Ethiopia – Determining Feasible Water and Feces Management Small Doable Actions for HIV Programs

USAID Hygiene Improvement Project, 2009. Trials of Improved Practice: Determining Feasible Water and Feces Management Small Doable Actions for HIV Programs in Ethiopia. (pdf, 480KB)

Diarrheal disease is the most common opportunistic infection in people living with HIV/AIDS (PLWHA) in resource limited settings. Diarrhea is very debilitating and negatively affects the PLWHA’s quality of life. Household members and especially children are at risk of contracting diarrhea from PLWHA suffering from bouts of diarrhea. Improving water, hygiene, and sanitation (WASH) helps prevent diarrhea in PLWHA and their households and enhances the quality of life. The major challenge is how to integrate WASH into HIV programs.

To address this challenge, USAID/HIP worked with NGOs providing home-based care services in Ethiopia to design and carry out a trial of improved practices (TIPs) to help identify the water, hygiene, and sanitation small doable actions (SDA) to be integrated into HIV programs. A rapid assessment was carried out in Amhara Region in December 2007. The SDA were reviewed with NGOs partners in Addis to identify the WASH behaviors to be explored in the TIPs. Water and feces management were the two areas that required more information and were thus selected for the TIPs. Further, despite the high risk of HIV transmission associated with menstrual blood, very little is known about HIV-positive women’s hygiene practices during menstruation. To fill this gap, USAID/HIP also included this topic in the TIPs.

For seven weeks trained data collectors and home-based care workers visited 62 PLWHA in Adama, Addis, Alemtena, and Wonji—urban, peri-urban, and rural sites in the Oromo Region.

USAID/HIP reviewed the findings from the Oromo and Amhara regions and developed recommendations on the WASH SDA to be integrated in the home-based care programs in Ethiopia.