Feasibility of collaboration between water, sanitation and hygiene and the neglected tropical disease control programmes in Rwanda

Abstract

Water, Sanitation, and Hygiene (WASH) interventions, in addition to Mass Drug Administration (MDA), are necessary for controlling and eliminating many neglected tropical diseases (NTDs). Collaboration between disease control programmes and stakeholders in WASH is a critical next step as Rwanda has met the WHO treatment targets and is well positioned to be among the first countries in Africa to control intestinal parasites as a public health problem. This study investigated the feasibility of NTD and WASH coordination in order to identify barriers and opportunities of widespread multisectoral collaboration and make recommendations about possible areas of engagement critical to future integrated programmes. Seventeen key informant interviews were conducted with national ministry stakeholders, donor organizations, United Nations agencies and international NGOs in the NTD and WASH sectors to explore challenges and opportunities in a multi-sectorial collaboration. Intersectoral collaboration feasibility was assessed in terms of acceptability, practicality, implementation and integration. A multisectoral collaboration approach was highly acceptable at the national level due to stakeholders clear understanding of the linkage between WASH and NTD sectors. Opportunities and possible ideal conditions for collaboration were identified around four general domains: capacity building; research; policy and communication; mapping. The most frequently mentioned barriers characteristics of inner setting and program implementation process included: 1) varied programmes priorities in the two sectors, including organizational objectives and donor driven priorities; 2) Poor coordination structures and lack of information sharing between the two sectors and 3) differences in the scale of funding. The feasibility of integrated WASH and NTDs has been examined in a number of countries mainly focusing on implementation and integration. There must be increased advocacy for and awareness among policy-makers of development projects that foster successful programme implementation. Opportunities include having established coordination structures at national and district levels. Through expanding and enhancing WASH interventions for NTD control, it could be feasible for both sectors to take an integrated approach to health and development. Key Words: Neglected Tropical Disease, Water, Sanitation, and Hygiene, Program, Collaboration, Integration