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Le Touquet – Paris-Plage, France

Uddin S.M.N.,Action Contre la Faim ACF | Uddin S.M.N.,University of Science and Technology Beijing | Li Z.,University of Science and Technology Beijing | Mang H.-P.,University of Science and Technology Beijing | And 2 more authors.
Journal of Water Sanitation and Hygiene for Development | Year: 2014

This paper applies a ‘comprehensive’ strengths, weaknesses, opportunities, and threats (SWOT) analysis to compare the ‘before and after’ scenarios of integrating a safe water supply (SWS) into a sustainable sanitation system (SSS) in the peri-urban Ger areas of Ulaanbaatar. Qualitative field investigations, including interviews and focus group discussions, are conducted with stakeholders and key informants to collect data on the scenarios before the SSS and to develop a conceptual framework after the SSS implementation. The before-implementation scenario has one strength, that is, the interest of communities and NGOs toward the SWS-SSS integration, which facilitates the acceptance and up-scaling of sustainable technologies. The after-implementation scenario shows additional strengths, such as community acceptance and satisfaction with SSS. The identified weaknesses are attributed to the lack of community-based organizations, community participation, and inter-sector coordination. The marketing of SSS, the involvement of banks and micro-credit systems, and the reuse of treated greywater have been identified as opportunities. The beforeimplementation scenario identifies the use of pit latrines and the lack of political will as the primary threats, whereas the after-implementation scenario identifies technology innovations for the extreme cold as a primary threat. The application of the SWS-SSS integration in other cases must be investigated further. © IWA Publishing 2014.


James P.T.,Action Contre la Faim ACF | James P.T.,London School of Hygiene and Tropical Medicine | Van den Briel N.,Action Contre la Faim ACF | Rozet A.,Action Contre la Faim ACF | And 3 more authors.
Maternal and Child Nutrition | Year: 2015

The treatment of uncomplicated severe acute malnutrition (SAM) requires substantial amounts of ready-to-use therapeutic food (RUTF). In 2009, Action Contre la Faim anticipated a shortfall of RUTF for their nutrition programme in Myanmar. A low-dose RUTF protocol to treat children with uncomplicated SAM was adopted. In this protocol, RUTF was dosed according to beneficiary's body weight, until the child reached a Weight-for-Height z-score of ≥-3 and mid-upper arm circumference ≥110mm. From this point, the child received a fixed quantity of RUTF per day, independent of body weight until discharge. Specific measures were implemented as part of this low-dose RUTF protocol in order to improve service quality and beneficiary support. We analysed individual records of 3083 children treated from July 2009 to January 2010. Up to 90.2% of children recovered, 2.0% defaulted and 0.9% were classified as non-responders. No deaths were recorded. Among children who recovered, median [IQR] length of stay and weight gain were 42 days [28; 56] and 4.0gkg-1 day-1 [3.0; 5.7], respectively. Multivariable logistic regression showed that children older than 48 months had higher odds of non-response to treatment than younger children (adjusted odds ratio: 3.51, 95% CI: 1.67-7.42). Our results indicate that a low-dose RUTF protocol, combined with specific measures to ensure good service quality and beneficiary support, was successful in treating uncomplicated SAM in this setting. This programmatic experience should be validated by randomised studies aiming to test, quantify and attribute the effect of the protocol adaptation and programme improvements presented here. © 2015 John Wiley & Sons, Ltd.

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