Alison Macintyre Operationalising water, sanitation and hygiene

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A comprehensive approach to addressing undernutrition...

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  • Preface with that this was a scoping study to assess avaiable examples. Very few out there in practice – theory behind how this could be done is growing.
  • Play video from chambers citationWhen it finishes, highlight that agruclture and food secruity often addressed and curative approaches to the 3 others but prevention ignored
  • Play video from chambers citationWhen it finishes, highlight that agruclture and food secruity often addressed and curative approaches to the 3 others but prevention ignored
  • Play video from chambers citationWhen it finishes, highlight that agruclture and food secruity often addressed and curative approaches to the 3 others but prevention ignored
  • Tip of the iceberg analogy – Diarrhoea is what is spoken most about but may only be the tip of the iceberg in terms of the impact of WASH on nutritionExplain EE hereAdd worms and parasite also contributeAntibodies – and allopathogens – other FTIs listed below
  • First part are guidelineSecond part are two program examplesSuaahara is USAID funded, talk through as an example
  • Focus on 1000 days – maternal nutrition – anaemia and underweight Child nutrition – stunting, wasting, Cross sectoral approachHH – target of interventionAll other levels of government are
  • Alison Macintyre Operationalising water, sanitation and hygiene

    1. 1. Operationalising the integration of water, sanitation and hygiene interventions into comprehensive nutrition programming Alison Macintyre alison.macintyre@wateraid.org.au Samantha Chivers samantha.chivers@results.org.au
    2. 2. The nutrition scene • Around seven million children die every year from preventable diseases; 45% of these deaths are related to undernutrition. • The highest burden of stunting in our region lies in India, Myanmar, Bangladesh, Indonesia, Laos and PNG • Timor Leste has one of the highest proportions of chronic malnutrition in the world, with 54% of their children under the age of five stunted. • Copenhagen Consensus: nutrition is one of best buys for aid and public health, returning between $30 and $138 in benefits per dollar invested.
    3. 3. A holistic approach to nutrition programming Chambers, R. and Von Medeazza, G. Sanitation and Stunting in India: Undernutrition's Blind Spot. Economic and Political Weekly XLVIII.25 (2013)
    4. 4. A holistic approach to nutrition programming Curative
    5. 5. Prevention is the neglected approach Absorption Antibodies Allopathogens Diarrhoea Environmental Enteropathy Worms and parasites Typhoid Polio Trachoma Hepatitis A and E
    6. 6. Prevention – Water, Sanitation and Hygiene Safe Water Safe Sanitation Good Hygiene Practices
    7. 7. Scale-Up Nutrition (SUN) Nutrition Specific Nutrition Sensitive e.g. e.g. • Micronutrient supplementation • Deworming • Treatment of severe acute malnutrition • Exclusive breastfeeding • • • • Reproductive health services Cash transfers Promote school attendance for females Access to safe water and sanitation Only 20% of stunting will be averted if there is 90% coverage of nutrition-specific interventions Nutrition-sensitive interventions are needed to address the remaining 80%
    8. 8. Current guidelines and programs
    9. 9. Suaahara Integrated Nutrition Program Nepal • Primary focus is the critical first 1000 days period (from conception to second birthday) • Integrating four key areas known to influence nutrition Nutrition Agriculture WASH Health Services Promotion District Regional • All levels engaged Household Community Implementing Assistance Health service support Lead organisation Agriculture National Social and Behaviour Change Communication Nutrition Water, Sanitation , Hygiene
    10. 10. Suaahara Integrated Nutrition Program Nepal • Sustained social and behaviour change is central focus • All interventions promoted by all frontline workers • Reinforced through media, health services, traditional healers etc • Multisectoral bi-annual monitoring and evaluation
    11. 11. Suaahara - CHALLENGES Recognition of nutrition as more than a health issue Lead time to implementation Reaching each household
    12. 12. Global - CHALLENGES Governance Subnational Support (decentralised systems) Sustainable financing Human Resources M&E

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