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4 Results for Health Topics

4.2 Water, sanitation and hygiene

4.2.3 Evidence gaps

Evidence gaps identified by key informants included:

Specific research gaps

  • The evidence base for WASH interventions needs to be strengthened; for instance, the evidence on interventionsfor some health outcomes is extremely limited (e.g. hepatitis E) or lacking in evidence compared to that of othersectors (e.g. the communicable disease sector has evaluated interventions against cholera more often thanWASH).
  • In addition to further research on transmission and risk factors for certain diseases (e.g. hepatitis E), andintervention effectiveness (e.g. using health, not just water quality, outcomes), experts concur that economicstudies could help establish which interventions to prioritise, depending on concurrent factors (e.g. rate ofmigration) across settings.
  • More evidence is needed regarding how WASH, communicable diseases, and nutrition relate and may worktogether; it is difficult for WASH interventions to show impact without linking to health outcomes and bettercoordination with these sectors could benefit both humanitarian actors and more importantly those receivinghealth interventions in complex emergencies.

Operationalising research

  • It is unclear who should be charged with evaluating WASH interventions – e.g. the UN, a consortium, or anindependent research body? There is often a lack of leadership and coordination in crisis settings, making impactevaluation very difficult– especially when multiple interventions across many sectors are targeting the samepopulations.
  • While WASH interventions are often first or second line responses, little has been established about their addedbenefit alongside other types of interventions (e.g. vaccination, nutritional supplementation
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