Integrating WASH and Nutrition: A WASHplus Learning Brief, 2015. WASHplus.
WASHplus anticipates that interest in expanding the integration of WASH into nutrition programs will continue to grow over the next decade. Policy engagement is a vital step for integrating WASH and other interventions that impact nutrition programs. Having a national nutrition policy that recognizes the importance of WASH for nutrition outcomes paves the way for the development of integrated programming at all levels. Donors, governments, and implementers should endorse and support an integrated approach. Staff in both sectors needs skills and knowledge to effectively implement integrated programs. While enough evidence exists to support WASH and nutrition integration, more data is needed to demonstrate how and in which ways specific WASH mechanisms affect nutrition outcomes and determine which implementation modalities are most likely to lead to strong and sustained impact.
An integrated program should have a monitoring and evaluation framework with corresponding WASH and nutrition indicators. However, when WASH activities are integrated into an existing nutrition program, WASH indicators need to be added to the monitoring framework. Traditional WASH interventions focused on human excrement may need to be supplemented with new approaches to break the fecal-oral transmission cycle from animal feces, particularly in infants and young children.
WASHplus is working to explore these programmatic approaches along with appropriate monitoring frameworks. WASHplus anticipates that results from the integrated programming in Bangladesh, Mali, and Uganda will be validated and replicated in other countries. As more countries and development partners implement a range of integrated approaches, the evidence base will grow
Predictors of Stunting among Children Aged 0-59 Months in a Rural Region of Armenia: A Case-Control Study. J Pediatr Gastroenterol Nutr. 2015 Jul 4.
Authors: Demirchyan A1, Petrosyan V, Sargsyan V, Hekimian K.
OBJECTIVES: The prevalence of stunting in Armenia more than doubled since 1990 s. This study aimed to investigate the prevalence and predictors of stunting among under-5 children in a rural region of Armenia – Talin, targeted by World Vision (WV) nutrition interventions.
METHODS: Anthropometric measurements were conducted among a large representative sample of children 0-59 months old to identify the prevalence of stunting. Children identified as stunted where included in a case-control study as cases and compared with normally growing controls randomly selected from the same pool of children. Mothers of cases and controls were interviewed. Logistic regression analysis was applied to identify the predictors of stunting.
RESULTS: Of 739 measured children, 101 (13.7%) were undernourished, including 94 (12.7%) stunted. The fitted logistic regression model identified seven independent predictors of stunting, of which four were protective: mother’s height, child’s birth length, number of child’s hand washings per day, and the full set of WV interventions carried out in the community, while three were risk factors: never/rarely using soap during handwashing, being the fourth or later child in the family, and family size.
CONCLUSIONS: The study findings suggest that although WV nutrition interventions have shown impact, there is also a non-nutritional pathway of child stunting in rural Armenia. Thus, anti-stunting interventions should include sanitation and hygienic measures along with adequate perinatal care and maternal and child nutrition to further reduce childhood stunting ensuring long-term health benefits for children not only in rural Armenia, but also in rural communities in other low/middle-income countries.