Integrated health, education and water/sanitation programs can defeat disease and poverty

As governments prepare to gather at the United Nations General Assembly in New York on September 19 and 20, a new report published by a group of six influential aid agencies provides clear and compelling evidence that a combined approach to tackling poverty and disease-that brings together work on water and sanitation, health, education, and nutrition/food security-achieves better results for the world's poorest.

Entitled Join up, Scale up: How integration can defeat disease and poverty, the report, co-authored by Action Against Hunger, Action for Global Health (UK & France), End Water Poverty, PATH, Tearfund, and WaterAid, highlights examples across 17 countries of how bringing different development approaches together-or integration-is working to help tackle poverty and disease, and calls on the international community, including donor and developing-country governments, to prioritise and invest in these joined-up programmes.

"We have clear and compelling evidence that integrated health, education, water and sanitation programs can achieve more significant and sustainable benefits for the world's poorest communities", stated Dr David Winder, CEO of WaterAid in America. "UN agencies and member States need to respond to the evidence presented here and use their influence to move the international community to expand upon these successes."

As the challenges of poverty and lack of access to health, nutrition, water and sanitation, and education overlap in people's lives, integrated aid programmes result in more effective and lasting solutions. For example, a hand washing and oral hygiene programme in elementary schools in the Philippines-involving the Department for Education, the not-for-profit organisation Fit for School, and regional and local government-cut school absenteeism by 30 percent, while the number of underweight children was reduced by one-fifth in targeted schools.

"Combining and coordinating services makes common sense - and fiscal sense too," commented the former President of Cape Verde, Antonio Monteiro, as recently appointed Nutrition Advocate for West Africa, "but most importantly it creates greater impact for those who most need these essential services."

The report also highlights work in Peru, where chronic child undernutrition was cut across the country by nearly five percent in under three years by bringing together community groups and politicians in a programme integrating small-scale financing, water and sanitation improvements, better child and maternal health care, and nutrition education programmes.

Meanwhile in Nepal, through working together, the national government, aid agencies, charities and local government have completed a programme to train all local doctors and nurses on hygiene education. This work is now going a step further with the setting up of a new nationwide water-quality surveillance system, dealing with the causes as well as the symptoms of the problem.

Integration is increasingly recognised across development fields as a critical supporting strategy, one that promotes sustainability and has demonstrated results in achieving impact. For example, the forthcoming report by The Partnership for Maternal, Newborn & Child Health, analyzing the commitments made to the Global Strategy on Women and Children's Health, includes integrated approaches as a key recommendation for improving the lives of women and children.

In total, the report showcases integrated aid work in 17 countries that, through addressing education, urban agriculture, hygiene, water and sanitation, income improvement, and a range of health needs, such as HIV/AIDs, diarrhoea, nutrition and maternal health, are making a real impact. Drawing from the evidence gathered, the report makes the following recommendations to international institutions, politicians, donors, and their NGO partners:

• Commit high-level political leadership and financial resources to integrated approaches, where they can create greater impact.
• Work with communities to design, implement, and evaluate integrated projects and programmes.
• Incorporate experience and expertise across different sectors and stakeholders into development programmes.
• Fund projects that demonstrate integrated approaches at the community level to learn what works, improve national plans, and inform scale-up strategies.
• Provide flexible funding to partner countries in support of national priorities and integrated programmes.