WASH and Environmental Conditions in Health Care Facilities

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Hello! My name is Anushka Banerjee, and I am an MPH candidate in the Global Health concentration at the UNC Chapel Hill Gillings School of Global Public Health. Some of my public health interests include water and sanitation hygiene (WASH), emergency and disaster preparedness and response, and community health access and equity. This summer, I am completing my practicum with the UNC Water Institute, and participating in a project that analyzes WASH and environmental conditions in health care facilities globally. The goal of the project is to use the information to curate and support development of training and capacity building to improve WASH services in these health care facilities (HCF). I am working with a few other MPH students at UNC, and so far it has been a pleasure to meet and work with them!

While our practicum started a few weeks ago, we have been diving headfirst into preliminary tasking. We have been reading through several reports from the Joint Monitoring Program (JMP) and the World Health Organization (WHO), including information about WASH FIT. Many healthcare facilities across the world lack the resources and tools, mechanisms, and personnel to reinforce proper WASH, which compromises the ability of such HCFs to deliver equitable, safe, and quality care to community members. Lack of WASH can also negatively impact infection prevention and control (IPC), which can cause a loss of IPC and lead to detrimental short-and-long term health outcomes. WASH FIT is a management tool and guide for HCFs and is used as a framework to develop, monitor, and implement improvement plans for key aspects of WASH services. These key aspects include water, sanitation, hand hygiene, environmental cleaning, health care waste management, and parts of energy/building/facility management.

Caption: An overview of the WASH FIT cycle, along with anticipated outcomes and impacts. (WHO, 2022)

WASH FIT collaborates with political, financial, human, civil society, and energy/climate/health resources to create a team, assess HCF facilities, identify areas for improvement, develop a plan and act, and monitor, review, adapt, and improve the plan. The goal of these plans guided by WASH FIT are to improve infrastructure, services, and facility management. This includes improved IPC, less environmental pollution, and a more efficient use of resources across the HCF.

As we move forward with the practicum, we will be conducting systematic reviews, interviews with health care facility personnel, and doing an analysis of the findings from both. Using this, we will develop our deliverables for the practicum, and have a more holistic view of the status of WASH in global health care facilities. The first few weeks of this practicum have excited me for what is to come, and I can’t wait to share next time!

– Anushka

Chronicles of my Ipas Practicum: Exploring Program Evidence & Climate Resilience

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Hello! I am excited to share with you the details of my summer practicum with Ipas. I started as Program Evidence Intern on May 15, so this is my first blog of the summer. I hope you enjoy reading about my experiences as I blog over the course of my practicum!

Selection Process: I was fortunate enough to be offered this internship with an organization I have long admired. To form connections at Ipas, I reached out to my now preceptor, Sally, during the Fall 2022 semester for an informational interview. During that conversation, Sally recommended I enroll in qualitative analysis coursework and informed me she would soon be looking for a summer intern. I highly recommend networking to my peers and incoming MPH candidates because it is the reason I landed this position, among others. As promised, Sally shared the internship application as soon as it was finalized. Soon after, I interviewed and was offered the position. Networking not only allowed me to make this connection that led me to acquiring my practicum, but also guided me to take a class on qualitative methods, which was highly marketable during my interview.

Company & Role: Ipas is a global organization that works across Africa, Asia, and Latin America to improve access to make safe abortion and contraception widely available, to connect people with vital information so they can access safe services, and to advocate for safe, legal abortion. By building resilient abortion and contraceptive ecosystems using a comprehensive approach across sectors, institutions, and communities, Ipas believes in a world where all people have the right and ability to determine their own sexuality and reproductive health. At Ipas, I work within the Technical Excellence department on the Program Evidence team, which is responsible for strategic guidance and decision-making to ensure evidence-based programming and continual learning. Including myself and my two preceptors, Sally and Val, there are nine people on this team. My role on this team is to partake in the qualitative analysis and dissemination of the project, “Assessing the resilience of sexual and reproductive health (SRH) services, communities, & individuals to climate change in Samburu County, Kenya.” This study measures climate resilience of the health system and communities impacted by climate crises.

Skill Development: Thus far, the majority of my time has been spent completing new hire trainings assigned by Human Resources and my preceptors to familiarize myself with Ipas and my role within the organization, respectively. This week, I will begin reviewing the study transcripts and summarizing the prevalent themes. By the end of this internship, I expect to further refine my skills in qualitative analysis and communication.

Networking & Professional Growth: There are a variety of individuals I will collaborate with in this role: my preceptors, the remainder of the Program Evidence team, the other Technical Excellence leads, and the other project staff based in Kenya. Outside of my team, I intend to network with other Ipas employees to grow my understanding of the opportunities and work being done at Ipas. As it so happens, Ipas is celebrating 50 years this year and a gala will take place on June 6, which I plan to attend in order to foster these connections. As the organization functions fully remotely, I am excited to meet my coworkers in person.

I cannot wait to share more with you at the end of my practicum experience! It has been a welcoming experience thus far, so I am optimistic and eager to see what there is in store for me.

– Caroline

Assessing Nutritional Status and Empowering the Community: My Experience in Ecuador

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Please note: All pictures shown in this blog have obtained permission for posting.

Join me on a heartfelt journey in Ecuador as I share one of the most impactful experiences from this summer. I had the incredible opportunity to be part of a medical and nutrition brigade in Canoa, where I actively engaged in initiatives that uplifted and empowered those in need. I will share the heartwarming and eye-opening experience of being part of a dedicated team of nutritionists and doctors who seek to improve the nutrition status of vulnerable populations. Our mission went beyond improving health; we aimed to address social determinants of health, provide culturally adapted nutrition education, and build trust within the community for future interactions.

Assessing Nutrition Status

Working alongside a team of passionate nutritionists, we assessed the nutritional status of approximately 240 individuals, including infants, children, teenagers, adults, and pregnant women in Canoa. Through the collection of anthropometric measurements and interactions with children and families, we gained valuable insights into the nutritional challenges faced by the community. We identified key factors such as economic inequalities, poverty, domestic abuse, lack of access to clean water, and other social determinants of health that were impacting the community’s well-being.

Empowering the Community through Education and Trust

Day 1: Me and the amazing team of nutritionists from La Universidad de San Francisco de Quito, Ecuador.

In Canoa, we prioritized empowering the community through culturally adapted nutrition education and building trust. Through evidence-based strategies, workshops, counseling sessions, and community outreach programs, individuals in Canoa gained the knowledge and skills to make informed decisions about their health and nutrition, while respecting their cultural beliefs.

This experience reinforced the importance of data-driven decision-making and the transformative power of education and trust in empowering communities. It deepened my understanding of the impact targeted interventions can have on promoting positive health outcomes!

By empowering the community and building trust, we laid the foundation for sustainable change and a healthier future in Canoa.

Lessons Learned and Future Initiatives 

Giving a presentation on traffic light nutrition labeling to moms and children in Canoa, Manabí, Ecuador.

My role involved evaluating and analyzing the data collected. Based on the findings, we identified challenges such as malnutrition, stunted growth, and obesity in the community, particularly among teenagers. To address these issues effectively, I evaluated potential initiatives for implementation. One important strategy we considered was the involvement of promotoras de salud, or community health workers. Their cultural knowledge and trusted position within the community make them valuable in providing culturally adapted nutrition education, monitoring progress, and facilitating access to healthcare services. By incorporating promotoras de salud, we empower the community and create lasting change!

I feel incredibly grateful and fortunate to have had the opportunity to work with La Universidad San Francisco de Quito and learn alongside Caro Román and Mónica Villar this summer.

Day 2: Team of nutritionists in a school located in Canoa.

 

– Mili