Effect of improved housing on illness in children under 5 years old in northern Malawi: cross sectional study

doi:10.1136/bmj.322.7296.1209

BMJ 2001;322:1209-1212 ( 19 May )

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Effect of improved housing on illness in children under 5 years old in northern Malawi: cross sectional study

Christopher G Wolff, researcher, ^a Dirk G Schroeder, associate professor, ^a Mark W Young, director. ^b

^a Department of International Health, Rollins School of Public Health of Emory University, 1518 Clifton Road, Atlanta, GA 30322, USA, ^b Primary Health Care Department, Ekwedeni Mission Hospital, Ekwendeni, Malawi

Correspondence to D G Schroeder dschr02{at}sph.emory.edu

Objective: To evaluate the effects of a Habitat for Humanityhousing improvement programme in northern Malawi on the prevalenceof childhoodillnesses.
Design: Household based cross sectionalstudy.
Setting: Rural communities centred near the small northernMalawi town ofEkwendeni.
Subjects: 318 children under 5 yearsold.
Main outcome measures: Prevalence of respiratory, gastrointestinal,and malarial infections according to maternal recall, laboratory,or clinicaldata.
Results: Children living in improved homes were lesslikely to have respiratory, gastrointestinal, or malarial illnesses(odds ratio 0.56, 95% confidence interval 0.35 to 0.91) afterconfounding factors were controlled for. The reductions in individualdiseases were notsignificant.
Conclusion: Improved housing significantly reduced theburden of disease among children under 5 yearsold.

What is already known on this topic
Poor quality housing is generally accepted as an important contributor to ill health

Few designed studies have quantified the impact of improved housing on health in the developing world

What this study adds
Improved housing reduced the odds of respiratory infection, gastrointestinal illness, or malaria by 44% in children under 5 years old

The reductions in individual illnesses were not significant

Housing development programmes are an important component of efforts to improve global health

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