Menu ENN Search

Call to Action on improving Water, Sanitation, and Hygiene for Maternal and Newborn Health

Summary of paper1

Location: Global

What we know: Water, sanitation, and hygiene (WASH) may impact maternal and newborn health (MNH).

What this article adds: A recent collaborative paper by WASH and MNH agencies urges action and offers recommendations to accelerate WASH service provision at home and in health care facilities to improve MNH.  The Post-2015 development framework is an opportunity for a stronger, more inter-sectoral response. The actions are achievable, the timing is favourable and there is sufficient knowledge to justify action.

A recently published paper by academics and representatives urges action and offers recommendations to accelerate water, sanitation and hygiene (WASH) service provision at home and in health care facilities to improve maternal and newborn health (MNH).  Key summary points are:

There is sufficient evidence that WASH may impact MNH to warrant greater attention from all stakeholders involved in improving MNH and achieving universal WASH access.

Enabling stronger integration between the WASH and health sectors has the potential to accelerate progress on MNH; this should be accompanied by improved monitoring of WASH in health care facilities providing MNH services as part of routine national-level monitoring, and at the global level through international instruments.

Global and national efforts to reduce maternal and newborn mortality and morbidity should adequately reflect WASH as a pre-requisite for ensuring the quality, effectiveness, and use of health care services.

The Post-2015 development framework is an opportunity for a stronger, more inter-sectoral response to the MNH challenge, and the goals and targets aimed at maximizing healthy lives and increasing access to quality health care should adequately embed WASH targets and success indicators.

Further implementation research is needed to identify effective interventions to improve WASH at home and in health care facilities, and to impact on MNH in different health system contexts.

An international framework that reflects the complex determinants of MNH must be applied at country level to achieve results. There are lessons to be learned from WASH and education on cross-sectoral action, e.g. from Malawi and Sri Lanka, that can inform health and WASH collaborations.

The World Health Organisation’s Essential Environmental Health Standards in Health Care (2008)2 sets out the essential environmental health standards required for varying levels of health care settings in medium- and low-resource countries.  The Standards contain a set of 11 guidelines, with a set of indicators and guidance notes and checklist for assessing the implementation of each guideline.

A comprehensive consultation across the international WASH sector involving more than 100 experts from more than 60 organizations worldwide has resulted in a proposed Water, Sanitation, and Hygiene Target for the Post-2015 Development Framework. The vision is that of universal access to safe drinking water, sanitation, and hygiene. The vision to be achieved by 2030 aims:

  1. to eliminate open defecation
  2. to achieve universal access to basic drinking water, sanitation, and hygiene for households, schools, and health care facilities
  3. to halve the proportion of the population without access at home to safely managed drinking water and sanitation services, and
  4. to progressively eliminate inequalities in access.

The emerging consensus on the need for a Universal Health Coverage (UHC) approach presents an important opportunity to bridge the gaps between the WASH sector and the health system and embed WASH in health care services, involving promotive, preventive, curative and rehabilitative/palliative services.

Show footnotes

Velleman Y, Mason E, Graham W, Benova L, Chopra M, et al. (2014). From Joint Thinking to Joint Action: A Call to Action on Improving Water, Sanitation, and Hygiene for Maternal and Newborn Health. PLoS Med 11(12): e1001771. doi:10.1371/journal.pmed.1001771

2 WHO (2008) Essential environmental health standards in health care. Geneva: WHO.

More like this

NEX: The growing interest in Nutrition and WASH: Some new initiatives and developments

Interest and commitment to nutrition-sensitive interventions and multi-sector coordination has led to an increased number of initiatives and publications on nutrition and...

FEX: WASHplus in Mali: integrating WASH and nutrition for healthy communities

By Renuka Bery, Sahada Traore and Lonna Shafritz Renuka Bery is the Integration Manager of the WASHplus project managed by FHI 360. She currently oversees the WASHplus...

FEX: Evaluation of an integrated health-nutrition-WASH project to reduce malnutrition prevalence in children under two in Bangladesh

By Monsurul Hoq and John Brogan Monsurul Hoq was working as a Statistician Epidemiologist during the study. He has experience in monitoring and evaluation of community-based...

FEX: BabyWASH coalition planned to overcome development silos

By Peter Hynes, World Vision Actors from non-governmental organisations (NGOs), donors, academia, United Nations (UN) agencies and others met recently to consider forming a...

FEX: From Pilot to Scale-Up: The CMAM Experience in Nigeria

By Maureen Gallagher, Karina Lopez, Stanley Chitekwe, Esther Busquet & Saul Guerrero Maureen Gallagher is the Technical Coordinator for ACFInternational in Nigeria since July...

FEX: Competing for scarce resources: the new concern for Syrian refugees and host communities in Lebanon

By Bassem Saadallaoui Bassem Saadallaoui was Country WaSH Coordinator for ACF Lebanon from May 2013 to July 2014. He is a post-graduate Water and Sanitation Engineer,...

FEX: Building a case for causality through the NCA approach in Satkhira, Bangladesh

Marijka van Klinken, Matthew Parnaby, Paulina Acosta and Julien Chalimbaud Marijka van Klinken was the NCA Analyst conducting this study. She holds an MSc of Public Health...

FEX: Beyond the drinking glass: expanding our understanding of water-nutrition linkages

By Dawit Mekonnen, International Food Policy Research Institute Dawit Mekonnen is a Research Fellow at the International Food Policy Research Institute (IFPRI) in the...

FEX: IYCF-Friendly Framework pilot in Jordan, Bangladesh and Kenya

By Bushra Rashid, Nicki Connell and Caroline Wilkinson Bushra Rashid is working as a Nutrition Advisor in the Humanitarian Surge Team of Save the Children UK. She has been...

FEX: The cost of a knowledge silo: A systematic re-review of water, sanitation and hygiene interventions

Summary of research1 By Michael Loevinsohn Michael Loevinsohn is a research fellow at the Institute of Development Studies, UK. An ecologist and epidemiologist, he has worked...

NEX: Improving nutrition behaviours through a Care Group Model project in Somalia

Halima Hillowis a nutritionist working in Somalia with World Concern. She has a degree in Food and Nutrition from the Ahfad University of Women in Sudan and is currently...

FEX: Integrating MIYCN initiatives across sectors in Dadaab refugee camps in Kenya

By Doris Mwendwa, James Njiru and Jacob Korir Doris Mwendwa is the current National MIYCN Deputy Programme Manager and has been working with ACF-USA Kenya Mission for the past...

FEX: Impact of community-based advocacy in Kenya

By Geoffrey Kipkosgei Tanui, Thatcher Ng'ong'a and Daniel Muhinja Geofrey Kipkosgei Tanui is currently working as a Community Development Officer for the Kenya Signature...

FEX: WASH interventions and their effects on the nutritional status of children

Summary of research1 Location: Global What we know: Water, sanitation and hygiene (WASH) interventions are frequently implemented to improve health and reduce infectious...

FEX: WaterAid

Agency profile Name: WaterAid Address: WaterAid, 47-49 Durham Street, London, SE11 5JD, UK Email: Website: Year founded:...

FEX: Is exposure to animal faeces harmful to child nutrition and health outcomes?

Summary of research1 Location: Ethiopia, Bangladesh and Vietnam What we know: Sub-clinical environmental enteric disorder (EED) is an important causal pathway from poor...

FEX: Scaling up nutrition services and maintaining service during conflict in Yemen: Lessons from the Hodeidah sub-national Nutrition Cluster

By Dr. Saja Abdullah, Dr. Rasha Al Ardi, and Dr. Rajia Sharhan Dr. Saja Abdullah is Chief of Nutrition with UNICEF Yemen Dr. Rasha Al Ardi is Health and Nutrition Office and...

FEX: Launch of BabyWASH Coalition

News The newly launched BabyWASH Coalition is a five-year initiative comprising organisations across civil society, United Nations (UN) organisations, funders, academics and...

NEX: Alive and Thrive forum on stunting reduction: October 2013

In October 2013, the Government of Ethiopia and Alive & Thrive and co-hosted a Forum on Stunting Reduction: Nutrition & Beyond for Solutions. The Forum brought together more...

NEX: Women, children, and adolescents: the post-2015 agenda

Summary of paper: The Lancet, volume 384, no. 9949, p1159, 27th September 2014 Child mortality in under-five-year-olds has fallen globally from 12.7 million in 1990 to 6.3...


Reference this page

Call to Action on improving Water, Sanitation, and Hygiene for Maternal and Newborn Health. Field Exchange 49, March 2015. p56.