Dear all,

For those of you, who are new to the discussion, I would like to briefly summerize the issues that were addressed so far and point out some of the arising questions.

Definition of “integration”
So far, there is no common understanding between institutions and professionals of what integration actually means. Several contributions address this issue:

1. Nutrition-specific vs. nutrition-sensitive interventions, WASH accounting for a nutrition-sensitive one, but it is difficult to specify, quantify and measure
2. WASH and Nutrition vs. WASH in Nutrition, AND referring to integration as equal circles with a largely overlapping health sector as a two-way integration, IN meaning a nutrition interventions that incorporate components from various other neighbouring sectors, such as WASH, food security, etc.

Thoughts: What are the differences between a “one-way” and a “two-way integration”? Is there a better and a worse? Shall we rather speak of collaboration?

Breaking sector silos
One-way integration (WASH in Nutrition) or two-way integration is one of the larger questions. There is common understanding in both communities that both can work well and create synergies. The question if it is in or and strongly depends on the context. Engaging with Scaling Up Nutrition (SUN) national platforms for building relationships outside the WASH-sector and start a dialogue can be a starting point to break silos.
Public health officials call out for horizontal - moving away from vertical programming. Aligning with stakeholders, who are geographically in the same area awareness and willingness to build/intensify partnerships can be a starting point.
Thoughts: How raise interest in each other (WASH, nutrition, health) and efforts to communicate without getting overloaded?

WASH to prevent under-nutrition
At community level, WASH interventions have shown impact on nutrition in household water treatment, safe storage, hygiene promotion, elimination of open defecation, access to water supply (UNICEF in Burkina Faso).
Thoughts: What can be done on household level / on larger scale? When is WASH preventive to under-nutrition and when curative?

The First 1000 Days / Baby WASH
Various measures focus on the “First 1000 Days” as a starting point for integrated approaches. Suggested among others are playmats or playpens for children to break the oral-faecal transmission route.
Thoughts: How to overcome the challenge that mothers / caretakers do not have to neglect their daily work?

Research
One gap to fill is finding ways to measure the impact of nutrition-sensitive interventions, (like water, sanitation, hygiene) on nutrition. The need for a set of common indicators are mentioned for implementing nutrition-sensitive interventions.
Thoughts: What can these indicators look like? Would a checklist be useful?

Costs and benefits
Better health outcomes are one among the listed benefits of an integrated approach. Costs that need to be taken into account include time spent in coordination.
Thoughts: What are other pros and cons for integration? How to maximize benefits and reduce costs?

First of all let me congratulate you on this initiative and Waiting anxiously for the start of the discussion!

Rachel Lozano, has long years of experience in nutrition-related projects. For the past three years, she is affiliated with Action Contre La Faim (ACF) HQ France as Nutrition Survey and Prevention Advisor. Before, she was working for UNICEF HQ in New York and Médecins Sans Frontières (MSF) in different field projects in Africa and Asia projects (Sudan, South Sudan, Niger, Afghanistan, Niger, Bangladesh, Kenya etc.) in various nutrition positions, in development and emergency programming.
“WASH’Nut is a key step to move forward treatment and prevention of under-nutrition – the Community Management Acute Malnutrition (CMAM) approach is not enough – a multisectorial approach is needed to better tackle under-nutrition problems and WASH is one of the key components to the success.”

With a background in communication science, politics and economics, Johannes Rück worked in the press department of the German Federal Ministry for Economic Cooperation and Development. In 2009 he joined the German Toilet Organization (GTO), supporting the rollout of the global campaign “Sanitation is Dignity”. In 2011 he became network coordinator of the newly founded German WASH Network, whose secretariat is hosted by the GTO. Since 2010 Johannes also signed responsible for different GTO projects and programmes, including the School Competition / Campaign “Toilets Making the Grade”, a larger strategic programme aiming to strengthen humanitarian WASH in Germany and the Bonn WASH Nutrition Forum 2015.
“WASH and Nutrition are two fundamental building blocks of human development, since it affects children from the very beginning of life. In order to create a world with equal opportunities and rights for all, I believe that an integrated approach to these fundamental prerequisites is key. Outcomes of development cooperation can be significantly improved when synergies between WASH and Nutrition are addressed.”

Rachel Lozano and Johannes Rück will guide through Part I of the online discussion with their thematic expertise. Great to have you here!