SuSanA - Forum Kunena Site Syndication Tue, 21 Apr 2015 11:39:01 +0000 Kunena 1.6 SuSanA - Forum en-gb Re: WATSAN-AGRICULTURE: Improving on the Nexus among Water Quality and Quantity, Sanitation, Hygiene, and Agriculture - by: antonini
Today I would like to introduce Charles Yaw Okyere from Ghana. Charles is doing his PhD research under the scope of the WATSAN Agriculture project. He looks at water quality in multipurpose water systems, sanitation, hygiene and health outcomes in Ghana.

The case study in Ghana looks at improving the capacity of communities in monitoring their WATSAN Agriculture environment. Randomized control trials focusing on informational interventions on water, sanitation and hygiene behavior were implemented in 2014. Randomly selected school children and adult household members were provided with water testing toolkits to test their stored drinking water for the presence of fecal bacteria. The experiment design will allow to assess the most effective channel for WATSAN information delivery.

Charles is currently undertaking the final stage of his field work and will hopefully be able to share first results soon!

Here is a short abstract of his research:

About 1.8 billion of the world’s population consumes water from highly contaminated sources. Level of fecal contamination of water differs between point-of-source (POS) and point-of-use (POU). Providing water quality information to households is known to improve water, sanitation and hygiene behaviors and reduction of diarrheal diseases. Studies in which water quality information is disseminated to randomly selected households potentially underestimate the impacts, missing the potential learning experiences from household self-water testing and also missing the most effective channels in the delivery of such information to the treatment groups. We conducted water testing experiments in southern Ghana (Greater Accra region) in which students in public basic schools, and adult household members were randomly assigned to receive water testing kits and water quality improvement messages. Selected participants were also trained on the use of water testing kits in testing for E. coli; an indicator bacteria of fecal contamination of water. Baseline orthogonality tests are used to check the similarities and differences between the intervention groups (clustered randomized design). Difference in difference (or comparison of means) estimators are analyzed by gender and type of participants (students vs adult household members). Robustness checks and sensitivity analysis are performed by testing for heterogeneity in treatment effects in order to limit false predictions/estimates. Short-run program effects are estimated for a wide range of outcome variables including water sources, diarrheal diseases, water transportation, and handling and storage techniques, among others. Demand for water testing (measured by participation rate) was high for students’ intervention group compared to adult household members group. Participation rate (used to proxy demand) was slightly higher for females compared to males.]]>
Nutrition and WASH Tue, 21 Apr 2015 08:34:31 +0000
Re: 8 practical ideas to link more WASH and Nutrition programmes - by: exobarbiche
Thanks for sharing this info. So far we have not "dared" to start ecosan in Tchad, fearing some resistance from population, but apparently that's possible, great! The experience we have with ecosan in sahel is mixed, in general people do use the built latrine, and sometimes also use the product for agriculture, but it seems that ecosan latrine are more expensive and difficult to make than traditional latrines, so since our strategy is to maximizing the latrine coverage to see clear effect on health and nutrition (which involve people making and financing their own latrine without subsidies) built ecosan latrine can be counter-productive...We also found that ecosan more relevant in urban or peri urban area, where empting and disposal of latrine is an issue (this operation tend to be easier with ecosan) than rural area, where they have a lot of space, and also a lot of other organic matter than human feces (such as straw, or animal feaces) if they want to produce organic fertilizer or compost. this being said, ecosan latrine have a lot of advantages, including environmental benefit, reduce smell we should try a way to reduce their cost!

Nutrition and WASH Thu, 16 Apr 2015 13:39:12 +0000
Re: WATSAN-AGRICULTURE: Improving on the Nexus among Water Quality and Quantity, Sanitation, Hygiene, and Agriculture - by: antonini
Let me introduce Ruchi Vangani to you: Ruchi is a Public Health expert and doing her research in collaboration with the Public Health Foundation of India (PHFI).

Ruchi is looking at irrigation agriculture in the peri-urban areas of Ahmedabad with particular focus on water quality, health impacts (diarrhea prevalence, waterborne illnesses, parasitic prevalence), nutrition impacts and hygiene behavior.

She also examines the economic tradeoffs between enhancing health outcomes through 1) facilitating behavioral change by providing information to communities (e.g. about infectious pathways), versus 2) changing WATSAN-infrastructure services (e.g. for improved drinking water and sanitation), versus 3) (re-) design of multi-use water systems, or all of the three above.

The detailed abstract of her research is presented in her post above!

Nutrition and WASH Wed, 15 Apr 2015 12:27:26 +0000
Stockholm World Water Week 2015 - WASH in Nut seminar - by: JovanaD
I would like to share with you the information on the event that ACF and partners are organizing during the Stockholm World Water Week 2015. The event will take place on Tuesday, 25th of August from 11:00 to 12:30. If anyone of you happens to be there and is interested in joining, please check the further information about the seminar below:

Wash In Nut – Review of strategy and operational solutions to fight undernutrition with Water, Sanitation and Hygiene

Event Description:

The publishing of a number of scientific reviews questioning the impacts of Water, Sanitation and Hygiene (WASH) activities on nutritional status of individuals, has encouraged different academic, development and humanitarian actors to take a closer look at the connection and dependence of these two sectors. Based on the recent research and operational initiatives taken by various organizations and scientific institutions, this event aims at providing an overview of the latest field experiences and research projects linking poor WASH status, infection and under-nutrition as well as boosting the advocacy efforts determined to increase global knowledge and awareness about this issue. Among others, the SuSanA Working Group on WASH and Nutrition will present the current version of its Factsheet together with ongoing and future activities. The Sahel “WASH in Nut” strategy, developed by different organisations with the primary goal to increase the efficiency of humanitarian response to continuing nutritional crisis in this region, will also be presented along with the operational field experiences such as the ACF project in Burkina Faso. SHARE and LSHTM will present research that strengthens the evidence base on the impact of WASH on nutritional status and interventions to tackle this. Finally, the event will advocate for more rigorous research, policy coherence and stronger cooperation among Health and Nutrition, WASH, Mental Health, Care Practices and Food Security sectors in order to ensure that WASH aspects are acknowledged and implemented as an integral part of nutrition interventions.

Event Classification
Policy and Governance

Lead convenors

• Action contre la faim (ACF)
• German WASH Network

• Sustainable Sanitation Alliance
• Sanitation and Hygiene Applied Research for Equity (SHARE) Research Consortium
• Concern Worldwide
• BMZ (Federal Ministry for Economic Cooperation and Development)

Event objectives and expected outcomes:

The main objectives:
• to advocate for a multi-sector to fight under-nutrition;
• to call for incorporation of WASH components, including WASH targets and indicators, into the activities focusing on prevention and treatment of under-nutrition in order to improve their efficiency;
• to advocate for funding of WASH sector in accordance with its impacts on under-nutrition.

Expected outcomes:

• Latest evidences showing links between WASH and nutritional status are presented and discussed;
• Existing WASH in Nutrition operational approaches and tools reviewed and the best practices showcased;
• Wasting and stunting characterized and WASH approaches adapted accordingly;
• Place and role of WASH components within nutrition sensitive interventions presented and discussed;
• The panel of experts consolidated and networking efforts among academic, humanitarian, public and private actors in this field strengthened.

Key messages:

1. Ongoing research efforts are key in determining the impact of WASH interventions on nutritional status, especially acute malnutirion;
2. The WASH sector is an integral component of national and international strategies for combating under-nutrition;
3. More rigorous research, policy coherence and stronger cooperation between Health and Nutrition, WASH, Mental Health, Care Practices and Food Security sectors are needed;
4. Funding efforts need to correspond more closely to the Target 7.C. of the Millennium Development Goals, particularly on sanitation and hygiene, which is currently far from being attained;
5. It is essential for strategies and programmes aiming at fighting under-nutrition to incorporate short and long-term multi-sector components including WASH targets and indicators.

Event summary :

The event is planned to be a combination of plenary sessions, with the time devoted for questions and answers, and a group work to share best practices. Furthermore, the event will provide an opportunity for the conveners and the participants to share materials such as case studies, strategic documents, posters and advocacy material.

Target audience:

Government and policy makers, civil society representatives and NOGs, donors, academics, researchers and practitioners with an interest in the fight against under-nutrition, seeking information exchange/sharing on the impact of WASH interventions on nutritional status.

If you need any additional information about this event please feel free to get back to me.]]>
Nutrition and WASH Wed, 15 Apr 2015 10:01:08 +0000
Re: 8 practical ideas to link more WASH and Nutrition programmes - by: WASHanna
I'm curious about the nutrition outcomes you are seeking since you mention agriculture yield. Could you share more on this aspect?

Nutrition and WASH Tue, 14 Apr 2015 09:29:08 +0000
Re: 8 practical ideas to link more WASH and Nutrition programmes - by: Annebauby
I am the Programme Manager that Franck mentionned in a previous post currently working in Chad. We are running a pilot project on ECOSAN latrines since November 2013. This is a very small scale project of 15 individual UDDT latrines builtd in 5 villages. Although the project is still on-going,we can list some lessont learnt so far.

* There is no particular taboos raised by this project until now, which is found as very surprising. We are in a muslim and semi-pastoralist area, which is not the best area to pilot such project. Religious and cultural taboos as well as issues related to beneficiairies leaving home for several weeks or months were expected at the begining of the project. However, they did not occur. We selected 3 volunteer families per village and one Imam was a volunteer.
* Latrines are highly accepted by the communities, not only by the volunteer families. The latrines were designed for being used by a households composed of in average 5 members and for a year. The vaults got full much faster because in some case more than 20 people have access to them. According to the result of our monitoring, the latrine did not raised any particular issue in the communities and everyone would be willing to use them (except from ederly who has difficulties to climb the steps).
* We focused a lot on sentitization, software activities and beneficiairies participation at all the stage of the project. They choose the design of the latrines to be built (we proposed UDDT, composting latrines, arboloo......)and for instance they participated in the construction. This factor is seen as reason for the success of the acceptance and the strong community leadership on the facilities.
* the beneficiairies are actually spreading the dry excreta on the fields or waiting for the rainy season to do so. Therefore we cannot know, the real success on agriculture yield yet. Therefore it is really too early to link this project with Nutrition outputs, which is the topic of this conversation!
* lastly, the design of the latrines is a bit poor. We did not have an engineer in the team when we designed the project and therefore we made some mistakes in the technical design (slabs a bit too small and steps too high) but they are not preventing users to actually use them. Also, even if we tried to reduce the construction cost...... the unit cost is about 300€/latrine which is a hight amount for a household latrine. We probably won't scale up this project for financial reasons.

I am happy to answer to any question!

Nutrition and WASH Tue, 14 Apr 2015 09:22:05 +0000
Re: WATSAN-AGRICULTURE: Improving on the Nexus among Water Quality and Quantity, Sanitation, Hygiene, and Agriculture - by: ruchivan Abstract: Given the scarce and poor quality water resources for the growing urban population and use of different types of water use for irrigation viz. wastewater, river water, wells and freshwater there is a need for research to analyse the social, environmental, health and economic trade-offs of the type of water use in agriculture. The present field study was conducted in the peri-urban areas of Ahmedabad in Gujarat (India). Wastewater irrigation is a commonplace in peri-urban areas of Gujarat and its use in irrigation is even growing due to the scarcity of freshwater resources. The research specifically seeks to address the questions on the impact of irrigation water use on the health and nutrition outcomes of communities exposed to the irrigation and the produce. Conceptually, the study seeks to address the research questions in the context of the dynamic interactions between different irrigation water, water sanitation (WATSAN) and health to eventually identify better strategies of linking water uses for ‘WATSAN’ and irrigation agriculture activities to improve health and nutrition status.

The initial baseline survey included the household’s demographic, socioeconomic and water sanitation module followed by a follow up visit biweekly basis for 7 months to collect information water related sickness reported in under 5 children and adult members of the Household. The height and weight of under 5 kids was measured as per the WHO anthropometric guidelines. The water sampling at household source and storage was done in laboratory using the MPN method as per the WHO guidelines. The water samples were collected in sterile containers from the source and storage water of HH and transported to the laboratory for the presence of faecal coliforms and E coli. Stool samples of under 5 children were tested in laboratory for the presence of parasites.

Attached are some pictures.]]>
Nutrition and WASH Fri, 10 Apr 2015 11:15:34 +0000
Re: WATSAN-AGRICULTURE: Improving on the Nexus among Water Quality and Quantity, Sanitation, Hygiene, and Agriculture - by: mhasan
Thank you for posting the AG-WATSAN activities in SuSanA forum. Indeed ZEF is doing wonderful research in the field of AG-WATSAN. As a part of that I am also partially contributing in the area of AG-WATSAN Which is mainly funded by Bill and Melinda Gates Foundation. Besides other funding institutions such as DAAD, Foundation of Fiat Panis is providing financial support for doing this research. There are also collaboration with the Institute of Biological Science (IBSc) of University of Rajshahi, Bangladesh for microbiological testing water and food preparing utensils in the lab. However, especial thanks to BRAC and IFPRI for supporting my field research in many ways.

My main research topic is: Investment in health within Agriculture-Water-Sanitation-Hygiene (AG-WATSAN) nexus for the rural households in Bangladesh.

This research is designed as RCT where Food Hygiene Education is being randomized in the 512 households in North-western Bangladesh. The drinking water and food preparing utensils are being tested for E.Coli bacteria in all three phases Baseline-Midline-and endline. The anthropometric measures (height and weight) of under five children of these sample households are also being taken.

The abstract of my research is here:

Safe drinking water is becoming scarce because of the water pollution, salinity and widespread arsenic contamination in Bangladesh. Still 14% of the households do not have access to safe water and 46% do not have access to improved sanitation facility. Besides, agriculture plays vital role for water, sanitation and hygiene maintenance in rural areas. The objective of this research is to identify how the agriculture-water-sanitation-hygiene (AG-WATSAN) nexus works in rural Bangladesh and how household and community investment can benefit the respective households and communities in terms of economic and health outcome. Water in the northern part of Bangladesh is scarce and contaminated by arsenic which is above the permissible level of human consumption. Public intervention such as domestic water supply from deep tube well provides the solution in some areas. The study also explores to what extent technological arrangement at community and household level such as domestic water supply from public intervention affect WATSAN status of rural households. Besides the public intervention, some collective institutional arrangement could also make some differences in the status of water and sanitation in the rural areas. This study also focuses on to what extent group-based lending of microfinance for longer period improves WATSAN status of the marginalized households in northern Bangladesh. It is expected that long term exposer of microfinance membership improves the water and sanitation status of the households. Finally it is very important to look at the food hygiene behavior of the households especially for the children under 5 who are vulnerable to different health shocks including diarrhea. The study will try to understand the economics of food hygiene within the household. The study will test bacteria such as E. Coli in water and food for three successive terms to see the impact of Food Hygiene Education (FHE) as they will be provided this education randomly within the village level. This study will attempt to identify the investment behavior in health within the nexus of AG-WATSAN of the rural households. Several econometric techniques will be applied to see the best outcome of the present research.

The treatment here is the combination of three things-
1) E.Coli test result of drinking water and food preparing utensils
2) 8 Keys to safe food (training session by a trainer who explain these messages to the households)
3) Food Hygiene Education poster (poster containing the 8 messages) to be hanged in the dinning area of the household.]]>
Nutrition and WASH Sat, 04 Apr 2015 20:01:24 +0000
Re: WATSAN-AGRICULTURE: Improving on the Nexus among Water Quality and Quantity, Sanitation, Hygiene, and Agriculture - by: usmansus I would like to thank Samantha for her great efforts to create the plate form for us to share our research ideas and field experience. I would also like to introduce myself. I am Usman and I am one of the team members working in the AG-WATSAN project. The project has been implemented in India, Bangladesh, Ghana, and Ethiopia —where improved WATSAN is limited and proper hygiene practices are lacking.

In Ethiopian, the project has been undertaken in collaboration with the Ethiopian Economics Association (EEA), Addis Ababa, to address the health needs regarding drinking water supply, sanitation, and proper hygiene practices in rural areas of the country. As part of this process, a household survey was conducted in rural areas of Fogera and Mecha districts of Northern Ethiopia over a five months period (from February to June 2014). About 454 agricultural households were randomly selected using a stratified two-stage cluster sampling technique. The survey collected a range of information, including demographic characteristics, agricultural production, household members’ health status, household consumption and expenditure, household time and labour use, land and asset holdings and income sources, households´ drinking water supply and quality, excreta disposal, and knowledge and practices concerning hygiene.

In addition to household survey, one particular innovation of the study is the water quality testing at household’s storage and community sources to determine the level of Escherichia coli (E. coli) – as measured by number of E. coli bacteria (CFU/100ml). The presence of faecal coliforms was analyzed using the membrane filtration method. Water quality sample testing was conducted both at household’s water storage and community water sources. Moreover, anthropometric measurements, such as height and weight, were also collected for children under five years of age and follow-up surveys were administered subsequently every two weeks for a period of three months to record the prevalence of diarrhea, fever, vomiting, constant cough, stomach pain or cramps and skin infection of children under five of the respective interviewed households.

Working title: Water and Sanitation — Agriculture nexus: Health and Nutrition Outcome in Ethiopia under Multi-use Water Systems.
Abstract of the thesis

As a result of limited availability of improved domestic water, a majority of the rural population relies on unimproved water sources, including unprotected springs, shallow wells, streams and surface water, which are easily polluted by human and animal faeces. In the rural setting, separate sources for drinking water supply and agriculture use do not exist in a number of areas, and irrigated agriculture has complex interactions with WASH services. There is a trade-off in the domestic use of irrigation water. Irrigation water might serve as an option to increase the availability of water for domestic uses and saving water collection time and energy. However, poor quality of irrigation water for domestic purposes may be harmful for health due to the presence of disease-causing pathogens.

The linkage between WASH and agriculture is often overlooked and understudied. Most of previous empirical works either focus on the relationship between WASH and health or irrigation and health, while isolating the complex interaction among irrigation agriculture, health and WASH. Agriculture uses the largest amount of water in the world, and food production affects the water cycle in various ways. The quality and quantity of drinking water can easily become affected through agricultural practices. On the other hand, adequate sanitation reduces the spread of water-related diseases and can also support sustainable food production, as excreta can be seen as a source for nutrients and organic matters. Besides, increased nutrition and reduced disease burden improves health. Considering the limited studies on the linkage between WASH and agriculture, this study sheds some light on the agriculture-WASH nexus by using state-of-the art econometric methods.

While achievement on improved water sources coverage has been applauded in rural Ethiopia, efforts should be doubled to increase further the coverage of improved water supply and sanitation service. As improved water supply and sanitation together with good hygiene behaviour have long been recognized a fundamental to improve health and a driving force to social and economic progress in developing countries. Additionally, the issues of water quality and sanitation particularly in the rural setting of developing countries are still neglected.
The findings will be presented in any international conferences and it will also be communicated to the communities.

Finally, comments and suggestion form anyone will be highly appreciated!!
I have shared you some pictures from the field work.

Nutrition and WASH Sat, 04 Apr 2015 11:27:13 +0000
Your feedback on hygiene promotion material for Sahel - by: JovanaD
The Action Contre la Faim is currently implementing operational research project called: “Benefits of a household WASH package to Community Management of Acute Malnutrition (CMAM) program” in Kanem region in Chad. The objective of the research is to demonstrate in a robust way a better performance and reduction in relapse rates in severe acute malnutrition cases discharged from the nutrition rehabilitation outpatient treatment program (OTP) due to the WASH intervention. This will be tested through a randomized control trial conducted by the ACF and partners.

The expected outcomes of the WASH intervention are following:
- Improvement of the water quality in the household of the malnourished children admitted in outpatient treatment programme (OTP);
- Improvement of the hygiene related care practices in the household of the malnourished children admitted in outpatient treatment programme (OTP);

This will be achieved through:
1. Provision of a “household WASH package” to each malnourished child and his/her caregiver included in the OTP program in the health centers targeted by the intervention;
2. Initial and weekly hygiene promotion session provided to the child caregiver in the health center;
3. A household visit conducted by village’s community health volunteers and the ACF intervention staff during the treatment, to provide refresh training on the messages and the use of the kit.

Regarding the weekly hygiene promotion sessions, we prepared a training material “Boite a images” in order to promote and disseminate the 7 hygiene messages which are the main focus of the project:

1. Systematic hand washing with soap for the child caretaker, after defecation, contact with human or animal fecal material, and before preparing / serving food;
2. Wash the child with soap, particularly hands, face, bottom and feet;
3. Cleaning and rapid burial of children's stools;
4. Drinking water provided to the malnourished child should be water treated with chlorine (Aquatabs) or boiled;
5. Safe transport and storage of drinking water;
6. Once weaned, avoid giving to the child leftover food, or only after warming it again;
7. Allocate a protected space for children to play, limiting the likelihood of them ingesting soil or animal feces;

We would like to kindly ask you to have a look at it and provide you feedback and comments. We are very much aware that these images could be improved, as they are for the moment a patchwork of various materials used in Sahel for hygiene or nutrition promotion. We have approach CASWT to see if they would be interested in developing such material for various contexts, waiting for their feedback, but if you see another way, or would like to be involved in the development of an IEC kit for WASH and nutrition, please let us know.

In the meantime, feel free to use this materiel if you think it can be useful for your project.

Thank you.]]>
Nutrition and WASH Tue, 24 Mar 2015 11:29:02 +0000
WATSAN-AGRICULTURE: Improving on the Nexus among Water Quality and Quantity, Sanitation, Hygiene, and Agriculture - by: antonini
I would like to present the WATSAN-AGRICULTURE project which is granted by the Bill & Melinda Gates Foundation, the grantee is the Center for Development Research (ZEF) in Bonn, Germany.

We will keep you posted about ongoing activities and share the outcomes of our research with you!

Samantha Antonini

Title of grant:
WATSAN-AGRICULTURE: Guiding pro-poor investments in the nexus among domestic water quality and quantity, sanitation and hygiene, and agriculture from the bottom-up

Purpose: to improve the health and nutrition status of poor people in Africa and South Asia by guiding investments for a more effective water, sanitation and hygiene nexus, also considering the related links to agriculture

Name of lead organization:
Center for Development Research (ZEF), University of Bonn

Primary contacts at lead organization:
Prof. Joachim von Braun (project director)
Dr. Evita Pangaribowo (project management)
Dr. Samantha Antonini (coordination and administration)

Grantee location: Bonn, Germany

Developing countries where the research is being or will be tested: Ghana, Ethiopia, India, Bangladesh

Start and end date: 2012- end of 2015

Grant type: Other

Grant size in USD: $1,044,016 (see also: Website Gates Foundation)

Short description of the project:
It is important to look how to invest in water, sanitation, and hygiene in the most effective way. A review of the impact of water, sanitation and hygiene intervention undertaken by the International Initiative for Impact Evaluation documents that hygiene practice through hand-washing with soap and the usage of toilets reduces the diarrhea prevalence by 37% and 34%, respectively. Improved water quantity and quality and improved sanitation and hygiene enhance health and nutrition outcomes.

Yet, these areas overlap with irrigation agriculture having an additional impact on health and nutrition outcomes. Irrigation agriculture influences health through various ways: Water harvesting techniques, irrigation canals, ponds, tanks and/or dames are among the contributing factors that impair the human health. Irrigation water can create suitable conditions for the propagations of waterborne related diseases-vectors such as mosquitoes transmitting malaria.

Having an integrated approach from different scientific disciplines is crucial in addressing the issues of water and sanitation and their links to other sectors, particularly agriculture. The WATSAN project will involve scientists from a broad range of relevant disciplines (ecology, hydrology, agronomy, economy, sociology, and public health). The project compiles household data from Demographic and Health Surveys and primary data collection in the community to address the missing link between water, sanitation, hygiene and agriculture.

Proposing policy recommendations on investment and priority activities and tools to empower households and communities to monitor their WATSAN environment

(1) identifying the critical sets of the tradeoffs between and synergies among domestic water quality and quantity, sanitation and hygiene and agriculture irrigation systems
(2) enhancing investments in technological and institutional arrangements for improving capacities of rural and peri-urban communities connected to multi-purpose water systems; and
(3) strengthening the capacity of households and communities to monitor and manage their own WATSAN environment, including to serve accelerated ‘ground truthing’ for the international monitoring schemes

Research or implementation partners:

Ethiopian Economic Association (EEA), Ethiopia
Institute of Statistical, Social and Economic Research (ISSER), Ghana
Public Health Foundation of India (PHFI) through Indian Institute of Public Health Gandhinagar (IIPHG), India
BRAC in Bangladesh

Links, further readings – results to date:
Documents in SuSanA library:
Project Website

Background paper:

Tsegai, D., Mc Bain, F., and Tischbein, B. “Water, Sanitation, Hygiene: The Missing Link with Agriculture”, ZEF Working Paper No 107, Center for Development Research, University of Bonn, 2013; available at: ZEF Website

Conference papers planned for 2015:

Usman, M. A. “Exploring the Trade-offs Between Irrigation and Drinking Water Supply under Multi-use Water System in Ethiopia”, will be presented at the IWRA XVth World Water Congress in Edinburgh on 25-29 May 2015

Okyere, C. Y. “Strengthening the Capacity of Households and Communities for Improved Water, Sanitation and Hygiene: water testing experiments with school children and adult household members in Ghana”, will be presented at the IWRA XVth World Water Congress in Edinburgh on 25-29 May 2015 and in an organized symposium at the 29th International Conference of Agricultural Economist in Milan on 8-14 August 2015.

Okyere, C. Y. “Modelling Household’s Decision on Water Supply and Sanitation in Greater Accra Region of Ghana”, will be presented at the IWRA XVth World Water Congress in Edinburgh on 25-29 May 2015

Pangaribowo, E., and Malek, M. A. “Informational Intervention and Behavior Change: experimental evidences on agricultural hygiene messages in Bangladesh”, will be presented in an organized symposium at the 29th International Conference of Agricultural Economist in Milan on 8-14 August 2015.

Current state of affairs:

One randomized control trial in Ghana, focusing on informational interventions on water, sanitation and hygiene behavior is implemented in Ghana. Randomly selected school children and adult household members were provided with water testing toolkits to test their household stored drinking water for the presence of fecal bacteria. The experiment design subsequently enables this study to assess the most effective channel for WATSAN information delivery. The end-line survey is about to start in April 2015.

One randomized control trial focusing on agricultural hygiene messages is being conducted in six sub-districts in Bangladesh. The core messages “Hygiene in the Field and at Household for a Better Life” are: 1. carry safe drinking water in the field, 2. wash hands with soap after farming and handling livestock in addition to wash hands with soaps at five critical activities, 3. protect drinking water and food, 4. treat the water before drink, 5. use hygienic latrines. The messages are distributed in a poster form. The end-line survey will be conducted in May 2015.

One randomized control trial on food hygiene messages is being implemented in 2 sub-districts in Bangladesh. The core messages of “8 Ways for Keeping Food Safe and Clean” are: 1. Wash hands with soap, 2. Wash food utensils with soap before and after use 3. Wash raw materials before cooking, 4. Use separate cutting utensils for meat and vegetables, 5. Cook food thoroughly 6. Drink safe water, 7. Protect kitchen and dining area from animals, 8. Cover cooked food to protect from dirt, dust and flies. The end-line survey will be conducted in April 2015.

Five PhD dissertations are being carried out in the four study countries:

Charles Yaw Okyere. Strengthening the Capacity of Households and Communities for an Improved Monitoring of Water and Sanitation (WATSAN) Environment: Experiments with School Children in Ghana

Florence Mc Bain. Can improved water-sanitation conditions together with health insurance effectively reduce poverty? (India).

Muhammed Abdella Usman. Leveraging Water, Sanitation, and Hygiene (WATSAN) Nexus: Synergies, Thresholds, and Trade-offs for a Better Nutrition and Health Outcome in Ethiopia.

Ruchi Vangani. Exploring the Links and Dynamics therein for WATSAN and irrigation agriculture (AG-WATSAN Nexus) for a Better Nutrition and Health Outcome in Gujarat, India.

Monirul Hasan: Investment in health within AG-WATSAN nexus for the rural households in Bangladesh.

Biggest successes so far:

The successful implementation of the research activities, especially in terms of field work, in Ethiopia, Ghana, and India.

The implementation of informational intervention (water quality information in Ghana, agricultural hygiene and food hygiene messages in Bangladesh).

Main challenges / frustration:

Bringing the multidisciplinary teams together in each country was challenging and it required some time to recruit experts who have sufficiently strong experience in public health, economics, hydrology and agronomy.

In Bangladesh the research implementation was slightly hindered due to a volatile and unstable political situation caused by the election in 2013/14.]]>
Nutrition and WASH Fri, 20 Mar 2015 13:14:06 +0000
Sanitation in Pakistan, stunting in children - by: F H Mughal
Sanitation in Pakistan

Ms. Geeta Rao Gupta, Deputy Executive Director, UNICEF, recently visited Pakistan. According to the news (Dawn, 9 March 2015,, she said that there are 41 million people who do not have access to a toilet in Pakistan and as a result they are defecating in the open. Open defecation has significant health and nutritional consequences, Ms. Geeta Rao Gupta said.

She further said: “Open defecation is a major contributor to stunting and that’s why we’ve got to do all we can to stop it.” Pakistan is the third largest country when it comes to people going to the bathroom in the open, behind India and Indonesia. The problem can spread disease and lead to intestinal infections, which can contribute to stunting in young children, she said. Stunting means children don’t grow as tall as they would otherwise, and it can also affect a child’s brain development. Stunted children are more at risk of disease, don’t do as well in school and stunted mothers can also give birth to stunted children.

UNICEF is working with the Pakistani government to improve sanitation by doing things like encouraging people to wash their hands more often. They’re also working with communities to help them build toilets so they don’t have to use the bathroom in a field or elsewhere. Building more toilets is also vital for empowering women and girls and keeping them in school, Ms Gupta said. If women have to walk long distances to find a private place to relieve themselves, they are more vulnerable and exposed to attack. They’re also less likely to go to school if there are no toilets. “Having toilets is a big advantage to girls,” she said.

F H Mughal]]>
Nutrition and WASH Tue, 10 Mar 2015 06:18:34 +0000
Re: Malnutrition’s Links to Sanitation in India - and Wikipedia pages on stunting, helminthiasis and EE - by: muench causes (prompted by what Henk had said above and the edits made by Kris).

It now reads like this:


Most stunting happens during the 1,000-day period that spans from conception to a child's second birthday.[citation needed] Whilst malnutrition used to be seen as the main and only caase of stunting, the actual causes are more complex and inter-twined. The three main causes of stunting in South Asia, and probably in most developing countries, are poor feeding practices, poor maternal nutrition, and poor sanitation.

Feeding practices
Inadequate complementary child feeding and a general lack of vital nutrients beside pure caloric intake is one cause for stunted growth. Children need to be fed diets which meet the minimum requirements in terms of frequency and diversity.

Maternal nutrition
Poor maternal nutrition during pregnancy and breastfeeding can lead to stunted growth of their children. Women who are underweight or anemic during pregnancy, are more likely to have stunted children which perpetuates the inter-generational transmission of stunting.

Water, sanitation and hygiene practices
There is most likely a link between children's linear growth and household sanitation practices. The ingestion of high quantities of fecal bacteria by young children through putting soiled fingers or household items in the mouth leads to intestinal infections. This affect children's nutritional status by diminishing appetite, reducing nutrient absorption, and increasing nutrient losses.

The diseases recurrent diarrhoea and intestinal worm infections (helminthiasis) which are both linked to poor sanitation have been shown to contribute to child stunting. The evidence that a condition called environmental enteropathy also stunts children is not inconclusively available yet, although the link is plausible and several studies are underway on this topic.[4] Environmental enteropathy is a syndrome causing changes in the small intestine of persons and can be brought on due to lacking basic sanitary facilities and being exposed to faecal contamination on a long-term basis.[4]

Research on a global level has found that the proportion of stunting that could be attributed to five or more episodes of diarrhoea before two years of age was 25%.[5] Since diarrhoea is closely linked with water, sanitation and hygience (WASH), this is a good indicator for the connection between WASH and stunted growth. To what extent improvements in drinking water safety, toilet use and good handwashing practices contribute to reduce stunting depends on the how bad these practices were prior to interventions.

I am not yet fully satisfied with it. I would like to add the right references at the right points. The new content that I added today was inspired by what I read on this website (careful: takes a while to load):

But I can't cite the website as a source. I know it's written somewhere in some documents but it's faster if someone who works in this field points me to the best sources to cite for which statement.

I also added two external links as follows:
Stop stunting conference website
Alive and Thrive

The second link I became aware of thanks to a posting by Hanna here.

If anyone has further feedback or feels like editing this Wikipedia article further, please tell me or go ahead. Thanks.]]>
Nutrition and WASH Fri, 27 Feb 2015 09:16:26 +0000
Feb 20, 2015 WASHplus Weekly on WASH & Nutrition - by: campbelldb
Nutrition and WASH Wed, 25 Feb 2015 14:20:10 +0000
Re: 8 practical ideas to link more WASH and Nutrition programmes - by: WASHanna
Thank you for sharing this information and the outputs from WEDC. We have been working on a Community of Practice that you might find interesting called Clean Fed & Nurtured. It seeks to explore integrations between WASH, Nutrition, and Early Childhood Development. In fact, safe child play spaces has been a topic that we have discussed. I think joining this group might be of interest to you.

More info here:
Email sign up here:]]>
Nutrition and WASH Mon, 23 Feb 2015 21:46:03 +0000