The document discusses an integrated diarrhea prevention program in Malawi that was funded by USAID. The program's goal was to reduce morbidity and mortality from diarrheal diseases through improved diarrhea case management and increased adoption of safe drinking water, hygiene, and sanitation practices. Key results included a 17.8% increase in caregivers treating water with WaterGuard and a 64.1% increase in children with diarrhea receiving oral rehydration salts. Over 1.7 million diarrhea episodes were averted through community distribution of WaterGuard and oral rehydration salts, as well as promotion of handwashing with soap and construction of local handwashing stations. Moving forward, the program looks to introduce zinc treatment for diarrhea and establish cost recovery

1. Integrated WASH in Malawi
Ashley Latimer
May 1, 2012
COREgroup Spring Meeting

2. Malawi Background
 Child mortality = 112 deaths per
1,000 live births
 Pneumonia and diarrhea leading
causes of death
 18% of children suffering from
diarrhea
 Only 51% of households have
improved sanitation facilities
 17% of households have access to
unimproved water sources
PAGE 2

3. Integrated Diarrhea Prevention Program
 USAID funded – Child
Survival Health Grants
Program
 Goal: To reduce morbidity
and mortality from diarrheal
diseases
 Improvement of diarrhea
case management
 Focus on increased adoption
of safe drinking water and
improved hygiene and
sanitation practices
PAGE 3

4. Implementation
 Community based
distribution channels
– 2,500 “Safe Water &
Hygiene Promoters”
 PSI’s DELTA process
(for marketing planning)
– Developed audience
profiles
– Targeted messages to
caregivers
page 4

5. Results
2005 Baseline 2011 Evaluation
% of caregivers of CU5 who 4.9 17.8
report that they treated their
drinking water in the last week
with WaterGuard
Increase of CU5 with diarrhea in 48.0 64.1
the past 4 weeks who were
reported to have received ORS
Increase of caregivers who 52.0 33.8*
practice immediate handwashing
using soap after toilet/latrine use
page 5

6. Distribution
 Since 1999…
– More than 1.7 million
diarrhea episodes averted
– More than 10,000 deaths
averted
– More than 6.7 million bottles
of WaterGuard distributed
– More than 14.6 sachets of
Thanzi ORS distributed
page 6

7. Hygiene and Sanitation Practices
 Targeted communities
built handwashing
stations
 2,200 households built
stations using local
materials
 Soap available at
stations
 School hygiene clubs
page 7

8. Thinking about the Future
 Zinc is now approved as a
diarrhea treatment
– Will look to launch bundled
ORS + zinc
 Cost recovery mechanism
for WaterGuard and Thanzi
 Additional research to
understand decrease in
handwashing
page 8

9. Questions?
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