The findings

Emerging evidence from the MapSan trial shows that simple, scalable sanitation technology can deliver far-reaching public health benefits to urban residents in low-income settings. The study has demonstrated dramatic improvements in child growth and reduced pathogen exposure attributable to high-quality latrines in urban Maputo, Mozambique. In addition, the intervention was associated with the improved quality of life and mental-wellbeing.

Findings show increased height among children served by the sanitation intervention compared with similar controls (see Figure 1). 

In brief, children living since birth in households served by WSUP sanitation were 31% less likely to be stunted.

Large reductions in pathogen exposures observed are likely the mechanism driving improved growth outcomes in children in MapSan. Overall, the WSUP intervention model holds great promise for improving rates of stunting and childhood development in urban settings.

In 2022/2023 researchers conducted a long-term cross-sectional follow up study which revisited the compounds from the Mapsan trial five years earlier. The purpose was to assess the health impacts on children who were born into the study households post-intervention. 

Scientists believed (hypothesised) the following:

• Risk of stool-based enteric pathogen detection among children 29 days to 5 years old is reduced for children born into households that previously received the sanitation intervention.
• Children born into households that previously received the WSUP sanitation intervention experience delayed exposure to enteric pathogens relative to comparably aged children from households which did not receive any improved sanitation facilities from WSUP (non-intervention households).