Water, sanitation and hygiene for trachoma elimination

Achieving facial cleanliness and environmental improvement (F and E) within communities requires addressing deep-seated behaviours and practices which are rooted in social and cultural norms as well as improving access to water and sanitation infrastructure.

Unlike the surgery and antibiotic components of SAFE, F and E require strong partnerships with water and sanitation agencies and longer lead-times to allow behaviours and practices to change sustainably. These actions help sustain the results of the programme over time by reducing transmission and improving the way institutions function.

In this video we examine the water, sanitation and hygiene (WASH) services needed to deliver the F and E components of the SAFE strategy. WASH interventions have broad public health benefits that reduce multiple diseases and contribute to non-disease outcomes such as school attendance. Poor access to WASH contributes to a vicious cycle of poverty and disease and adds a substantial burden to already stretched health systems. Affected individuals and their families can be faced with catastrophic health costs, indebtedness and become less economically productive. For example, in 2003 the global economic cost of trachoma from lost productivity was estimated to be US$ 5.3 billion annually. Conversely, every dollar invested in water and sanitation is estimated to result in a return of over five dollars in health benefits (WHO, 2015). WASH activities require planning with multiple stakeholders. Transition activities can be planned at the national or district levels and embedded into the community, or even at school level. A toolkit can be used to guide this process.

As you watch the video consider who would you involve in planning for WASH activities in your setting, at national or district level?