Dear Forum Members,

The following readings have been selected to help give some background to this conversation and the need for integration. If you have a chance, look through these documents to prepare yourself for our conversation:

(1) Preventing environmental enteric dysfunction through improved water, sanitation and hygiene: an opportunity for stunting reduction in developing countries
The hypothesis that a large fraction of stunting is related to Environmental Enteric Dysfunction (EED) and the need for a clean environment was one of the main reasons for starting the BabyWASH Coalition. The authors in this paper describe the cyclical role that EED plays in childhood stunting and highlights the need for improved early childhood development interventions as well as water, sanitation and hygiene interventions alongside of nutrition to improve childhood stunting. It is a strong piece of evidence in the call for more effective integration.

(2) Water, sanitation and hygiene (WASH), environmental enteropathy, nutrition, and early child development: making the links
The authors “advocate for a more holistic view of WASH oriented to babies in the first years of life and for the development of interventions targeted to this age group.” Most ECD and WASH interventions are not integrated, and this can create a gap in care for children under 3, where a clean play environment and proper nutrition is key to reaching full potential later in life. The authors explore the linkages between sectors and urge more integration between sectors to protect the health of children.

3) Water, sanitation and hygiene in health care facilities: Status in low- and middle- income countries and way forward
This report is the first comprehensive, multi-country analysis on the status of water, sanitation and hygiene in health care facilities. While there is not a lot of data available (especially for hygiene and sanitation), the report found that out of 54 countries, 38% of HCFs do not have an improved water source, 19% do not have improved sanitation, and 38% do not have water and soap for handwashing. A concerted effort with leadership from the health sector needs to be undertaken to improve WASH in HCFs, with a specific focus on pregnant mothers and children. This piece of work is key to why maternal, newborn and child health needs to be included in integration conversations.

(4) BabyWASH Coalition Brochure
The BabyWASH Coalition is a group of organizations focused on increasing integration between water sanitation and hygiene, early childhood development, nutrition, and maternal newborn and child health programming, policy-making and funding to improve child well-being in the first 1,000 days. The Coalition will incorporate the suggestions made in this discussion into its workplan. To join the work of the Coalition, email Peter Hynes, the Coalition coordinator (This email address is being protected from spambots. You need JavaScript enabled to view it.)

We hope that these readings provide you with a good introduction to the topic. If you have other great examples or evidence of integration, please post it in the discussion for the first theme.