Accion Contra el Hambre Environmental Health Evaluation

An NGO requested a post-hoc evaluation of an ongoing environmental intervention to determine impact, and to improve monitoring capabilities going forward. The Sahel countries of Mauritania, Mali and Niger have some of the highest child mortality rates globally. The NGO wanted to know if there had been changes in child mortality in the four years since the program was implemented and, if so, could observed changes be due to the impact of a water, sanitation and hygiene initiative that had been integrated into pre-existing nutrition programs (WaSH in Nut). Available date were non-standardized government registries, hospital data, and ad hoc WaSH in Nut implementation data across the three countries. A basic standardized surveillance framework was developed and the evaluation successfully completed. Child mortality decreases were observed in all three Sahel countries over time, despite known external factors including a documented food crisis in Year 2 of program implementation. Easy to implement, iterative improvements to the surveillance framework were recommended and adopted by all three governments and the sponsoring NGO. Subsequently the NGO expanded the program within the Sahel and to other countries.