Evidence for Integration in the first 1000 days

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Evidence for Integration in the first 1000 days

Over the past year, there has been increased international focus on water, sanitation and hygiene (WASH) as a key missing piece in health programming. A Lancet series provided a focus on the need for WASH in nutrition, the SHINE study started to illuminate the link between WASH and early childhood development (ECD), a WSP/UNICEF series highlighted the lack of sanitation for children under 2, and a new spotlight on health care facilities by WHO/UNICEF highlights the poor WASH conditions that contribute to maternal and newborn mortality and morbidity. With the Sustainable Development Goals (SDGs) encouraging more cross-sector work and collaboration between different development players, a focused coalition addressing issues of sectoral integration is essential.

The BabyWASH coalition was formed from the examination of this evidence and the realization that there needed to be more integration between WASH, ECD, Nutrition, and Maternal Newborn and Child Health (MNCH).

Some of the evidence is posted below. Please contribute any new evidence you discover that enhances the case for integration, especially during the first 1000 days of life.

1. The Shine Trials are an innovative set of studies examining the hypothesis that a child's unsanitary environment in the first few years can lead to Environmental Enteric Dysfunction (EED) and keep the child from ever reaching his/her growth potential. Joint ECD, WASH and Nutrition interventions are needed to help reduce the effect of EED. cid.oxfordjournals.org/content/61/suppl_7.toc

2. The WHO/UNICEF study of WASH in Health Care Facilities illuminates the lack of water and sanitation at many health facilities in low and middle income countries. In order to address maternal and newborn mortality, WASH programming must be addressed. who.int/water_sanitation_health/publicat...-care-facilities/en/

3. The Lancet Series demonstrates the importance of nutrition and describes how tackling malnutrition is really an intersectoral issue. www.thelancet.com/series/maternal-and-child-nutrition

4. The WSP/UNICEF series describes beliefs and practices around child fecal disposal and is a key document in understanding how to improve sanitation at the household and environmental level. www.wsp.org/content/ensuring-safe-sanitation-children-0

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