The public health necessity of improved sanitation has been well documented. Diarrhea, as a result of poor access to water and sanitation, is the biggest cause of death for children under 5 in Africa. Globally, diarrheal diseases kill 1.4 million children every year. Poor sanitation and hygiene also has a negative impact on maternal and newborn health. Unsanitary toilets and open defecation have negative impacts on both health and cognitive development. Due to lack of sanitation, more than half of school-age children in Africa suffer from worm infections.