I am writing on behalf of Roland Frutig, who coordinates water projects in Maharashtra, India. Thank you, Roland, for sharing your experience and views!

I’m working in development projects – mainly watershed development – in Maharashtra, India. We have just finished a pilot project with 50 biogas-toilet-bathroom units in 8 different village in Ahmednagar District. Working with the rural poor for years already we have made good experiences in a development process where villagers are integrated from the beginning. They outcome from this long experience is clear: it doesn’t make sense to build toilets if people have no water and no food. Watershed Development or Waterharvesting and –Management projects are implemented all over the world now under many different names. But finally it comes to the point that restoring the water cycles and the related natural ressources is the starting point at the roots of the problems.

To fight poverty, climate change, migration and food security are closely related and interconnected problems with the same roots. For the past decades governments and NGOs were mainly working on isolated actions but nowhere we could find an integrated policy or action plan. The specialist driven mechanisms were fairly expensive and by no means efficient. One of the biggest issues – the use of firewood – is still one minor subject within a large number of different goals. Fast developments in all the different aspects of substainability – ecological, economical and social development – can be noticed at places where integrated projects with a bottom up approach are implemented:

1. watershed development, different water harvesting practices are considering the natural resources of villages and regions; here starts the social component of community participation and motivation. The relationsships built up during this process will be the basis for all further developments;
2. water management can only be properly implemented with the way people do farming; natural farming, permaculture are reducing water needs for agriculture of small farmers by 70 to 80% compared to chemical farming;
3. decentralized energy supply starts with combined biogas units where sanitation – toilets and grey water use – is integrated; these structures only function well if the water suppbly and the natural resources are restored. The next steps of decentralized energy supply through solar or wind energy needs a certain development in the village that they are economically feasible.
4. social development, self help groups, education, health care are developed parallel to the first three steps.
5. once renewable energies are available even in small scale the community receives a logistic and communication center that serves all different social and economical aspects.

It took more than 25 years until organizations started thinking about such type of cooperations. Giving up positions of individual strengths and specialities, joining cooperations where all parties are contributing theirs specialities to an integrated concept are now slowly coming up. We should work on more such cooperations to work faster and more efficient on all aspects of poverty alleviation and the related subjects.

We are willing to share our experiences in case others are interested in such cooperations.

Kind regards

Roland Frutig
Coordinator

Dear Megan,

thank you for your sharing your thoughts with us! I like the idea of a continuum rather than two extremes and I agree that a common vision is of utmost importance!

I hope others will share practical experience and how we can establish long-term collaboration.

Theresa

Thanks for the interesting post. You raise an important question about understanding what it is we mean by integration as it relates to WASH and nutrition.

A couple of reflections:
- Integration means different things to different people. It requires action at different levels including political, technical and administrative.
- Integration is best described as a continuum rather than two extremes - for example WASH and nutrition integration can describe both the co-location of services, as well as a programme which is funded and delivered by WASH and nutrition stakeholders with joint activities and joint indicators. There are just different degrees of integration, and its about understanding practically how the two sectors can better work together, coordinate and collaborate at the different levels and touch points.

Regardless of the type and degree of integration, it is important that both sectors share a common vision and there is mutual benefit to foster long-term collaboration.

Interested to hear what others think!

Dear All,
According to me there is no concerted efforts for emphasising on WASH and Nutrition Linkage ...... . Still we need to aim at meaningful and participatory involvement of all stakeholders to ensure eventual effectiveness of WASH activities. An important aspect is the inter-sectoral convergence. For example, the Stakeholders working in the Nutrition Sector should not consider only about the Food and their respective calorific value, but also about the importance of WASH practices to get maximum out of such calorific food values. As an instance, Mid-day Meal Programme in School (being implemented in India ) is sponsored by Government in Schools keeping in view of importance on Nutrition, but the conditions in the schools, arising out of absence of an well maintained WASH facilities or the Hand Washing practices, should also not be ignored, which may eventually hamper the desired impacts. Also the necessary emphasis on food varieties (alongwith nutrition aspects) is not linked with the importance on selection of food menu based on location specific adverse water qualities. Thanks and Regards.

« Actions on water, sanitation and hygiene « are recommended in the Rome Declaration on Nutrition and the Framework for Action which country delegates adopted at the second International Conference on Nutrition (ICN2) in November 2014. However, this call for action is not new as in 1992 at the first International Conference on Nutrition (ICN) improved access to and use of safe drinking-water and sanitation services to further address the nutrition challenges was called upon and committed by member countries. Further, in 1990 UNICEF demonstrated in its « conceptual framework of undernutrition », the links between an unsafe environment including access to water, sanitation and hygiene, disease and undernutrition. Hence, we know why WASH is important for nutrition and countries have committed to actions already decades ago.

So what is new?
1. The international community is aiming for the eradication of hunger and malnutrition in all its forms in the era of the post-2015 Sustainable Development goals and aims to achieve this through multisectoral approaches. The time is ripe to demonstrate that nutrition and WASH can be integrated for better health and the betterment of humanity as colleagues from UNICEF, WHO and USAID put it in a recent publication to the topic (« Improving nutrition outcomes with better water, santiation and hygiene : practical solutions for policies and programmes »).
2. There is evidence available on the benefits of WASH for improving nutrition outcomes.
On-going research shows that not only diarrhoea and intestional worm infections such as helminthiasis and schistosomiasis prevent the efficient absorption and utilization of nutrients, but also the environmental enteric dysfunction (EED), an asymptomatic syndrome causing chronic inflammation, reduced nutrient absorption of the intestine and a weakened barrier function of the small intestine, with children being most affected. The pathways along which pathogens can be transmitted are manifold, reaching from water and soil to flies and hands. Once brought in contact with food, pathogens can easily affect the intestinal tract. ( Cumming et al. 2015 )
3. There are multisectoral strategies, technical papers (e.g. World Bank Group 2016 ) and lessons learnt available from national nutrition programmes which include a WASH component, large-scale programmes aimed at reducing malnutrition through a cross-sectoral approach, and others. (see Case studies in: Improving nutrition outcomes with better water, santiation and hygiene : practical solutions for policies and programmes »)

In most projects/programmes the integration happened at the design stage. Interventions were conducted in health care facilities, schools, households and communities. Some could link the reduction of stunting levels in part to the WASH component. (e.g. Shouhardo project, Bangladesh ).

In this part of the thematic discussion, we like to focus on the « how ».

A What do we mean by integration, and at what level? What are the target groups ? Should we focus on special groups like households with pregnant and lactating women and children under 2 (first 1000 days, « Baby-WASH ») ?

B How do we effectively integrate WASH & Nutrition in development projects/programmes ? What is the integration mechanism ? How do we make WASH interventions more nutrition-sensitive ? How do we address WASH through Nutrition projects? Please provide examples of good practice.

C What are the challenges to multisectoral approaches in the WASH sector? What are the opportunities for Nutrition-Sensitive WASH?