WASH’ Nutrition

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out-patient facilities minimum WASH package MONITORING CHECKLIST WASH minimum package in outpatient nutrition centres 1. Access to drinking water (chlorinated) for patients and medical staff and existence of water storage adapted to the needs? 2. Access to hand washing basin with the soap for medical staff and patients in sufficient quantity (consultations, hospitalization, toilets, kitchen, distribution points)? YES / NO YES / NO 3. Presence of water management system in the centre and immediate surroundings? YES / NO 4. The centre regularly delivers integrated WASH/nutrition prevention messages? YES / NO 5. Personnel are trained about the aspects related to healthy environment? YES / NO 6. Access to improved sanitation or alternative system for hygienic disposal of feces/temporary emergency solution? 7. Among personnel present in the nutrition centre, a focal point for cleaning, maintenance and disinfection of “water and sanitation” equipment is appointed? The areas are clean and disinfected + maintenance kit is available? WASH minimum package in outpatient nutrition centre is present YES / NO YES / NO YES / NO *only one or more NO indicates that “minimum package” is not present Essential functionality indicator Drinking water contains residual chlorine (positive measure on a monthly basis) where the appetite is tested? YES / NO MONITORING OF WASH’Nutrition INTEGRATION AT HEADQUARTERS LEVEL Yearly monitoring of missions developing WASH’Nutrition strategy (in blue) toward a random sample of missions Source: ACF, 2016 152 WASH’Nutrition A practical guidebook
6. EVALUATION Examples of WASH’Nutrition PROJECT outcomes indicators (see also Chapter 5) Domain Increased policy and institutional support for integrating WASH into nutrition programmes Joint planning and targeting Human resources development Reach of joint programme activities Water Sanitation Indicator - Country has developed a national nutrition plan that includes WASH - National WASH plans include explicit targeting of areas with high rates of malnutrition and food insecurity - Number of strategies, initiatives and/or partnerships/agreements advocating for integrating WASH and nutrition programmes - Proportion of targeted institutions with (increased) expenditures for integrated WASH–nutrition programming - Proportion of targeted institutions reporting collaboration between nutrition and WASH programmes (e.g. joint documents, decisions/policies, work plans) - Proportion or number of villages/areas where nutrition programmes that are implemented include a WASH element - Proportion or number of villages/areas with high prevalence of acute malnutrition targeted by WASH activities - Proportion or number of villages/areas with high prevalence of stunting targeted by WASH activities - Proportion of households with children enrolled in acute malnutrition treatment programmes receiving minimum package of services that include a WASH element - Proportion of targeted organizations that have modified follow-up supervision and monitoring to include WASH elements - Number of nutrition professionals trained in WASH elements per 100 000 population - Proportion of households in target areas participating in activities where both nutrition and WASH messages were delivered - Number of children under 5 years of age reached by joint nutrition and WASH programmes - Proportion of households with access to an improved water source - Proportion of households consistently storing their drinking-water safely - Proportion of households consistently treating their drinking-water with recommended HWT technologies - Proportion of households with knowledge of at least one HWT method - Proportion of households using an improved sanitation facility - Proportion of households safely disposing of children’s faeces - Number of villages achieving open defecation–free status - Proportion of households with sanitation facilities that are accessible by children and disabled members of the household Handwashing - Proportion of households with handwashing station in compound - Proportion of households where primary caregiver can cite critical times for handwashing with soap Hygiene Food hygiene - Proportion of households keeping clean areas where children’s food is prepared and served - Proportion of households safely storing children’s food - Proportion of households using clean kitchen utensils (to feed children) - Proportion of households that use treated and/or safely stored drinking-water for preparing children’s food - Proportion of households washing raw vegetables with treated water before feeding children - Proportion of households reheating children’s food thoroughly before feeding them Environmental hygiene - Proportion of households with no visible faeces (animal or human) in the compound/yard/children’s play area - Proportion of households with no domestic animals in food preparation area Infant and young child feeding - Proportion of infants 0–5 months of age who are exclusively breastfed - Proportion of children 6–23 months of age who receive minimum acceptable diet - Proportion of children breastfed within 1 hour of birth - Proportion of children 12–15 months of age who are fed breast milk - Proportion of children 20–23 months of age who are fed breast milk Source: WHO/UNICEF/USAID (2015) “Improving nutrition outcomes with better water, sanitation and hygiene: practical solutions for policy and programmers” WASH’Nutrition A practical guidebook 153
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WASH’ Nutrition A practical guide
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WASH’Nutrition A practical guideb
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Table of Contents STATEMENT ON COPY
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ACKNOWLEDGEMENTS This guidebook has
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FOREWORD Undernutrition remains a s
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LIST OF BOXES BOX 1: Design charact
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NCD NGO NTD NTU ORS PEFSA V PHAST P
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The basics of undernutrition and WA
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1. DEFINING undernutrition Defined
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2. the main causes of undernutritio
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Chronic undernutrition impairs chil
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of undernutrition, the global probl
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The CMAM approach has four componen
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6. Global trends in undernutrition
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Today, the world’s attention is t
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Linking nutritional outcomes with t
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1. nutritional status and the WASH
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Figure 8: Median age-specific incid
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3. CONTRIBUTING WASH-related diseas
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Figure 12: The F-diagram - Fecal-or
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KEY MESSAGES Chapter 2 Despite not
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WASH’Nutrition strategy WASH’Nu
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1. Aligning WASH and Nutrition prog
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assessment, programme design and/or
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pile sorting 89 or focus group disc
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2.3. Formulation and financing of i
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Table 5: Common barriers and challe
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3.1. Why targetiNG children, pregna
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4. emphasis on behaviour change PIL
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4.2. Barrier analysis Barrier Analy
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4 Signing memorandum of understandi
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Table 8: WASH minimum package for h
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In remote regions, where infrastruc
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Table 10: WASH Minimum package for
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Better alignment and integration al
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integratING activities at different
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1. at the individual and household
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Figure 17: Allocate a protected spa
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BOX 9: Five CRITICAL times for hand
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1.7. Household water treatment and
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Food hygiene implies maintaining pr
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1.10. monitoring of HOUSEHOLD WASH
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2.1. Community access to WASH for i
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2.3. Community engagement in safe e
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Sanitation marketing (SM) uses comm
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Table 12: WHO definition of environ
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BOX 13: Reducing animal waste conta
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3. AT INSTITUTIONAL LEVEL (HEALTH C
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EXAMPLE FROM THE FIELD 14 Improvin
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EXAMPLE FROM THE FIELD 15 Improvin
Page 101 and 102: 3.4. WASH and nutrition in schools
Page 103 and 104: enefit when the main vectors for di
Page 105 and 106: Figure 23: Holistic approach to WAS
Page 107 and 108: 5. Integrating interventions in eme
Page 109 and 110: Figure 24: DRM cycle, continuum and
Page 111 and 112: Promoting breastfeeding (and other
Page 113 and 114: 3) Hygiene promotion Hygiene promot
Page 115 and 116: Key messages on aligning WASH and N
Page 117 and 118: Monitoring and evaluation of integr
Page 119 and 120: 1. Monitoring integrated activities
Page 121 and 122: WASH Key indicators 1 Diarrhea prev
Page 123 and 124: © ACF Chad, 2016 Picture 11: Monit
Page 125 and 126: MOVING TOWARDS UPTAKE WASH’Nutrit
Page 127 and 128: 1. OPERATIONAL RESEARCH Beyond the
Page 129 and 130: Southampton University The Universi
Page 131 and 132: WASHplus Since 2010, the USAID-fund
Page 133 and 134: Table 16: Advocacy tools for promot
Page 135 and 136: LEARN MORE A follow-up document to
Page 137 and 138: Canada, the European Union, France,
Page 139 and 140: PROGRAMMATIC resources WASH’NUT A
Page 141 and 142: 1. PROGRAMMING EXAMPLE OF AN INTEGR
Page 143 and 144: 2. IDENTIFICATION MIRA (Multi-secto
Page 145 and 146: 3. FORMULATION EXAMPLE OF A WASH’
Page 147 and 148: EXAMPLE OF A WASH’Nutrition PROJE
Page 149 and 150: 4. FINANCING EXAMPLE OF A WASH’Nu
Page 151: 5. IMPLEMENTATION AND MONITORING ho
Page 155 and 156: WASH’Nutrition A practical guideb
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WASH’ Nutrition

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