Multisectoral Approaches to Improving Nutrition: Water, Sanitation, and Hygiene

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Claire Chase and Francis Ngure


Water, sanitation, and hygiene (WASH) was recognized in the report as a key sector for maximizing nutritional impact, but was not covered in depth as part of the self-contained guidance notes originally produced. Emerging evidence in the WASH sector suggests the linkages between WASH and nutrition may be stronger than previously understood. This has generated a great deal of momentum in both the WASH and nutrition sectors about how the two can work more closely to achieve better outcomes. This paper addresses this objective from both the WASH perspective, on how nutrition-specific programs (as well as nutrition-sensitive social protection, livelihoods, and community-driven development programs) can provide an alternative platform to deliver services at scale and more cost-effectively; and the nutrition perspective, on how WASH interventions can be adapted to include nutritional considerations, making them more nutrition-sensitive, and more impactful on nutrition. This document outlines the rationale for nutrition-sensitive WASH, summarizes the scientific evidence on the pathways through which WASH impacts nutritional outcomes, discusses the challenges and opportunities for nutrition sensitive WASH, and proposes a set of practical strategies and enhancements to existing project design that offer promising opportunities to impact nutritional outcomes. Despite well-known challenges to effective integration, an emerging interest in and attention to the role of WASH, and sanitation in particular, on nutritional outcomes provides a ‘window of opportunity’ to influence policy and program design for greater impacts on nutrition.