Interventions to reduce undernutrition and improve child growth have incorporated improved water, sanitation, and hygiene (WASH) as part of disease transmission prevention strategies. Knowledge gaps still exist, namely, when and which WASH factors are determinants for growth faltering, and when WASH interventions are most effective at improving growth. This study drew cross-sectional data from a longitudinal cohort study and used hierarchical regression analyses to assess associations between WASH factors: water index, sanitation, hygiene index, and growth: height-for-age (HAZ), weight-for-age (WAZ), weight-for-height (WHZ) at 1, 6, and 12 months postpartum among infants a priori born healthy in Soweto, Johannesburg. Household access to sanitation facilities that were not safely managed was associated with a decrease in HAZ scores at 1 month (β = −2.24) and 6 months (β = −0.96); a decrease in WAZ at 1 month (β = −1.21), 6 months (β = −1.57), and 12 months (β = −1.92); and finally, with WHZ scores at 12 months (β = −1.94). Counterintuitively, poorer scores on the hygiene index were associated with an increase at 1 month for both HAZ (β = 0.53) and WAZ (β = 0.44). Provision of safely managed sanitation at household and community levels may be required before improvements in growth-related outcomes are obtained.

减少营养不良和促进儿童成长的干预措施已将改善的水，卫生和卫生（WASH）纳入疾病预防策略的一部分。知识差距仍然存在，即何时和哪些WASH因素是阻碍增长的决定因素，以及何时WASH干预措施最有效地促进增长。这项研究从一项纵向队列研究中提取了横截面数据，并使用了层次回归分析来评估WASH因素之间的关联：水指数，环境卫生，卫生指数和生长：年龄高度（HAZ），年龄重量（ WAZ），先验婴儿在产后1、6和12个月的身高体重（WHZ）在约翰内斯堡索韦托出生的人健康。住户使用未经安全管理的卫生设施会导致HAZ得分在1个月（β = -2.24）和6个月（β = -0.96）下降。在1个月（β = -1.21），6个月（β = -1.57）和12个月（β = -1.92）时WAZ降低；最后，WHZ评分为12个月（β = -1.94）。与直觉相反，HAZ（β = 0.53）和WAZ（β= 0.44）。在获得与增长有关的结果之前，可能需要在家庭和社区一级提供安全管理的卫生设施。