WASH diarrhea political economic

public health.

types of public health frameworks

• causal frameworks

• monitoring and evaluation frameworks

• action frameworks

causal frameworks

what are the causes of nutritional problems ?

monitoring and evaluation frameworks

how is progress towards PH goals going ?

action frameworks

organization of actions to address PH issues (sanitation, hygiene, diarrheal disease, prevention/treatment)

maternal and child undernutrition

short term consequences= mortality, morbidity, disability

long term consequences= adult size, intellectual ability, economic productivity, reproductive performance, metabolic and cardiovascular disease

Care is the provision in the household and the community of time, attention, and support to meet the
physical, mental, and social needs of the growing child and other household members.

(CONCEPT MAP) for the exam *** 2 main goals of the WASH sector

• improve access to safe drinking water

• improve availability and use of improved sanitation facilities

• hint= failure to meet these 2 goals = 2 underlying cause of diarrheal disease

how do we measure malnutrition in children ?

• stunting

• wasting

• underweight

stunting

low height for age

wasting

low weight for height

underweight

low weight for age

how we measure malnutrition in children

• assessed as standardized deviation from a reference population in z scores

• 2 z scores below median classifies child as stunted, wasted, or underweight

anthropometric indicators of undernutrition

• height for age stunting

• weight for height wasting

stunting indicates a failure to achieve one’s genetic potential for height

when does child undernutrition occur ?

critical window: first 1000 days

Children throughout the world can reach their growth potential if they are nurtured in healthy environments and their caregivers follow recommended health, nutrition and care practices.

most common anthropometric measures

• height for age (length for age)

• weight for age

• weight for height

height for age (length for age)

• the best for assessing populations

• Because children > 3 years generally don’t recover their lost height, a stunted
  child may be adequately nourished now, but malnourished in the past.

• Stunting; HAZ < -2

weight for age: as easier proxy for HAZ

underweight= WAZ < -2

weight for height

Low scores tell you that a child is underfed now.
• Wasting = WHZ < -2

stunting: inadequate linear growth

• considered a consequence of chronic undernutrition

• measured as length or height for age and sex

• length up to 24 months

• height thereafter

• children can become stunted without every becoming wasted (low weight for height)

• therefore “invisible”

Clinical Syndrome of Severe Acute Malnutrition (SAM)

2 primary forms of SAM:

• marasmus= is the predominant form throughout most developing countries. it is also the form that affects adults

• associated with: severe food shortage (or severe inadequate feeding of children), failure or early cessation of breastfeeding, illness especially diarrhea

• Kwashiorkor = less common, affects mostly children, and is most common in parts of the world where staple foods are excessively starchy (ex: yam, cassava, sago)

global targets and indicators

millenium development goals (MDG)

MDG target 7

• reducing by half the proportion of people without sustainable access to safe drinking water and basic sanitation

• goals were targeted for 2015

millenium development goals target 75% global sanitation coverage by 2015

• the cost to reach this milestone is estimated at US $14 billion annually through the period

• among other health gains, sanitation is estimated to reduce diarrhea cases by 391 million worldwide each year

economic benefits to improved sanitation ?

• increased schooling, earning, especially from fewer missed days of school

• foregone medical costs

• time savings, greater productivity for caregivers if distance to safe water source is low

• world bank estimates $63 billion in savings if MDG 7 is met

• benefit to cost ratio is $5:1

The Sustainable Development Goals (SDGs)

• SDGs are a set of 17 interconnected global goals established by the United Nations in 2015 to address various social, economic, and environmental challenges by 2030

• Aim to promote peace, prosperity, and sustainability for all people and the planet. The SDGs cover a wide range of issues– poverty, inequality, climate action, education, health, and gender equality.

• In contrast, MDGs were an earlier set of eight goals established in 2000, aimed primarily at addressing extreme poverty and its various dimensions by 2015

• While MDGs focused on specific targets, the SDGs are broader, more inclusive, and emphasize holistic sustainable development

key differences between MDGs and SDGs (1. scope and coverage)

• scope and coverage

• MDGs= focused mainly on developing countries and had eight goals centered on poverty reduction, health, and education

• SDGs= Universal in nature, applying to all countries and addressing a wider range of issues, including environmental sustainability and inequality.

key differences between MDGs and SDGs (2. number of goals)

1. MDGs: 8 goals.
2. SDGs: Consist of 17 goals with 169 associated targets

key differences between MDGs and SDGs (3. inclusivity and participation)

1.MDGs: Developed with limited input from stakeholders outside the UN.

2. SDGs: Created through a more inclusive process that involved extensive consultation with
governments, civil society, and the private sector

key differences between MDGs and SDGs (4. focus on implementation and accountability)

1. MDGs: Lacked a robust accountability mechanism for monitoring progress.
   2. SDGs: Emphasize accountability and monitoring, with specific indicators to measure
   progress.

who’s 2025 global targets

1. 40 % reduction in the number of children under-5 who are stunted

2. 50% reduction of anemia in women of reproductive age

3. 30% reduction in low birth weight

4. no increase in childhood overweight

5. increase the rate of exclusive breastfeeding in the first 6 months up to at least 50%

6. reduce and maintain childhood wasting to less than 5%

world health organization’s global cause for clean water, sanitation, and hygiene

1 . infrastructure development:

• building and upgrading water treatment plants

• expansion of sewage systems

• rainwater harvesting systems

2. public awareness campaigns

• education on hygiene practices (governments, in collaboration with NGOs, have run campaigns to educate the public about the importance of handwashing, safe water storage, and general sanitation practices)

• promoting latrine use and waste management (campaigns that encourage the use of latrines and proper disposal of human waste help to reduce contamination in communities

• regulatory measures and standards