USAID and WASH. USAID s central procurement for supporting global & mission-level environmental health programming,

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USAID and WASH USAID s central procurement for supporting global & mission-level environmental health programming, 2010-2016

WASHplus GOAL: Promote healthy households and communities through improved Water, Sanitation, and Hygiene, and Clean Cooking practices in order to reduce diarrheal diseases & pneumonia STRATEGIC OBJECTIVES: 1 Increase availability and use of proven highimpact WASH and Clean Cooking interventions 2 Develop and implement strategies for integration of WASH and Clean Cooking interventions into other health and non-health programs 3 Support USAID s participation in strategic partnerships with other donors and cooperating agencies Jessica Scranton 4 Develop and test new and innovative approaches and tools for implementation of high-impact WASH and Clean Cooking interventions

Jessica Scranton

WASHplus Countries & Contexts Nepal: Cookstove consumer preference & market study/strategy Mali: WASH & nutrition integration Liberia: Mid-term assessment of I-WASH project Burkina Faso: WASH & NTDs integration model program Benin: Peri-urban hygiene promotion and urban CLTS Uganda: HIV/AIDS integration & nutrition Ethiopia: Sanitation marketing Kenya: HIV/AIDS integration & inclusive sanitation/clts Bangladesh: Comprehensive rural WASH, WASH nutrition integration, cookstove consumer preference & market study/strategy Zambia: WASH in schools Malawi: Water quality testing Madagascar: Urban WASH & fecal sludge management 5

WASHplus Focus 2010

Thought Leadership SUSTAINABLE DEVELOPMENT GOAL (SDG Target 6.2) By 2030, achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations

Thought Leadership 8

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CLTS and Handwashing Program What We Did MALI: WASH-nutrition integration 180 villages 400,000 residents Why It Matters Sanitation & handwashing reduce diarrheal disease KENYA: WASH-HIV integration + inclusive sanitation Sub-counties with rural population of 600,000

Open Defecation Prevalence (2013-2015) 80% MALI KENYA 60% 58% 53% 44% 47% 40% 34% 27% 20% 0% 11% 6% 21% Observed difference 36% Observed difference Baseline Endline Baseline Endline Intervention Control

Disposal of Child Feces in Latrine (2013-2015) 100% MALI KENYA 87% 80% 33% Observed difference 76% 60% 54% 49% 51% 40% 35% 45% 25% Observed difference 20% 26% Baseline Endline Baseline Endline Intervention Control

Functional Handwashing Device (2013-2015) 80% MALI KENYA 66% 60% 40% 38% 28% Observed difference 45% 33% 58% 25% Observed difference 20% 16% 13% 14% 0% Baseline Endline Baseline Endline Intervention Control

Kenya: Odds of having a latrine if a person 65+ years old lives in household Intervention Baseline Intervention Endline p =.00 Control Baseline Control Endline 0 3 6 9 14

Kenya: Odds of having a latrine if household is in third SES quartile Intervention Baseline Intervention Endline p =.00 Control Baseline Control Endline 0 5 10 15 20 15

Modifications to Existing Latrines (2013-2015) 80% 76% 70% 60% 66% 61% 56% 50% 45% 40% 30% 20% 10% 33% 11% 20% 25% 38% 34% 35% 0% Repairs since installed New pit Ring set Fitted slab/pan Baseline Endline Wall/roof repair Bangladesh (Over 1 million residents in targeted districts) Constructed above flood level 16

Zambia: WASH in Schools What We Did WASH-education Integration in Zambia 200,000 students in 400+ schools Why It Matters WASH-friendly schools decrease absenteeism, contribute to learning outcomes, help keep girls in school

Student Absenteeism, 2-Week Recall* (Fitted % from Mixed Logistic Regression) 60% 50% 49% 57% 52% 40% 30% 42% 36% Observed difference 20% 10% 15% 16% 0% 1 Qtr 2 Qtr 3 Qtr Control Intervention * Differences at each quarter by study group and interaction effect (Qtr. by Study Group) statistically significant 18

Student Absenteeism, 2-Week Recall by Gender (Fitted % from Mixed Logistic Regression) 70% 60% 59% 54% 50% 40% 30% 50% 48% 46% 38% 55% 50% 20% 10% 15% 15% 21% 18% 0% Qtr 1 Qtr 2 Qtr 3 Control Boys Treatment Boys Control Girls Treatment Girls

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The Four Pluses of WASHplus 1 2 3 4 A behaviorcentered approach Innovation with a special focus on sanitation Sustainable WASH systems Integration

Clean Cooking

Working in Partnerships 23

Agenda 1:00 Opening 1:30 Behavior Change 2:00 Sanitation and Innovation 2:45 Knowledge Expo 3:15 Sustainable WASH Systems 4:00 Integration 5:00 Closing & Reception

INNOVATION SANITATION PERI-URBAN WASH MULTIMEDIA CLEAN COOKING BAR INTEGRATION WASHplus Knowledge Expo Knowledge Products Food and Beverages MHM WASH in Schools WASH Nutrition WASH NTDS WASH HIV KNOWLEDGE MANAGEMENT RECEPTION

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