Chakravarty Indira, Bhattacharya Animesh, Das Saurabh K
Public Health Engineering Department, Kolkata, Government of West Bengal, India.
WHO South East Asia J Public Health. 2017 Sep;6(2):22-33. doi: 10.4103/2224-3151.213787.
Access to adequate water, sanitation and hygiene (WASH) is essential for the health, well-being and dignity of all people. The World Health Organization South-East Asia Region has made considerable progress in WASH provision during the past two decades. However, compared with increases in coverage of improved drinking water, in some parts of the region, access to adequate sanitation remains low, with continued prevalence of open defecation. The Sustainable Development Goals (SDGs) have set ambitious targets for WASH services to be achieved by 2030. Examples of major health outcomes that would benefit from meeting these targets are diarrhoea and nutrition status. Although the total number of deaths attributable to diarrhoea declined substantially between 1990 and 2012, inadequate WASH still accounts for more than 1000 child deaths each day worldwide. And, despite the reductions in mortality, diarrhoea morbidity attributable to diarrhoea remains unchanged at around 1.7 billion cases per year. It has been known for decades that repeated episodes of diarrhoea increase a child's risk of long-term undernutrition, reduced growth and impaired cognitive development. Nutritional effects of inadequate WASH also include environmental enteropathy, leading to chronic intestinal inflammation, malnutrition and developmental deficits in young children. Inadequate WASH also contributes to iron deficiency anaemia resulting from infestation with soil-transmitted helminths. The cross-sectoral emphasis of the SDGs should act as a stimulus for intersectoral collaboration on research and interventions to reduce all inequities that result from inadequate WASH.
获得充足的水、环境卫生和个人卫生设施（水卫设施）对于所有人的健康、福祉和尊严至关重要。在过去二十年中，世界卫生组织东南亚区域在提供水卫设施方面取得了相当大的进展。然而，与改善饮用水覆盖率的提高相比，在该区域的一些地方，获得充足卫生设施的机会仍然很低，露天排便现象依然普遍。可持续发展目标（SDGs）为到2030年实现水卫设施服务设定了宏伟目标。实现这些目标将受益的主要健康成果包括腹泻和营养状况。尽管1990年至2012年间腹泻所致死亡总数大幅下降，但水卫设施不足在全球范围内每天仍导致1000多名儿童死亡。而且，尽管死亡率有所下降，但腹泻发病率仍保持在每年约17亿例不变。几十年来人们都知道，反复腹泻会增加儿童长期营养不良、生长发育迟缓以及认知发展受损的风险。水卫设施不足对营养的影响还包括环境肠病，导致幼儿慢性肠道炎症、营养不良和发育缺陷。水卫设施不足还会导致因土壤传播蠕虫感染而引起的缺铁性贫血。可持续发展目标的跨部门重点应成为推动跨部门合作开展研究和干预措施的动力，以减少因水卫设施不足导致的所有不平等现象。
