Interventions resulting in public infrastructure changes were found to be less effective than household-based interventions; however, both are important aspects of improved health outcomes for women (128, 130). Public water infrastructure requires regular maintenance and periodic replacement and water from these sources is often contaminated (130). However, even public water points that provide good-quality water have had minimal impacts on health outcomes (136). One review estimated that water-source interventions were associated with a 27% reduction in diarrhea risk at all ages, whereas household-based interventions were associated with a 43% reduction (128). This could be associated with bias and confounding, as measuring WASH outcomes is not a blinded process (128). The differential impact could also be related to practice. As compared with public water sources, home water connections were associated with greater odds of handwashing and fecal waste disposal (136). As a significant portion of diarrheal disease is a result of person-to-person transmission and poor hygiene, interventions that improve domestic hygiene behaviors can have a significant impact (136). Behavior change communication and resource provision, e.g., soap and point-of-use water treatment resources, were also important and sustainable aspects of WASH interventions (131, 137).
Vitamin D: Over the past decade, dozens of studies have revealed many important roles for vitamin D, the nutrient that skin cells produce when they are exposed to sunlight. The recommended daily intake of Vitamin D is 600 IU per day, although recommended levels are under review. If you avoid the sun or live in the northern half of the U.S., ask your doctor whether your vitamin D level should be tested.

  Infrastructure  ↓ water point distance, ↑ time savings, ↑/NC women's hygiene, ↑/NC water quality, ↓/NC diarrheal morbidity, ↓ intestinal parasite prevalence, ↑ school attendance, NC wage employment  ↓ water point distance, ↑ time savings, ↑/NC women's hygiene, ↑/NC water quality, ↓/NC diarrheal morbidity, ↓ intestinal parasite prevalence, NC wage employment, ↑ participation in income-generating activities  ↓ maternal mortality, ↓ water point distance, ↑ time savings, ↑/NC women's hygiene, ↑/NC water quality, ↓/NC diarrheal morbidity, ↓ intestinal parasite prevalence, NC wage employment, ↑ participation in income-generating activities  ↓ water point distance, ↑ time savings, ↑/NC women's hygiene, ↑/NC water quality, ↓/NC diarrheal morbidity, ↓ intestinal parasite prevalence, NC wage employment, ↑ participation in income-generating activities 
Nutrition education, including communication and counseling to raise awareness and promote nutrition-related knowledge and behaviors aligned with public health goals, was found to increase women's knowledge and improve women's dietary diversity and protein intake (15–21). It also reduced energy intake of overweight women over a 9-mo period (22). However, evidence for the effectiveness of nutrition education interventions showed mixed impact on biological and anthropometric markers of women's nutritional status (14–16, 18, 23–29). This could be due to lack of statistical power given the small sample sizes of the reviewed studies. For adolescent girls, nutrition education was found to reduce odds of overweight, and improve knowledge, dietary intake, physical activity, and sedentary behavior (27, 29, 30). This was particularly true for nutrition education that lasted longer than 12 mo (29). Nutrition education was also more strongly associated with changes in health outcomes in studies evaluating childhood obesity treatment, rather than childhood obesity prevention (29).
Consult your health care professional. Women of childbearing age may want to consider taking folic acid supplements to reduce the risk of having a pregnancy affected with neural tube defects. Many women and teenage girls don't get enough calcium or vitamin D, both of which are critical to healthy bones and avoiding osteoporosis. Some people with diabetes appear to benefit from chromium. Vegetarians, especially vegans, may want to consider supplements to obtain nutrients they aren't getting from animal products.
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