Saving Lives Through HygieneSaving Lives Through Hygiene

Merri WeingerMerri WeingerHygiene Improvement Program Manager, USAID Hygiene Improvement Program Manager, USAID

1. What percentage of the 1.5 million annual child deaths caused by diarrhea are preventable?

a. 0%-30%b. 31%-60%c. 61%-80%d. over 80%

In what regions of the world In what regions of the world does the majority of child does the majority of child

mortality from diarrhea take mortality from diarrhea take place? place?

Where do children < 5 Where do children < 5 die from diarrhea?die from diarrhea?

sub-Saharan

Africa

South Asia

East Asia

Middle East

LAC

11 countries account for over 70% of the annual 11 countries account for over 70% of the annual deaths globally from diarrheadeaths globally from diarrhea

11 countries account for over 70% of the approximately 1.52 million global deaths from diarrhea annually

0

100,000

200,000

300,000

400,000

500,000

India

Nigeria

Pakist

anDRC

China

Bangla

desh

Ethiop

ia

Angola

Afgha

nistan

Indo

nesia

Tanza

nia

Dea

ths

fro

m d

iarr

hea

90% of deaths are in children

Source: Safer water, better health (WHO, 2008)

2. Out of the total world population of over 6.5 billion, how many people around the globe lack access to safe water?

a. 50 millionb. 500 millionc. about 1 billiond. more than 2 billion

88WHO/UNICEF, 2010

3.How many people in the world lack access to hygienic sanitation facilities?

a. 2.6 millionb. 26 millionc. 260 milliond. 2.6 billion

1010WHO/UNICEF, 2010

4. The only sure way to prevent diarrheal diseases is to ensure that all households have access to water and sanitation facilities.True _________

False_________

False!False!

5. Which of the following are among the recognized globally important hygiene behaviors for diarrhea prevention? (check all that apply)__ keeping food safe from contamination__ bathing daily__ effective handwashing __ washing feet before entering the home__ hygienic disposal of human feces __ face washing once a day__ clearing brush near the house__ safe water handling, transport, and storage

Safe Storage

& Treatment of Water

Handwashing

Safe Feces Disposal

Hygiene Behaviors to Prevent Hygiene Behaviors to Prevent DD (WHO, 1992)DD (WHO, 1992)

Keeping drinking water cleanKeeping drinking water clean

Keeping hands cleanKeeping hands clean

Keeping the environment clean Keeping the environment clean (sanitation perspective)(sanitation perspective)

Keeping food cleanKeeping food clean

Fields

Fluids

Fingers

Flies

Feces FoodNewHost

Primary PreventionThe F-Diagram

Source: Wagner and Lanois, 1958

Fields

Fluids

Fingers

Flies

Feces FoodNewHost

Primary PreventionThe F-Diagram

Source: Wagner and Lanois, 1958

Water Quality

Fields

Fluids

Fingers

Flies

Feces FoodNewHost

Primary PreventionThe F-Diagram

Water Quantity

Source: Wagner and Lanois, 1958

Water Quality

Fields

Fluids

Fingers

Flies

Feces FoodNewHost

Primary PreventionThe F-Diagram

Sanitation

Source: Wagner and Lanois, 1958

Water Quality

Water Quantity

Fields

Fluids

Fingers

Flies

Feces FoodNewHost

Primary PreventionThe F-Diagram

Hand Washing

Sanitation

Source: Wagner and Lanois, 1958

Water Quality

Water Quantity

6. Key WASH interventions will reduce diarrheal disease by

a. 0-20%b. 21-50%c. 51-80%d. over 80%

POU water treatment - POU water treatment - 30-50% 30-50% reduction in child DD prevalence – reduction in child DD prevalence – twice as effective as interventions at twice as effective as interventions at water sourcewater source

Safe storageSafe storage – 21% reduction – 21% reduction

Proper Proper handwashinghandwashing - 43% reduction - 43% reduction

SanitationSanitation – basic, low-cost systems – basic, low-cost systems can reduce DD by 30% or morecan reduce DD by 30% or more

7. Name three reasons why household drinking water can often be unsafe for human consumption.

TransportTransport

Handling, and StorageStorage

8.What are effective methods for water disinfection at the point-of-use?

Household Water Treatment Options

Chlorination PuR Ceramic

Filtration Biosand

Filtration Solar/SODIS Boiling

9.9. What are the critical times What are the critical times for handwashing with soap (or for handwashing with soap (or soap substitute) for diarrhea soap substitute) for diarrhea

prevention?prevention?

Critical Times for Critical Times for Handwashing with SoapHandwashing with Soap

After defecationAfter defecation

After cleaning a After cleaning a baby’s bottombaby’s bottom

Before preparing Before preparing food/cookingfood/cooking

Before Before eating/feeding a eating/feeding a babybaby

10. Which of the following are effective ways of promoting latrines?

• Public financing and distribution of latrines to all households

• Public shame

• Demand creation (e.g. Community-Led Total Sanitation)

• Develop partnerships with private sector producers of sanitation technologies (e.g. Sanitation Marketing)

MAY NOT DEPEND ON HEALTH MOTIVATIONS…

WHAT FACTORS BESIDES HEALTH MOTIVATED SANITATION ADOPTION IN THIS COMMUNITY?

RESPECT, PRESTIGE

PERSONAL COMFORT,

SELF-ESTEEM

Increasing Demand for SanitationIncreasing Demand for Sanitation

No Toilet, No Bride

The "No Toilet, No Bride” program in the Indian state of Haryana has been the most successful sanitation promotion effort there so far. Started about two years ago, the campaign has resulted in 1.4 million latrines being built.

"I will have to work hard to afford a toilet. We won't get any bride if we don't have one now," said 22-year-old villager Harpal Sirshwa from Nilokheri, who is hoping to marry soon. "I won't be offended when the woman I like asks for a toilet." 

11. What are the best entry 11. What are the best entry points for integrating hygiene points for integrating hygiene improvement into existing improvement into existing health and development health and development programs?programs?

Food Security and Nutrition

Education

Antenatal and neonatal care

Teacher training

HIV/AIDSChild health

Avian flu

USAID/GH Supported Partners in USAID/GH Supported Partners in Hygiene ImprovementHygiene Improvement

CDC: Safe Water SystemCDC: Safe Water System

www.cdc.gov/safewater/www.cdc.gov/safewater/

International Network to Promote Household International Network to Promote Household Water Treatment and Safe StorageWater Treatment and Safe Storagewww.who.int/household_water/network/en/

Global Public-Private Partnership For Global Public-Private Partnership For Handwashing with SoapHandwashing with Soap

www.globalhandwashing.orghandwashing.org

For further information, contact:For further information, contact:

Merri Weinger (Hygiene Merri Weinger (Hygiene Improvement) Improvement)

mweinger@usaid.gov; 202-712-; 202-712-51025102