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The United Nations Children's Fund (UNICEF) says poor drinking water quality and open defecation in rural areas are contributing to high child malnutrition rates in Cambodia. In a news statement to mark the World Water Day, the UNICEF said that in Cambodia, 50 percent of people in rural areas do not have access to safe drinking water and over 8 million people in rural areas - or 66 percent - do not have access to sanitation. "Open defecation is a common practice among children and 22 percent of schools do not have toilets," the statement said. "It is estimated that even in primary schools with toilets, some 30 percent do not work. In these circumstances children are constantly exposed to infection." UNICEF Representative to Cambodia Rana Flowers said that infection makes children lose their appetite and steals nutrients from the children's bodies, nutrients are also lost through diarrhea. "Twenty-eight percent of Cambodian children are underweight and four out of ten children are stunted," she said. "The solution is achievable in Cambodia - studies have shown that having and using a proper toilet facility and washing hands will reduce child underweight in the country." She said a sick child cannot absorb nutrients efficiently. Malnutrition leads to poorer cognitive development and schooling outcomes and children are more likely to repeat a grade or drop out of school. "They are less able to work, less productive, and earn less as adults. This presents a heavy economic burden on Cambodia's health system in terms of child health outcomes and adult chronic disease," she said. "It also hampers Cambodia's development, robbing the country of a healthy, cognitively developed population for generations to come." According to the statement, to break the cycle of infection and malnutrition, UNICEF called for stronger collaboration between the Ministries of Rural Development, Health, Education, Agriculture, Water Resource and Local Government to address the situation holistically. Under the recently launched National Strategy for Rural Water Supply, Sanitation and Hygiene, a number of positive interventions are in place including water safety planning, household water treatment and safe storage, community-led sanitation improvements, and hygiene education. However, integration of these activities into programs with a focus on Health, Social Protection, Food Security or Nutrition will be critical to tackle malnutrition in young children. It will also require greater prioritization of sanitation and water supply within the Education agenda.