Combating water borne diseases at the household level

Payden Water, Sanitation and Health Unit Sustainable Development and Healthy Environment Department WHO South-East Asia Regional Office
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Current water and sanitation challenges

About 1 billion people globally, 300 million people in south-east asia and about 45million people in Indonesia lack access to improved water supply About 109 million people in Indonesia lack access to improved sanitation Around 59 million Indonesians still defecate in the open
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What are the risks?

Improved water is not always safe to drink at the tap Intermittent supply improper storage of water at household level Poor management of water and sanitation systems, leakages in distribution system Unhygienic practices Open defecation and toilets not used
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How many are dying from diarrhea annually in South-East Asia?

1400 1200

No. of deaths (000s)

1000 800 600 400 200 0 Diarrheal diseases Respiratory Infections TB HIV/AIDS Measles Malaria

Vast majority children under five years of age

How much can be prevented?

A 2005 systematic review concluded that diarrhoeal episodes are reduced by 25% through improving water supply, 32% by sanitation, 45% through hand washing, 39% by household water treatment & safe storage

About 94% of the diarrheal cases can be prevented with safe water, proper sanitation and good hygiene practices
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The 7-point plan to reduce childhood diarrhea WHO and UNICEF

Treatment package to reduce deaths Prevention package to make a lasting reduction in the diarrhoea burden for years to come
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The 7- point plan

Treatment package Fluid replacement and zinc treatment Prevention package
Rota virus and measles Vaccination Promoting early and exclusive breastfeeding and vitamin A supplement Promotion of Household water treatment and safe storage Improved water quality and quantity Community wide total sanitation promotion

Way forward
Target vulnerable populations where water quality if poor and those drinking from unimproved sources Advocacy the health and cost benefits of household level actions Mass campaigns for improving hygiene at homes through consumer associations where existing Inter-sectoral collaboration and allocation of resources for intensification of STBM Giving choice to consumers instead of asking them to accept a specific water treatment technology more sustainable

Way forward
Training for the correct use of Point of Use treatment technologies (studies indicate lack of training as one of the reasons for discontinuation and ineffectiveness of PoU) Changing behavior - using the right behavior change communication techniques Research to evaluate interventions on efficacy, cost-effectiveness, health impacts, acceptability, affordability, sustainability and scalibility Universal sanitation coverage Improving overall water safety and reliability through water safety plans long term
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Thank You!

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