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This article is part of the supplement: The Lives Saved Tool in 2013: new capabilities and applications

Open Access Review

Estimating the child health equity potential of improved sanitation in Nepal

Anjali Acharya*, Li Liu, Qingfeng Li and Ingrid K Friberg

Author Affiliations

Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA

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BMC Public Health 2013, 13(Suppl 3):S25  doi:10.1186/1471-2458-13-S3-S25

Published: 17 September 2013

Abstract

Background

Access to improved sanitation plays an important role in child health through its impact on diarrheal mortality and malnutrition. Inequities in sanitation coverage translate into health inequities across socio-economic groups. This paper presents the differential impact on child mortality and diarrheal incidence of expanding sanitation coverage across wealth quintiles in Nepal.

Methods

We modeled three scale up coverage scenarios at the national level and at each of the 5 wealth quintiles for improved sanitation in Nepal in the Lives Saved Tool (LiST): equal for all quintiles, realistically pro-poor and ambitiously pro-poor.

Results

The results show that equal improvement in sanitation coverage can save a total of 226 lives (10.7% of expected diarrhea deaths), while a realistically pro-poor program can save 451 child lives (20.5%) and the ambitiously pro-poor program can save 542 lives (24.6%).

Conclusions

Pro-poor policies for expanding sanitation coverage have the ability to reduce population level health inequalities which can translate into reduced child diarrheal mortality.