Reducing diarrhoeal diseases: lessons on sanitation from Ethiopia and Haiti

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Lack of basic sanitation is the root cause of the high incidence of diarrhoea and child mortality in developing countries. Nurses have unique opportunities to reduce the mortality associated with diarrhoeal diseases by going beyond treatment to primary prevention.


This article applies current literature on sanitation and examples from two countries to enable nurses to participate in or lead sanitation improvement and diarrhoea reduction.


Major reports on sanitation and websites for various governmental and non-governmental organizations were reviewed for problems and strategies amenable to nursing action. Databases were searched for articles on the nursing role in sanitation using the keywords hygiene, sanitation, toilets, diarrhoea, hand washing and nurse. Concepts from the literature were integrated with experiences of nurses in two countries.


Several publications on sanitation improvement provided sufficient detail for nurses to utilize. No articles were found on the comprehensive role of nurses in sanitation. Community behaviour change in sanitation improvement was identified as critical in the literature and in the field.


While sanitation engineers and others may act to improve sanitation in a nation, they do not provide the ongoing health education needed for community behaviour change. Lessons from Ethiopia and Haiti show the value of community participation in sanitation planning, as well as the need for ongoing reinforcement. Nurses can save many lives by incorporating hygiene and sanitation strategies into their practice to reinforce efforts of others or to take leadership roles.

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