Integrating Safe Water, Sanitation, and Hygiene into ...

[Pages:156]Integrating Safe Water, Sanitation, and Hygiene into Infant and Child

Nutrition Programmes

A Training and Resource Pack for Uganda

THE REPUBLIC OF UGANDA Ministry of Health

NOVEMBER 2014 I

? 2014 FHI 360. All rights reserved. Any part of this manual can be adapted provided the source is acknowledged.

WASHplus 1825 Connecticut Avenue, NW Washington, DC 20009-5721

The WASHplus project supports healthy households and communities by creating and delivering interventions that lead to improvements in water supply, sanitation, and hygiene and household air pollution. This five-year project (2010-2015), funded through USAID's Bureau for Global Health (AID-OAA-A-10-00040) and led by FHI 360 in partnership with CARE and Winrock International, uses at-scale as well as integrated programming approaches to reduce diarrheal diseases and acute respiratory infections, the two top killers of children under age five globally.

Suggested citation: USAID/WASHplus Project, 2014. Integrating Water, Sanitation, and Hygiene into Child Nutrition Programmes: A Resource Pack for Uganda. Washington DC: FHI 360.

i INTEGRATING WASH INTO INFANT AND CHILD NUTRITION PROGRAMMES

TABLE OF CONTENTS

Table of Contents

ABOUT THE MANUAL

2

Acronyms.......................................................................................................................... 3 Acknowledgements.......................................................................................................... 4 Introduction and Context................................................................................................. 5 How to Use This Resource Pack........................................................................................ 7

MODULE I: TWO-DAY BASIC TRAINING FOR COMMUNITY LEVEL

RESOURCE PERSONS

10

Session 1: Introduction to the Training

13

A. Introducing Participants........................................................................................ 13 B. Purpose of the Workshop..................................................................................... 13 C. Introducing the Training Schedule........................................................................ 15

Session 2: Why WASH Matters in Infant and Child and Nutrition

16

A. The Importance of Drinking Clean Water, Using Latrines, and Washing Hands.... 16 B. The Consequences of Poor Hygiene Practices...................................................... 18

Session 3: Blocking Fecal Contamination

20

A. Contamination Routes.......................................................................................... 20 B. How to Prevent Contamination of the Surroundings............................................ 22

Session 4: WASH Behaviours

26

A. Explaining Behaviour and Behaviour Change....................................................... 26 B. Four Tools to Block Fecal-Oral Contamination...................................................... 27 C. Factors that Influence Behaviour Change............................................................. 27

Session 5: Hand Washing

29

A. The Importance of Hand Washing........................................................................ 29 B. Current Hand Washing Practices.......................................................................... 31 C. The Correct Way to Wash Hands.......................................................................... 31 D. When to Wash Hands........................................................................................... 32 E. Making a Tippy Tap for Hand Washing.................................................................. 34 F. The Benefits of a Tippy Tap................................................................................... 35

INTEGRATING WASH INTO INFANT AND CHILD NUTRITION PROGRAMMES ii

TABLE OF CONTENTS

Session 6: Improving WASH Behaviours through Small Doable Actions 37

A. Introducing the Concept of Small Doable Actions................................................ 37 B. Negotiating Small Doable Actions......................................................................... 38 C. Qualities and Skills of a Good Communicator....................................................... 40 D. Listening and Body Language Skills....................................................................... 41

Session 7: Keeping Drinking Water Safe from Source to Mouth

42

A. The Links in the Water Safety Chain..................................................................... 42 B. Ensuring Water Remains Safe to Drink................................................................. 43

Session 8: Action Planning

45

A. Small Doable Actions to Promote WASH.............................................................. 45 B. Action Plan to Promote the Identified Small Doable Actions............................... 45

Module I Evaluation

47

Module I Handouts

48

MODULE II: EXTENDED ONE-DAY TRAINING FOR COMMUNITY LEVEL

RESOURCE PERSONS

66

Session 1: Water Treatment Methods

68

A. Do We Need to Treat Water for Drinking if It Looks Clean?.................................. 69 B. Filtering................................................................................................................. 69 C. Boiling................................................................................................................... 70 D. Solar Disinfection.................................................................................................. 71 E. Chlorine................................................................................................................ 72 F. Advantages and Disadvantages of the Different Methods.................................... 75

Session 2: WASH and Food Hygiene

77

A. The Link between WASH and Safe Food............................................................... 77 B. Understanding the Food Chain............................................................................. 78 C. How to Keep Food Safe......................................................................................... 78 D. Identifying Small Doable Actions to Promote Food Hygiene................................ 80

Session 3: Improving WASH Programmes

81

A. Documenting and Monitoring WASH Activities.................................................... 81 B. Self Reflection to Improve Skills............................................................................ 82

Module II Evaluation

84

iii INTEGRATING WASH INTO INFANT AND CHILD NUTRITION PROGRAMMES

TABLE OF CONTENTS

Module II Handouts

86

MODULE III: HALF-DAY SEMINAR FOR POLICY AND DECISION

MAKERS TO SUPPORT THE INTEGRATION OF WASH INTO NUTRITION

PROGRAMMES

94

Session 1: Introduction to the Seminar

96

A. Introducing Participants........................................................................................ 96 B. Purpose of the Seminar........................................................................................ 96 C. Introducing the Seminar Schedule........................................................................ 97

Session 2: Why WASH Matters in Infant and Child Nutrition

98

A. Basic Concepts and Importance of Good Nutrition.............................................. 98 B. The Link between Nutrition and Diarrhoea.......................................................... 99

Session 3: Blocking Fecal Contamination

100

A. Contamination Routes........................................................................................ 101 B. How to Prevent Contamination of the Surroundings.......................................... 103

Session 4: Small Doable Actions Approach

106

A. Introducing the Concept of Small Doable Actions.............................................. 106 B. Small Doable Actions for WASH.......................................................................... 107

Session 5: Supporting the Integration of WASH into Nutrition Programmes 109

A. Roles in Supporting Lower Level Cadres............................................................. 109 B. Developing an Action Plan.................................................................................. 110

Module III Handouts

112

WASH INTEGRATION JOB AIDS

124

INTEGRATING WASH INTO INFANT AND CHILD NUTRITION PROGRAMMES iv

About the Manual

ACRONYMS

Acronyms

CKW ................................................................................ Community Knowledge Worker CLTS ............................................................................... Community Led Total Sanitation HIV ...............................................................................Human Immunodeficiency Virus IYCF .................................................................................Infant and Young Child Feeding MOH ..................................................................................................... Ministry of Health NACS ...................................................... Nutrition Assessment, Counseling, and Support PHAST ............................................ Participatory Hygiene and Sanitation Transformation PSG .................................................................................................. Peer Support Group SDA .................................................................................................. Small Doable Action SODIS...................................................................................................... Solar Disinfection TB .............................................................................................................. Tuberculosis UDHS................................................................. Uganda Demographic and Health Survey USAID ............................................. United States Agency for International Development VHT .................................................................................................. Village Health Team WASH ................................................................................Water, Sanitation, and Hygiene WHO ...................................................................................... World Health Organization

3 INTEGRATING WASH INTO INFANT AND CHILD NUTRITION PROGRAMMES

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