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WaterAid’s Presentationto the DPG - Health in Tanzania

Namwaka OmariFerdinandes AxwesoIbrahim Kabole, MD

May 7 2014

At USAID-DSM

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Water, Sanitation & Hygiene (WASH) Contribution Towards Universal Health

Coverage

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The role of WASH in Health• WASH is crucial for control and prevention of many diseases,

both communicable and non-communicable

• And it is also relevant to health and health systems:

Impact on wellbeing & poverty (broader definition of health: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. WHO, 1948)

Relevance for quality of healthcareRelevance for disease management & careDisease-related stigma & exclusion from WASH services

(HIV, leprosy, disability)

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The role of WASH in health

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WASH related diseasesAcute

respiratory infections

Under Nutrition

Trachoma

Guinea worm Schistosomiasis

Soil-transmitted Helminths

Lymphatic Filariasis

Malaria

SepsisHepatitis E

Diarrhoea Neglected

TropicalDiseases-NTDs

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Faecal-oral route of transmission

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Sanitation and Hygiene interventions act as barriers to Transmission Pathogens that cause Infections and Infestations

Access to Safe and Adequate Water is a key Determinant for SH to be effective in Infection and Infestation Control.

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% WASH-Safe Facilities & Delivery Rooms Tanzania data

Hospital Health Centre Dispensary0%

20%

40%

60%

80%

100%90%

62%

39%

70%

40%

19%

Facility Delivery room

Average - delivery room

24%

Average – facility

44%

Puerperal and New born sepsis

Universal coverage

Discouraging women from coming

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Risk that the focus on a ‘package’ of services will once again push out public health measures (WASH, vector control, housing, indoor cooking etc). Ownership, Leadership and championing by the Health Sector Stakeholders (DPG-Health and WASH, Ministries of Health, Water, Education and Local Government to address this risk –to Position Ministries of Health ‘Stewards of Public Health’, and Not simply Service Delivery Agencies.

Limits and challenges of UHC policy

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• WASH is a neglected issue in public health lack of political prioritisation and resourcing

poor progress on targets (2.5 billion without sanitation!)

only 13% of Tanzanians have access to improved sanitation

Limits and challenges of UHC policy

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• UHC provides an opportunity to firmly embed WASH in Health as a fundamental aspect of public health.

• This will help re-prioritise and resource WASH, and put the weight of the health sector behind the importance of WASH as a fundamental public health intervention.

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What we do in Tanzania? Zanzibar WASH and Maternal health study Trachoma mapping WASH in Health Facilities – Singida Contribution to the national sanitation

campaign (The Mtumba approach). Global advocacy priority – WASH in health HR capacity study on sanitation

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WaterAid Tanzania1469 Masaki Street, off Haile Selassie RdMsasani PeninsularDar es Salaamwww.wateraid.orgRegistered charity numbers 288701 (England and Wales) and SC039479 (Scotland)

Thank you and looking forward to fruitful collaboration!