The presence and prioritization of WASH issues within the health sector appears to be low, for a number of reasons, some of which are beyond the control of the health sector, for example funding. sShould health sector intervene in the water sector, the key would be to coordinate the various stakeholders in the water, education and health sectors in order to address WASH issues coherently and effectively, therefore a good starting point would be reviewing and enhancing the current memorandum of understanding between the ministry of health, ministry of water and environment and the ministry of education and sports.
Training in WASH issues of all actors involved in the health sector is crucial; it is well known that if water, sanitation and hygiene are improved then a number of health issues can be more easily addressed and vulnerability to many diseases will reduce. this can extend to the communities in running awareness schemes for PHC on the variety of issues raised so far, for example on topics such as WASH in schools and maternal health. awareness of rights among communities can also be raised in these schemes.
Health infrastructure is another limiting factor in improving WASH in relation to the health sector. health sector has the technical expertise and the strategic links to other agencies that creates the capacity to implement facilities but also ensure the operation and, maintenance of the facilities by the health centres and communities. the health infrastructure technical working group may be a key stakeholder to engage in this. water supply issues can be targeted in line with this, through developing technologies suitable to those who struggle with access.
Another vital area that appears to have some gaps in the health sector is monitoring and evaluation. Through experience across the water sector, health sector has gained an idea of best practices and methods for monitoring and evaluation, particularly at local level (which is an important part of the health sector plan). working with the ministry of health, in particular the supervision, monitoring and evaluation technical working group, health sector can assist the development of a monitoring and evaluation framework, and especially effective WASH indicators that can be used for monitoring.
These are the main areas that have been identified as areas that health sector can potentially intervene in order to improve WASH in the health sector, but as recognised in previously there are a number of strategic choices that can be made.
It is health sector’s intention to collaborate with stakeholders across the water, education and health sectors to create an integrated approach in improving WASH. However, proceeding with caution is imperative; it is fully appreciated that all stakeholders have expertise and knowledge that can be shared so engagement and discussion is the way to move forward.