Operationalising the integration of water, sanitation and hygiene
interventions into comprehensive nutrition programming
Alison [email protected]
Samantha [email protected]
The nutrition scene
• Around seven million children die every year from preventable diseases; 45% of these deaths are related to undernutrition.
• The highest burden of stunting in our region lies in India, Myanmar, Bangladesh, Indonesia, Laos and PNG
• Timor Leste has one of the highest
proportions of chronic malnutrition in the world, with 54% of their children under the age of five stunted.
• Copenhagen Consensus: nutrition is one of best buys for aid and public health, returning between $30 and $138 in benefits per dollar invested.
Chambers, R. and Von Medeazza, G. Sanitation and Stunting in India: Undernutrition's Blind Spot. Economic and Political Weekly XLVIII.25 (2013)
A holistic approach to nutrition programming
A holistic approach to nutrition programming
Curative
Prevention is the neglected approach
Absorption Antibodies Allopathogens
Diarrhoea
EnvironmentalEnteropathy
Worms and parasites
TrachomaTyphoid
PolioHepatitis A and E
Prevention – Water, Sanitation and Hygiene
Safe WaterSafe SanitationGood Hygiene
Practices
Scale-Up Nutrition (SUN)
Nutrition Specific
e.g.
• Micronutrient supplementation• Deworming• Treatment of severe acute
malnutrition• Exclusive breastfeeding
Nutrition Sensitive
e.g.
• Reproductive health services• Cash transfers• Promote school attendance for
females• Access to safe water and
sanitation
Only 20% of stunting will be averted if there is 90% coverage of nutrition-specific interventions
Nutrition-sensitive interventions are needed to address the remaining 80%
Current guidelines and programs
Lead organisation
Agriculture
Health service support
Implementing Assistance
Social and Behaviour Change Communication
Water, Sanitation,
Hygiene
Nutrition
Suaahara Integrated Nutrition Program Nepal
• Primary focus is the critical first 1000 days period (from conception to second birthday)
• Integrating four key areas known to influence nutritionNutrition Agriculture WASH Health Services Promotion
• All levels engaged Household Community District Regional National
Suaahara Integrated Nutrition Program Nepal
• Sustained social and behaviour change is central focus
• All interventions promoted by all frontline workers
• Reinforced through media, health services, traditional healers etc
• Multisectoral bi-annual monitoring and evaluation
Suaahara - CHALLENGES
Lead time to implementation
Reaching each household
Recognition of nutrition as more
than a health issue
Global - CHALLENGES
Subnational Support
(decentralised systems)
Governance
Sustainable financing
Human ResourcesM&E
