Studies have shown linkages between water, sanitation and hygiene (WASH) and stunting in children under 2 years in sub-Saharan Africa. WASH interventions have been shown to reduce stunting rates; however, the biological mechanisms and socio-economic influences responsible for this trend remain poorly understood. This paper reviews the literature regarding these links, and the efficacy of both general WASH interventions and those targeted at children in their first 1,000 days, known as babyWASH, for stunting reduction. Fifty-nine papers published between 2008 and 2019 were reviewed, retrieved from Science Direct, Scopus and Web of Science databases, comprising field trials and data analysis, and literature and systematic reviews. Key findings showed that stunting is directly attributed to diarrhoea, environmental enteric dysfunction and undernutrition although a more comprehensive understanding of these biological mechanisms is necessary. Interventions to interrupt the faecal transmission cycle proved to effectively reduce stunting rates, particularly improved sanitation facilities to reduce open defaecation, increased proximity to water and widespread behavioural change. Methodologies should move away from randomised controlled trials towards selected contexts, mixed data collection methods and inclusion of broader social, cultural and environmental conditions. Improved cross-sectoral collaboration is encouraged, particularly to ensure the complexity of social and contextual factors is fully considered.

研究表明，撒哈拉以南非洲地区2岁以下儿童的水，环境卫生和个人卫生（WASH）与发育迟缓之间存在联系。事实证明，WASH干预可以降低发育迟缓率；然而，导致这种趋势的生物学机制和社会经济影响仍然知之甚少。本文回顾了有关这些联系的文献，以及一般的WASH干预措施和针对头1000天内针对儿童的儿童的干预措施（称为babyWASH）的效果，以减少发育迟缓。审查了2008年至2019年之间发表的59篇论文，这些论文从Science Direct，Scopus和Web of Science数据库检索，包括实地试验和数据分析以及文献和系统评价。主要发现表明，发育迟缓是腹泻的直接原因，环境肠道功能障碍和营养不良，尽管需要对这些生物学机制有更全面的了解。事实证明，干预措施可以有效减少粪便传播周期，特别是改善卫生设施以减少露天排便，增加与水的接触和广泛的行为改变。方法学应从随机对照试验转向特定情况，混合数据收集方法以及更广泛的社会，文化和环境条件。鼓励改善跨部门合作，特别是确保充分考虑到社会和背景因素的复杂性。事实证明，干预措施可以有效减少粪便传播周期，特别是改善卫生设施以减少露天排便，增加与水的接触和广泛的行为改变。方法学应从随机对照试验转向选定的背景，混合的数据收集方法以及更广泛的社会，文化和环境条件。鼓励改善跨部门合作，特别是确保充分考虑到社会和背景因素的复杂性。事实证明，干预措施可以有效减少粪便传播周期，特别是改善卫生设施以减少露天排便，增加与水的接触和广泛的行为改变。方法学应从随机对照试验转向特定情况，混合数据收集方法以及更广泛的社会，文化和环境条件。鼓励改善跨部门合作，特别是确保充分考虑到社会和背景因素的复杂性。混合的数据收集方法，包括更广泛的社会，文化和环境条件。鼓励改善跨部门合作，特别是确保充分考虑到社会和背景因素的复杂性。混合的数据收集方法，包括更广泛的社会，文化和环境条件。鼓励改善跨部门合作，特别是确保充分考虑到社会和背景因素的复杂性。