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Incentivizing collaboration to address childhood stunting

Craig Kullmann's picture

Childhood stunting is one of the most significant impediments to human development and economic growth, affecting approximately 155 million children under the age of five globally, with long-term consequences later in life such as impaired cognitive development, chronic disease, and lower earnings as adults. Evidence shows that there is an urgent need for collaboration between actions in water, sanitation, health, nutrition, and other sectors to effectively combat childhood stunting.
 

 
This was discussed during the recent World Bank-IMF Annual Meetings, where leaders from the World Bank and client countries met to talk about Changing Behaviors to Incentivize Collaboration to Address Childhood Stunting. Aimed to provide guidance on how to collaborate better across sectors and institutions, this event provided an opportunity to share the latest results from the global Water Supply, Sanitation, and Hygiene (WASH) Poverty Diagnostic Initiative, led by the World Bank’s Water and Poverty Global Practices in collaboration with the Health, Nutrition, and Population and Governance Global Practices.

Israel: How meeting water challenges spurred a dynamic export industry

Scott Michael Moore's picture
The Sorek Desalination Plant is the world's
biggest seawater desalination plant.

We’re used to talking about how the failure to invest in water management can impede economic growth, but the positive case for water management investments can be just as compelling. With support from the Israeli government, my colleagues and I recently took a study tour to Israel, and what we saw on the ground showed that combining policy and technology can lead not only to better local water management, but also result in a multi-billion dollar, export-driven industry. 

 

“Compressed demand”: How Uttar Pradesh is making sure rural sanitation subsidies for toilets go to the most needy

Arun Kumar Dobhal's picture

When the “Swachh Bharat Mission-Gramin” (SBM-G) was launched in October 2014 with the goal of making rural India free from open defecation by 2019, it gave states and districts more flexibility than previous national sanitation programs had. This led to a successful experiment in Uttar Pradesh called “demand compression”.

The state was preparing to use a tried-and-tested triggering process, where trained motivators concentrate their efforts on a community to help improve their understanding of safe sanitation and stimulate demand for toilets in rural communities where open defecation is still common. However, they faced a problem. If all the households that were eligible for government subsidies would actually claim them, funds would soon run out. With an estimated 15 million households across Uttar Pradesh without a toilet and eligible for a government subsidy of around $200, about $3 billion would be needed.

Household toilet constructed from own resources

When nutrition meets WASH: reflections from Ethiopia and Madagascar on fighting stunting

Claire Chase's picture

Co-author: Sophie Durrans, Research Uptake Officer at London School of Hygiene & Tropical Medicine

A child who is stunted early in life – who fails to grow as tall as expected for their age – often has reduced physical and mental development. Water supply, sanitation, and hygiene (WASH) influences a child's growth in multiple ways. Evidence across low and middle-income countries demonstrates that higher open defecation rates are associated with stunting and higher overall incidence of poverty.

Water and sanitation deprivation: What is next for Tajikistan?

Emcet O. Tas's picture
Also available in: Русский

Two years ago, I visited a village in Rudaki, a hilly district located to the south of Dushanbe, Tajikistan. It lies about forty kilometres from the capital, but it feels like a thousand kilometres away. On our drive up a hill, we saw women carrying buckets of water from a nearby spring. Moving further up, we saw children bathing and animals drinking from the same river. Once in the village, it was clear that life is largely shaped by water scarcity—the backyards were filled with pots and buckets, fuel and stoves for boiling water, and pit latrines that were no longer used because of lack of water. Although we could spot remnants of a once-functional water supply network, people living there had not had access to piped water for at least two decades. Without it, they were only able to practice the most basic forms of sanitation and hygiene. 
A community in Rudaki district, Tajikistan.
Photo credit: World Bank team.



The conditions we witnessed in Rudaki were harsh, but not rare. Located on the western tip of the Himalayas, Tajikistan is a country blessed with large fresh water resources in its lakes, rivers, and glaciers. Yet, access to safe drinking water and sanitation connected to a functioning sewer system is lacking, particularly for rural residents and the poor. Much of the existing infrastructure was built during the Soviet era and has not been upgraded for decades. Tajikistan is one of the few countries outside Africa that did not meet the Millennium Development Goal on drinking water and basic sanitation. Because poor water and sanitation conditions, together with poor nutrition and care, are key determinants of childhood stunting, Tajikistan’s childhood stunting rates remain high. Recent estimates indicate that in Tajikistan more than one in five children under the age of five are stunted and will not reach their full potential as adults.
 
In a new report, Glass Half Full: Poverty Diagnostic of Water Supply, Sanitation and Hygiene (WASH) Conditions in Tajikistan, we document the realities of Tajikistan’s WASH-deprived population. Our analysis builds on one of the largest data collection efforts of its kind – including national surveys of households and schools, water quality tests, ethnographic work, and case studies of existing WASH projects. It also includes poverty mapping and analysis of other secondary data, including a UNICEF nutrition survey that shared a subsample with our WASH survey.

Gender and sex inequalities in water, sanitation, and hygiene

Libbet Loughnan's picture

This blogpost is part of a series of thematic blogs for the World Bank's Water Supply, Sanitation, and Hygiene (WASH) Poverty Diagnostic.

Woman carries water containers near polluted stream and water pipe in Maputo, Mozambique

Addressing gender and sex inequalities in WASH is not only recognized in Sustainable Development Goals (SDGs) 4 and 6, it is central to the entire ambition of the SDGs themselves. Some water, sanitation, and hygiene issues are faced only by women because of their biological sex, whereas others are more influenced by gendered societal norms. To truly leave no one behind, we need to be mindful of and work against gender and sex inequalities in all development work. 
 
New World Bank research is a valuable contribution to doing just that.  ‘Reducing Inequalities in Water Supply, Sanitation, and Hygiene in the Era of the Sustainable Development Goals’ reveals that a drastic change is required in the way countries manage resources and provide key services, starting with better targeting to ensure they reach those most in need.  In many cases, this means women and girls. 

Water flows through development – big ideas from World Water Week

Guangzhe CHEN's picture
Guangzhe Chen, Senior Director, the World Bank’s Water Global Practice, 
speaks at the opening plenary of World Water Week 2017. Credit: Tim Wainwright

It was inspiring to see so many committed water practitioners at World Water Week in Stockholm the last week of August, coming together to share experiences and advance global action to achieve the Sustainable Development Goal of safe and accessible water and sanitation for all (SDG6) by 2030.  As we know, access to water and sanitation is key to thriving communities. It determines whether poor girls are educated, whether cities are healthy places to live, whether industries grow, and whether framers can withstand the impacts of floods and droughts.

Without it, we are limiting our full potential. In fact, today we face a “silent emergency”, with stunted grown affecting more than a third of all children under five in countries such as Bangladesh, Indonesia, Niger and Guatemala. This was presented in the new World Bank report WASH Poverty Diagnostics, provides new data on water, sanitation and hygiene (WASH) for 18 countries and finds that we get the biggest bang for the buck when we attack childhood stunting and mortality from many angles simultaneously, in a coordinated way. While improving water and sanitation alone does improve a child’s well-being, the impacts on child height are multiplied when water, sanitation, health, and nutrition interventions are combined. The report also pinpoints the geographical areas in a country where access to services are low or missing completely, and suggests that to move the needle on improving poverty indicators, policies need to be implemented and resources have to be better targeted to reach the most vulnerable.

How can we make water and sanitation more inclusive and accessible?

Kamila Anna Galeza's picture

“What’s wrong with this picture?” Louisa Gosling of WaterAid asked the participants at her training on Disability-inclusive Water Operations at the World Bank Water Week in March 2017. She pointed to a photo of a woman standing on the wall of a well. It was round and high, the ground around it muddy, and there was no lifting mechanism in sight.

More pictures followed… latrines and water sources with steep steps, narrow doorways, unstable construction without handles or rails. The more pictures we saw, the clearer it became what was wrong - all the facilities shown were inaccessible and dangerous, quite likely impossible to use for many people. 

Photo Credit: WaterAid

The biggest bang for our limited water and sanitation buck: can investing in small towns lead the way?

Aroha Bahuguna's picture



While the share of poor people in Sub-Saharan Africa decreased from 56 percent in 1990 to 43 percent in 2012, the region’s rapid population growth outpaced the decrease in poverty, resulting in higher number of poor people than before. More specifically, Africa’s urban population is expected to triple in size in the next half century, which is putting pressure on scarce resources in cities, exacerbated by capacity, budget and governance bottlenecks. The densely-populated areas with low levels of water and sanitation services pose a serious threat to public health – cholera epidemics have broken out in urban areas in several African countries in recent years.

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