Category Archives: Sanitation and Health

WASHplus Weekly: Focus on WASH & Nutrition

WASHplus Weekly | Issue 171| Dec 12, 2014 | Focus on WASH & Nutrition

This issue provides updates on new resources since the September 2014 WASHplus Weekly on WASH and nutrition with links to a December 15, USAID webinar; the recently published Global Nutrition Report; presentations at the UNICEF Stop Stunting Conference in India; and just-published studies on stunting, environmental enteropathy, and other WASH and nutrition topics.

EVENTS

December 15, 2014, Draft Guidance for USAID-Funded Nutrition-Sensitive ProgrammingLink
During this webinar, Richard Greene, senior deputy assistant administrator with USAID’s Bureau for Food Security, will share a two-page draft guidance document that will assist implementers in applying the new USAID Multi-Sectoral Nutrition Strategy to nutrition-sensitive agriculture programs.

November 19–21, 2014, The Second International Conference on Nutrition
(ICN2)
Link | Vision statement
The Second International Conference on Nutrition (ICN2) was a high-level intergovernmental meeting that focused global attention on addressing malnutrition in all its forms. The two main outcome documents—the Rome Declaration on Nutrition and the Framework for Action—were endorsed by participating governments at the conference, committing world leaders to establishing national policies aimed at eradicating malnutrition and transforming food systems to make nutritious diets available to all.

November 10–12, 2014, UNICEF Stop Stunting Conference, India. Link
The Stop Stunting regional conference provided a knowledge-for-action platform where state-of-the-art evidence, better practices, and innovations were shared to accelerate sectoral and cross-sectoral policies, programs, and research in nutrition and sanitation to reduce the prevalence of child stunting in South Asia.

REFERENCE MANUALS

Global Nutrition Report, 2014. International Food Policy Research Institute. Link | WaterAid review of the Global Nutrition Report
The first-ever Global Nutrition Report provides a comprehensive narrative and analysis on the state of the world’s nutrition. The Global Nutrition Report convenes existing processes, highlights progress in combating malnutrition, and identifies gaps and proposes ways to fill them. Through this, the report helps to guide action, build accountability, and spark increased commitment for further progress toward reducing malnutrition much faster.

Water, Sanitation and Hygiene in Nutrition Efforts: A Resource Guide, 2014. WASH Advocates. Link
This resource guide includes manuals, reports, academic studies, and organizations working on WASH and nutrition. The guide can serve as a tool for implementers and advocates in the WASH/Nutrition nexus looking to pursue and promote integrated programming.

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Dec 15, 2014 – Launch of study on WASH and maternal/newborn health

Invitation to attend the
Launch of the PLOS Medicine paper
From joint thinking to joint action: A call to action on improving water, sanitation and hygiene for maternal and newborn health
and a discussion on how water, sanitation and hygiene (WASH) can accelerate progress on maternal and newborn health

  • on the 15th of December 2014 at 5:00 – 6:00 PM
  • at the John Snow Lecture Theatre,
  • and followed by a reception until 7:00 PM,
  • at the London School of Hygiene & Tropical Medicine (LSHTM), Keppel Street, London WC1E 7HT.

We are delighted to invite you to attend the launch of an important new paper published by PLOS Medicine. This paper, authored by scientists and technical experts from leading universities and international agencies, outlines the importance of WASH for maternal and neonatal health outcomes. lshtm

The event will be chaired by Oliver Cumming (LSHTM) and speakers will include:

  • Ms Jane Edmondson (Head of Human Development, UK DFID)
  • Dr Maria Neira (Director of Public Health and Environment, WHO)
  • Professor Oona Campbell (LSHTM)
  • Professor Wendy Graham (University of Aberdeen, & SoapBox)
  • Dr Paul Simpson (Deputy Editor, PLOS Medicine)
  • Ms Yael Velleman (Senior Policy Analyst, WaterAid)

To attend, please kindly register at https://plos-medicine.eventbrite.co.uk. Seating is limited, so we would request that you register as soon as possible (free of charge).

Treat your sanitation workers well

There are two contrasting stories this week on the treatment of sanitation workers: in China a local restaurant treats 180 of them to a free lunch, while in Gaza they go on strike after having received no pay for over six months.

More than 180 sanitation workers in Chengdu, Sichuan province enjoyed a free lunch courtesy of a local hotpot restaurant.

More than 180 sanitation workers in Chengdu, Sichuan province enjoyed a free lunch courtesy of a local hotpot restaurant. Photo: weibo.com

Sanitation workers in China get low pay, have poor working conditions and work long hours. Mr. Li, a restaurant owner in Chengdu, decided it was time to show some appreciation for their hard work, especially now as temperatures were dropping. He offered over 180 local sanitation workers a free lunch; they were “encouraged to order whatever they wanted, including alcohol”, writes Dina Li in the Shanghaiist.

The free lunch was also a compensation for the mess created when Mr Li opened his new restaurant and employees distributed more than 100,000 leaflets, most of which ended up on the streets for sanitation workers to clean up.

Waste piles up in Al-Shifa Hospital, Gaza Strip, as a result of strike by sanitation workers.

Waste piles up in Al-Shifa Hospital, Gaza Strip, as a result of strike by sanitation workers. Photo: Mohammad Asad, MEMO

How differently sanitation workers are treated in the Gaza Strip. Since the formation of the Palestinian unity government in June 2014, they have not received any pay. This has spurred a strike with severe consequences for the health care system. The accumulation of large piles of waste and garbage has forced the Al-Shifa Hospital to stop all work in their operation and emergency rooms.

Deputy Minister of Health, Yusuf Abu Al-Reesh warned of dangerous health conditions inside the hospitals and medical centres in Gaza since staff from the private sanitation companies went on strike.

Source:

  • Dina Li, Chengdu hotpot restaurant treats over 180 sanitation workers to free lunch, Shanghaiist, 5 Dec 2014
  • Gaza sanitation workers’ strike stalls hospital operations, Middle East Monitor, 4 Dec 2014

UNICEF/WSP – Child feces disposal in Bangladesh

Child feces disposal in Bangladesh, 2014. UNICEF; Water and Sanitation Program.

Part 1: Overview of current practices (full text, pdf)
Excerpt – In Bangladesh, in 2006, only 22% of households reported that the feces of their children under three were deposited into a toilet/latrine. Therefore, the stools of over 7.5 million children under three were not disposed safely. Th is includes over 3.5 million children whose feces were left in the open.2 Even among those 22% of households with safe child feces disposal, only half (11% overall) have an improved sanitation facility into which they could easily dispose the feces.  In rural areas of Bangladesh, crawling infants come into contact with animal feces, the baby’s own feces, and those of its brothers and sisters. According to one study, half of the mothers in two villages near Dhaka had also seen their infants eating or touching feces during the previous two weeks.

Part 2 – Interventions and Possible Program Interventions: Ideas from the Field (full text, pdf)
Excerpt –  This brief includes all relevant information that the authors have been able to locate thus far on current interventions to improve children’s sanitation in Bangladesh, as well as collating possible integration ideas from the field. It concludes with an appeal to readers to send in any additional information they may be aware of.

 

My toilet: global stories from women and girls

You are invited to view an exciting new exhibition by WSUP, launched to mark World Toilet Day.

My Toilet documents women and girls and their toilets to build a visual representation of the day to day reality and the effect this has on their lives, both positive and negative.

Keyla, 4, by her toilet in Bolivar, Ecuador. Photography Karla Gachet. Panos Pictures for WSUP.

Keyla, 4, by her toilet in Bolivar, Ecuador. Photo: Karla Gachet, Panos Pictures for WSUP.

The images and stories show that, although the type of toilet changes from country to country, the impacts have recurring themes. Having can mean a better chance of education, employment, dignity, safety, status and more. Wherever you are in the world, a toilet equals far more than just a toilet.

Get involved on social media!
Help spread this message by sharing a picture of yourself holding up a sign with the hashtag #ToiletEquals followed by a word, or a few words, to describe what having a toilet equals for you and for millions of others around the world. All the tweets and pictures will be shown on the My Toilet website.

Visit the exhibition!
Images from 20 countries, spanning every continent, will be exhibited at The Royal Opera Arcade Gallery, London SW1Y 4UY. The gallery is open to the public from 17 – 22 November 2014, 10am – 5pm daily. Entry is free. We hope to see you there!

Beyond Malnutrition: The Role of Sanitation in Stunted Growth

Below are the 3 latest posts to the WASH Nutrition Library, http://blogs.washplus.org/washnutrition that is maintained by the USAID Community of Practice on WASH and Nutrition. If your organization has recent studies that we can add to the library, please let us know.

  • ​Beyond Malnutrition: The Role of Sanitation in Stunted Growth
  • Reframing Undernutrition: Faecally-Transmitted Infections and the 5 As
  • Understanding the Rapid Reduction of Undernutrition in Nepal, 2001–2011:​

Beyond Malnutrition: The Role of Sanitation in Stunted GrowthEnv Health Perspect, Nov 2014

Author: Charles W. Schmidt

An excerpt from the article: Beyond Nutrition – Nutritionists have tried dozens of approaches to prevent stunting, such as micronutrient supplements for pregnant women and children (especially growth promoters including iron, zinc, calcium, and folate); increased availability of fat-fortified commercial products such Nutributter and Plumpy’nut; a concerted push to encourage breastfeeding during the first six months of life; and efforts to improve the nutritional quality of the complementary foods babies eat while weaning.6

But Jean Humphrey, a professor of human nutrition at the Johns Hopkins Bloomberg School of Public Health, says none of these interventions has been able to eliminate stunting completely. At best, she says, they improve growth by about a third of the typical height deficit in stunted Asian and African children. “This tells us that dietary improvements are important but not sufficient,” she says. “If we really want to eliminate stunting, we need to do more.”

Meanwhile, mounting evidence has shown that poor hygiene and sanitation also constrain linear growth in children. One study found that Bangladeshi children who had access to clean drinking water, improved toilets, and facilities for handwashing with soap, for instance, had a roughly 50% improvement in HAZ scores compared with control children who didn’t.18 Similar results emerged from studies in Sudan19 and Mexico,20 yet it was unclear exactly why poor WASH would contribute to stunting and WASH improvements would help to ameliorate it.

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Reframing Undernutrition: Faecally-Transmitted Infections and the 5 As, October 2014.

Robert Chambers and Gregor von Medeazza, Institute of Development Studies.

The dominant nutrition discourse concerns access to adequate food and its quality. It now includes food security, food rights and justice, governance and agriculture. Despite many initiatives to assure food access, and growing economies, high levels of undernutrition persist in much of Asia. It is increasingly suggested that much of this ‘Asian enigma’ can now be explained by open defecation (OD) combined with population density. However, the insight that ‘shit stunts’ remains a widespread blind spot. The persistence of this blind spot can in part be explained by factors which are institutional, psychological and professional.

Reductionist focus on the diarrhoeas, which are serious, dramatic, visible and measurable, has led to the relative neglect of many other often subclinical and continuously debilitating faecally-transmitted infections (FTIs) including environmental enteropathy (EE), other intestinal infections, and parasites. These are harder to measure but together affect nutrition much more: the diarrhoeas are only the tip of the much larger sub-clinical iceberg. How OD and FTIs, poverty and undernutrition reinforce each other is illustrated in this paper by looking at the case of India, which has about 60 per cent of the OD in the world, around a third of the undernourished children, and approximately a third of the people living in poverty. Through OD, FTIs and in other ways, lack of sanitation leads to losses, which may be estimated, in the range of 1 to 7 per cent of GDP in various countries.

To reframe undernutrition for a better balance of understanding and interventions, we propose two inclusive concepts: the FTIs and the 5 As. The first two As – availability and access – are oral, about food intake, while the last three As – absorption, antibodies and allopathogens – are novel categories, anal and internal, about FTIs and what happens inside the body. These concepts have implications for research, professional teaching and training, and policy and practice. While other countries make rapid progress towards becoming open-defecation free, India remains obstinately stuck, making undernutrition in India one of the great human challenges of the twenty first century. The concepts of FTIs and the 5 As reframe more inclusively how undernutrition is perceived, described and analysed. Our hope is that this reframing will contribute however modestly to a cleaner, healthier and happier world in which all children and adults are well-nourished and can grow and live to their full potential.

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Understanding the Rapid Reduction of Undernutrition in Nepal, 2001–2011: IFPRI Discussion Paper 01384, 
October 2014.

AUTHORS: Derek D. Headey (d.headey@cgiar.org) is a senior research fellow in the Poverty, Health, and Nutrition
Division of the International Food Policy Research Institute (IFPRI), Washington, DC.

John Hoddinott is a senior research fellow in the Poverty, Health, and Nutrition Division of IFPRI,  Washington, DC.

Abstract: South Asia has long been synonymous with unusually high rates of undernutrition. In the past decade, however, Nepal has arguably achieved the fastest recorded decline in child stunting in the world and has done so in the midst of civil war and postconflict political instability. Given recent interest in reducing undernutrition–particularly the role of nutrition-sensitive policies–this paper aims to quantitatively understand this surprising success story by analyzing the 2001, 2006, and 2011 rounds of Nepal’s Demographic Health Surveys.

To do so, the authors first construct and test basic models of the intermediate determinants of child and maternal nutritional change and then decompose predicted changes in nutrition outcomes over time. They identify four broad drivers of change: asset accumulation, health and nutrition interventions, maternal educational gains, and improvements in sanitation.

Many of these changes were clearly influenced by policy decisions, including increased public investments in health and education and community-led health and sanitation campaigns. Other factors, such as rapid growth in migration-based remittances, are more a reflection of household responses to changing political and economic circumstances.

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Oliver Cumming – Does Improving Sanitation Benefit Health? (podcast)

PODCAST: Does Improving Sanitation Benefit Health?

Description In this podcast, Oliver Cumming, Policy & Research Manager at SHARE, discusses whether improving sanitation benefits health and explains how a sanitation campaign in rural India has led to a rethink about future interventions. This podcast was first published on 23/10/14 by LSHTM.