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Environmental Health Project News - August/September 2003
---------------------------------------------------------
 
Dear colleagues:
 
Welcome to "EHP News"
 
Previous issues of our EHP E-newsletter, new reports and other re-
sources can be accessed on our website at:
http://www.ehproject.org
 
To subscribe to the EHP E-newsletter, please contact us at
mailto:info@ehproject.org. 
 
We hope you enjoy this issue. 
 
May Post
Dan Campbell 
Abdulzatar Kuku
Milton Stern
EHP Information Center
mailto:info@ehproject.org
 

******************************************
Environmental Health Project E-Newsletter
August/September 2003
Vol. 3, No. 5
******************************************
 
IN THIS ISSUE:
 
* NEPAL-INDIA CROSS BORDER COLLABORATION: STUDY ON POPULATION 
  MOVEMENT ACROSS NEPAL-BIHAR BORDER FOR TREATMENT OF KALA-AZAR AND
  MALARIA
 
* NICARAGUA: CAPACITY BUILDING OF NGOs IN PARTICIPATORY COMMUNITY
  MONITORING
 
* ERITREA VILLAGE PILOT PROGRAM FOR MOSQUITO SOURCE MANAGEMENT
 
* PAHO-EHP PARTNERSHIP FOR HYGIENE BEHAVIOR CHANGE 
 
* REDUCING URBAN MALARIA TRANSMISSION IN UGANDA
 
* NEW EHP PUBLICATIONS
 
***************************************** 
 
NEPAL-INDIA CROSS BORDER COLLABORATION: STUDY ON POPULATION MOVEMENT 
ACROSS NEPAL-BIHAR BORDER FOR TREATMENT OF KALA-AZAR AND MALARIA
 
Kala-azar and malaria have emerged as an increasing burden to India 
and Nepal in those communities situated along their common border. 
Inadequate public health services and an open, porous border between 
the two countries have further exacerbated the problem. To address 
these issues, a joint meeting was held in Bihar, India, organized by 
the Department of Health, Government of Bihar, India, and HMG Minis-
try of Health, Nepal. The meeting was coordinated and facilitated by 
EHP/Nepal.
 
At the meeting, a consensus was reached by the participants on six 
key follow-up activities. One activity was to conduct a study on 
population movement across the Nepal-Bihar border for treatment of 
kala-azar and malaria. A protocol is being developed under the activ-
ity. The study area will be the Nepal-Bihar border and will focus on 
households with cases of kala-azar/malaria. The study will look at: 
characteristics of the border population, their health seeking behav-
ior including reasons for border crossing, and the socio-economic im-
pact of kala-azar and malaria in the Nepal-Bihar border. The findings 
will be used to identify a coordinated approach to prevention and 
control strategies. 
 
For more information, please contact: 
Lisa Nichols 
mailto:nicholsls@ehproject.org 
or Panduka M. Wiejeyaratne
mailto:panduwij@ehp.wlink.com.np
 
***************************************** 
 
NICARAGUA: CAPACITY BUILDING OF NGOs IN PARTICIPATORY COMMUNITY 
MONITORING
 
In 1999, USAID responded to the devastation caused by Hurricane Mitch 
in Nicaragua by supporting a two-year reconstruction program. The 
program was implemented through EHP. Interventions included provision 
of sustainable water supply and sanitation services through construc-
tion/rehabilitation of community water systems, repair/replacement of 
household latrines, and hygiene promotion through community mobiliza-
tion. 
 
For program sustainability, it is essential that participatory commu-
nity monitoring (PCM) strategies be integrated into these community-
based programs. Therefore, at the end of the two-year program, EHP 
initiated a partnership with NicaSalud, a consortium of NGOs in Nica-
ragua, to ensure the monitoring, evaluation and follow-up of the com-
munity-based environmental sanitation and hygiene programs. 
 
Working with NicaSalud, EHP is developing a comprehensive PCM method-
ology that will be institutionalized. The approach emphasizes capac-
ity building of NicaSalud NGOs in PCM skills and participation by all 
community stakeholders including women, youth, and households with 
low socio-economic status. Strategies include development of a train-
ing manual, training for consortium NGOs, and appropriate tools for 
community monitoring of hygiene improvement activities. 
 
For more information, contact 
Sarah Fry
mailto:frysk@ehproject.org
 
***************************************** 
 
ERITREA VILLAGE PILOT PROGRAM FOR MOSQUITO SOURCE MANAGEMENT
 
The Eritrea National Malaria Control Program (NMCP) has long used 
source reduction and chemical larvicides in its control programs. EHP 
is helping introduce the use of biologiocal larvicides and is provid-
ing assistance to refine protocols that maximize the effectiveness of 
larval control methods. 
 
With technical support from EHP, the NMCP tested the efficacy of two 
bacterial larvicides, Bti and Bs, and determined the frequency and 
dosages required to maintain effective control of mosquito larvae in 
several types of breeding sites. The NMCP then launched an opera-
tional pilot program in four intervention villages and four control 
villages. 
 
The first year of the pilot has been completed. The procedures proved 
feasible, and results demonstrate that larvicides were effective in 
reducing larval and adult mosquito populations within defined areas. 
The study highlighted the importance of larval management throughout 
the year, with special emphasis during the dry season, particularly 
at man-made sites. The pilot program will continue for a second year, 
during which the NMCP will expand the size of the areas under control 
and begin implementing larval control interventions in collaboration 
with village health agents.
 
For more information, contact 
Gene Brantly
mailto:brantlyep@ehproject.org. 
 
***************************************** 
 
PAHO-EHP PARTNERSHIP FOR HYGIENE BEHAVIOR CHANGE
 
Since 2001, EHP has been collaborating with PAHO in the development, 
field application and testing of a hygiene behavior change (HBC) 
strategy for diarrheal disease prevention. Pilot behavior change ac-
tivities have been initiated within the community-based Integrated 
Management of Childhood Illness (C-IMCI ) framework in Peru and Nica-
ragua. The strategy being used in the two pilot activities was devel-
oped by EHP and used successfully in the Dominican Republic. A key 
aspect of the strategy includes coordinating and collaborating with 
respective Ministries of Health to scale-up the pilot HBC process. 
Plan International is the lead implementing NGO in both countries.
 
The pilot activities include design, testing and development of HBC 
materials and activities to promote three key hygiene behaviors 
(handwashing, safe excreta disposal and use of safe water) and capac-
ity building of a multi-partner, local implementation team to design, 
plan, implement and monitor a community-based HBC activity. The proc-
ess also incorporates a consultative approach between HBC promoters 
from NGOs and community members to enhance community participation 
and ownership in HBC approaches and targets.
 
The HBC process guide and products developed in the two pilot activi-
ties will be integrated into materials that PAHO is using under its 
IMCI Initiative throughout Latin America and the Caribbean.
 
For more information, contact 
Lisa Nichols 
mailto:nicholsls@ehproject.org 
or John Gavin 
mailto:gavinjm@ehproject.org
 
***************************************** 
 
REDUCING URBAN MALARIA TRANSMISSION IN UGANDA
 
Recent data indicate that malaria is a problem in urban areas in 
Uganda. EHP is supporting an activity in two cities, Kampala and 
Jinja, aimed at reducing urban malaria transmission using environ-
mental management.
 
During the first year of the activity, entomological and parasi-
tological surveys were implemented by EHP in two sites in each city. 
Additionally, larval breeding sites were mapped. The survey of breed-
ing sites indicated that most breeding takes place in brick pits, 
puddles and blocked drains. Biting and malaria transmission rates as 
well as prevalence rates for parasitemia in children six months to 
five years of age were also assessed. Based on the findings, EHP de-
veloped action plans in consultation with communities, local partners 
and district health authorities to reduce larval breeding in target 
sites in both cities. The second year will focus on implementation of 
the action plans. 
 
The activity is co-funded by USAID/Uganda, the Office of Health, In-
fectious Disease and Nutrition in the Bureau of Global Health 
(USAID/GH/HIDN), and the Office of Urban Programs in the Bureau for 
Economic Growth, Agriculture and Trade (USAID/EGAT/ENV/UP).
 
For more information about the activity, please contact 
Fred Rosensweig
mailto:frosensweig@trg-inc.com
or Gene Brantly
mailto:brantlyep@ehproject.org
 
***************************************** 
 
NEW EHP PUBLICATIONS
 
JOINT PUBLICATION 6. USAID VILLAGE WATER AND SANITATION PROGRAM, WEST 
BANK--ENVIRONMENTAL HEALTH ASSESSMENT--PHASE II
 
This survey is the second in a series of environmental health assess-
ments conducted for the West Bank Village Water and Sanitation Pro-
gram. The survey looked at access to and quality of water, health 
outcomes, and health and hygiene knowledge. This publication, in col-
laboration with Save the Children, presents the results of this fol-
low-up assessment.
 
A 1.92 MB PDF version of this joint publication is available at: 
http://www.ehproject.org/PDF/Joint_Publications/JP006-WestBankFollowup.pdf
 
For more information or a hard copy, mailto:info@ehproject.org
 
***************************************** 
 
ACTIVITY REPORT 120. COMBINING HYGIENE BEHAVIOR CHANGE WITH WATER AND 
SANITATION: MONITORING PROGRESS IN HATO MAYOR, DOMINICAN REPUBLIC
 
Two surveys were conducted as part of a hygiene behavior change pro-
gram monitoring process in nine communities of the municipality of 
Hato Mayor, Dominican Republic. The surveys were part of a total com-
munity participation process in that the team that initiated and im-
plemented the activities participated in the systematic process of 
ongoing community level data collection. The purpose of these surveys 
was to provide NGO program managers and communities with timely in-
formation about changes in diarrhea prevalence and hygiene behaviors 
before and after water and hygiene interventions were introduced and 
to quantify the changes that were plausibly associated with their ef-
forts. This report documents the results of those surveys.
 
A 555 kB PDF version of this activity report is available at: 
http://www.ehproject.org/PDF/Activity_Reports/AR-120%20EHP%20Hato%20Mayor.pdf
 
For more information or a hard copy, mailto:info@ehproject.org
 
***************************************** 
 
EHP BRIEF 17. WEST BANK VILLAGE WATER AND SANITATION PROGRAM: 
FINDINGS FROM ENVIRONMENTAL HEALTH ASSESSMENTS
 
A 747 kB PDF version of this brief is available at: 
http://www.ehproject.org/PDF/EHPBriefs/EHPB17.pdf
 
EHP BRIEF 18. PARTICIPATORY MONITORING OF HYGIENE BEHAVIOR CHANGE IN 
HATO MAYOR, DOMINICAN REPUBLIC 
 
A 712 KB PDF version of this brief is available at: 
http://www.ehproject.org/PDF/EHPBriefs/EHPB18.pdf
 
For more information or a hard copy of the above EHP Briefs, 
mailto:info@ehproject.org

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