1. Saving Lives Through Hygiene Merri Weinger Hygiene Improvement Program Manager, USAID

2. 1. What percentage of the 1.5 million annual child deaths caused by diarrhea are preventable? a. 0%-30% b. 31%-60% c. 61%-80% d. over 80%

4. In what regions of the world does the majority of child mortality from diarrhea take place?

5. Where do children < 5 die from diarrhea?

6. 11 countries account for over 70% of the annual deaths globally from diarrhea

7. 2. Out of the total world population of over 6.5 billion, how many people around the globe lack access to safe water? a. 50 million b. 500 million c. about 1 billion d. more than 2 billion

8. 8 WHO/UNICEF, 2010

9. 3.How many people in the world lack access to hygienic sanitation facilities? a. 2.6 million b. 26 million c. 260 million d. 2.6 billion

10. 10 WHO/UNICEF, 2010

12. 4. The only sure way to prevent diarrheal diseases is to ensure that all households have access to water and sanitation facilities. True _________ False_________

13. False!

15. 5. Which of the following are among the recognized globally important hygiene behaviors for diarrhea prevention? (check all that apply) __ keeping food safe from contamination __ bathing daily __ effective handwashing __ washing feet before entering the home __ hygienic disposal of human feces __ face washing once a day __ clearing brush near the house __ safe water handling, transport, and storage

16. Safe Storage & Treatment of Water Handwashing Safe Feces Disposal

17. Hygiene Behaviors to Prevent DD (WHO, 1992) Keeping drinking water clean Keeping drinking water clean Keeping hands clean Keeping hands clean Keeping the environment clean (sanitation perspective) Keeping the environment clean (sanitation perspective) Keeping food clean Keeping food clean

18. FieldsFluidsFingersFliesFecesFood New Host Primary Prevention The F-Diagram Source: Wagner and Lanois, 1958

19. FieldsFluidsFingersFliesFecesFood New Host Primary Prevention The F-Diagram Source: Wagner and Lanois, 1958 Water Quality

20. FieldsFluidsFingersFliesFecesFood New Host Primary Prevention The F-Diagram Water Quantity Source: Wagner and Lanois, 1958 Water Quality

21. FieldsFluidsFingersFliesFecesFood New Host Primary Prevention The F-Diagram Sanitation Source: Wagner and Lanois, 1958 Water Quality Water Quantity

22. FieldsFluidsFingersFliesFecesFood New Host Primary Prevention The F-Diagram Hand Washing Sanitation Source: Wagner and Lanois, 1958 Water Quality Water Quantity

23. 6. Key WASH interventions will reduce diarrheal disease by a. 0-20% b. 21-50% c. 51-80% d. over 80%

24. POU water treatment - 30-50% reduction in child DD prevalence – twice as effective as interventions at water source POU water treatment - 30-50% reduction in child DD prevalence – twice as effective as interventions at water source Safe storage – 21% reduction Safe storage – 21% reduction Proper handwashing - 43% reduction Proper handwashing - 43% reduction Sanitation – basic, low-cost systems can reduce DD by 30% or more Sanitation – basic, low-cost systems can reduce DD by 30% or more

25. 7. Name three reasons why household drinking water can often be unsafe for human consumption.

27. Transport Storage Handling, and Storage

28. 8.What are effective methods for water disinfection at the point-of- use?

29. Household Water Treatment Options  Chlorination  PuR  Ceramic Filtration  Biosand Filtration  Solar/SODIS  Boiling

30. 9. What are the critical times for handwashing with soap (or soap substitute) for diarrhea prevention? 9. What are the critical times for handwashing with soap (or soap substitute) for diarrhea prevention?

31. Critical Times for Handwashing with Soap After defecation After defecation After cleaning a baby’s bottom After cleaning a baby’s bottom Before preparing food/cooking Before preparing food/cooking Before eating/feeding a baby Before eating/feeding a baby

32. 10. Which of the following are effective ways of promoting latrines? Public financing and distribution of latrines to all households Public shame Demand creation (e.g. Community-Led Total Sanitation) Develop partnerships with private sector producers of sanitation technologies (e.g. Sanitation Marketing)

33. MAY NOT DEPEND ON HEALTH MOTIVATIONS… WHAT FACTORS BESIDES HEALTH MOTIVATED SANITATION ADOPTION IN THIS COMMUNITY? RESPECT, PRESTIGE PERSONAL COMFORT, SELF-ESTEEM Increasing Demand for Sanitation

34. No Toilet, No Bride The "No Toilet, No Bride” program in the Indian state of Haryana has been the most successful sanitation promotion effort there so far. Started about two years ago, the campaign has resulted in 1.4 million latrines being built. "I will have to work hard to afford a toilet. We won't get any bride if we don't have one now," said 22-year-old villager Harpal Sirshwa from Nilokheri, who is hoping to marry soon. "I won't be offended when the woman I like asks for a toilet."

37. 11. What are the best entry points for integrating hygiene improvement into existing health and development programs? 11. What are the best entry points for integrating hygiene improvement into existing health and development programs?

38. Food Security and Nutrition Education Antenatal and neonatal care Teacher training HIV/AIDS Child health Avian flu

39. USAID/GH Supported Partners in Hygiene Improvement CDC: Safe Water System CDC: Safe Water System www.cdc.gov/safewater/ www.cdc.gov/safewater/ International Network to Promote Household Water Treatment and Safe Storage International Network to Promote Household Water Treatment and Safe Storage www.who.int/household_water/network/en/ Global Public-Private Partnership For Handwashing with Soap Global Public-Private Partnership For Handwashing with Soap www.globalhandwashing.org www.globalhandwashing.org www.global

40. For further information, contact: Merri Weinger (Hygiene Improvement) mweinger@usaid.govmweinger@usaid.gov; 202-712-5102 mweinger@usaid.gov