Absolutely agree with you. This sub component is really relevant (prevention / care or support to treatment).
I also want to ask your opinion on a tricky question: do you think that the five pillars of the WASH In Nut strategy actually integrate these two subcomponents or do they only focus on the emergency and the "care" ?

This scaling (National, community, people) makes sense in terms of operations. I would add a sub component to each of them: Prevention/ Care. such distinction makes it more readable for the donor community whose agenda could be focused on only one of the two.

How to operationalize the integration of WASH, particularly sanitation, and nutrition (WASH for Nut? WASH to Nut? WASH In Nut)?

If access to sanitation is neglected today, the idea is not to redress the balance by sectoral sanitation projects only without an integrated response strategy based on a contextual analysis. The factors of under-nutrition are multiple they are also extremely different from one context to another, and the knowledge of priority causal assumptions, in a given area, is sometimes far from obvious ... It is more than appropriate to promote multisectoral and contextual analysis, to properly understand the barriers to nutrition security before developing an intervention (Nutrition Causal analysis, barrier analysis for behavior change, PVCA, and many others ...).

After diagnosis and project definition, move to implementation, and again, several other best practices, inspired by the WASH IN Nut strategy and recommendations of many technical and financial partners (including during the WIN side event in Stockholm 08/15), agree on the following points:
• Allow a geographical coherence of sectoral projects (intervention package);
• Ensure the targeting of sanitation activities on nutritional vulnerability criterias (prevalence of undernutrition, 1,000 days window ...)
• Ensure that sanitation and nutrition projects share a common response strategy, particularly in terms of behavior change;
• Target the couple caretaker / child for the Fecal Transmission Infections (FTIs) prevention activities (diarrhea, worms, environemental enteropathy, malaria): management of faeces, including those of children; hand washing with soap; baby WASH;
• Develop a minimum package of sanitation activities at health facilities but also in communities, working closely with hygiene promotion;
•Consider integrated analysis of both WASH and nutrition value chains to support financial sustainability (PPP, innovative social marketing etc.)
• Ensure that sanitation and nutrition sectors include representatives from the other sector at all stages of their project management cycle.

More globally, I would broaden the approach "WASH & Nut" to three scales: 1) National level: WASH to Nut (public health approach, strengthening the health system, disaster risk management ..); 2) Communautary level: WASH for Nut (CAMM, vector disease risk reduction, WASH In School, CLTS ...); 3) 'caretaker & malnurished child' couple: WASH in Nut (targeting of nutritional vulnerabilities and access to water and sanitation, behavior change, WASH and care practices, including baby food and hygiene WASH).

What do you think?