Evidence based engagement and influencing for WASH and MNH Water Aid Ethiopia’s Experience Shegaw Fentaye Sisay

WASH & MNH Background: Ethiopia Population: 90 million (2011) Population growth: 3.2% per year The Crude death rate 7.6 /1000 population, Life expectancy at birth of male and female is 62 years and 65 years respectively. Infant mortality rate;44 /1000 live births; under five mortality rate is 64 deaths per 1000 live births. The Maternal Mortality Ratio is estimated at 420 per 100,000 live births 14,416 HPs, 2,689 HCs and 111 public hospitals Background: WASH & MNH HSDP IV prioritizes maternal and newborn care and child health (MNC) Objective To Share WAE’s experience on evidence based engagement regarding WASH for MNC and how we got the attention of the government. To highlight the challenges of WASH for MNH in Ethiopia.

WAE’s research on WASH for Quality Health Services WAE research showed that 41% use water from unprotected sources. 46% (rural) no sanitation facilities 31% have hand washing facilities 88% no separate latrine blocks for male and female 61% no separate sanitation facilities for staff and visitors Visitors use open spaces to relieve themselves Available sanitation facilities are not disability friendly Most of the health facilities have unimproved types of latrines No clothes washing basin Health institutions

Impacts of Lack of WASH in Health Institutions: 1.Risking health Water from unprotected sources and limited handwashing access by staffs & visitors often results in WASH-borne diseases among mothers, neonates and staff 2. Burden on health budget Health institutions forced to move proportion of health budget to fix non-functionalities. 3. Reduced efficiency and effectiveness of health workers 75% of staff spend time looking for water & toilets outside 4. Attitudinal impacts on visitors (aesthetic value)

WaterAid Ethiopia have: Researched “WASH for Quality Health Services” and developed a policy brief to facilitate evidence based engagement Influenced Gov’t to develop a WASH in Health Institutions Design & Construction Manual Contributed to developing indicators for WASH in the Child Survival Strategy Supported MoH to consider WASH for MNC while reviewing Urban Health Extension Program Working with parliamentarians on institutional WASH (HF and School) Working with media agencies Engaged in national WaSH and MNC policy and implementation bottleneck analysis research to further influence the health sector on WASH for MNC Engagement & advocacy: WASH and MNH

Now –CASH Project Clean and Safe Health facility Campaign “CASH Initiative”(Gov’t initiate)

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