- Immunization and nutritional supplementation programme for vitamins and minerals for children and pregnant and lactating women. 107. Nevertheless, there are challenges: - In Burundi, the 2010 Demographic Health Survey shows that 58% of children under 5 are chronically malnourished, too small in age and therefore stunted; - Malnutrition among children is due to a combination of multi sectoral factors including poverty, food insecurity, inadequate nutrition of the child, difficulty of access to drinking water and hygiene, difficult access to quality health care; - Infant and young children feeding practices need to be improved. Breastfeeding is a widespread practice in Burundi and the average duration of breastfeeding is estimated at 2 years 8 months. Access to water, hygiene and sanitation 108. Hygiene and sanitation practices and access to safe drinking water are key factors in the prevention of childhood diseases including diarrhoea, kwashiorkor and acute respiratory infections. At the national level, 75% of households drink water from an improved source, including 44% from protected sources and 23% from public taps or standpipes. Of the 23% of households that consume water from an unimproved source, 14% use an unprotected source and 8% use surface water. The proportion of households that consume safe water is higher in urban than in rural areas (85% vs. 74%). In urban areas, in 42% of cases, households have a tap installed inside or outside the dwelling (in the yard / plot) and 34% get their supplies from a public tap / standpipe. On the other hand, in rural areas, these proportions are only 1% and 22% respectively. A quarter of rural households drink water from an unimproved source (25%), 15% of which comes from an unprotected source.25 109. About 60 per cent of Burundian households still use unimproved toilets, of which 56 per cent are latrines without slabs / open holes. The level of unimproved toilet use is higher in rural than in urban areas (64% vs. 27%). Nearly one-third of households (31%) use unshared improved toilets, of which 29% are slums with slabs. There is no significant variation by place of residence for unshared improved toilets (32% in rural areas versus 31% in urban areas). In addition, less than one in ten households (8%) have shared sanitation facilities and this proportion is much higher in urban areas than in rural areas (43% vs. 5%).26 86. The key health indicators from 2005 to 2015 are in the appendix d. Social security and services and facilities for the development of the child 25 26 EDS 2010. Ditto 28