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April 8, 2010 Welcome to HIP’s Webinar on Presenters:  Renuka Bery & Eleonore Seumo,  with  Julia Rosenbaum and Elizabeth ...
Why WASH Matters <ul><li>Most diarrhea is caused by unsafe water, inadequate sanitation and poor hygiene </li></ul><ul><li...
Treating and Safely Storing Drinking Water <ul><li>Treatment and safe storage of drinking water at point of use reduced th...
Hand Washing with Soap <ul><li>Hand washing can reduce the risk of diarrhea by  42-44% (Curtis et al. 2003) </li></ul><ul>...
Sanitation <ul><li>Presence of latrine was associated with 31% reduced diarrhea and 37% reduced number of days ill (Lule s...
Integrate WASH into HIV programs <ul><li>Home-based Care </li></ul><ul><li>Orphans and Vulnerable Children </li></ul><ul><...
Integration Approach <ul><li>Review guidance on WASH within HIV policies and guidelines </li></ul><ul><li>Provide technica...
Small Doable Action Approach <ul><li>Identify feasible incremental steps that move people from a current hygiene practice ...
Sample Small Doable Action <ul><li>Ideal Hand Washing </li></ul><ul><li>Wash hands with soap using running water at all cr...
Integrate WASH into Existing HIV programs <ul><li>Get HIV worker to do and teach the following: </li></ul><ul><li>WASH ski...
Drinking Water Treatment Safe Storage & Handling <ul><li>Current Practices Needing Improvement </li></ul><ul><li>Drinking ...
Safe Drinking Water Treatment and Storage <ul><li>Small Doable Actions </li></ul><ul><li>Treat drinking water with an effe...
Hand Washing  <ul><li>Current Practices Needing Improvement </li></ul><ul><li>Hand washing without soap when soap is not a...
Hand Washing (continued) <ul><li>Small Doable Actions </li></ul><ul><li>Use tippy tap to conserve water </li></ul><ul><li>...
Hand Washing (continued) <ul><li>Small Doable Actions </li></ul><ul><li>Wash hands at key times:  </li></ul><ul><li>After ...
Feces Management <ul><li>Defecation in the open </li></ul><ul><li>Difficulty using poorly constructed latrines </li></ul><...
Feces Management (continued)  <ul><li>Small Doable Actions </li></ul><ul><li>All family members use latrine and/or potty <...
Current Practice: Menstrual Blood Management <ul><li>Some bed-bound women lack materials to absorb the blood </li></ul><ul...
Small Doable Actions: Menstrual Blood <ul><li>Women in periods should use pads, rags or locally available materials (banan...
Small Doable Actions: Menstrual Blood <ul><li>If caregivers help a women, they should protect hands with gloves/plastic ba...
WASH-HIV Integration Toolkit  <ul><li>Five components:  </li></ul><ul><ul><li>Training Manual & Handouts </li></ul></ul><u...
Sample Training Manual Content <ul><li>Module 1: Introductory Activities  </li></ul><ul><li>Module 2: WASH Intro, Link to ...
 
 
Client Who Can Sit Up
 
Get the HIV/WASH Integration Kit <ul><ul><ul><li>Go to:  http://www.hip.watsan.net/page/3442 </li></ul></ul></ul><ul><ul><...
THANK  YOU
Question 1 <ul><li>What have you found to be the biggest challenges in implementing wash initiatives and how have you over...
Question 2 <ul><li>I am wondering if HIP includes any policy advocacy components.  If so, what have been some of the succe...
Question 3 <ul><li>Was the menstrual blood management program only targeted at bedridden women or also on regular househol...
Question 4 <ul><li>What kind of concrete recommendations can you give to people living with HIV/AIDs in terms of acquiring...
Question 5 <ul><li>Do all members of the household share the same latrine with an infected member?  Or must he or she get ...
Question 6 <ul><li>How are home based care workers responding to having WASH integrated into their overall scope of respon...
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Meeting the Water, Sanitation and Hygiene Needs of People Living with HIV/AIDS and their Families

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Meeting the Water, Sanitation and Hygiene Needs of People Living with HIV/AIDS and their Families

  1. 1. April 8, 2010 Welcome to HIP’s Webinar on Presenters: Renuka Bery & Eleonore Seumo, with Julia Rosenbaum and Elizabeth Younger If you have any technical issues during this presentation, contact [email_address] tel. 202-884-8949 Meeting the Water, Sanitation and Hygiene Needs of People Living with HIV/AIDS and their Families
  2. 2. Why WASH Matters <ul><li>Most diarrhea is caused by unsafe water, inadequate sanitation and poor hygiene </li></ul><ul><li>Diarrhea affects 90% of people living with HIV and AIDS, significant morbidity and mortality </li></ul><ul><li>Diarrheal disease reduces antiretroviral absorption </li></ul><ul><li>Diarrhea reduces absorption of nutrients </li></ul><ul><li>Burden on caregivers in clinics and at home </li></ul><ul><li>People with HIV/AIDS have greater water needs </li></ul>
  3. 3. Treating and Safely Storing Drinking Water <ul><li>Treatment and safe storage of drinking water at point of use reduced the risk of diarrhea by 30–40% (USAID 2004); and severity of diarrhea in PLWHA by 35% (Lule et al. 2005) </li></ul>
  4. 4. Hand Washing with Soap <ul><li>Hand washing can reduce the risk of diarrhea by 42-44% (Curtis et al. 2003) </li></ul><ul><li>Presence of soap was associated with reduced number of days of diarrhea (Lule et al. 2005) </li></ul>Hand Washing
  5. 5. Sanitation <ul><li>Presence of latrine was associated with 31% reduced diarrhea and 37% reduced number of days ill (Lule study) </li></ul>
  6. 6. Integrate WASH into HIV programs <ul><li>Home-based Care </li></ul><ul><li>Orphans and Vulnerable Children </li></ul><ul><li>Counseling and Testing </li></ul><ul><li>Prevention of Maternal to Child Transmission </li></ul><ul><li>Nutrition and HIV </li></ul>
  7. 7. Integration Approach <ul><li>Review guidance on WASH within HIV policies and guidelines </li></ul><ul><li>Provide technical assistance on WASH and HIV concepts </li></ul><ul><li>Identify country-specific Small Doable Actions to help people improve WASH practices </li></ul><ul><li>Form a Community of Practice with existing implementing partners to facilitate collaboration </li></ul><ul><li>Provide tools and training that organizations can use to integrate WASH into HIV programs </li></ul>
  8. 8. Small Doable Action Approach <ul><li>Identify feasible incremental steps that move people from a current hygiene practice toward the ideal practice </li></ul><ul><li>Identify existing hygiene and sanitation good practices to be reinforced and congratulate the HIV-positive householder/caregiver for these practices </li></ul><ul><li>Identify practices to be improved and negotiate the options with HIV-positive person/caregiver </li></ul>
  9. 9. Sample Small Doable Action <ul><li>Ideal Hand Washing </li></ul><ul><li>Wash hands with soap using running water at all critical times </li></ul><ul><li>Small Doable Action </li></ul><ul><li>Wash hands with ash </li></ul><ul><li>Use a tippy tap after using the toilet </li></ul>
  10. 10. Integrate WASH into Existing HIV programs <ul><li>Get HIV worker to do and teach the following: </li></ul><ul><li>WASH skills </li></ul><ul><li>Negotiation skills </li></ul><ul><li>Provide motivation </li></ul><ul><ul><li>Reduces burden of care and related costs </li></ul></ul><ul><ul><li>Someone gets better </li></ul></ul><ul><ul><li>Cleaner premises </li></ul></ul>
  11. 11. Drinking Water Treatment Safe Storage & Handling <ul><li>Current Practices Needing Improvement </li></ul><ul><li>Drinking water not treated </li></ul><ul><li>Drinking water often stored in a large mouth unclean container </li></ul><ul><li>Storage container uncovered </li></ul><ul><li>Unclean cup used to collect or serve water </li></ul><ul><li>Hands of the person collecting the water often in contact with water </li></ul>Easily contaminated open water storage
  12. 12. Safe Drinking Water Treatment and Storage <ul><li>Small Doable Actions </li></ul><ul><li>Treat drinking water with an effective treatment method </li></ul><ul><li>Store water in a clean, covered, and narrow-necked container </li></ul><ul><li>When serving, pour or use a ladle, don’t put hands in the water </li></ul><ul><li>Keep serving cup or ladle clean and off the ground </li></ul>Narrow neck with cover
  13. 13. Hand Washing <ul><li>Current Practices Needing Improvement </li></ul><ul><li>Hand washing without soap when soap is not available </li></ul><ul><li>“ Dip” hand washing from communal bowl </li></ul><ul><li>No systematic hand washing after cleaning the potty or after defecation </li></ul><ul><li>No systematic hand washing before eating/cooking, before/after caring for sick or before providing medicine to client </li></ul>“ Dip” hand washing
  14. 14. Hand Washing (continued) <ul><li>Small Doable Actions </li></ul><ul><li>Use tippy tap to conserve water </li></ul><ul><li>Create hand washing station next to client and next to latrine </li></ul><ul><li>When soap is not available, use ash for hand washing—rub hands together, rinse, and air drying. </li></ul>Using a tippy tap
  15. 15. Hand Washing (continued) <ul><li>Small Doable Actions </li></ul><ul><li>Wash hands at key times: </li></ul><ul><li>After defecation or disposing of feces from a potty into latrine </li></ul><ul><li>After cleaning a baby’s bottom </li></ul><ul><li>Before preparing food </li></ul><ul><li>Before eating or helping someone eat or giving medicine </li></ul><ul><li>Before and after caring for a client </li></ul>Using ash for hand washing
  16. 16. Feces Management <ul><li>Defecation in the open </li></ul><ul><li>Difficulty using poorly constructed latrines </li></ul><ul><li>Feces in potty dumped inappropriately </li></ul><ul><li>Plastic bags used for defecation </li></ul><ul><li>Bedbound client soils bed and lays in excrement for many hours </li></ul><ul><li>Bucket potties have feces for hours </li></ul><ul><li>Animal feces found in household compound areas </li></ul><ul><li>Caregivers do not protect hands from client feces </li></ul>
  17. 17. Feces Management (continued) <ul><li>Small Doable Actions </li></ul><ul><li>All family members use latrine and/or potty </li></ul><ul><li>Construct larger latrine and install support poles or stools to assist PLWHA </li></ul><ul><li>Bedridden and children use potty; dispose feces in latrine immediately after defecation </li></ul><ul><li>Wash potty with soap and water </li></ul><ul><li>Use mackintosh/plastic sheeting under sheet to protect bed </li></ul><ul><li>Pen up or keep animals out of household </li></ul>
  18. 18. Current Practice: Menstrual Blood Management <ul><li>Some bed-bound women lack materials to absorb the blood </li></ul><ul><li>Bed-bound women do not always have access to material to clean themselves </li></ul><ul><li>Caregivers touch menstrual blood without protection on their hands </li></ul>
  19. 19. Small Doable Actions: Menstrual Blood <ul><li>Women in periods should use pads, rags or locally available materials (banana fibers) to absorb blood. </li></ul><ul><li>Place water and rags next to the bed for the client to clean blood from her body. </li></ul><ul><li>Put soiled materials in container next to bed until they can be washed or disposed of properly. </li></ul>
  20. 20. Small Doable Actions: Menstrual Blood <ul><li>If caregivers help a women, they should protect hands with gloves/plastic bags when handling menstrual blood and washing rags used to absorb blood. </li></ul><ul><li>Dry cloth in the sun. </li></ul>
  21. 21. WASH-HIV Integration Toolkit <ul><li>Five components: </li></ul><ul><ul><li>Training Manual & Handouts </li></ul></ul><ul><ul><li>Participant’s Guide </li></ul></ul><ul><ul><li>Assessment Tool </li></ul></ul><ul><ul><li>Counseling Cards </li></ul></ul><ul><ul><li>WASH-HIV Integration Indicators </li></ul></ul>
  22. 22. Sample Training Manual Content <ul><li>Module 1: Introductory Activities </li></ul><ul><li>Module 2: WASH Intro, Link to HIV </li></ul><ul><li>Module 3: Intro WASH Behavior Change </li></ul><ul><li>Module 4: Hand Washing </li></ul><ul><li>Module 5: Making Water Safe to Drink </li></ul><ul><li>Module 6: Handling Feces </li></ul><ul><li>Module 7: Menstrual Blood Management </li></ul><ul><li>Module 8: Negotiating Behaviors </li></ul><ul><li>Module 9: Action Planning; Tracking Progress </li></ul>
  23. 25. Client Who Can Sit Up
  24. 27. Get the HIV/WASH Integration Kit <ul><ul><ul><li>Go to: http://www.hip.watsan.net/page/3442 </li></ul></ul></ul><ul><ul><ul><li>Link to your webpage! </li></ul></ul></ul><ul><li>Contact Information </li></ul><ul><ul><ul><li>Renuka Bery [email_address] </li></ul></ul></ul><ul><ul><ul><li>Julia Rosenbaum [email_address] </li></ul></ul></ul><ul><ul><ul><li>Eleonore Seumo [email_address] </li></ul></ul></ul><ul><ul><ul><li>Elizabeth Younger [email_address] </li></ul></ul></ul>
  25. 28. THANK YOU
  26. 29. Question 1 <ul><li>What have you found to be the biggest challenges in implementing wash initiatives and how have you overcome these challenges? </li></ul>
  27. 30. Question 2 <ul><li>I am wondering if HIP includes any policy advocacy components. If so, what have been some of the successes and challenges in this area? </li></ul>
  28. 31. Question 3 <ul><li>Was the menstrual blood management program only targeted at bedridden women or also on regular households? </li></ul>
  29. 32. Question 4 <ul><li>What kind of concrete recommendations can you give to people living with HIV/AIDs in terms of acquiring or building a latrine if they don’t have one? What kind of recommendations do you offer if they don’t have a latrine? Are there organizations in country that can help people acquire or build a latrine? </li></ul>
  30. 33. Question 5 <ul><li>Do all members of the household share the same latrine with an infected member? Or must he or she get their own latrine? </li></ul>
  31. 34. Question 6 <ul><li>How are home based care workers responding to having WASH integrated into their overall scope of responsibilities? </li></ul>

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