2 Weight-for-Age Distribution of Children in Ghana and Pakistan
71 5.3 Two-Week Diarrheal Prevalence Rate by Age and Underweight
Status in Ghana and Pakistan
73 5.4 Underweight Malnutrition Rates in Children with and without
Diarrheal Infections in Ghana and Pakistan
74 5.5 Calculating Revised Estimates (Indirect and Direct Effects)
78 5.6 Final Results of Ghana and Pakistan Case Studies
152 D.1 Summary of the Methodology
155 D.2 Exposure Categories
159 D.3 Exposure Categories, Population Shares, and Relative Risks
of ALRI in Ghana
Ta b l e s
3 1.1 Millennium Development Goals and Environmental Health
10 1.2 Annual Cost of Direct and Indirect Impact of Environmental
Risk Factors in 2005
18 2.1 Water-Related Transmission Routes and Disease Outcome
21 2.2 Im