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Undernutrition is a multi-sectoral problem with multi-sectoral solutions. By applying integrated approaches, the impact, coherence and efficiency of the action can be improved. This operational guidebook demonstrates the importance of both supplementing nutrition programmes with WASH activities and adapting WASH interventions to include nutritional considerations i.e. making them more nutrition-sensitive and impactful on nutrition. It has been developed to provide practitioners with usable information and tools so that they can design and implement effective WASH and nutrition programmes. Apart from encouraging the design of new integrated projects, the guidebook provides support for reinforcing existing integrated interventions.

The guidebook primarily addresses field practitioners, WASH and Nutrition programme managers working in humanitarian and development contexts, and responds to the need for more practical guidance on WASH and nutrition integration at the field level. It can also be used as a practical tool for donors and institutions (such as ministries of health) to prioritise strategic activities and funding options.

It contains a number of notes, boxes with tips and further comments, links to web pages and suggested reading. Throughout the guidebook you will find practical examples from the field (case studies), collected from ACF missions and the contributors.

The content is organized as follows:

Chapter 1 outlines the basics of undernutrition and provides a brief overview of the key concepts relevant for WASH and Nutrition integrated programming.

Chapter 2 provides the rationale behind linking nutritional status with WASH environment and explains how WASH interventions, by preventing infection and disease, help reduce undernutrition. A short summary of existing evidence based knowledge is presented in this Chapter.

Chapter 3 is organized around the five pillars of WASH’Nutrition strategy. It gives operational guidance and advice on how to integrate WASH and nutrition interventions, highlighting possible challenges and proposing strategies for overcoming them.

Chapter 4 describes a practical implementation of integrated activities at different levels (household, community, national) and in different settings (health and nutrition centres, schools). Special attention is given to integrating WASH and Nutrition in emergency contexts.

Chapter 5 proposes a framework for monitoring and evaluating integrated interventions, together with a set of indicators that can be used to measure progress and impact.

Chapter 6 covers advocacy for WASH and nutrition integration, communication, capacity-building for project staff and the operational research.

A Programmatic resources SECTION contains a collection of practical tools and examples from field projects to help integration efforts at each phase of a classical project cycle.


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