From Diarrhea to Coronavirus: The Multiple and Critical Benefits of WASH

March 22nd, 2020 | viewpoint


World Water Day (March 22) is an opportunity to reflect on how fundamental access to clean water is to public health. Over the past few weeks, our awareness (and hopefully practice) of handwashing has increased exponentially around the world as a recommended preventive measure against transmission of the novel coronavirus. Of course, adherence to this important protective measure is also beneficial for reducing other viral and bacterial disease incidences. Access to clean water, sanitation, and hygiene—a package of interventions commonly referred to by the fitting acronym WASH—is often employed to curb the spread of diarrheal diseases such as typhoid, cholera, and rotavirus, as well as childhood stunting.

Hygiene promotion and rotavirus vaccination: the mutual benefits of integration 

Integrating WASH interventions with other primary health care services, such as routine immunization, is being evaluated as a means of further reducing mortality and morbidity. Similarly, the potential benefit of hygiene promotion on oral vaccine efficacy has been studied in a number of contexts, with mixed findings. While research moves forward, experts in these fields acknowledge the potential multiplying benefits of joining forces.

Nepal provides a great learning opportunity for this. Through the Rotavirus Accelerated Vaccine Introduction Network (RAVIN), JSI and partners (IVAC, CDC) have been providing technical support to the Family Welfare Division of the Nepal Ministry of Health (MOH/FWD) for the planned launch of the rotavirus vaccine (RVV) into the country’s routine EPI schedule in the second quarter of 2020.

While RAVIN focuses on decision-making and planning for RVV introduction, our technical assistance approach also considers opportunities to strengthen the routine immunization and primary health care system as a whole. As such, RAVIN has been collaborating with WaterAid Nepal and the MOH/FWD to develop training materials, conduct planning, and roll out an integrated RVV/WASH training package. WaterAid piloted delivering this hygiene promotion behavior change package during routine immunization sessions in four districts (2015-2017), with results suggesting improvements in immunization coverage. Essential WASH education can be delivered through the existing EPI platform without a large additional investment, and in doing so increase demand for life-saving vaccines.

WASH and immunization experts alike agree that more research is needed to fully understand the synergies between these two fields. It is clear, however, that integration of the two presents a number of opportunities for progress toward achieving the WHO’s Sustainable Development Goals.

Written by: Chloe Manchester

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