Sanitation and nutrition: Let’s break the vicious circle!

This short, educational, animated video from Generation Nutrition explores the links between sanitation and nutrition. The video has been translated into English with funding from the USAID WASHplus project.

WASHplus is working on integrating WASH and Nutrition programming not only by improving water, sanitation and hygiene (WASH) in places where we work but also by working towards a fuller integration of WASH, health and nutrition programming. Learn more about WASHplus’s work in WASH-Nutrition Integration.

 

9 AM EST, Feb 16 Webinar: WASHing Away Diseases, Two Hands at a Time

WASH NTDs webinar

On February 18 at 9:00 AM EST, please join the Global Public-Private Partnership for Handwashing and the USAID/WASHplus project for a webinar discussing why water, sanitation, and hygiene (WASH) matter to neglected tropical diseases (NTDs), and addressing the need for new approaches for multi-sector initiatives to promote equity, poverty alleviation, health, and well-being.

Register here today!

Featuring experts from WaterAid, Sightsavers, the FHI 360-led USAID/WASHplus project, and USAID, this webinar is an excellent opportunity for those working in both WASH and NTDs to learn about the global landscape of WASH/NTD strategy and glean practical insights from projects that are operating in this context.

This webinar will include brief presentations on:

  • The link between WASH and NTDs
  • How we can work together to achieve common goals through the World Health Organization’s Joint WASH-NTD strategy; and
  • Integration in practice.

About the panelists:

  • Renuka Bery, MPH, Senior Program Manager for the USAID/WASHplus project, has an extensive background in WASH integration.
  • Sophie Boisson, PhD, Technical Officer for Water, Sanitation, Hygiene and Health at the World Health Organization (invited).
  • Edouard Tianhoun, RN, MSc, WASH-NTD Coordinator for the USAID/WASHplus Burkina Faso pilot project, has been in involved in WASH programs in his native Burkina Faso since 2011.
  • Yael Velleman, MSc, Senior Policy Analyst on Health and Sanitation, leads WaterAid’s strategy, advocacy, and research agenda on health.
  • Merri Weinger, MPH, Senior Environmental Health Advisor at USAID’s Bureau for Global Health, has over 30 years of experience in health programs at USAID, WHO, and PAHO.
  • Geordie Woods, MPH, Technical Adviser-NTDs at Sightsavers, specializes in health behavior and strategic communication with a technical focus that includes NTDs and WASH.

Following the presentations there will be a Question & Answer session.

Register now!

Celebrate Global Handwashing Day: Raise a Hand for Hygiene!

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October 15 marks the annual celebration of Global Handwashing Day. Over 200 million people will be promoting one simple behavior that can save lives all over the world—handwashing with soap. Every year, 1.7 million children are killed by diarrhea and pneumonia—two diseases that can be significantly prevented through good hygiene practices. Even with the knowledge that handwashing with soap can improve health and save lives, it isn’t practiced nearly enough, and resources geared toward its promotion, necessary supplies, or facilities are inadequate.

The WASHplus project, funded by USAID, is working diligently to address the lack of infrastructure that prevents access to handwashing with soap, and promoting simple messaging around washing hands with soap at critical times. This can reduce the incidence of diarrhea among children under 5 by 47 percent and respiratory infections by approximately 25 percent.

Hygiene is also critical to educational achievement, ensuring that students don’t miss school due to illness; economics, through increased worker attendance and productivity; and equity, which girls gain when they are able to safely manage menstruation at school. Given the broad impact of hygiene, it is essential that handwashing facilities and behavior change programs be prioritized.

Join us in raising a hand for hygiene on Global Handwashing Day and every day! Enjoy the joyful images of handwashing activities from our project activities, where we work to increase awareness and understanding about the importance of handwashing with soap as an effective and affordable way to prevent diseases and save lives.

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These school children in Zambia’s Eastern Province know the importance of having clean hands and can now practice good hygiene behavior thanks to the SPLASH (Schools Promoting Learning Achievement through Sanitation and Hygiene) project’s installation of handwashing stations at their school.
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Plastic water bottles are easy to find and turn into simple tippy taps for handwashing. Strung together on a pole, they make a group handwashing station at a school in Madagascar.
Through SPLASH, WASH-Friendly Schools in Zambia teach students about the importance of hand washing and provide hand washing stations nearby latrines.
Thanks to WASHplus’s SPLASH project in Zambia, students at Kakumbi Primary take their lessons on handwashing seriously and pass these improved behaviors along to their households and communities.
Mother and child in Bangladesh wash hands before mealtime
In Bangladesh, WASHplus works to integrate important WASH (water, sanitation, and hygiene) behaviors into nutrition activities. Washing hands before cooking, eating, or feeding a baby is emphasized to mother’s groups.
Schoolboy washing his hands
This school boy is lucky to attend a WASH-Friendly school that ensures its students have enough latrines for boys and girls with available handwashing stations, a clean schoolyard, and lessons that incorporate important sanitation and hygiene messages.
Children at EPP Ambanitsena washing their hands with soap and water before going home for lunch.
Children in Madagascar wash their hands with soap and water before going home for lunch.
Woman washing hands at a tippy tap in Benin
WASHplus trains community health workers in Benin to make household tippy taps for handwashing using readily available materials. These workers pass on the knowledge through household visits and community events.
A little girl learns to wash her hands before eating
As part of its nutrition screening and referral activity in Mali, WASHplus shows how to wash hands properly with soap before children eat at nutrition centers and before meals are prepared during community cooking demonstrations.
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New water points and soap encourage handwashing at schools in Zambia and also have a profound impact on surrounding communities that are encouraged to use them after attending sensitization training on how to protect the infrastructure and contribute to its maintenance.

WASHplus presents at CIES 2015

Lets Talk About It

WASHplus staff participated in four events at the 2015 Comparative and International Education Society (CIES) Conference.  From the WASHplus SPLASH Project in Zambia, Chief of Party Justin Lupele spoke on a panel hosted by the USAID/Zambia education projects on “Why WASH Is an Essential Element of Quality Education.” A poster on the same theme was also displayed. Sarah Fry, WASHplus’ Senior Technical Advisor on WASH in Schools, made a presentation titled “Let’s Talk About It: Safe and Equitable Learning Environments in Zambia,” which focused on SPLASH’s Menstrual Hygiene Management (MHM) advocacy and activities. Renuka Bery, WASHplus Technical Advisor on WASH & Nutrition Integration, facilitated a workshop on “Clean, Fed & Nurtured,”  along with Carol da Silva from FHI 360, and Monica Woldt from the USAID FANTA Project. Participants formed groups to conduct an activity around Identification of Risks and Opportunities in WASH, Nutrition, and Early Childhood Development in the Home and Surrounding Community. The presentation that accompanied the workshop can be viewed here.

Celebrating World Health Day: Why Food Hygiene Matters

You are what you eat

It is estimated that 2 million deaths occur every year from contaminated food or drinking water. Diarrheal disease alone kills an estimated 1.5 million children annually, and most of these cases are attributed to contaminated food or drinking water, according to the World Health Organization (WHO). 

In Uganda, the WASHplus project worked closely with USAID implementing partners including Community Connector, SPRING, STAR-SW, FANTA, and others to integrate WASH and aspects of food hygiene, among other interventions, into HIV care and support. WASHplus developed a series of job aids to support outreach workers and clinical counselors to integrate WASH into their home-based and clinical practice. The job aids are available in English, and two local languages, Rukiga and Rufumbira. Also, notable in WASHplus’s work in Uganda is the application of the small doable action approach to food hygiene to address local challenges of keeping food safe.

Resources developed by WASHplus are provided below.

Integrating Safe Water, Sanitation, and Hygiene into Infant and Child Nutrition Programmes. A Training Resource Pack for Uganda, 2014.

Integrating Safe Water, Sanitation, and Hygiene into Infant and Child Nutrition Programmmes

In Uganda, the WASHplus project is integrating WASH into to Nutrition and Feed the Future Programming. Integrating WASH into nutrition focuses on the importance of improving household sanitation and nutritional needs in a child’s first 1,000 days. By building capacity of implementing partners and district focal and community resource personnel, WASHplus facilitated the integration of WASH into clinical nutrition assessment, home visits with householders of small children and families affected by HIV, and through community mobilization campaigns. For example, Community Connector now not only includes WASH as part of the model homes in its 1,000 days campaign, the project included WASH in its community drama initiatives, radio talk show, behavior change communication materials, and field day exhibition, which emphasized the integration of nutrition, agriculture, income, and WASH. Integrating WASH into the District Nutrition Coordination Committees further emphasized the importance of WASH and nutrition integration during the budgeting process, implementation, and supervision of district efforts to fight undernutrition.

Small Doable Actions for Improving Household Water, Sanitation, and Hygiene Practices. Job Aids for Village Health Teams, Peer Educators, and their Supervisors (English, RufumbiraRukiga), 2104.

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Small Doable Actions for keeping food safe

Working with SPRING, WASHplus created the first-ever job aids promoting small doable actions for food hygiene, based on the World Health Organization’s “Five Keys to Safer Food.” The job aids address issues of food safety during preparation, serving, and related to storage. This initiative directly addressed the contribution of poor food handling in spreading contamination that leads to diarrhea. Other job aids highlight safe disposal of infant and animal/poultry feces, which may be significant contributors of undernutrition and inhibitors of growth according to a growing evidence base. Feces from these sources find their way to a child’s mouth through food or water contamination or through direct ingestion, causing diarrhea, enteropathy, and contributing to the excessive growth stunting documented in the region.

Additional WASHplus Resources

You Are What You Eat: Why Food Hygiene Matters for Child Growth. Julia Rosenbaum, FHI 360/Deputy Director of the USAID funded WASHplus Project, and Merri Weinger, USAID/Bureau for Global Health/Environmental Health Team leader. A presentation at the USAID Mini-University, March 2015.

Why WASH Matters for Improved Child Health, Nutrition & Growth: A Knowledge Sharing Event. Julia Rosenbaum, FHI 360/Deputy Director of the USAID funded WASHplus Project, June 2014.

Hygiene Intervention Reduces Contamination of Weaning Food in Bangladesh, Islam et. al. Tropical Medicine and International Health, Volume 18, no 3, pages 250–258, March 2013.

WASHplus Uganda Project Transitions to Local Actors

Three girls sew their own menstrual pads.
Girls take menstrual hygiene management into their own hands as they make reusable menstrual pads, one of the many small doable actions WASHplus helped to promote in Uganda.

In November 2014 WASHplus concluded a busy year and a half of work in Uganda (May 2013–November 2014) to reduce diarrhea and improve the health and resilience of key populations in three districts—Kabale, Kisoro, and Kanungu. This multidisciplinary initiative focused on integrating water, sanitation, food hygiene, and hand washing into nutrition and Feed the Future activities as well as community and clinically based HIV activities. WASHplus also worked to strengthen the capacity of local districts to plan, budget, implement, and monitor water, sanitation, and hygiene (WASH)–related activities. A WASH forum was held in collaboration with USAID implementing partners December 2 to celebrate project accomplishments and mark the official transition to district actors. The project produced a number of publications and materials for field use that are now available, including training and resource packages on Integrating Safe Water, Sanitation, and Hygiene into HIV Programmes and Integrating Safe Water, Sanitation, and Hygiene into Infant and Child Nutrition Programmes, and job aids/assessment cards in English and two local languages—Rufumbira and Rukiga (available on the WASHplus website). Districts will reproduce these materials in even larger quantities using their USAID WASH grants. An end-of-project review is also available here.

Update from UNGA and TEDMED: Handwashing, Partnerships, Integration and Innovation

by Layla McCay

Cropped_headshot_reasonably_smallAbout the author: Dr. Layla McCay is the Director of the Public Private Partnership for Handwashing (PPPHW) Secretariat, housed at FHI 360. The USAID-funded WASHPlus Project supports the PPPHW in its efforts to promote handwashing and hygiene improvement. Follow Layla on Twitter: @LaylaMcCay

Partnerships and integration were the buzz words surrounding the UN General Assembly in New York in September. The Public Private Partnership for Handwashing secretariat delved into the deluge of international development players, with the purpose of seeking opportunities for handwashing, and learning about current issues in partnerships for international development.

A key message being reiterated in the development community over the course of UN General Assembly week is that as a community, we are becoming ‘post-public-private-divide’. There is increasing appreciation of the synergies and complementary roles of the different sectors, and an appetite to bring all players together to maximize impact. While that can be easier said than done, tendencies to either sanctify or vilify different sectors or particular players were deemed outdated; instead, the focus this September was on the benefits of working together to inspire and drive better practices all around. In terms of business, there was recognition that social good is starting to move out of the CSR/philanthropy departments to become business as usual, a business investment in efficiency and sustainability – which means we should expect more public-private partnering. Indeed, looking towards the successors to the Millennium Development Goals (MDGs), the Sustainable Development Goals (SDGs) are expected to be key drivers of the multi-sector partnerships that will be needed to deliver them.

Another persistent message during ‘UNGA’ was the importance of integration, as opposed to programming in silos. In the context of handwashing, this means exploring opportunities to integrate handwashing programs ‘horizontally’ into a range of sectors, such as sanitation, nutrition, maternal and child health, healthcare, HIV/AIDS, education, gender empowerment, economic development… but also considering how to integrate ‘vertically’, across the enabling environment, including investment in infrastructure and the social determinants of health. This approach is about harnessing the power of cross-sectoral partnerships to address a range of development challenges being experienced by a population, rather than focusing on single issues. It was striking how many of our development colleagues believed the barrier to meaningful, strategic integration was not just the practicalities of integrating on the ground, but the ‘single issue’ nature of funding for international development. For example, investing in school uniforms may help girls attend school – but to keep them in school, investing in menstrual hygiene materials and facilities may be needed too, but these two interventions may have entirely different funders and programs. The “celebrity couple” of nutrition and hygiene came up repeatedly, with the implication that this “couple” should think about taking their relationship to the next level, with greater integration of nutrition and hygiene work.

Integration across sectors for health promotion was also a theme at the TEDMED conference, which I got the opportunity to attend in September. You can read my general write-up of the whole event here. In terms of food for thought regarding handwashing, there was a compelling discussion about refreshing and diversifying messaging for health promotion. Using the example of breastfeeding promotion, one speaker noted that messages about breastfeeding for babies’ health are important but as these messages become increasingly familiar to people, they (a) risk losing their impact, and (b) only engage a subset of people. However by diversifying the messages to also make breastfeeding a women’s health issue, and a heart health issue (focusing on how breastfeeding reduces the mother’s risk of obesity and heart disease), new lines of engagement are opened, with the opportunity for new champions, new messages, new incentives, greater reach, more targeted appeal, and hopefully more uptake of the behavior. There may be useful lessons for diversifying hygiene messages to expand impact.

My first experience of seeing a ‘celebrity handwashing champion’ in action came in the form of Kajol, at Unilever’s Help a Child Reach 5 hygiene event with USAID. Her messages were simple, but her presence created a clear buzz. In addition to the keen interest of press in the room, some of whom told me they were there specifically to see her, it was interesting to see Kajol’s legions of fan clubs and fans around the world picking up and retweeting her handwashing messages (a tweet I sent about her reached over 100,000 people). This was an interesting insight into the potential reach of handwashing promotion messages from strategically selected and deployed celebrity champions.

Finally, the use of technology to improve hygiene is always an interesting question, and it tends to come up on these forward-looking platforms. It was inspiring, for example, to see examples from Unilever and MAMA of how mobile phones can be used to deliver hygiene education directly to pregnant women. At TEDMED, there was also some interesting discussion about crowdfunding health – using the web to set up facilities like Kickstarter to enable the public to directly fund specific health interventions in specific places. With the Millennials embracing this sort of targeted giving, there could be some interesting opportunities for crowdfunding hygiene in future. Throughout the events, there was significant talk about harnessing the voice, experiences, ideas, and energy of youth to drive progress.

WASHplus Kenya End of Project Experience Sharing Workshop and Report

From January 2010 to September 2014 WASHplus worked with the Kenyan government to generate demand for sanitation; improve water, sanitation, and hygiene (WASH) practices among all households; and introduce simple supportive technologies to vulnerable households. The project supported the Ministry of Health (MOH) and its partners to integrate improved WASH practices into HIV policies, programs, and training. To do so WASHplus worked within existing structures under the MOH, such as the departments of Environmental Health, Sanitation and Community Health Services and the National AIDS and STI Control Program, as well as with other U.S. government bilateral partners—the APHIAplus projects and Centers for Disease Control and Prevention partners.

The two WASHplus program components—integrating WASH into HIV and advancing improved sanitation uptake—worked together to improve WASH practices across Kenya. The program objectives were to:

  • Assist government and NGO programs in Kenya to integrate improved WASH practices into HIV policies and programs, with special emphasis on inclusive approaches
  • Support uptake of improved sanitation practices using a community-led total sanitation (CLTS)-plus approach
  • Help to build a vibrant private sector to address demand for sanitation especially focused on quality latrines that meet minimum standards

What started as an activity to integrate sanitation and hygiene practices into HIV/AIDS care and support programs has grown over the years into a holistic approach to prevent diarrhea among households at risk. USAID’s WASHplus project helped communities and households in Kenya make the connection between improved sanitation, healthy hygiene habits, and positive outcomes for people living with HIV and AIDS (PLHIV), their families, children, the elderly, and other vulnerable households. Along the way WASHplus technical support, participatory training, partner engagement, and behavior change efforts yielded valuable lessons for other countries battling to improve sanitation and health outcomes in the context of uncertain funding. Innovation, flexibility, and commitment to working hand-in-hand with the government proved to be keys to the project’s success. With the government’s endorsement and adoption of WASHplus’s signature approach, small doable actions are likely to continue to resonate with many audiences long after the WASHplus transition.

On September 24th the WASHplus Kenya project held an end-of-project experience-sharing workshop in Nairobi. Photos from the workshop are presented below. The WASHplus Kenya end-of-project report “Integrating WASH into HIV Interventions and Advancing Improved Sanitation Uptake” can be downloaded from the WASHplus website.

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Kenya’s deputy Chief Public Health Officer Dr John Kimani addresses the WASHplus Kenya end-of-project experience-sharing workshop held in Nairobi on September 25th 2014. Photo: Elisha Ratem
Kenya’s deputy Chief Public Health Officer Dr John Kimani addresses the WASHplus Kenya end-of-project experience-sharing workshop held in Nairobi on September 25th 2014. Photo: Elisha Ratem
Kenya’s deputy Chief Public Health Officer Dr John Kimani addresses the WASHplus Kenya end-of-project experience-sharing workshop held in Nairobi on September 25th 2014. Photo: Elisha Ratem
Caroline Vata, a government public health officer, presents a case study during the WASHplus Kenya end-of-project experience-sharing workshop  of in Nairobi September 25th 2014. Photo: George Obanyi
Caroline Vata, a government public health officer, presents a case study during the WASHplus Kenya end-of-project experience-sharing workshop held in Nairobi on September 25th 2014. Photo: George Obanyi
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Evelyn Makena, WASHplus manager in Kenya, makes a presentation during the end-of-project experience-sharing workshop held in Nairobi on September 25th 2014. Photo: George Obanyi
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Charles Odira of Plan International makes a point during the plenary session of an experience-sharing workshop held in Nairobi on September 25th, 2014 to enable other partners scale up its approaches. Photo: Elisha Ratemo
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A community health volunteer admires his own photo displayed in  gallery showcasing achievements of WASHplus program in Kenya. This was during the Kenya end-of-project experience-sharing workshop held in Nairobi on September 25th 2014 to enable other partners scale up its approaches. Photo: Elisha Ratemo
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Public Health Officer James Yatich explains about a commode he improvised for chronically ill patients. The innovation was displayed in a gallery showing the works of WASHplus program in Kenya over the past four years. Photo: Elisha Ratemo