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Integrating WASH with nutrition programming
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. 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. 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)
6. Prevention is the neglected approach
Absorption
Antibodies
Allopathogens
Diarrhoea
Environmental
Enteropathy
Worms and parasites
Typhoid
Polio
Trachoma
Hepatitis A and E
7. Prevention – Water, Sanitation and Hygiene
Safe Water
Safe Sanitation
Good Hygiene
Practices
8. 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%
10. 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
11. 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
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