WASH’ Nutrition

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The management of SAM encompasses two levels of intervention: Ambulatory treatment: SAM is diagnosed and related treatment intakes provided at the health unit level, but the care is ensured by the family at household level. Supporting ambulatory SAM treatment mainly consists of providing affected households with a WASH minimum package to ensure safe access to water supply and hygiene for the duration of the treatment: 450g of soap/p/month for each member of the family until the end of the SAM treatment. Consumables to ensure
Better alignment and integration allow WASH and nutrition programmes to maximize their impact, increase cost-effectiveness, sustainability, and create greater benefits for the beneficiaries. KEY MESSAGES Chapter 3 Integrated mapping of nutrition and WASH indicators provides contextually specific, evidencedbased information to better understand population needs and ensure more focused geographical integration of the interventions. Joint assessments of different technical and operational sectors are more likely to obtain a more comprehensive understanding of the situation and encourage an integrated response. The formulation of integrated activities can either take the form of building a joint integrated project, or incorporating specific objectives, activities and indicators of one sector into the project proposal of another (e.g. including nutrition-sensitive indicators such as child weight/ height, anemia in WASH projects). The priority target populations are communities, families and individuals who are the most affected and vulnerable to undernutrition and inadequate WASH conditions. It is recognized that the focus should be placed on the “1,000-day window of opportunity” as prevention of undernutrition during this period is crucial. Given the high vulnerability and indivisible connection between the two, integrated WASH and nutrition strategies and interventions should protect and support the “mother/caretaker – (malnourished) child” couple and encourage integrated service delivery for both. There is a set of responses that can help ensure and reinforce the principle of WASH minimum package both in health and nutrition centres as well as at the household level so as to protect the “mother/caretaker – (malnourished) child” dyad from infection and disease. In addition to the essential role it plays in complementing undernutrition prevention strategies, the WASH minimum package should be implemented to support the management of acute undernutrition in all its forms (SAM and MAM). Placing emphasis on behaviour change in the households for the “mother/caretaker – malnourished child” couple and in the communities affected by undernutrition is essential, knowing that provision of hardware only (access to water and sanitation facilities) brings little benefit to health if it is not accompanied with suitable hygiene behaviour. Strong coordination, close collaboration and awareness of the technical and programme issues important for the other sector are the essential parts of an integrated WASH and nutrition programming. Cluster approach is a suitable mechanism for ensuring a coherent and complementary action of two sectors in a response to a humanitarian crisis. <strong>WASH’</strong><strong>Nutrition</strong> A practical guidebook 69
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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
Page 17 and 18: 1. DEFINING undernutrition Defined
Page 19 and 20: 2. the main causes of undernutritio
Page 21 and 22: Chronic undernutrition impairs chil
Page 23 and 24: of undernutrition, the global probl
Page 25 and 26: The CMAM approach has four componen
Page 27 and 28: 6. Global trends in undernutrition
Page 29 and 30: Today, the world’s attention is t
Page 31 and 32: Linking nutritional outcomes with t
Page 33 and 34: 1. nutritional status and the WASH
Page 35 and 36: Figure 8: Median age-specific incid
Page 37 and 38: 3. CONTRIBUTING WASH-related diseas
Page 39 and 40: Figure 12: The F-diagram - Fecal-or
Page 41 and 42: KEY MESSAGES Chapter 2 Despite not
Page 43 and 44: WASH’Nutrition strategy WASH’Nu
Page 45 and 46: 1. Aligning WASH and Nutrition prog
Page 47 and 48: assessment, programme design and/or
Page 49 and 50: pile sorting 89 or focus group disc
Page 51 and 52: 2.3. Formulation and financing of i
Page 53 and 54: Table 5: Common barriers and challe
Page 55 and 56: 3.1. Why targetiNG children, pregna
Page 57 and 58: 4. emphasis on behaviour change PIL
Page 59 and 60: 4.2. Barrier analysis Barrier Analy
Page 61 and 62: 4 Signing memorandum of understandi
Page 63 and 64: Table 8: WASH minimum package for h
Page 65 and 66: In remote regions, where infrastruc
Page 67: Table 10: WASH Minimum package for
Page 71 and 72: integratING activities at different
Page 73 and 74: 1. at the individual and household
Page 75 and 76: Figure 17: Allocate a protected spa
Page 77 and 78: BOX 9: Five CRITICAL times for hand
Page 79 and 80: 1.7. Household water treatment and
Page 81 and 82: Food hygiene implies maintaining pr
Page 83 and 84: 1.10. monitoring of HOUSEHOLD WASH
Page 85 and 86: 2.1. Community access to WASH for i
Page 87 and 88: 2.3. Community engagement in safe e
Page 89 and 90: Sanitation marketing (SM) uses comm
Page 91 and 92: Table 12: WHO definition of environ
Page 93 and 94: BOX 13: Reducing animal waste conta
Page 95 and 96: 3. AT INSTITUTIONAL LEVEL (HEALTH C
Page 97 and 98: EXAMPLE FROM THE FIELD 14 Improvin
Page 99 and 100: 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
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1. Monitoring integrated activities
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WASH Key indicators 1 Diarrhea prev
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© ACF Chad, 2016 Picture 11: Monit
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MOVING TOWARDS UPTAKE WASH’Nutrit
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1. OPERATIONAL RESEARCH Beyond the
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Southampton University The Universi
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WASHplus Since 2010, the USAID-fund
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Table 16: Advocacy tools for promot
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LEARN MORE A follow-up document to
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Canada, the European Union, France,
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PROGRAMMATIC resources WASH’NUT A
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1. PROGRAMMING EXAMPLE OF AN INTEGR
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2. IDENTIFICATION MIRA (Multi-secto
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3. FORMULATION EXAMPLE OF A WASH’
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EXAMPLE OF A WASH’Nutrition PROJE
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4. FINANCING EXAMPLE OF A WASH’Nu
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5. IMPLEMENTATION AND MONITORING ho
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6. EVALUATION Examples of WASH’Nu
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WASH’Nutrition A practical guideb
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WASH’ Nutrition

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