Diarrhoea is an aggravating factor in malnutrition, as it reduces the body’s capacity to absorb nutrients (leaky bucket syndrome). In addition, malnourished children are more likely to contract diarrhoea, as their systems are already weak, and the effect is cumulative.

The likelihood of mortality from diarrhoea when a child is severely underweight is almost 10 times higher than average (Black et al, 2008).  The vicious circle created has a strong negative impact on child growth and development.

In the past years attention has focused a lot on diarrhea, as this is dramatic, measurable and episodic (Chambers, 2010).  However, other faecally-related infections are often neglected and are very widespread such as Ascaris (1.5 billion), hookworm (740 million), Schistosomiasis (200 million) and liverfluke (40 – 70 million).  These are often subclinical and less visible, less measurable, not episodic but continuously debilitating, and less treated.

Intestinal nematode infections like Ascaris and hookworm infections claim nutrients for themselves so that they are not available to be taken up by the human body. This issue has an impact on the long-term and causes chronic malnutrition. In addition, faecal bacteria ingested in large quantities by young children living in unhygienic conditions can lead to permanent gut damage which leads to nutrient malabsorption and consequently to undernutrition and stunting – a phenomenon known as environmental enteropathy (Humphrey, 2009).

The SuSanA Working Group on WASH and Nutrition will therefore also consider the impact that faecally-related infections other than diarrhea can have on the nutritional status of children and other vulnerable groups.

In the last few years a significant body of evidence suggests that poor WASH services also plays a considerable role in the increasing risk of sever acute malnutrition and stunting particularly among children. In the specific case of sever acute malnutrition an NGO examined the relationship between adequacy of water supply and children’s length of stay in a therapeutic feeding program in Niger. This study suggests that therapeutic feeding programs need to assure a good wash environment, in the target children’s villages, if they are to provide optimal care.

Consequently, this study highlights the causal link between WASH and Nutrition. The provision of safe water and sanitation coupled with improvements in hygiene (WASH) can hence contribute significantly to this nutritional challenge and to health improvements. Assuring access to safe water and sanitation and to good hygiene practices (e.g. handwashing) should thus be a key integrated element in all humanitarian responses to a nutritional crisis.

Objectives

Raise awareness for the links and opportunities for integration between WASH and Nutrition (including health and other relevant sectors) by providing space for practitioners to discuss experiences, best practices, research, challenges and gaps.

Activities

• Exchange on latest projects, research, guidance, policies, tools and events relevant to WASH and Nutrition and foster networking and collaboration among members to ensure capacity building on WASH & Nutrition integration.
• Develop a fact sheet (and keep up to date) on the link between WASH and Nutrition to be used by practitioners and policy makers.

Pizzacalla, K. & Nantume, G. (2020) Sanitation For Millions - WinS Models that Work
Step-by-Step Actions to reach the National Standards for WASH in Schools (WinS) in Line with the Three Star Approach (TSA)

The Ministry of Education and Sports recognizes that Water, Sanitation and Hygiene (WASH) programs in schools (WinS) are a key priority area and that improved hygiene practices and a clean school environment are contributory factors to ensuring that learners can enjoy an acceptable standard of health. The need for a […]

ACF, IFRC, UNICEF, French Red Cross, Danish Red Cross, TdH, WHH, WaterAid, Concern Worldwide. (2019) WASH and Nutrition e-learning course

E-learning course on WASH and Nutrition. The modules are zipped, in order to use them you need to follow these steps: 1. Download zipped folder 2. Save it on your computer 3. Unzip it 4. In the unzipped folder click on launch_story

UNICEF (2016) Nutrition - WASH Toolkit
Guide for Practical Joint Actions

Undernutrition is a major cause of disease and death, affecting billions of people worldwide, especially women and children in impoverished communities. In the East Asia and Pacific (EAP) region, despite economic growth, and achievements in health and nutrition indicators, maternal and child malnutrition rates and burden remain high. Almost 28 […]

Durrans, S., Jones, D., Pando, N.U., Wilson-Jones, M. (2017) The recipe for success
How policy-makers can integrate water, sanitation and hygiene into actions to end malnutrition

In this report the authors analyse the approaches governments and donors are taking to cross-integrate nutrition and water, sanitation and hygiene (WASH) within their nutrition and WASH national policies and plans. The report aims to provide a ‘recipe’, or toolkit, to stimulate debate and discussion of the options and opportunities […]

World Health Organisation (2017) Water, sanitation and hygiene to combat neglected tropical diseases
Initial lessons from project implementation

Water, sanitation and hygiene are essential for preventing and managing diseases including neglected tropical diseases which affect over 1 billion people among the poorest communities. Closer coordination of WASH and NTD programmes is needed to ensure WASH services are reaching the most vulnerable populations. Many WASH and NTD actors have […]