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The STOP Diarrhoea Initiative: Glamorous no, lifesaving yes.

Global Hand washing day and World Toilet day raise awareness of the facts and the essential interventions to prevent death and disease from water borne disease. These days aren’t glamorous, but they are fun and effective ways to prevent diarrhoea.

The stats speak for themselves

stats on global Diarrhoea

Diarrhoea causes 8% of under-five deaths; diarrhoea and pneumonia combined cause more than 20% of deaths of children under the age of five (3). Promotion of handwashing with soap is estimated to reduce diarrheal diseases by 40% and pneumonia by 23-25% in children under five (1) (2). Improvements in sanitation alone will lead to a reduction in diarrhoea disease by one third.

The world is not on track to meet the SDG for sanitation that calls for equitable sanitation hygiene for all and to end open defecation by 2030 through investment in sanitation systems that can be managed simply, responsibly and sustainably by communities (6).

How can we help prevent diarrhoea?

Save the Children UK has been working with SC India and Nigeria on a 4 year programme, The Stop Diarrhoea Initiative (SDI) that seeks to understand the challenges in implementing a prevention and treatment package developed by WHO, the 7 Point Plan for Diarrhoea.

This has since been developed into the WHO Global Action Plan for Pneumonia and Diarrhoea (GAPPD) adding key activities for pneumonia.

The highest national burden of diarrhoeal disease is in our programme areas (5).  280 children die in India every day from diarrhoea, and 204 in Nigeria (5). SDI has been implemented in slums in Kolkata and Delhi and rural communities in Uttar Pradesh and Uttarakhand reaching two million people. In Nigeria, the programme is in one large urban slum, Somolu, in Lagos and reaches 1,300,000 people.

SDI works through government and community systems delivering WASH and health care, supporting communities to manage their own water and sanitation services and to get the most from government and private services available to them.

Social behaviour change communication (SBCC) activities are key, they include radio, posters, campaigns and demonstrations, training and support to frontline health workers and community committees.

Rehabilitation and installation of water points and construction and rehabilitation of sanitation structures support government initiatives by working in marginalised communities and piloting new innovation in communities and schools.

SDI supports 400 schools in India and 48 schools in Nigeria. As well as infrastructure, SDI supported children’s health and hygiene clubs (CHHC) introducing packages of games, posters, speaking books and songs which have reinvigorated these clubs and enabled all children in our target communities to learn and share information that will protect them and their families.

Global Handwashing Day and World Toilet Day

children wash their hands during world handwashing day

Global Hand washing day, October 15th is dedicated to increasing awareness and understanding about hand washing with soap as an effective and affordable way to prevent disease.  The 2018 theme, Clean hands: a recipe for health’, focused on the links between hand washing and food, including food hygiene and nutrition and making hand washing a part of everyday life.

World Toilet Day is celebrated on 19th November. This year’s theme ‘When Nature Calls’ highlighted the huge need to address sanitation.

In Nigeria, a football competition, “Kick diarrhea out of Lagos” was held in all supported schools  together with activities and messages on sanitation activities on the days leading up to both Global handwashing day and World Toilet day. Specific meetings were held with local authorities and school management teams on sanitation and hygiene. SDI team members were interviewed on local television about the programme and importance of fulfilling national objectives for access to water and sanitation.

India SDI held celebration days that included awareness and sensitization activities, rallies and meetings supporting district authority workshops. Children in health and hygiene clubs held quizzes and painting competitions and street plays were held in supported schools.  A Digital Campaign showcased construction models and key messages.

This is the final year of the programme, we will evaluate and disseminate our lessons learnt for governments and communities to take forward in to future programmes. The final survey results and our impact will be ready in the coming months although the feedback from communities is already there.

We didn’t know it will benefit us but when they started doing the work we now say we are to stay with (it) because if you look… at the rate at which the children died before they introduced this thing… quote from a father in Somolu.

  1. CHERG 2010. Sandy Cairncross, Caroline Hunt, Sophie Boisson, Kristof Bostoen, Val Curtis, Isaac CH Fung, and Wolf-Peter Schmidt Water, sanitation and hygiene for the prevention of diarrhoea.Int. J. Epidemiol. 2010 39: i193-i205.
  2. Freeman MC, Stocks M, Cumming O, Jeandron A, Higgins JPT, Wolf J, Prüss-Ustün A, Bonjour S, Hunter PR, Fewtrell L, Curtis V. Hygiene and health: systematic review of handwashing practices worldwide and update of health effects. Trop Med Int Health, 2014; 19(8): 906-16.
  3. UNICEF (2017). Levels & Trends in Child Mortality: Report 2017
  4. WHO factsheet 2018
  5. Preventing diarrhoea through better water, sanitation and hygiene: exposures and impacts in low- and middle-income countries. WHO 2014
  6. United Nations (2018) Sustainable Development Goal 6 Synthesis Report 2018 on Water and Sanitation:http://www.unwater.org/un-reports-that-world-is-off-track-on-water-and-sanitation-goal

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