WASH’ Nutrition

If the budget available for WASH activities is low, the recommendations are to:
Prioritize provision of a WASH minimum package for the affected households (see Pillar 5 of the WASH’Nutrition
strategy) and awareness-raising sessions for mothers/caretakers of children admitted to SAM treatment programme.
Include interventions to ensure sustainable access to safe water, adequate sanitation and hygiene items and products
in the health facilities (see Pillar 5 of the WASH’Nutrition strategy and Chapter 4 for example activities in the health
and nutrition centres). Priority has to be given to the health structures which have the largest admission of SAM cases
and those receiving inpatients.
If the budget available for WASH interventions is higher, in addition to what is recommended above:
Include WASH activities in the most affected communities, or in the case of a prevention approach, in the communities
most vulnerable to undernutrition (see Chapter 4 for example activities at the community level).
Include interventions aiming at strengthening construction/rehabilitation work in health care facilities and expending
the coverage of supported health structures.
Include barrier analysis to ensure greater impact of hygiene promotion and behaviour change activities (see Pillar 3 of
the WASH’Nutrition strategy).
It is worth noting that local, inexpensive, more sustainable solutions
such as soap and chlorine production and social marketing should be
preferred over distribution of the same items. Similarly, investments
in hard, sustainable WASH infrastructure should be prioritized as
replacements of poorer quality infrastructural parts often cost more
than one more sustainable building.
In recent years, the number of donors who incorporate multi-sectoral
components into their funding strategies has increased. Without
claiming to be exhaustive, the Programmatic resources section
provides a brief overview of several funding agencies which encourage
the integration of WASH and nutrition actions. Also, an example of
budget elements for an integrated WASH and nutrition project 91 can
be found in the Programmatic resources section.
In the Democratic Republic of Congo, adding the
smallest WASH component to an ACF emergency
nutrition project managed to claim about
16% of the budget for the most basic package
(WASH kits for the children admitted to SAM
programme, provision of temporary solutions for
water treatment and storage at health centres, a
few rehabilitations of infrastructure, for latrines
especially. In Nigeria, a similar approach managed
to obtain 40%. Therefore, cost calculations and
budgeting are always context specific.
NOTE
2.4. Common barriers, challenges and needs for successful integration
While the impact of WASH on nutrition and vice versa is acknowledged, numerous difficulties in implementing integrated
programmes for improved health outcomes still remain. In other words, unless WASH or nutrition indicators are included in
project objectives, there is little incentive to work towards an integrated goal. 92 WASH and nutrition programme managers can
use the information from Table 5 for project planning, to prepare for challenges they might encounter and better understand
what conditions are necessary for successfully integrated programmes. 93
91 - Example taken from the ACF mission in Nigeria, 2014/15
92 - Teague et al (2014) “Water, sanitation, hygiene, and nutrition: successes, challenges, and implications for integration”
93 - Based on the study conducted by Teague et al (2014) in 6 countries and 10 organizations
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WASH’Nutrition
A practical guidebook