Health and Nutrition Impact of Potable Water in Rural Bolivia

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Abstract
To facilitate evaluation of the health impact of the potable water systems it is installing, CARE conducted a baseline health and nutrition survey in ten rural Bolivian villages. Mothers were interviewed and 221 children aged 6 to 59 months were measured for weight and height. Current malnutrition was encountered in 8% of the children. Stunting affected 36% of the children. Rates of malnutrition were similar at high and low altitudes. The primarily carbohydrate diet (75%) was deficient in calories, high quality protein, vitamin A, riboflavin, calcium, and iron. Dietary deficits were more pronounced at high altitudes. Breast-feeding practices were beneficial, but solid foods were frequently introduced beyond six months of age, especially at high altitudes. Gastro-intestinal infections were a serious health problem and a major determinant of malnutrition. The 1- to 2-year-old child was the most seriously affected by malnutrition, diarrhoea, and other serious illnesses. Diarrhoea played as great a role as an inadequate diet in causing malnutrition in 1- to 2-year-old children, and in children living at lower altitudes. Malnourished children in general had a higher incidence of diarrhoea and serious illness than the well nourished. Infant and child mortality rates were high compared to other Latin American countries. The findings support the need for potable water as a public health measure because of the high rates of malnutrition, diarrhoea, and child deaths. Future evaluations in programme and control villages will reveal whether a significant health impact can be achieved by installation of potable water systems accompanied by health education.

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