Global Handwashing Day Interview with NNN Vice-Chair, Arielle Dolegui

Combining hand hygiene and broader water, sanitation and hygiene (WASH) interventions with NTD programs is one of the most cost-effective ways to improve public health. WASH, including hand and face washing, prevents NTDs like trachoma, soil-transmitted helminthiasis (STH), schistosomiasis and Guinea worm disease, and is needed for safe and dignified treatment and care. Hand hygiene is also effective at preventing other infectious illnesses, such as COVID-19. To commemorate Global Handwashing Day 2020, the NTD NGO Network (NNN) has committed to ensuring hand hygiene for all. It strives to support cross-sectoral political leadership, create an enabling environment, and promote sustainable and inclusive programming at scale.

Cross-sectoral partnerships are nothing new for NNN’s Vice-Chair, Arielle Dolegui. As a Technical Advisor for Health Systems Strengthening and Cross-Sector Coordination at World Vision, supporting the USAID-funded Act to End NTDs | West program, Arielle brings to the NNN a wealth of experience at the intersection of WASH, NTDs and education.

For Global Handwashing Day today, NNN WASH Working Group Chair and Director of Policy and Communications at the SCI Foundation, Yael Velleman, interviewed Arielle for her insights on the challenges and opportunities for coordinated programming, as well as the role of the NNN in driving this work forward and at scale as to realize hand hygiene for all.

Q: As a Technical Advisor to World Vision, you’ve worked at the intersection of WASH, NTDs and education. Please tell us about your experience, and the impact you’ve seen on-the-ground from such coordinated programming.

AD: In my role at World Vision, supporting the USAID-funded Act to End NTDs | West program, we have supported the institutionalization of cross-sector coordination of NTD programs. For example, we have supported the Ghana Health Service/National NTDP with the revamping and relaunch of their multi-sector coordination mechanism–the Intra-Country Coordinating Committee (ICCC)–to facilitate integration of NTDs into the national health systems’ priorities and policies and engage key sectors such as WASH and education for joint planning and implementation to sustain the elimination and control objectives of NTDs in Ghana. This has been a tremendous achievement on-the-ground as streamlined cross-sector collaboration remains the cornerstone strategy for effective NTD programming and a testament to country ownership and political will to move the NTD sustainability agenda forward. In Senegal, Sierra Leone, and Niger, we have also supported the Ministries of Health leadership in restructuring their multi-sectoral interventions, leveraging existing robust partnerships with the education sector while building and strengthening the nascent collaboration with the WASH sector to support both service delivery integration as well as behaviour change strategies and interventions.

Q: The WASH UP! Initiative you lead teaches children proper hygiene practices to prevent NTDs via muppet ambassadors, Raya and Elmo. What additional innovations are needed to promote and sustain behaviour changes? How can the NNN promote such best practices?

AD: WASH UP! is a school-based program that World Vision implements in over 11 countries in collaboration with Sesame Workshop and Ministries of Education. This program was expanded to include NTDs, specifically schistosomiasis and STH, as a pilot in Ghana and Niger. The play-based curriculum aims to promote positive WASH attitudes and behaviours among children and their school communities, including those with disabilities, with a focus on vulnerable populations. Targeted behaviours in the WASH UP! curriculum include safe water and food practices, increased latrine use, improved waste management, consistent handwashing, good personal hygiene, and kindness to all, including those who are sick and/or disabled. 

World Vision has a long history of providing clean water and access to sanitation for millions of children and their families, a critical element in the prevention of NTDs. World Vision’s WASH programs focus on five key aspects: capacity building, sustainable water supplies, hygiene behaviour change, sanitation, and strengthened networks and management capacity among various stakeholders, including both government and communities. Recent projects include constructing and rehabilitating community latrines, digging wells, mobilizing communities to be declared Open Defecation Free, and promoting handwashing. In Zambia, World Vision supported the School Health and Nutrition Program, operated by the Ministry of Education in collaboration with the Ministry of Health, to leverage infrastructure and financial resources for NTD-focused health education curriculum. Other projects in Malawi and Uganda have also contributed to reduced prevalence of blinding trachoma through increased uptake of hygiene and sanitation practices and strengthened capacity in planning, coordination, and monitoring of trachoma control programs.

As for the NNN, via the WASH Working Group we are currently surveying the community of practice to identify WASH and NTD research priorities, from WASH-related determinants of NTDs to implementation research for improved coordinated programming to evaluating impacts of such joint efforts. Plans to develop a technical resource on behaviour change are also underway. These are only some of the examples of how the NNN is promoting best practices for NTD elimination and control.