How a simple solution slashed child mortality in rural Kenyan villages

“a large-scale experiment called WASH Benefits, which randomly selected certain villages in rural Kenya to receive a variety of water, sanitation, and hygiene (WASH) programs, while other villages served as a control group.

The experiment tried a bunch of different WASH interventions, including more sanitary latrines, programs promoting hand-washing with soap, nutrition supplements for young children, and more.

One tactic in particular jumped out: adding a simple chlorine solution to drinking water.”

“Water chlorination is standard in developed countries these days; America’s experience began in Jersey City, New Jersey, in 1908, at the instigation of a doctor named John L. Leal. Chlorine is a powerful disinfectant, and in the US context, doses of chlorinated solution safe for human consumption proved particularly powerful at killing the bacteria that caused typhoid fever in the water supply.

Other cities and states copied Leal’s advance, and typhoid deaths plummeted. In Massachusetts, for instance, a state for which good records exist, the death rate from typhoid fell by over 99 percent between 1905 and 1945, driven by cleaner water and increased vaccination.

It wasn’t just typhoid. Chlorination and other clean-water programs played a huge role in the fall in overall mortality and child mortality in the US over the 20th century.”

“The new study on chlorination in Kenya used data collected in 2018 on the deaths of all children in the target villages born after January 2008, and compared death rates in villages that got these chlorine dispensers four to six years earlier to those in villages that didn’t get them.

The results were astonishing: Mortality for children under 5 fell by 63 percent. The baseline death rate for children under 5 in the control villages was a horrific 2.23 percent — more than one in 50 children died before their fifth birthdays.

Providing chlorine cut that rate to 0.82 percent, or less than one in 100.

To be sure, that’s still far too high; in the US in 2019, the under-5 death rate was about 0.13 percent. But cutting child mortality by more than half is a huge achievement.”

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