- 1. Safe Drinking Water and Clean Hands: Essential Nutrients!
Presented at: Knowledge, Tools and Lessons for Informing the Design
and Implementation of Food Security Strategies in Asia November 14,
2011 Rochelle Rainey, Ph.D. Senior Advisor, Environmental Health
USAID/Washington DC
2. Objectives 1. To understand the connections between
undernutrition and WASH* 2. To understand ways to prevent diarrhea
and undernutrition 3. To understand options for integrating WASH
into agriculture programs for improved nutrition 3. Global
Contribution of Undernutrition to Child Mortality Diarrhea: 17% of
all child deaths Undernutrition contributed to 73% of these deaths
Diarrhea 17% 73% 4. Co-habitation with domestic animals Lack of
access to adequate safe water Dirt floors Crowded housing Poor diet
Lack of refrigeration Lack of/poor medical care Breastfeeding /
weaning practices Lack of access to sanitation Inadequate
handwashing Poverty Lack of knowledge War, conflict THE VICIOUS
CYCLE Diarrhea Exposure to feces Malnutrition Decreased immunity
Poor drainage Decreased immunity 5. Nutrition Program Intervention
Points Feces in the environment Child Exposed to Feces Diarrhea/
Worms In Child Improved Resistance Nutritional Status -healthy
birthweight -exclusive breastfeeding -complementary feeding
-micronutrients (Zn, Vit A, Fe) Measles Vaccinations Bednets Case
Management -oral rehydration therapy -Zinc -continued feeding
-deworming -timely care seeking Primary Prevention of Diarrhea 6.
This is PRIMARY PREVENTION Fields Fluids Fingers Flies Feces Food
New Host Hand Washing Source: Wagner and Lanoix, 1958 Water Quality
Water Quantity Food Hygiene Hand Washing Sanitation WORMS! 7. Key
Hygiene Behaviors Point of use drinking water treatment and safe
storage Handwashing with soap at critical times Use of basic
sanitation Food handing and safe storage Behaviors must be correct,
consistent, and sustained to get desired health impact! 8. Enabling
Environment (mobilization, policies, financing) Access to Hardware
and/or Products Formative research, marketing, education, promotion
Sustainable Improvements in Water, Sanitation and Hygiene Behaviors
FRAMEWORK FOR PREVENTION 9. Mothers of small children wash hands
with soap before preparing food, and air dry Comprehensive strategy
for: Communication Training Infrastructure Product Mobilization
Policy Financing Demos Flipcharts Contest for healthy families
Complete education kit with games Theater, songs Sports star Global
Handwashing Day Health Agents: -Proper hand washing -Basic water
issues -How to conduct household and community meetings Community
members: -Pump repair -Soap making -Proper hand washing Creation of
water committees Community participation in decision making Engage
women AND men Professional/ service organization Water sources
Installation of taps and sinks near latrines and kitchens
Availability of soap Soap Basins Sinks Soap making kits Plumbing
supplies Advocacy on hand washing Inclusion of govt. health agents
in program Include in curricula at all levels, teacher training as
well as schools Social marketing Voucher system Water committee
collection for handwashing stations Small grants Public private
partnerships with soap makers 10. Improved Nutritional Status
especially of Women and Children Improved access to diverse and
quality foods Improved nutrition and hygiene related behaviors
Improved utilization of maternal and child health and nutrition
services Increased resilience of vulnerable communities and
households Improved agriculture productivity, improved markets,
increased agricultural value chain on and off farm jobs Health
Nutrition and WASH Framework Governance, Education 11. Access to
agricultural inputs and technologies to diversify food production
at household and community level Access to water sources and
fertilizer to improve diverse food production (household/community)
Multiple-use water systems, ecological sanitation Improve knowledge
of seasonally available nutritional foods for different age groups
based on geographical region, climate and cultural traditions
Improve quality control systems for complementary foods Improve
post harvest storage and food processing techniques to retain or
improve nutritional value of food Improved use of household
resources to access diverse nutritious foods Improved access to
diverse and quality foods 12. Household Nutrition Behaviors
Household Hygiene Behaviors Community level behaviors Community
water and sanitation committees Community nutrition monitoring
Sanitation demand creation Improved nutrition and hygiene related
behaviors 13. Treatment of acute malnutrition Micronutrient
Supplementation Antenatal and postnatal services integrate
nutrition and WASH counseling Facility-based training on
counseling, provide materials Growth Monitoring and Promotion
services improved at community and facility Integrate nutrition and
Family Planning counseling and services Improved access to
sanitation infrastructure, and water for production and consumption
uses, along with training in hygiene promotion, at schools and
health facilities Latrine and water point construction,
rehabilitation and maintenance, along with hygiene promotion
Strengthen nutrition activities in facility-based Integrated
Management of Childhood Illness (IMCI) Improved utilization of
maternal and child health and nutrition services 14. Improved
community-based initiatives to mitigate nutrition shocks Integrate
nutrition into existing Early Warning Systems Improved
community-based feedback mechanism for nutrition monitoring
Improved water resource management infiltration/check dams, water
storage, rainwater harvest, water efficiency Improved access and
correct, consistent, sustained use of basic sanitation Community
Led Total Sanitation (CLTS) Increased resilience of vulnerable
communities and households 15. Conclusions and Recommendations Look
for opportunities for synergy with agriculture and economic growth
programs Use all available channels in community, engage men and
women in WASH and nutrition Focus on small do-able steps to improve
WASH and nutrition behaviors Facilitate private sector engagement
16. Thanks for your time! Questions? Rochelle Rainey
USAID/Washington [email protected] Locally produced water filters,
Cambodia