In low-income countries, children are often exposed to enteric infections because of an environment with multiple water, sanitation and hand-washing problems. During this period, they are also exposed to undernutrition. Beyond the acute morbidity and suffering involved, repeated enteric infections, in addition to nutritional deficiencies during the early years of life, can have lasting effects on a child's growth, cognitive development, and human capital as an adult.
As a result, the topic of WASH'Nutrition integrated approach is at the heart of a growing number of scientific studies, pilot projects and operational research. This strongly resonates with the mandate of Nutriset who has been providing its products for some studies on this theme.
WASH'Nutrition research work and initiatives multiply
Numerous clinical and operational studies have focused on documenting and analyzing interventions combining access to drinking water, relating to the treatment or nutritional support of undernourished children. One stream of research work focuses on the link between inadequate sanitation and its (underestimated) impact on undernutrition and stunting, especially among children under five.
The growing interest in implementing WASH'Nutrition is evident when looking at the commitment of international initiatives such as the Scaling-Up Nutrition (SUN) movement or Sanitation and Water for All (SWA). It is at the heart of advocacy led by nutrition professional groups such as No Wasted Lives. Multiple platforms (ie SuSanA, ENN, Baby Wash Coalition, etc.) organize a broad dissemination of knowledge and practical tools to support the implementation of WASH'Nutrition interventions, which increasingly gets the attention of public decision makers and donors.
Towards new practices and new solutions
At the forefront of humanitarian and development interventions, many field-based practitioners are ready to systematically adopt WASH'Nutrition programs, as it makes sense to the communities they serve and improves the impact, coherence and efficiency of their work.
A landmark study of the links between WASH, environmental enteropathy, nutrition and early childhood development, points to this: " In addition to expanding the scope of interventions, it is also important to broaden the conceptual structure of WASH as an aspect of child nutrition and development interventions, and not simply as the sum of toilets, caregiver hand washing, and water purification.” (Francis M. Ngure et al., 2014).
[1] Sustainable Sanitation Alliance, SuSanA Factsheet “WASH in NUTRITION” (Décembre 2014) https://www.susana.org/en/knowledge-hub/resources-and-publications/library/details/2163
[2] Action Against Hunger « WASH Nutrition 2017 Guidebook » p. 150, (Février 2017) https://www.actionagainsthunger.org.uk/publication/wash%E2%80%99nutrition-2017-guidebook
Through strategic partnerships Nutriset wishes to strengthen its contribution to the evolution of WASH'Nutrition programs. As such, Nutriset has teamed up with Aquatabs® (the link to the article), the world leader in water purification tablets. This partnership, founded on common values, is driven by the recognition that undernutrition, especially among children, is directly or indirectly related to the quality of the water supply. By combining their expertise, Nutriset and Aquatabs® aim to design a range of products and effective solutions to improve the nutritional impact of interventions, reduce the incidence of water-related diseases and make Wash'Nutrition programs more cost-effective.
Research must continue to identify the benefits of combined actions WASH and nutrition in the early years of life
Recently, the WASH'Benefits study, which observed the synergy between WASH-nutrition combined interventions compared to WASH-only or nutrition-only interventions, did not conclude on rigorous evidence of the impacts of sanitation, water quality, handwashing and nutritional interventions on the health and development of the child in the early years.
These results should not be generalized, as there is a growing consensus about the correlation between poor WASH practices and stunting. In a recent analysis on that matter, the NGO WaterAid recalls: " Those working to improve child health must continue to make public policy decisions based on the full body of available evidence, which underpins a strong link between poor WASH and nutrition."
The WASH'Benefits study demonstrates that the challenge for research and operations in this field is to better understand and prevent the transmission of fecal-oral pathogens, to improve the coverage and quality of WASH interventions, and to analyze cases of diarrhea cases in relation to children growth. These factors have a strong nutritional incidence.
With its Department of External Research and Nutritional Strategy, Nutriset provides lipid-based nutrient supplement products (SQ-LNS, see the Enov® range) used for studies such as WASH'Benefits. It is exploring new research partnerships to advance knowledge of WASH and nutrition combined interventions to improve child health and development.
[3] Ngure et al., Water, sanitation, and hygiene (WASH), environmental enteropathy, nutrition, and early child development: making the links, The New York Academy of Sciences (2014) https://nyaspubs.onlinelibrary.wiley.com/doi/abs/10.1111/nyas.12330
[4] http://www.washbenefits.net/
[5] WaterAid blog : « WASH et nutrition: essais et tribulations? » (Février 2018) https://washmatters.wateraid.org/blog/wash-and-nutrition-trials-and-tribulations
