WASH’ Nutrition

pile sorting 89 or focus group discussions would enable WASH and nutrition teams to get a better insight into the practices
of different community groups (men, women, children), compare their perceptions on certain issues and validate what the
community’s real needs are. This would also help analyse the potential obstacles for implementation and sustainability of
integrated projects. Participatory approaches offer a good opportunity for identifying key people in the community (traditional
and religious leaders, doctors, teachers, etc.) and learning about cross-cutting issues such as age, gender, disability, etc.
Finally, in order to properly define integrated WASH and nutrition
interventions, it is important to understand the capacity of relevant
stakeholders, especially institutional and local. This will determine
capacity-building activities that should be conducted and barriers to
engaging different partners in the implementation process. In addition,
based on the results of these analyses, WASH and nutrition teams will
be able to define and implement suitable advocacy initiatives.
An example of a WASH questionnaire to be included in nutrition
assessment can be found in Table 4. The questions are examples only,
but it is important to consider a number of questions for each presented
category: household drinking water, sanitation, hand washing, and food
hygiene, as each one is associated with a fecal-oral transmission route.
Conducting an anthropological study is a very
useful way to increase understanding of social
and cultural determinants in the population
and helps integration by providing a more
comprehensive picture of the context. For
example, an anthropological study contacted by
ACF in Cameroon and Chad in 2012 showed
that men’s opinion on the taste of water had
a great influence on the use of chlorine in the
households. Issues like this should be taken into
account when designing diarrhea prevention
strategies (ACF, 2012).
NOTE
BOX 4: Seasonal calendar
To facilitate information sharing, joint thinking and a common
vision, a collaborative tool such as a seasonal calendar
could be used. On a basis of available information, this
calendar identifies a seasonality of undernutrition along with
variations in the local context that affect nutrition security:
climatic factors and weather patterns (e.g. seasonal floods),
food prices in the local markets, employment opportunities,
water availability, communicable diseases etc. This calendar
can show, for example, that some months see a higher level
of diarrhea due to the dry season and that the onset of
rains brings malaria, possibly affecting household health and
increasing expenditure on medicine. These are the months
when undernutrition is more likely to increase. “Seasonal
peaks” of wasting for example, induced by the deterioration
of one or several above mentioned risk factors, are observed
in Africa, Asia and Latin America.
By constructing and analysing seasonal calendar jointly,
different sectors (Nutrition, Health, WASH, Food Security
and Livelihoods) can develop a comprehensive and shared
understanding of various factors influencing nutrition
security and adjust their programming to respond in the most
effective way. An example of a seasonal calendar developed
by ACF can be found in the Programmatic resources section
of this guidebook.
Source: ACF (2014) “Nutrition security policy” & World Food Programme (2014)
“Nutrition sensitive programming: What and why”?
© A. Parsons/i-Images for Action Against Hunger
89 - Participatory tool to help a group of people discuss common water, sanitation and hygiene practices and beliefs
WASH’Nutrition
A practical guidebook
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