Annual Meeting of the International Network on Household Water Treatment and Safe Storage and Joint HWTS/WSP Workshop

Nagpur, IndiaNovember 2013

International Network on Household Water Treatment and Safe Storage-

focusing on the needs of the most vulnerable

Overview• Basis for household water treatment and safe storage

(HWTS)

• WHO/UNICEF International Network on HWTS

• Important HWTS initiatives• National policy development

• HWTS Taskforce and integrated interventions

• International Scheme to Evaluate HWT

• Linking with water safety plans

Basis for Household Water Treatment and Safe Storage

• Important interim solution for:– 780 million without access to improved drinking-water– Billions without access to safe and reliable drinking-water

• Proven primary health intervention:– Reduces diarrhoea 32-42%( Clasen, et al. 2006;Waddington,et al. 2009)

– Included in UNICEF/WHO 7 point strategy for diarrhoea control (2009); WHO/UNICEF Global Action Plan to Prevent Childhood Pneumonia and Diarrhoea (2013)

• Optimizing benefits requires optimal choice, consistent and correct use by at-risk populations:– WHO recommendations on HWT performance (2011)

– WHO/UNICEF Toolkit for Monitoring and Evaluating HWTS (2012)

MoH Kenya, John Kariuki

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International Network on Household Water Treatment and Safe Storage

• Co-hosted by WHO and UNICEF, Communications by UNC Water Institute

• Over 140 participating organizations

• Phase II Strategy (2011-2016) aims to:– Support national policy and framework development– Strengthen evidence base– Evaluate and disseminate best practices– Realize tangible results in scaling-up– Advocate integration of HWTS into other public health and

WASH interventions

• Global Network targets address key areas of work

HWTS Global Strategy 2011-2016- Mission Statement -

To contribute to a significant reduction in water-borne and water-related vector-borne diseases,

especially among vulnerable populations, by promoting household water treatment and safe

storage as a key component of community-targeted environmental health programmes.

Some Key Network Achievements for 2013

• Convened West Africa workshop on integrated interventions and national HWTS strategies

• Annual Network meeting in India with joint engagement on Water Safety Plans

• Supported implementation of national HWTS action plan in Ethiopia, Gambia and Zambia

• Reviewed national HWTS action plans for Ethiopia, Malawi, Zambia

• Inclusion of HWTS within Global Action Plan on Diarrhoea and Pneumonia (GAPPD)

Some Key Network Achievements for 2013 (contd)

• Established WHO International Scheme to Evaluate HWT• Enhanced understanding on carbon credits gained through

global exchange (see publications)• Two participatory workshops on monitoring & evaluation of

HWTS (i.e. WHO/UNICEF toolkit)• Survey of current HWTS research efforts• Template for country profiles completed; 9 profiles drafted

Facilitating National Policy Development

• Regional workshops and development of national action plans

– East Africa 2011: Ethiopia, Kenya, Rwanda, Tanzania and Uganda– Southern Africa 2012: Malawi, Mozambique and Zambia– West Africa 2013: Gambia, Ghana, Liberia and Sierra Leone

• Focus on inclusion of HWTS in national policies

– Child and maternal health– WASH– Nutrition– HIV/AIDS and TB– Emergencies

Source: WHO, 2012. Status of national policies on household water treatment and safe storage in select countries. Geneva, Switzerland.

34%

24%

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Water Health Emergency Sanitation Other

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Sector Policies

Inclusion of HWTS in National Policies/Strategies (Survey of 70 countries)

WHO Taskforce on Integration of HWTS and Health (2013)

• Objectives Review health evidence, provide recommendations on what can and should be done to scale-up HWTS

• Participants WHO staff from maternal and child health, nutrition, malaria, neglected tropical diseases, HIV, emergency alert and response

• Recommendations

- Link with HWTS with major int'l and nat'l initiatives (child health, HIV, Dengue, etc)

- Select HWT options that meet WHO criteria AND most likely to be used

- Implement within existing public health and other community channels

- Monitor and track progress

- Invest in operational research

Why Integration?-Greater health gains

• Antenatal Care in Malawi (Sheth, AN, et al., 2010; Wood, et al., 2011)

– Marked increase in antenatal visits, delivery in health facilities, and postnatal checks

– 30-fold increase in household water treatment 3 years later

• Zambia HIV+ mothers (Peletz, et al.; 2012; Peletz, et al.; 2013)

– Use of filters 96% among HIV+ mothers – Significant reductions in diarrhoea in young children and the

household– Long-term high use sustained even after intervention ceased

• Kenya multi-disease campaign (Walson, et al.; 2013)

– Use higher in intervention vs control: 99.5% vs 76% (any method); 93% vs 0.4 % (filter)

– Significant reductions in diarrhoea and HIV mortality

WHO/ R Granich

International Scheme to Evaluate HWT

• Promote and coordinate independent and consistent testing and evaluation of household water treatment products based on WHO performance criteria; and

• Support national governments building technical capacity of research institutions and strengthening national regulation of HWT.

• First call for submissions will be issued in Q4 2013; first round of testing in Q1 2014

Natural water

sources

Water Transport• Tanker trucks• Carts• Carrying water• etc

Safe drinking water at thecommunity level

Storage and Consumption of safe water

Pit latrines

Poor handling behavior

Flooding

Poorly maintained and leaking pipe

networks

Household level solutions• Boiling• disinfection• filtration• pasteurization• Safe storage, etc

Community Level solutions• Boreholes• Treatment plants• Spring protection• Mechanized systems, etc

How does HWTS fit into Water Safety Plans?

HWTS and Water Safety Plans

• HWTS in WSPs helps the consumer (end user) to be aware and responsible for the quality/safety of the water being consumed

• HWTS is one of the key mitigating measures in WSPs that ensures safe water at the point of consumption – thereby completing the cycle

• Many countries (Afghanistan, Democratic Republic of the Congo, Ethiopia, Kenya, Lao PDR, etc) working to holistically address water quality with WSPs and HWTS

WHO/ M Montgomery

• Water quality: –Refers more to the chemical, physical and biological properties of water. It tells the situation with the properties at a time “t”. It is subject to change as it is influenced by microorganisms such as viruses and bacteria, industrial activities, agricultural activities, human behavior, etc.

• Water Safety: –Refers to a process/procedure/approach to ensuring that the quality of water is maintained from the catchment, through treatment to consumption by the consumer, eliminating contamination.

• Water Safety Plans: –Is a strategic plan to ensure the safety of drinking water using a comprehensive risk assessment and risk management approach that covers all the steps in water supply chain.

Water quality Vrs Water safety

• Signup for listserve –regular newsletters, event information, release of documents

• Share experiences in EzCollab discussions• Participate in a webinar and/ Network meetings• Use and provide feedback on tools and guidance• Spread word to others• Visit us online at:http://www.who.int/household_water/network/enhttp://waterinstitute.unc.edu/hwts

Interested in knowing more?

Stanford University, A Pickering

“Afya ni bora kuliko mali.”

Thank you.Questions?

Health is better than wealth.(Swahili Proverb)

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Inclusion of HWTS in National Policies/Strategies (Survey of 70 countries)