The WASH and Nutrition Nexus: Addressing Child Stunting Through Water, Sanitation, and Hygiene | Source: Agrilinks blog

APR 14, 2014 by BECKY MANNING - (USAID/BFS/SPPM).

Water, sanitation, and hygiene are necessary for healthy populations, safe food, and sustainable development. In recognition of this truth, USAID established its first global Water and Development Strategy for the period 2013-2018. The goal of this Strategy is to “save lives and advance development through improvements in water supply, sanitation, and hygiene (WASH) programs, and through sound management and use of water for food security.”

On April 1, 2014, USAID invited Dr. Francis Ngure, of the World Bank, to present upon and discuss the current strategic and operational approaches that link WASH to nutrition programming. You can download the presentation slides here.

In his presentation, Dr. Ngure highlighted the benefits of cross-sectoral efforts to address stunting, and new evidence that shows how WASH affects early child development. WASH can affect child development through inflammation, stunting, and anemia. A key link between poor hygiene and developmental deficits may be a prevalent subclinical condition of the gut, environmental enteropathy (EE).

Though early child development research and programs provide an abundance of support in the areas of nutrition, stimulation, and child protection, the programs lack evidence-based interventions to provide clean play and feeding environments. It is important to keep a hygienic environment to limit fecal-oral exposure. The concept of “baby WASH” has been recommended as an additional component of early childhood development programs.

These findings call attention to the reality that although nutrition-specific interventions—such as improved infant and young child feeding—have helped achieve modest improvements in child growth across developing nations, two thirds of the average height deficit in Asian and African children remains unresolved. A cross-sectoral approach to nutrition programming is key, and WASH needs to be a high priority.

Ngure’s bottom line was that evidence supports the integration of WASH and nutrition programming. His recommendations, based on the approach of “thinking multi-sectorally but acting sectorally,” included:

  • Strengthen the enabling environment for WASH and nutrition integration at various administrative levels and with donors.
  • Utilize the evidence base for advocacy and to increase understanding of nutrition in WASH and other sectors.
  • Implement joint training to combat sector silos through training and capacity building.
  • Allow nutrition evidence to influence WASH targeting; view WASH through a nutrition lens.
  • Develop an effective monitoring and evaluation framework by: Including nutrition-sensitive indicators in WASH projects; Identifying context-specific WASH indicators that predict nutrition outcomes; and Developing operational measures of environmental hygiene.

Reducing Malnutrition: It takes more than food

by Dan Campbell on April 17, 2014

Reducing Malnutrition: It takes more than food

Excerpts = USAID’s Bureau of Food Security (BFS), the lead implementer of Feed the Future—the U.S. Government’s global hunger and food security initiative—organized a symposium at the American Association for the Advancement of Science (AAAS) annual meeting in Chicago on Feb 15, 2014. The symposium, “Innovative and Integrated approaches to reducing malnutrition,” organized by the BFS Office of Agriculture and Research Policy, shed light on the recent advances in scientific research related to nutrition and food security, and how we at USAID can adopt this new evidence-based knowledge in our programming and policies to have a bigger impact on women and child malnutrition. The Feed the Future operates on an evidence-based model and this symposium highlighted that approach.

Each of the presentations underscored the idea that the best possible health outcomes in developing nations result from policy focused not only on growing more food but also on the quality of the crops grown and the cleanliness of the environment in which it is consumed. Boosting agricultural productivity alone won’t do away with health problems caused by malnutrition—a surprise to policymakers who have thought a bigger, richer food supply could help alleviate nutrition-related maladies in developing nations. New evidence reveals that even if fruits, vegetables, and protein sources abound, the body can’t absorb the nutrients therein if living conditions suffer—like bacteria in the local water or fungal toxins in local corn crops that prevent nutrients from being processed. This disconnect between food supply and nutrition-related health issues has been highlighted by efforts to increase food stocks that still leave malnourished individuals in developing countries stunted. Indeed, new evidence, much of it from research in animals, suggests that global agricultural policies could do more to solve the stunting problem by focusing on factors they have previously ignored, like sanitation.

This session explored several such factors that directly or indirectly affect nutritional outcomes. Dr. John Leslie (presentation available here) has characterized the fungi that produce immune-compromising aflatoxins and discussed the crops most commonly contaminated with them. Dr. Jeffrey Griffiths, Director of the Feed the Future Innovation Lab for Collaborative Research on Nutrition in Africa, discussed the importance of water and sanitation, mediums by which bacteria and toxins can make their way into the gut. Dr. Jeffery Gordon discussed how water, sanitation, and aflatoxins together alter gut microbiome, preventing nutrient absorption. Finally Dr. Griffiths and Director of the Feed the Future Innovation Lab for Collaborative Research on Nutrition in Asia Dr. Patrick Webb, both of whom have evaluated nutrition programs in Uganda and Nepal, respectively, talked about where efforts that focus on agriculture and health have led to greater benefits than focusing on agriculture alone (presentations available here). They explored whether certain policy processes helped positively impact the nutrition programs in these locations, providing insight into how collaboration between agriculture and nutrition can be increased going forward.

Association between economic growth and early childhood undernutrition

April 8, 2014

Association between economic growth and early childhood undernutrition: evidence from 121 Demographic and Health Surveys from 36 low-income and middle-income countries. Lancet Global Health, Apr 2014. Full text Authors: Sebastian Vollmer, et al. Background - Economic growth is widely regarded as a necessary, and often sufficient, condition for the improvement of population health. We aimed to […]

Read the full article →

Childhood malnutrition and parasitic helminth interactions

April 8, 2014

Childhood malnutrition and parasitic helminth interactions. Clin Infect Dis. 2014 Apr 4. Full text, pdf Papier K, et al Background. There is evidence to support that nutritional deficiency can reduce the body’s immune function thereby decreasing resistance to disease and increasing susceptibility to intestinal parasites. Methods. A cross-sectional survey was carried out on 693 school-aged […]

Read the full article →

Catch-Up Growth Occurs after Diarrhea in Early Childhood

April 8, 2014

Catch-Up Growth Occurs after Diarrhea in Early Childhood. Jnl of Nutrition, April 2014. Order info Stephanie A. Richard, et al. To whom correspondence should be addressed. E-mail: wcheckl1@jhmi.edu. Diarrhea and linear growth faltering continue to burden low-income countries and are among the most important contributors to poor health during early childhood. Diarrhea is thought to […]

Read the full article →

Prevalence of Anemia and Its Risk Factors Among Lactating Mothers in Myanmar

April 8, 2014

Prevalence of Anemia and Its Risk Factors Among Lactating Mothers in Myanmar. Am J Trop Med Hyg, Mar 2014. A Zhao. (Abstract) In Myanmar, 60 percent of the population consists of mothers and children, and they are the groups most vulnerable to anemia. The objectives of this study are to determine:  the anemia prevalence among lactating […]

Read the full article →

Extra Food Means Nothing to Stunted Kids With Bad Water: Health

April 2, 2014

Extra Food Means Nothing to Stunted Kids With Bad Water:  Health | Source: by Adi Narayan, Bloomberg, June 2013. Excerpts – Aameena Mohammed gives her 20-month-old daughter Daslim Banu plenty to eat. The girl’s mother supplements breast milk with eggs, soup and rice to help her grow. The extra food doesn’t help. Daslim still weighs […]

Read the full article →

Francis Ngure – The WASH and Nutrition Nexus Current Operational Approaches, Lessons Learned and Practical Considerations for Future Programming

April 2, 2014

This presentation was made at a meeting at USAID on April 1, 2014. The WASH and Nutrition Nexus Current Operational Approaches, Lessons Learned and Practical Considerations for Future Programming, by Francis M. Ngure, Water and Sanitation Program. Presentation, pdf Excerpts from the presentation – There is enough evidence to support integration of  WASH and nutrition […]

Read the full article →

WASH/Nutrition Literature Update – March 2014

April 2, 2014

WASH/Nutrition Literature Update – March 2014 The March 2014 literature update includes details on an upcoming USAID-sponsored WASH nutrition presentation on April 1, 2014, and the March 2014 issue of USAID’s Global Waters magazine with descriptions of USAID WASH and nutrition efforts in Liberia and other countries. Other resources include a 2014 WHO report on […]

Read the full article →

Interventions to Address Maternal and Childhood Undernutrition: Current Evidence

March 12, 2014

Interventions to Address Maternal and Childhood Undernutrition: Current Evidence Order info Bhutta Z.A. · Das J.K. Black RE, Singhal A, Uauy R (eds): International Nutrition: Achieving Millennium Goals and Beyond. Nestlé Nutr Inst Workshop Ser. Nestec Ltd. Vevey/S. Karger AG Basel, © 2014, vol 78, pp 59-69 The global burden of undernutrition remains high with […]

Read the full article →