Advocacy for Integration of Nutrition and WASH – South Sudan

Undernutrition increases the risk of mortality and illness; it impedes physical growth and cognitive development irreversibly. It therefore reduces achievements at school, reduces physical productivity and results in a decrease in income potential later in life. An undernourished child is at risk of losing 10% of their lifetime earning potential (World Bank, 2015). At national level, losses to gross domestic product (GDP) through undernutrition are as high as 11% per year (International Food Policy Research Institute [IFPRI], 2016). The annual economic losses due to poor sanitation are equivalent to between 1% and 2.5% of GDP (World Bank, 2012). The global economic return on sanitation spending is US$ 5.5 per US dollar invested.

Undernutrition is estimated to cause nearly half of all deaths (45%) of children under five — 2.6 million deaths a year, globally. In South Sudan, this is equivalent to at least 17,310 deaths per year among children under five. Each of these deaths can be prevented (WHO and UNICEF, 2009) by addressing the causes of undernutrition. South Sudan’s population has one of the worst access to toilets in the world, resulting in approximately 61% of the population practicing open defecation (World Bank, 2015). In South Sudan, diarrhea is responsible for 10% of deaths in children under 5 years of age (WHO, 2015).  Of diarrheal deaths of children under five worldwide, 88% per cent are attributable to unsafe water, inadequate sanitation and poor hygiene.
The causes of undernutrition are complex and multi-factorial. An unhealthy environment with poor WASH, leading to diseases including diarrhea, helminth infections and conditions such as environmental enteric dysfunction, is a significant causal pathway to undernutrition. Greater investment in policies, processes and practices for scaling up WASH and Nutrition within an overall multi-sectoral approach is therefore needed.