1. www.wateraid.org WaterAid’s Presentation to the DPG - Health in Tanzania Namwaka Omari Ferdinandes Axweso Ibrahim Kabole, MD May 7 2014 At USAID-DSM

2. www.wateraid.org Water, Sanitation & Hygiene (WASH) Contribution Towards Universal Health Coverage

3. www.wateraid.org The role of WASH in Health WASH is crucial for control and prevention of many diseases, both communicable and non-communicable And it is also relevant to health and health systems:  Impact on wellbeing & poverty (broader definition of health: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. WHO, 1948)  Relevance for quality of healthcare  Relevance for disease management & care  Disease-related stigma & exclusion from WASH services (HIV, leprosy, disability)

4. www.wateraid.org The role of WASH in health

5. www.wateraid.org WASH related diseases Acute respiratory infections Under Nutrition Trachoma Guinea worm Schistosomiasis Soil-transmitted Helminths Lymphatic Filariasis Malaria Sepsis Hepatitis E Diarrhoea Neglected Tropical Diseases-NTDs

6. www.wateraid.org Faecal-oral route of transmission

7. www.wateraid.org  Sanitation and Hygiene interventions act as barriers to Transmission Pathogens that cause Infections and Infestations Access to Safe and Adequate Water is a key Determinant for SH to be effective in Infection and Infestation Control.

8. www.wateraid.org % WASH-Safe Facilities & Delivery Rooms Tanzania data Facility Delivery room Average - delivery room 24% Average – facility 44% Puerperal and New born sepsis Universal coverage Discouraging women from coming

9. www.wateraid.org  Risk that the focus on a ‘package’ of services will once again push out public health measures (WASH, vector control, housing, indoor cooking etc).  Ownership, Leadership and championing by the Health Sector Stakeholders (DPG-Health and WASH, Ministries of Health, Water, Education and Local Government to address this risk –to Position Ministries of Health ‘Stewards of Public Health’, and Not simply Service Delivery Agencies. Limits and challenges of UHC policy

10. www.wateraid.org WASH is a neglected issue in public health  lack of political prioritisation and resourcing poor progress on targets (2.5 billion without sanitation!) only 13% of Tanzanians have access to improved sanitation Limits and challenges of UHC policy

11. www.wateraid.org UHC provides an opportunity to firmly embed WASH in Health as a fundamental aspect of public health. This will help re-prioritise and resource WASH, and put the weight of the health sector behind the importance of WASH as a fundamental public health intervention.

12. www.wateraid.org What we do in Tanzania?  Zanzibar WASH and Maternal health study  Trachoma mapping  WASH in Health Facilities – Singida  Contribution to the national sanitation campaign (The Mtumba approach).  Global advocacy priority – WASH in health  HR capacity study on sanitation

13. www.wateraid.org WaterAid Tanzania 1469 Masaki Street, off Haile Selassie Rd Msasani Peninsular Dar es Salaam www.wateraid.org Registered charity numbers 288701 (England and Wales) and SC039479 (Scotland) Thank you and looking forward to fruitful collaboration!