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The Global Handwashing Partnership

Key WASH and Nutrition Resources for World Water Day

March 22, 2016

Key WASH/Nutrition Integration Documents

The month of March, as part of Water Action Month, the Global Public-Private Partnership for Handwashing is celebrating the impact that water, sanitation, and hygiene (WASH) can have on fighting undernutrition.

Today, World Water Day, we are sharing some key documents and resources that relate to WASH and nutrition integration. Be sure to join the conversation about WASH and nutrition on Twitter using #WaterActionMonth and #March4Nutrition.

WASHplus in Mali: Integrating WASH and Nutrition for Healthy Communities, 2016. R Bery (WASHplus), ENN Field Exchange. [Link]

This article outlines an integrated WASH and nutrition project in northern Mali that revolves around community-led total sanitation using behavior change approaches to improve nutrition and hygiene practices. Activities included hygiene promotion, water treatment, breastfeeding counseling, media and advocacy, and identification/referral of malnourished cases. Achievements to-date included improved regional policies; increased district capacity on WASH and nutrition interventions; and improved community infrastructure and practices around women and child health.

Changing WASH Practices in Southwest Bangladesh– One Small Doable Action at a Time, 2016. J Rosenbaum, et al. USAID WASHplus. [Link]

WASHplus’ Julia Rosenbaum co-presented a paper on “Changing WASH Practices in Southwest Bangladesh–One Small Doable Action at a Time” at SACOSAN 6 in Dhaka in January 2016. The USAID WASHplus project successfully increased access to WASH by applying a comprehensive and innovative approach in hard-to-reach areas of southwest Bangladesh. Rather than promoting ideal WASH infrastructure and behavioral improvements, households were encouraged to take “small doable actions”–feasible yet effective improvements–that moved toward the ideal practice. Through this approach, the project met and surpassed all project targets before the end of the project period. Project implementers worked with community members to develop age-specific behaviors for safely disposing infant and child feces and also for patching leaky latrines that dump feces back into the environment.

Integrating WASH and Nutrition Learning Brief, 2015. USAID WASHplus Project. [Link]

Since 2010, the USAID WASHplus project has been engaged both at the global and country levels in stimulating the discussion and improving the evidence base around integrating WASH into nutrition programming, sharing experiences and approaches to integrating the two sectors. This Learning Brief describes WASHplus country activities in Bangladesh, Mali, and Uganda and global knowledge sharing efforts.

The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) Trial: Rationale, Design, and Methods, 2015. Clinical Infectious Diseases. J Humphrey. [Link]
The SHINE trial is motivated by the premise that environmental enteric dysfunction (EED) is a major underlying cause of both stunting and anemia, that chronic inflammation is the central characteristic of EED mediating these adverse effects, and that EED is primarily caused by high fecal ingestion due to living with poor WASH conditions. This article describes the rationale, design, and methods underlying the Trial.

Water, Sanitation, Hygiene, and Nutrition in Bangladesh: Can Building Toilets Affect Children’s Growth? 2015. I Mahmud, The World Bank Group. [Link]
Issued in early 2016, this World Bank study provides a systematic review of the evidence on the relationship between water and sanitation and nutrition in Bangladesh. The report is intended to accomplish two things. First, to synthesize the results and evidence on WASH and undernutrition for practitioners working in the sectors as a way to stimulate technical discussions and effective collaboration among stakeholders. Second, the report can serve as an advocacy tool to assist policy makers in formulating a multisectoral approach to tackling the undernutrition problem.

The Impact of Poor Sanitation on Nutrition, 2015. SHARE; UNICEF. [Link]
This policy brief summarizes the evidence on the impact of poor sanitation on nutritional outcomes and highlights the potential impact of greater WASH integration within nutrition policy and programs.

Evidence linking hand washing to improved child feeding outcome, 2015, L Unicomb, The International Centre for Diarrhoeal Disease Research, Bangladesh. [Link]

This presentation discusses the nutrition status of children under the age of five that are stunted and underweight, discusses the impact of diarrhea on malnutrition, and presents associated health implications.

Indicators to Assess Child Well-Being, Growth and Development: 2015 consultative meeting – final report, 2015. Clean, Fed & Nurtured 2015 [Link]

This report presents the results of the consultative meeting “Clean, Fed & Nurtured:  Indicators to Assess Child Well-being, Growth, and Development” held on October 7, 2015 in Washington DC. It also summarizes an associated presentation on “Indicators to assess interventions for child growth and development” and the discussion that followed on paths for moving forward.

WASH and Maternal and Newborn Health: Time to Act, 2015. SHARE. [Link]

This policy brief documents the state of the evidence on how poor WASH impacts maternal and newborn health (MNH). It also highlights opportunities for future research and offers insights that could influence policy and improve programming in both sectors globally. In doing so, it offers a powerful argument in favor of using WASH to support efforts on MNH to leverage greater progress in reducing maternal and neonatal mortality, and offers concrete recommendations as to how this opportunity might be seized.

USAID Webinar on Environmental Enteropathy and WASH. L Smith; H Petach; T Davis; Food Security & Nutrition Network. [Link]

This webinar discusses the latest environmental enteropathy findings, including how WASH can be integrated into USAID nutrition and other programs. The webinar was sponsored by the USAID Community of Practice: The Nexus between WASH, Nutrition and Feed the Future with support from the USAID-funded TOPS program and WASHplus project.

WASH in Nutrition Efforts: A Resource Guide, 2014. WASH Advocates. [Link]

Manuals, reports, academic studies, and links to organizations working on WASH and nutrition are included in this resource guide, which can serve as a tool for implementers and advocates in the WASH/Nutrition nexus looking to pursue and promote integrated programming.

Early child growth: how do nutrition and infection interact? 2011. A&T Technical Brief Issue 3. Alive & Thrive [Link]

Even when there are no obvious symptoms, physiological conditions associated with infections can impair growth by suppressing appetite, impairing absorption of nutrients and increasing nutrient losses, diverting nutrients away from growth. There is little direct evidence that nutrition interventions are less effective when infection is common and further research is needed. Four intervention trials showed that the negative effects of diarrhea on growth can be reduced or eliminated by improved nutrition and interventions that combine improved nutrition with prevention and control of infections are likely to be most effective for enhancing child growth and development. This technical brief provides insights into infections that are very common in the first 2 years of a child’s life.

WASH & Nutrition. USAID WASHplus. [Link]

USAID WASHplus has developed guidance and tools to assist country programs integrate WASH into nutrition policies and programs.

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