The overlap between areas at risk of certain neglected tropical diseases (NTDs) and ones lacking adequate water and sanitation (WASH) facilities in Ethiopia is now well understood.

The country has had a national framework in place for a few years, linking together WASH and NTD programmes, along with a World Health Organization (WHO) approved toolkit to implement the framework across its districts.

Before this, NTDs were not given enough attention by sectors outside of the Ministry of Health, but now they all recognise the overlap between areas at risk of certain neglected tropical diseases (NTDs) and ones lacking adequate water and sanitation (WASH) facilities, explains Fentahun Tadesse,  country lead for Ascend Lot 1 in Ethiopia.

“The health, water, education, and finance sectors are all coming together,” says Fentahun. “Because while NTDs have their own programme, ultimately access to water and sanitation infrastructure are essential to sustain diseases elimination and help to ensure equity.”

But while frameworks and tools to implement this have been produced, the challenge has been their actual implementation, and utilisation, by departments in a coordinated manner at the subnational and regional level across the country.

This is where the UK-Aid funded Ascend (Accelerating the sustainable control and elimination of neglected tropical diseases (NTDs) programme is providing support. The programme is working with the Nala Foundation to support 79 districts in coordinating their WASH and NTD services.

“By working together properly, all sectors can easily achieve their goals with minimum cost and better achievements,” says Anteneh Mekonnen, social and behaviour change and WASH expert for NTDs at Ethiopia’s federal ministry of health.

The value of workshops

In February, Ascend supported the organisation and running of workshops for technical working groups that brought together government departments, such as the ministries of water, finance and education, as well as NGOs and others working in the WASH/NTD field from six regions: Afar, Amhara, Oromia, SNNP, Somali and Benishangul Gumuz.

The purpose was to train attendees and provide a better understanding of the national WASH/NTD framework and how best to use it and increase the implementation of integrated services. For example, an overview of the NTD burden in Ethiopia was provided while highlighting where cross-cutting issues may lie and the role of WASH services in achieving goals such as the elimination of NTDs like schistosomiasis or trachoma, explains Anteneh.

A message guide was also shared, identifying core messages that apply across regions to help prevent the transmission of diseases such as schistosomiasis – which is transmitted through contact with water which has been contaminated by the faeces of an infected person – and trachoma, which spreads through person to person contact and contact with contaminated materials or flies that come into contact with the nose or eyes of an infected person.

Schistosomiasis can be prevented by informing people not to defaecate openly and constructing more latrines, while trachoma can be prevented through regular face and hand washing and access to clean water. It’s equally important that when mass drug administration is conducted in affected communities, that people are aware of the need to eat before taking the drugs.

“We expect this training to bring better coordination of the two sectors,” says Anteneh, adding that they now expect people to follow the guidance. “It is the national policy and strategy, and the message guide can be used during campaigns,” he says.

“When we come together, it will have better efficiency and better outputs for all sectors,” says Anteneh. “The water sector can see the outcome of these efforts and the education sector because people are healthy and receive education. The health sector goal is to eliminate or eradicate all these diseases.”

Through better coordination, “all sectors can easily achieve their goals with minimum cost and better achievements.”

The UKAid funded Ascend Lot 1 programme is managed by a consortium of Crown Agents, Oriole Global Health, ABT Associates and KIT Tropical Institute