Practical Pathways to Integrate Nutrition and Water, Sanitation, and Hygiene

Around the world, more than one in five children younger than five years old are stunted, irreversibly damaging their physical and cognitive development and limiting their chances at a healthy life. Poor sanitation is the second leading risk factor for stunting worldwide.

To end hunger and the devastating, long-term effects of chronic malnutrition, we must tackle its root causes. Lack of access to safe drinking water, decent sanitation and good hygiene remains a major driver of malnutrition, especially among children. It is time for governments, civil society organizations, donors, and the private sector to collectively implement new approaches to ensure that water, sanitation and hygiene (WASH) interventions are better integrated with nutrition policies and programs. 

Consistent lessons from Madagascar, Cambodia and Ethiopia

There is no silver bullet for creating a multisectoral approach to nutrition and actions must be context-specific. However, Action Against Hunger and WaterAid’s joint research in Madagascar, Cambodia, and Ethiopia points to at least seven drivers, or enabling factors, that can support more connections between nutrition and WASH stakeholders and enable successful integration of WASH interventions with nutrition policies and programs. These seven pathways can contribute to creating lasting change for communities and countries held back by chronic malnutrition.

Our experience, based on qualitative stakeholder interviews in the three countries, points to opportunities and entry points for governments and partners to strengthen multisectoral approaches. This finding is consistent with previous work and experience of the World Bank, USAID, Action Against Hunger, and other international development actors. We recognize the complexity of the issue, but hope to contribute to the conversation through sharing our experience.

Seven pathways towards ending malnutrition by integrating nutrition and water, sanitation, and hygiene 

  • Leadership: Engage leaders of the highest level (prime ministers or presidents) to ensure interdepartmental coordination and to hold accountable the relevant ministries responsible for the integration of WASH and nutrition.
  • Policies: Ensure that national and regional development plans adopt a cross-sectoral approach to integrating nutrition and WASH interventions to improve child nutrition. Secondly, to ensure the harmonization and complementarity of nutrition and WASH policies.
  • Funding and Strength of Government Systems: Fully fund national WASH and nutrition plans through clearly defined funding strategies across ministries that promote better coordination.
  • Data: Governments and donors need to prioritize investments in data systems to enable effective targeting and prioritization as well as reliable monitoring.
  • Sub-national coordination: Transpose strong national coordination mechanisms at the subnational level to ensure accountability at all levels.
  • Knowledge Sharing: Local authorities, civil society organizations, non-governmental organizations, and donors need to prioritize documentation and sharing of knowledge and experiences in integrating WASH and nutrition projects to support governments in the adoption and reinforcement of proven models.
  • Accountability: Transparency and respect for the principle of accountability are essential in cross-sectoral approaches.

To learn more about practical actions that drive governments and development actors to the pathways to success, read our global brief >>