Child health and household water supply: a longitudinal study of growth and its environmental determinants in rural Malawi.

The growth of 1029 children under 5 years of age, in rural Malawi, was studied during 1 year before and 1 year after the introduction of a piped water supply system. The study was performed to evaluate the effect of socio-economic and environmental factors, especially water supply, on growth. In general, the first 2 years of life were highly liable to nutritional impairment. The seasonal variation of growth rate was most pronounced in children under 2 years. It was found that crowding, measured both as population density and as members per household, had a negative impact on the growth of younger children. In households utilizing piped water, children did not display significantly better growth when compared with children in households using traditional water sources. Although clean water in itself is vital, it was not enough to improve the growth of young children under the conditions that we have studied. It is suggested that, when providing an improved water supply, sanitation and hygiene education are necessary additions. Other ways of reducing recurrent infections, in combination with effective nutrition during and after episodes of disease, should also be given increased consideration in order to improve growth.