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Water, Safety, & Hygiene (WASH) Series

AIDSTAR-One finalized a training resource that addresses problems around water, sanitation, and hygiene (WASH) at health facilities to improve the quality of life of people living with HIV and their families. The curriculum provides detailed activities to improve WASH systems in health facilities by ensuring a safe and sufficient supply of water, sanitation, and basic hygiene practices exist at the facility level. In resource-limited countries, many essential practices are lacking in the majority of health care facilities making adequate patient care more difficult, particularly for people living with HIV (PLWH) and others who are more likely to get an infection. This curricula was piloted in Kenya and Ethiopia in 2011. Included in this series are the facilitator and training manuals, as well as the pilot reports from Kenya and Ethiopia.

Cover of Water, Sanitation, and Hygiene Pilot Curriculum Assessment, Ethiopia

Water, Sanitation, and Hygiene Pilot Curriculum Assessment, Ethiopia

Low access to safe drinking water, insufficient quantities of water for basic hygiene, and inadequate access to sanitation create a high burden for people living with HIV (PLHIV), who are vulnerable to opportunistic infections.

In April 2011, AIDSTAR-One with support from the Federal Ministry of Health (FMOH) piloted a training curriculum in Ethiopia that aims to address water, sanitation, and hygiene (WASH) at health facilities to improve the quality of life of PLHIV and their families. The FMOH was integral to the development of the curriculum and multiple reviewers provided comments before the curriculum was finalized. During implementation of the pilot training, AIDSTAR-One engaged the Regional Health Bureau of the Southern Nations, Nationalities, and People’s Region in the selection of health facilities and the provision of the training to health care providers and administrators.

To determine the impact of the training and to provide guidance on how to improve WASH knowledge and practices at the facility level, AIDSTAR-One conducted a mixed-methods assessment in June 2012 examining the evidence in eight health facilities one year after AIDSTAR-One’s WASH training. Collecting both qualitative and quantitative data, the assessment examined existing WASH approaches at the eight clinic sites, focusing on overall integration into the health clinic operations. Although WASH integration with nutrition assessment, counseling, and support (NACS) services was outside the mandate of the original pilot training, AIDSTAR-One was tasked to explore how WASH is incorporated into the technical area of NACS in the assessment phase to examine if integration into a technical area produces more sustainable WASH results.

Cover of Water, Sanitation, and Hygiene Pilot Curriculum Assessment, Kenya

Water, Sanitation, and Hygiene Pilot Curriculum Assessment, Kenya

In February 2011, AIDSTAR-One, with support from the Ministry of Public Health and Sanitation (MOPHS) piloted a training curriculum in Kenya that aims to address water, sanitation, and hygiene (WASH) at health facilities to improve the quality of life of people living with HIV and their families. To determine the impact of the training and to provide guidance on how to improve WASH knowledge and practices at the facility level, AIDSTAR-One, with support and leadership from the MOPHS, conducted a mixed-methods assessment in February 2012 examining the evidence in seven MOPHS health facilities in Kenya one year after AIDSTAR-One’s WASH training. Collecting both qualitative and quantitative data, the assessment examined existing WASH approaches at the seven clinic sites focusing on overall integration into the health clinic operations while also collecting baseline data for integration into the technical area of nutrition assessment, counseling, and support services to examine if integration into a technical area produces more sustainable WASH results.

Increased availability of handwashing and drinking water at the health facilities was a key measurable impact of the AIDSTAR-One pilot. At the training, participants from each health facility were asked to select small doable actions (SDAs)—simple, easy-to-adopt WASH-related activities or practices to reduce the risk of diarrhea and other opportunistic infections in people living with HIV—to implement upon return to their facilities. Of the 25 SDAs chosen, 17 (68 percent) were fully implemented, 5 (20 percent) were partially implemented/not sustained, and 3 (12 percent) were not implemented. All of the participants reported that the knowledge gained at the training and the implementation of the SDAs assisted in improving WASH standards at their facilities. These results include four facilities that provided a dedicated drinking water tank post-training, that were previously without drinking water. These results demonstrate the effectiveness of identifying SDAs during the actual training as they hold participants accountable to implementing actions learned during the training.

Cover of Improving the Lives of People Living with HIV (PLHIV) Through WASH: Water, Sanitation, and Hygiene—Participant Guide

Improving the Lives of People Living with HIV (PLHIV) Through WASH: Water, Sanitation, and Hygiene—Participant Guide

Welcome to this course on Improving the lives of people living with HIV (PLHIV) through water, sanitation, and hygiene (WASH). This training is different from many courses, and we believe that you will enjoy it a great deal. The goal is to help PLHIV live better and healthier lives.

For effective functioning of health care settings, it is important to include a safe and sufficient supply of water, sanitation, and basic hygiene practices. In resource-constrained countries, many of these essentials are lacking in the majority of health care facilities, making adequate patient care more difficult, particularly for PLHIV and others who are more likely to get an infection. Addressing the problems around WASH can substantially improve the quality of life of PLHIV and their families. Providing patients and caregivers with practical educational messages to promote safe WASH can reach homes and communities at large.

This Participant Guide (PG) is yours to keep. You may write notes wherever you like. The PG includes key technical resources and references for further reading that will be used in almost all of the sessions in the course. Additionally, you can place relevant handouts, including job aids, in the appropriate PG sessions. The PG provides detailed technical information you need to know, including suggested readings for each day of the course as well as useful reference work that you can include when you return to your clinic or hospital.