The December 2013 issue of the WASH/Nutritition Literature Update has links to recent reports and journal articles and news items.

The link is: goo.gl/LDHYNS

November 2013 WASH/Nutrition Literature Update

Below are 3 of about 12 WASH/nutrition related abstracts from the 20th International Congress of Nutrition conference in Sept 2013 that we are adding to the WASH/Nutrition Library at: blogs.washplus.org/washnutrition/

The library also has a Community of Practice Members Update page at blogs.washplus.org/washnutrition/cop-member-updates/ to contain notices of upcoming events and recent publications by COP members. It has links to the Alive & Thrive November newsletter which has a new technical brief, presentations from a Forum on Stunting Reduction in Ethiopia, etc. Please email me any notices, new publications, etc that you would like to have posted.

There is also a simple Discussion Forum on the library at blogs.washplus.org/washnutrition/news/ where COP members can post questions, etc. It currently has an information request from Angela Tavares of CRS about environmental enteropathy so please contact her if you have resources or information.

1 - EVIDENCE LINKING HANDWASHING TO IMPROVED CHILD FEEDING OUTCOME | 20th International Congress of Nutrition , Granada, Spain, September 15–20, 2013
Link to the presentation on the Alive & Thrive website
L. Unicomb1, F. Nizame1, D. Biswas1, P. Ghosh1, S. Roy2, T. Sanghvi2, S. Luby 1,3 1International Centre For Diarrhoeal Disease Research, Bangladesh, 2 Alive and Thrive, Bangladesh, 3 Infectious Diseases and Geographic Medicine, Center for Innovation and Global Health Stanford University, Stanford, USA

Background and objectives: Handwashing with soap can prevent childhood infections; reduced infections and improved complementary feeding can reduce malnutrition. We describe formative research to link handwashing with soap to complementary feeding and an intervention trial.

Methods: A formative study on perceptions, practices, barriers and motivators, among households across three districts in Bangladesh, with a child 6-23 months of age given complementary food included video data collection, motivational exercises, indepth interviews, and focus group discussions. An intervention trial of an integrated handwashing and complementary feeding included qualitative studies and baseline-endline surveys among up to 450 households.

Results: Distant location of soap and water from the child feeding place was a common barrier to handwashing with soap before child feeding; commonly water only was used. Limited knowledge of the link between handwashing with soap around food events and childhood disease prevention was detected. Facilities that brought soap and water together, located near the kitchen was a motivator and reminder for handwashing with soap. By the trial end, 65% of participants were observed washing hands with soap at key times, 75% reported that they intended to adopt and continue, 83% followed complementary feeding recommendations, the main motivators being child health and convenience. Trial target handwashing practice was associated with intervention component exposure, handwashing facility near the kitchen and perceived link between disease and handwashing. Acceptable complementary feeding was associated with wealth, older child age and intervention component exposure.

Conclusions: The integrated handwashing and improved complementary feeding intervention was acceptable and feasible. Handwashing facilities location increase convenience and facilitate handwashing. Increasing knowledge on complementary feeding and links between handwashing and disease prevention were incorporated into a national media campaign to motivate behavior change.

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2 - POSITIVE UNINTENDED CONSEQUENCES IN PROGRAMS FOR WOMENS AND CHILD NUTRITION IN BANGLADESH: SCALING UP TIPPY-TAPS | 20th International Congress of Nutrition , Granada, Spain, September 15–20, 2013.
E. Williams1, Y. Arafat2, T. Williams3, A. Guyon3 1SPRING/Bangladesh, Helen Keller International, Gulshan, Dhaka, Bangladesh 2SPRING/Bangladesh – Save the Children, Dhaka, Bangladesh 3SPRING – JSI Research and Training, Arlington, USA
Background and objectives: Bangladesh has made notable progress in reducing child mortality and morbidity. However, high rates of undernutrition remain, with 41% of children Methods: In 2012, USAIDs SPRING project collaborated with Bangladeshs Food Security and Nutrition Surveillance Program conducting a baseline survey of nutrition, hygiene and agricultural practices among 770 households in SPRINGs intervention areas. Respondents were asked about use of soap in handwashing over the last 24 hours and unprompted responses on reasons they washed their hands.
Results: Though up to 60% of households reported hearing messages on appropriate handwashing only 12% and 40% washed their hands with soap before feeding children and after defecation, respectively. Therefore, SPRING refined its interventions targeting pregnant and lactating women, and children under two to increase positive nutrition and hygiene practices and access to diversified diet. Through advocacy, training and supportive supervision with government and non-governmental groups, SPRING promotes adoption of ‘small-doable actions’on nutrition and hygiene following life cycle approach and has provided training to 1839 health workers and 485 agriculture and community workers. SPRING established 783 Farmer Field Schools (FFS) providing low income households with access to diversified and nutritious vegetables, fruits and animal source foods. Household ‘tippy-taps were introduced to improve adoption of hygiene practices in target households. SPRING is the first project to scale up tippy-taps to rural Bangladesh. Seventy percent of trained agriculture workers report including nutrition and hygiene with making of tippy-taps in agriculture extension sessions and approximately 6000 households participating in FFS have installed tippy-taps to date. This successful and rapid adoption of practices is attributed to streamlined and practical messages given across multiple platforms.
Conclusions: Integrating tippy-taps into nutrition, hygiene and homestead food production seems a promising strategy to improve handwashing behaviors.

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HOUSEHOLD WATER ACCESS AND SANITATION AS INDICATORS OF VITAMIN A AND ZINC EFFICACY ON GUT PARASITE RESOLUTION | 20th International Congress of Nutrition , Granada, Spain, September 15–20, 2013
K. Long1, P. Vasan2, H. Raga3, J. Santos4, J. Rosado5, A. Mamun6 | 1 School of Population Health, University of Queensland, Australia | 2 Government Primary Health Center, Madurai, India | 3 UN World Food Programme, West Timor, Indonesia | 4 School of Medicine, National Autonomous University of Mexico, Mexico | 5 School of Natural Sciences, Universidad Autonoma de Queretaro, Queretaro, Mexico | 6 School of Population Health, University of Queensland, Australia
Background and objectives: Vitamin A and zinc supplementation can reduce childhood intestinal parasite burden but household characteristics involved in parasite transmission may modify efficacy. We evaluated supplementation efficacy on Ascaris lumbricoides, Entamoeba histolytica and Giardia lamblia infection resolution among children from households differing in water access, sanitation and hygiene.
Methods: A randomized, double-blind, placebo-controlled trial carried out in Mexico City assigned children 6-15 mo of age to receive vitamin A every 2 months, a daily zinc supplement, a combined vitamin A – zinc supplement or a placebo and followed them for 1 year. Parasite infection durations among children in the different treatment arms determined in monthly collected stools were compared using hazard analyses stratified by personal and household factors.
Results: Vitamin A + zinc supplemented children from households with no piped water had reduced G. lamblia infection resolution compared to children from households with piped water. Children in all three treatment arms from households with dirt floors had reduced A. lumbricoides resolution compared to children from households with concrete floors (P for interaction=0.06, 0.01 and 0.07, respectively). Increased E. histolytica infection resolution was found among vitamin A supplemented children from households with dirt floors and no indoor bathrooms.
Conclusions: The contrasting outcomes of supplementation found in the stratified analyses suggest that children enrolled in mass chemoprophylaxis programs may be targeted for specific supplementation regimens using household characteristics as indicators.

Dan Campbell, Knowledge Resources Specialist
WASHplus Project
1825 Connecticut Ave NW
Washington DC 20009
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
Phone: (202) 884-8887
Website: www.washplus.org

4 studies have been added to the WASH/Nutrition Library so far in October at: washnutrition.wordpress.com/.
There are links to the full text for 3 of the 4. If your organization has recent studies, manuals, etc that should be added to the library, please let me know.

1 - Handwashing before Food Preparation and Child Feeding: A Missed Opportunity for Hygiene Promotion. Am Jnl Trop Med Hyg, Sept 2013.

2 - The Intestinal Pathobiome: Its Reality and Consequences Among Infants and Young Children in Resource-Limited Settings. Journal of Infectious Diseases Advance Access, October 9, 2013

3 - Effects of Early-Life Exposure to Sanitation on Childhood Cognitive Skills: Evidence from India’s Total Sanitation Campaign, 2013.


4 - Aid for Nutrition: Maximising the impact of nutrition-sensitive interventions, 2013. ACF International.

Sept 20, 2013 - WASHplus Weekly: Focus on WASH & Nutrition

This issue contains some of the most recent studies and resources that discuss the integration of WASH (water, sanitation, and hygiene) with nutrition. Included are a recent webinar on environmental enteropathy, an online tutorial about nutrition programming that has a WASH component, and studies on child height and open defecation. Another resource is the WASHplus online library of WASH and nutrition, which is still under development but contains the resources listed below as well as other recent studies and reports.

Link: us2.campaign-archive2.com/?u=ed50820bda8...4db&id=284e5cde80&e=[UNIQID]

Below are links to the latest posts to the WASH/Nutrition Library, WASHplus Innovation blog and some of the various Updates

WASH/NUTRITION LIBRARY, washnutrition.wordpress.com

Village Sanitation and Children’s Human Capital,
Clean, Fed & Nurtured: Joining forces to promote child growth and development
Building consensus on building latrines
Growing taller among toilets: Evidence from changes in sanitation and child height in Cambodia

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Household drinkng water quality updates, blogs.washplus.org/drinkingwaterupdates

Current practices in manufacturing locally-made ceramic pot filters

Development of a quaternized chitosan with enhanced antibacterial efficacy
Water quality perceptions and willingness to pay for clean water in peri-urban Cambodian communities.
Water and sanitation in the time of cholera
Remotely Accessible Instrumented Monitoring of Global Development Programs
Comparative study of disinfectants for use in low-cost gravity driven household water purifiers

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Innovation exchange, blogs.washplus.org/innovation

Peter Morgan – Innovation for better sanitation in Zimbabwe
UP FOR DEBATE: Getting to Full Water and Sanitation Coverage
How PlayPumps are an example of learning from failure
Show diarrhoea the red card: using fun, games and sport to create awareness and behaviour change.

SANITATION UPDATES, sanitationupdates.wordpress.com

Big business pledge for access to WASH @ workplace
Asian Development Bank and Gates Foundation set up new sanitation trust fund
Tapping the Market: Opportunities for Domestic Investments in Sanitation for the Poor
Online Course “Governance in Urban Sanitation”
Aug. 31, 2013 – 17th Sustainable Sanitation Alliance (SuSanA) Meeting!!!
Thai researcher reinvents toilets for urban poor
Rose George. Let’s talk crap. Seriously

Yes, they are working now. Thanks, Elisabeth

Cheers,

F H Mughal

Thanks for being observant, Mughal.

I have fixed the links in Mercedes' post above. Please try to access them again, it works now.

Greetings,
Elisabeth

Dear Mercedes,

I'm sorry, but both the links are not working.

Thanks,

F H Mughal

Dear all,

Here is some interesting studies on Wash and Nutrition linkages,

www.livemint.com/Politics/JTCF9qGB79rJhg...-with-bad-water.html

www.livemint.com/Opinion/xdB1Icq8xKNJSYd...ilding-latrines.html

Best regards,

Mercedes

Great publications, as usual, Dan

Regards,

F H Mughal

WASH/Nutrition Literature Update - August 2013

Attached is a bibliography of recently published WASH/Nutrition studies. If you have others that I should add to the bibliography, please let me know.

Regards,
Dan

Below are some recent studies and reports on WASH and Nutrition. I will try to do a literature search on this topic once every 2 weeks.

1 - Commentary: Sanitation and Stunting in India Undernutrition’s Blind Spot. Economic & Political Weekly, June 2013. Robert Chambers.
www.indiasanitationportal.org/sites/defa...tunting_in_India.pdf

The puzzle of persistent undernutrition in India is largely explained by open defecation, population density, and lack of sanitation and hygiene. The impact on nutrition of many faecally-transmitted infections, not just the diarrhoeas, has been a blind spot. In hygienic conditions much of the undernutrition in India would disappear.

2 - Household Environmental Conditions Are Associated with Enteropathy and Impaired Growth in Rural Bangladesh. Am J Trop Med Hyg. 2013 July. A Lin.
www.ncbi.nlm.nih.gov/pubmed/23629931?report=abstract

This study assessed the relationship of fecal environmental contamination and environmental enteropathy. It compared markers of environmental enteropathy, parasite burden, and growth in 119 Bangladeshi across rural Bangladesh living in different levels of household environmental cleanliness. Results are consistent with the hypothesis that environmental contamination causes growth faltering mediated through environmental enteropathy.

3 - The Nutritional Value of Toilets: How Much International Variation in Child Height Can Sanitation Explain? June 2013. Dean Spears.
riceinstitute.org/wordpress/wp-content/u...anitation-6-2013.pdf

This update by Dean Spears states that the effect of sanitation on human capital does not merely reflect wealth or other dimensions of development.Open defecation, which is exceptionally widespread in India, can account for much or all of the excess stunting in India.

4 - Preventing Cryptosporidiosis: The Need for Safe Drinking Water. WHO Bulletin, Apr 2013. Rachel Peletz.
www.scielosp.org/scielo.php?pid=S0042-96...2&script=sci_arttext

Cryptosporidiosis is a significant disease in young children. The Global Enteric Multicenter Study found that Cryptosporidium is a major contributor to infant and toddler diarrheal illness in seven countries in Africa and Asia. Cryptosporidiosis was associated with a relatively high case fatality and nutritional stunting.