“The programme is effective in building latrines, but not all households participate,” said lead author Thomas Clasen from Emory University, Atlanta, USA, and the London School of Hygiene and Tropical Medicine in the UK. “Moreover, many householders do not always use the latrines. This, combined with continued exposure from poor hygiene, contaminated water, and unsafe disposal of child faeces, may explain the lack of a health impact.”
Further studies are needed to identify why the intervention failed to improve health, but the authors said that insufficient coverage and inconsistent use of latrines, a lack of handwashing with soap, or animal faeces could be contributing to the disease burden.