indent:.5in;line-height:150%'>Sanitation promotion is another component of the systemic approach to reducing diarrheal illnesses. Especially in urban settings in poor countries, sanitation services are neglected since resources for any infrastructure are stretched thin [55]. Barriers to the provision of sanitation services include the reluctance of governing bodies to legitimize illegal occupation of land by providing social services, lack of experience, and lack of funding [55]. Yet the effectiveness of sanitation-focused interventions, including hand-washing and latrine promotion, has been shown; recent studies have found they reduce diarrheal incidence between 32% and 43% [55].

Hand washing has been shown to reduce diarrhea incidence by an average of 33%, but interventions must address the complexity of behavior change and the resources that are needed [46]. Plain hand soap must be provided, and washing hands after defecating or handling children's feces and before handling food entails an average of 32 hand washes per day, using a total of 20 liters of water per day [46]. Thus, these interventions must go hand-in-hand with projects to provide clean water. But, as with any systemic change, the details must be tailored to the needs and abilities of the target communities.


                                                                                                     VIII.      The Role of International Organizations


One of UNICEF’s major foci is on water, environment, and sanitation. They work with governments and other organizations to implement effective water sanitation interventions, with local organizations to ensure that households have clean water supplies, and with schools to make students healthier and allow girls to access education instead of fetch water for their families [30]. UNICEF is also present in emergency situations to bring clean water supplies to affected populations [30].


The World Health Organization is a division of the United Nations, governed by 192 member states through the World Health Assembly. The mission of WHO is “is the attainment by all peoples of the highest possible level of health. Health is defined in WHO's Constitution as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity [56].” There are several programs through WHO that focus on reducing diarrheal diseases around the world. The International Network to Promote Household Water Treatment and Safe Storage (HWTS) works to improve access to safe drinking water and provide interventions to people without safe drinking water [57]. The publication International Travel and Health offers guidance for travelers in avoiding various diseases, including diarrheal ones [56]. The WHO Global Taskforce on Cholera Control provides technical support for cholera control and prevention in several countries, trains health professionals in prevention, preparedness, and response to diarrheal disease outbreaks, and disseminates information on cholera and other enteric diseases to health professionals and the general public [58]. The Initiative for Vaccine Research (IVR) has vaccine programs for rotavirus, cholera, and Shigella [59].


VI. What You Can Do

Learn More

            This chapter serves as an introduction to the complexities of one of the most common causes of mortality for children around the world. More information can be found through any of the sources used for this chapter, or through the following links:

Disease Control Priorities Project                          

American College of Physicians       

Rx for Survival


Get Involved

            There are countless ways that you can personally get involved in the efforts to end the preventable deaths and illnesses caused by diarrheal diseases around the world. For information on how to volunteer:

Institute for OneWorld Health          

Save the Children                                            

Water Partners International                          

Peace Corps 

For more information on advocacy efforts:

Save the Children                                          

Sanitation Connection               

Global Health Council                    

For information on making donations:

Institute for OneWorld Health              

Save the Children    

Water Partners International                                           

International Center for Diarrheal Disease Research, Bangladesh


For information on employment in the field:

Institute for OneWorld Health                

Save the Children                                              

International Center for Diarrheal Disease Research, Bangladesh


Most importantly, stay safe and implement prevention measures for yourself and your household. More information can be found here:




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