Category Archives: Regions

Will better sanitaton and nutrition reduce stunting?

Zimbabwe SHINE trial - Cornell University

Photo: Cornell University

A trial is underway in Zimbabwe to measure the independent and combined effects of improved sanitation and hygiene (WASH) and improved infant diet on stunting and anemia among children 0-18 months old [Cornell University CENTIR Group blog].

The Sanitation, Hygiene and Infant Nutrition Efficacy (SHINE) Trial is led by the Zvitambo Institute for Maternal and Child Health Research in Harare, Zimbabwe in collaboration with the Ministry of Health and Child Care/Government of Zimbabwe. Other contracted experts include Sandy Cairncross, Val Curtis and Peter Morgan.

The SHINE Trial is being undertaken in Chirumanzu and Shurugw, two districts with high HIV prevalence. Besides investigating the effects of sanitation and nutrition, SHINE will also test whether Environmental Enteric Dysfunction (EED)is a major cause of a major cause of child undernutrition. EED, also called environmental enteropathy, is a condition believed to be due to frequent intestinal infections.

SHINE is being being funded by the Bill & Melinda Gates Foundation and the UK Department for International Development (DFID). There are additional contributions from Wellcome Trust, National Institutes of Health, and the Swiss Development Cooperation.

A special open access supplement of Clinical Infectious Diseases is devoted to SHINE containing the following articles:

  • The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) Trial Team, doi:10.1093/cid/civ844
  • Design of an Intervention to Minimize Ingestion of Fecal Microbes by Young Children in Rural Zimbabwe, doi:10.1093/cid/civ845
  • The SHINE Trial Infant Feeding Intervention: Pilot Study of Effects on Maternal Learning and Infant Diet Quality in Rural Zimbabwe, doi:10.1093/cid/civ846
  • Using Geographic Information Systems and Spatial Analysis Methods to Assess Household Water Access and Sanitation Coverage in the SHINE Trial, doi:10.1093/cid/civ847
  • Assessment of Environmental Enteric Dysfunction in the SHINE Trial: Methods and Challenges, doi:10.1093/cid/civ848
  • The Potential Role of Mycotoxins as a Contributor to Stunting in the SHINE Trial, doi:10.1093/cid/civ849
  • Assessing the Intestinal Microbiota in the SHINE Trial, doi:10.1093/cid/civ850
  • Assessing Maternal Capabilities in the SHINE Trial: Highlighting a Hidden Link in the Causal Pathway to Child Health, doi:10.1093/cid/civ851
  • Theory-Driven Process Evaluation of the SHINE Trial Using a Program Impact Pathway Approach, doi:10.1093/cid/civ716

Testing CLTS Approaches for Scalability: Nepal Learning Brief

Nepal UNC

Pour Flush Toilet in Nepal. Photo Credit: Vidya Venkataramanan

Plan International supports Community-led Total Sanitation (CLTS) implementation in a number of districts in Nepal. In this learning brief, we review Plan International Nepal’s CLTS activities. We found government targets and definitions to be ambitious while decentralized planning allowed a focus on community-led processes. Plan International and other sanitation practitioners can support CLTS outcomes by providing post-triggering training and technical support to community volunteers, focusing on achieving gradual, yet sustained outcomes in program areas, and continuing to work with local governments to ensure that financing mechanisms for the poor are locally developed and equitable.

Link to learning brief:

Citation: Community-led Total Sanitation in Nepal: Findings from an Implementation Case Study. Venkataramanan, Vidya, Alexandra Shannon, and Jennifer Bogle. 2015. Chapel Hill, USA: The Water Institute at UNC.

New week NEW BRIEF! Finance Brief N. 8: “A few cents on your water bill: Tana’s (Anatanarivo) surcharge system” By Sylvie Ramanantsoa, Julie Ranaivo and Guy Norman

Tana 001    In Madagascar’s capital Antananarivo (Tana), water bills include various surcharges designed to help finance water and sanitation. In recent years, Water & Sanitation for the Urban Poor (WSUP) has been working with local government and with the utility JIRAMA to optimise the use of these revenues to support water supply improvements in low-income communities. This brief describes how this interesting system works, and considers how it might be further developed.

FB008 Tana fonds de travaux_Page_1


Water, Sanitation, Hygiene, and Nutrition in Bangladesh:

Water, Sanitation, Hygiene, and Nutrition in Bangladesh” Can Building Toilets Affect Children’s Growth? 2015.

Authors: Iffat Mahmud and Nkosinathi Mbuya. World Bank.

This report provides a systematic review of the evidence to date, both published and grey literature, on the relationship between water and sanitation and nutrition. bangladesh-wash-1

We also examine the potential impact of improved water, sanitation, and hygiene (WASH) on undernutrition. This is the first report that undertakes a thorough review and discussion of WASH and nutrition in Bangladesh.

The report is meant to serve two purposes. First, it synthesizes the results/evidence evolving on the pathway of WASH and undernutrition for use by practitioners working in the nutrition and water and sanitation sectors to stimulate technical discussions and effective collaboration among stakeholders.

Second, this report serves as an advocacy tool, primarily for policy makers, to assist them in formulating a multisectoral approach to tackling the undernutrition problem.

Unilever unveils new film and rural programme about handwashing with soap for newborn survival

Unilever’s health soap, Lifebuoy introduced ‘Chamki’, a compelling new film to raise awareness of the importance of handwashing with soap for new mums as part of Lifebuoy’s Help A Child Reach 5 handwashing programme.

This year, the campaign focuses on a child’s neonatal period (the first 28 days of life). It also coincides with the launch of a partnership with the Children’s Investment Fund Foundation (CIFF) to scale up Lifebuoy’s handwashing programmes in rural Bihar, India.

The newest Help a Child Reach 5 film was developed by Mullen Lowe Group and shot by the famous feature film director, Anand Gandhi. The film showcases the emotional journey of a real pregnant mother and her aspirations for her child.

It highlights the importance of doing something very simple, yet important during pregnancy and early in the child’s life: washing hands with soap.

Continue reading

Shared sanitaion for the urban poor: understanding what works

The MapSan study aims to explore the links between sanitation, population density, and health outcomes in Maputo, Mozambique. The video describes a controlled, before-and-after trial of an urban sanitation intervention to reduce enteric infections in children:

Plan International – Testing CLTS Approaches for Scalability: Indonesia Learning Brief

Testing CLTS Approaches for Scalability: Indonesia Learning Brief, 2015. Plan International.

Sanitation Marketing Project in Grobogan District, Indonesia. photo credit to Jonny Crocker

Sanitation Marketing Project in Grobogan District, Indonesia. photo credit to Jonny Crocker

Plan International supports Community-led Total Sanitation (CLTS) implementation in a number of sub-districts in Indonesia.

In this learning brief, we review the roles of local actors in Plan International Indonesia’s program activities and highlight considerations for scalability, planning, implmentation, and evaluation.

Plan International and other sanitation practitioners can support the national government and local actors by placing more responsibility on sub-district staff to lead triggering, enlisting the added support of village facilitators to lead post-triggering, and scaling up village-based financing mechanisms to sustain CLTS outcomes.

Link to project website: