Pre-ART loss to follow-up in HIV-positive adults at a primary health care center in urban Mozambique

Abstract

Background: The water, sanitation and hygiene (WASH) sector and nutrition sector have common goals: to increase child survival and improve maternal and child health. Both sectors’ work achieves these goals to some extent, but new evidence suggests that neither is sufficient to fully improve maternal and child health. This study explores how the two sectors, WASH and nutrition, can integrate intervention activities to more effectively achieve their common goals. Structure/Method/Design: Twenty semi-structured in-depth interviews with members of the WASH and nutrition sectors were conducted to investigate: 1) if and how organizations have integrated WASH and nutrition activities; 2) perceptions of members of the two sectors on integration and co-location of interventions; 3) barriers to integration of the activities; and 2) potential steps to overcome barriers and more effectively integrate WASH and nutrition. Interviews have been completed and data analysis is ongoing, and is estimated to be completed by February 2014. Results (Scientific Abstract)/Collaborative Partners (Programmatic Abstract): Preliminary results indicate that the majority of current initiatives to integrate WASH and nutrition programs are those that incorporate co-messaging of hygiene behaviors into nutrition interventions, followed by geographic co-location of WASH and nutrition programs. Key barriers to integration include vertical funding streams, lack of common indicators on which to report, limited knowledge of nutrition in the WASH sector and vice versa, and the challenge of promoting too many new behaviors in a target population. The main recommendations from those working in the two fields are that donors should require collaboration between sectors in their requests for proposals, common indicators for programs should be developed, and sharing of knowledge between sectors and programs should occur in order for integrated programs to succeed. Summary/Conclusion: It is widely recognized in the WASH and nutrition sectors that the two are both compatible and intertwined; however, integration of the two programs is less common among organizations, and if it is done, it is still novel. In order to integrate WASH and nutrition and to do so more effectively, donors should require integration, knowledge among sectors should be shared, and incentives should be given for the two sectors to work together toward common goals.