WASH’ Nutrition

Figure 23: Holistic approach to WASH and nutrition integration
Policy & plans
Delivery platforms
- Community
- Health facilities
- Schools
Information systems, M&E
Adapted from UNICEF Indonesia
“Promotion of holistic approach to address poor WASH and chronic undernutrition in Indonesia”
BOX 15: Public health approach to nutrition
Public health and nutrition are interdependent. Relying on this synergistic relationship, overall nutrition of vulnerable
populations could be improved by delivering public health interventions—like access to health, water, sanitation and
hygiene services, disease prevention and control—with nutrition elements like micronutrient supplementation and
promotion of optimal infant and young child feeding. By integrating public health and nutrition efforts, existing resources
can be leveraged to maximize impact (UNICEF, 2013). This requires integrating nutrition outcomes within the design,
monitoring, and reporting system used by the Ministry of Health. In other words, it involves incorporating nutrition indicators
into health programmes along the continuum of care (e.g. antenatal care, postnatal care, family planning, immunization) and
across different platforms (health facilities, outreach services, community care), designing robust monitoring systems on
nutrition interventions from the beginning of each programme and integrating key nutrition indicators in health management
information systems.
Making optimal nutrition a public health goal also entails integrating nutrition-sensitive activities, like WASH, agriculture,
food security, etc., into health programmes, national strategies, and planning documents, so as to ensure a multi-sectoral
approach to addressing nutrition.
4.2. WASH, nutrition and health system strengthening
There is a common understanding that it will be impossible to achieve national and international goals, such as the new 2030
Agenda for Sustainable Development, without greater and more effective investment in health systems and services. Wellfunctioning
health systems deliver the quality health care people need, when they need it, where they need it, and at prices
they can afford. 190 Strengthening health systems, however, is challenging given their complexity. It could be defined as “the
process of identifying and implementing the changes in policy and practice in a country’s health system, so that the country can
respond better to its health and health system challenges” or “any array of initiatives and strategies that improves one or more of the
functions of the health system and that leads to better health through improvements in access, coverage, quality, or efficiency”. 191
Considering the key role that health systems are playing in WASH and nutrition integration, ACF has worked on identifying
opportunities for strengthening health systems building blocks by aligning WASH and nutrition efforts. Some of the main
recommendations 192 per building block are summarized below:
190 - USAID (2015) “Health System Strengthening”.
191 - WHO (2015) “Health Systems”.
192 - Recommendations derived from the ACF technical workshop on WASH and nutrition held in Nairobi, 2013.
WASH’Nutrition
A practical guidebook
105