WASH-NTD Integration Program Model

More than 1 billion people worldwide suffer from one or more painful, debilitating tropical diseases that disproportionately impact poor and rural populations, cause severe sickness and disability, compromise mental and physical development, contribute to childhood malnutrition, reduce school enrollment, and hinder economic productivity. Three of these diseases are directly linked to water, sanitation, and hygiene practices.

WASHplus designed and implemented a model integrated WASH-NTD program that was tested as a small pilot effort in Burkina Faso from 2015–2016. The objectives in Burkina Faso were to:

1. Promote coordination within government among sectors related to WASH-NTD integration

2. Develop a comprehensive implementation activity in several villages in one district

3. Share experience and lessons learned with other partners who may be able to advance or further develop this activity

4. Provide a toolkit for Burkina Faso and global partners to use

This toolkit is the result of the WASHplus project in Burkina Faso and has the following components.

WASHplus Year Five Annual Report, October 2015

WASHplus Year 5 Annual Report.png

In its Year Five Annual Report, WASHplus has stories to tell, results to share, events to celebrate, and studies that add to the evidence base. WASHplus activities serve as the backdrop for many stories: the Zambian school girl who has access to privacy and menstrual supplies when she needs them, the Malian household that can now build an improved latrine on their rocky soil, the mother in Bangladesh who understands the importance of a feces-free environment, the Nepali home breathing cleaner air as it trials an improved cookstove. And perhaps more compelling than the individual stories are the results the project is beginning to record through endline data collection in Kenya and formative research on school enrollment and in Zambia. Providing water, sanitation, and hygiene (WASH) infrastructure to schools is having a notable impact on enrollment. Community-led total sanitation (CLTS) may be inoculating communities exposed to cholera. Numbers also tell the story of the project’s impact. Look for a snapshot of those figures throughout the report.

The conclusion of field activities in Uganda and Zambia this year provided opportunities to reflect, celebrate accomplishments through end-of-project (EOP) events, and share lessons learned. Several articles were published this year in peer-reviewed journals and others submitted on topics ranging from consumer preferences and willingness to pay for improved cookstoves to habit formation and costing of handwashing. WASHplus also played a key role in preparing the joint document on WASH and nutrition for publication and distribution.

WASHplus’s focus on integrating WASH into other development initiatives enabled the project to get in on the ground floor on subjects that are gaining traction at USAID and globally, such as WASH and nutrition, neglected tropical diseases, and MHM. This integration focus dovetailed nicely with the project’s mandate to serve a technical leadership role, and project staff had many opportunities this year to share its work and lessons from the field on a global stage, strategize with partners on important advocacy issues, inform policy, and develop guidance in multiple countries. Also toward that end, WASHplus launched its first two learning briefs on small doable actions and WASH and nutrition. This series details the variety of approaches WASHplus uses to improve WASH and household air pollution (HAP) across its portfolio of countries.

And finally, it’s been an exciting year for innovation with pilot projects underway in Ethiopia and Bangladesh focusing on sanitation marketing and sand envelopment. These two efforts will add to WASHplus’s body of knowledge on sanitation innovation and aligns closely with USAID’s global interest on the topic. WASHplus is also documenting its fecal sludge management work in Madagascar to tell the next chapter in that story.

WASHplus Presents Poster at ASTMH 2015

Renu at ASTMH 2015

@wasplusinfo’s Renu Bery presents a poster on integrating into at 2015 ASTMH Meeting!

In October 2015, WASHplus presented a poster at the American Society of Tropical Medicine and Hygiene Annual Meeting on the current situation, intervention design, behavior change plan, and expected results of its Burkina Faso WASH and neglected tropical disease (NTD) pilot activity, called “How Can Integrating Sanitation and Hygiene into an NTD Control Program Accelerate Reduction in NTDs?” View the poster here.

WASHplus Pilots Integration Program for WASH and NTD Interventions in Burkina Faso

NTDsWASHplus is implementing a pilot program in Burkina Faso that is designed to develop an integrated WASH–NTD model that can be scaled up in-country and replicated elsewhere. Burkina Faso is a country with very little latrine coverage, relatively poor hygiene practices, and pockets of high burden of disease related to water, sanitation, and hygiene. Without a serious focus on face washing and environmental cleanliness.

WASHplus is working in Burkina Faso to partner with stakeholders at district and provincial levels to implement a comprehensive WASH–NTD integrated program in one district. We will then document and disseminate the learnings gained through this pilot program. WASHplus will also engage multiple stakeholders inside and outside of government, including working with existing government structures at multiple levels, such as local government that has the mandate for water and sanitation at the local level. Typically, WASH and NTD programs have not worked together in Burkina Faso, though some precedence exists for inter-sectoral collaboration through the WASH-Nutrition group that has been spearheaded by UNICEF and embraced by government stakeholders.

To learn more about the pilot in Burkina Faso read this brief prepared by WASHplus: “WASHing Away Worms and Other Neglected Tropical Diseases .”

To learn more about WASHplus work in NTDs visit the WASHplus website (http://www.washplus.org/wash-ntds).

WASHing Away Worms and Other Neglected Tropical Diseases

wash ntd integration

More than 1 billion people worldwide suffer from one or more painful, debilitating neglected tropical diseases (NTDs). These diseases disproportionately impact poor and rural populations, causing severe sickness and disability, compromising mental and physical development, contributing to childhood malnutrition, reducing school enrollment, and hindering economic productivity. Soil-transmitted helminths (STH), including round worm, whip worm, and hook worm, as well as schistosomiasis (bilharzia) and trachoma, are all clearly linked to inadequate sanitation and poor hygiene, indicating a need for water, sanitation, and hygiene (WASH) interventions to battle these NTDs. Although mass drug administration is key to reducing NTDs, reinfection will remain a problem if WASH behaviors are not addressed.

WASHplus is documenting the links between WASH and NTDs and exploring ways to integrate WASH into NTD programs. WASHplus has conducted a global desk review that highlights integration in eight countries. The team assessed the possibilities for integrating WASH into NTDs in two countries: Bangladesh and Burkina Faso, and ultimately chose the latter in which to implement a pilot program. WASHplus is piloting an integration program for WASH and NTD interventions in Burkina Faso, designed to develop an integrated WASH–NTD model that can be scaled up in-country and replicated elsewhere (Click here to learn more about the Burkisa Faso WASH-NTD pilot intervention).

Globally, WASHplus is collaborating with organizations already engaged in WASH–NTD integration such as the International Coalition for Trachoma Control and the SHARE consortium, which are developing tools and indicators to facilitate WASH–NTDs integration.

Want to learn more about WASHplus’s NTD work? Visit the WASHplus project website.

For more information on what WASHplus is doing regarding integration of WASH and NTD programming, contact Renuka Bery (rbery@fhi360.org) or Ron Clemmer (rclemmer@fhi360.org).

Controlling NTDs through WASH in Burkina Faso

wash ntd integration

WASHplus  is exploring WASH interventions that can be used to help eliminate and/or control trachoma, soil transmitted helminthes, and schistosomiasis. The activities are conceptualized in three phases: desk review; joint NTD/WASHplus assessments in two countries—Bangladesh and Burkina Faso; and pilot implementation in one country. The pilot WASH-NTD integration activity is being implemented in Gnagna Province, eastern Burkina Faso. Following an assessment visit, WASHplus hired a coordinator who is establishing relationships with the Ministry of Health’s neglected tropical disease division, UNICEF, other USAID partners and local organizations engaged in WASH and NTD activities. WASHplus will precede program implementation with a baseline study on WASH practices and NTD knowledge in intervention villages. WASHplus will also assist the government to facilitate a WASH-NTD integration working group at the national level and in the communes in which WASHplus will work. The community-based behavior change intervention will be carried out by a local organization and supported, if feasible, with a radio campaign. The materials developed by the project will be available for the government and other key partners to use in other areas of the country, when the WASHplus project closes in 2016.

WASH and Neglected Tropical Diseases

More than 1 billion people worldwide suffer from one or more painful, debilitating tropical diseases that disproportionately impact poor and rural populations, cause severe sickness and disability, compromise mental and physical development, contribute to childhood malnutrition, reduce school enrollment, and hinder economic productivity. Five of these neglected tropical diseases (NTDs) can be controlled and/or eliminated with four to six years of mass drug administration (MDA). Although MDAs are key to reducing the spread of disease quickly and cost effectively, consistent reinfection occurs if behaviors and the environment remain unchanged. Schistosomiasis, soil transmitted helminths, and trachoma are all clearly linked to inadequate sanitation, contaminated food and water, and poor hygiene, which provide an opportunity for WASH-related approaches to help change behaviors and the environment.

The global NTD community has begun working together to address galvanize support for improved water, sanitation and hygiene (WASH) efforts to reach the control/elimination goals for NTDs in the coming 5-10 years. Two meetings were scheduled consecutively in September 2014 to discuss WASH and NTDs. The first was a roundtable in London organized by the SHARE consortium to review progress and advance activities in monitoring and evaluation and research. The second meeting was the annual meeting of the NTD-NGDO Network (NNN). The NNN meeting consists of several thematic meetings on the different diseases and working groups that culminates in two days of plenaries to report on the results of the thematic meetings.

WASHplus staff participated in the European Roundtable on WASH and NTDs and in the NNN meeting to discuss how to contribute to documents and materials being developed on WASH and NTDs. WASHplus has also started implementation of
its first WASH and Neglected Tropical Disease (NTD) activity in Burkina Faso, adding a facet of WASH integration to its
portfolio.