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This document was prepared by UNICEF Regional Office for West and Central Africa, under the leadership of Christophe Valingot and the review of Joachim Peeters (WASH Specialist) and Arnaud Laillou (Nutrition Specialist), on behalf of the WASH Regional Group and the Nutrition Regional Group.
This
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WASH - Nutrition strategic guidance note for West and Central Africa builds on the precedent WASH-in-NUT strategy elaborated in 2012 and is the regional outcome of a multiyear collaborative work conducted at country level between 2018 and 2022, in Mali, Niger, Nigeria Chad, Burkina Faso. This work is based on a strong multi-partner collaboration, involving national technical directorates of the water and sanitation sector as well as technical directorates of Health and Nutrition, civil society organizations, national and international NGOs as well as United Nations agencies.
This document can serve as a technical and strategic guide for any partner wishing to strengthen the intersectorality of WASH-Nutrition programmes. It presents the regional WASH & Nutrition context, a brief review of the latest scientific evidence, and proposes an integrated WASH-Nutrition programming framework adapted to the regional context of West and Central Africa. Beyond the implementation of programmes, this document also calls for the explicit and concrete inclusion of WASH-Nutrition integration into national policy documents.
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After five consecutive below-average rains, the humanitarian crisis in the Horn of Africa is expanding and deepening.
Combined with insecurity and macroeconomic volatility, the impact of the drought on food and nutrition security has been devastating. Across Ethiopia, Kenya and Somalia, an estima
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ted 22 million people are now acutely food insecure because of the drought. The malnutrition situation is also critical. Some 5.1 million children across drought-affected areas of the three countries are acutely malnourished in 2023, with dire implications for their health, growth and survival. Concerningly, the upcoming March-May 2023 rains are also forecast to be below-average. Should these rains fail, and humanitarian assistance not be delivered at scale, food insecurity will continue to deteriorate.
Regardless of how the 2023 rains perform, extremely high humanitarian needs will persist through 2023 while a full recovery from a drought of this magnitude will take years. To address the devastating drought-induced hunger and malnutrition across the region, WFP is pursuing an integrated dual track approach; meeting immediate life-saving food and nutritional needs while simultaneously building resilience to extreme climate variability.
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These guidelines have been compiled for education ministries or other educational leaders (including development partners, non-governmental or private organizations working with schools or directly with caregivers) who want to adapt and adopt resources to support the marginalized caregivers of child
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ren with disabilities.
The guidance presented in this document was developed by a team of international and national experts following a proof-of-concept pilot4 of the resources in two countries. The work was carried out between February 2021 and January 2022. The pilots demonstrated that principles and activities described in the resources could be carried out, in practical terms, in line with existing government programmes supporting the implementation of disability-inclusive education.
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In the early morning of 6 February 2023, a magnitude 7.8 earthquake occurred in southern Türkiye near the
northern border of Syria. The earthquake was followed 11 minutes later by a magnitude 6.7 aftershock. Many
aftershocks are still being felt across the region. Whilst the impact is still bei
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ng assessed, initial reports evidence
significant damage in the areas of southern Türkiye and northern Syria.
In response, the Syria Ministry of Health (MoH) activated its emergency operations centre (EOC) on 6 Feb 2023
under the chairmanship of the Deputy Minister. In all affected governorates, public and private health facilities
and medical convoys have been repurposed to support the response and are being managed by the National
Ministry of Health (MoH) and Directorate of Health (DoH) at governorate level. Support has been directed to
affected areas, with medical convoys including 28 ambulances and 7 mobile clinics, deployed from the health
directorates of Damascus, Rural Damascus, Quneitra, Homs, Tartous, Aleppo and Latakia
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Human rabies remains a significant public health problem in Africa with outbreaks reported in most countries. In Nigeria–the most populous country in Africa–rabies causes a significant public health burden partly due to perennial obstacles to implementing a
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national prevention and control program.
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Following the publication of Guidelines on certification of elimination of human onchocerciasis in 2001 by the World Health Organization (WHO), these are the first evidence-based guidelines developed by NTD Department according to the international standards. They provide a set of recommendations th
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at would guide national programme managers in collaboration with their respective oversight committees on when to stop mass drug administration (MDA) and conduct post-treatment surveillance (PTS) activities for a minimum period of 3 to 5 year before confirming the interruption of transmission of Onchocerca volvulus parasite and hence its elimination. They also include steps to undertake for verification of elimination of transmission of the parasite in the whole endemic country by the International Verification Team (IVT) prior to the official acknowledgement by WHO Director General.
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The key actions, activities, and approaches in this document are organized within each of the 5Cs (see Table 1 in the PDF) and those of the Strategic preparedness and response plan (SPRP) pillars as follows:
National action plan key activities, p
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rioritized for the current context and the current understanding of the threat of SARS-CoV-2
A. Transition from emergency response to longer term COVID-19 disease management.
B. Integrate activities into routine systems.
C. Strengthen global health security.
Special considerations for fragile, conflict-affected and vulnerable (including humanitarian) settings
WHO global and regional support to Member States to implement their national action plans
Key guidance documents for reference
This is a living document that will be updated to incorporate new technical guidance in response to the evolving epidemiological situation. National plans should be implemented in accordance with the principles of inclusiveness, respect for human rights, and equity.
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The World Health Organization (WHO) has been present in Niger since 1960, and acts as the Government's principal advisor on public health and lead of the health cluster. WHO covers all eight regions of the country with 113 staff members in Niamey and in 7 sub-offices (Agadez, Diffa, Zinder, Maradi,
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Tillabéri, Dosso, Tahoua).
To strengthen its cooperation with Niger, WHO has recently developed a new Country Cooperation Strategy (CCS) for 2023-2027 period in collaboration with the Ministry of Public Health, Popula-tion and Social Affairs. The CPS is based on the WHO's 13th General Programme of Work (GPA) 2019-2025 and national priorities. It enables WHO to support Niger in the implementation of its national health policy and the 2022-2026 Health and Social Development Plan (HSSP).
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In Sierra Leone, Health care delivery is organized around a three-tier system i) primary level constituting peripheral health units (community health centers, community health posts, and maternal and child health posts secondary level constituting district hospitals tertiary level comprising region
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al and national referral hospitals [Figure 3].
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The protracted humanitarian situation in northeastern Nigeria, particularly in Borno, Adamawa, and Yobe (BAY) States, remains a concern due to ongoing insecurity, displacement, food insecurity, disease outbreaks, and climate-related shocks. To address these complex challenges, the health sector has
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developed a comprehensive humanitarian response strategy aligned with the three States Development plans, Durable Solutions for the Population Displacement Plan, and the Humanitarian Need Response Plan for 2025. This strategy aims to reduce morbidity and mortality among crisisaffected populations by ensuring timely, equitable, and effective delivery of lifesaving health services, while strengthen the resilience of health system and enhancing local and national capacities for sustainable health response in protracted emergency.
Supported by an in-depth analysis of the ongoing health humanitarian response using the Strengths, Weaknesses, Opportunities, and Threats (SWOT) methodology, the strategy is guided by three key objectives:
1. Provide access to lifesaving interventions and sustain an effective response to the prolonged health emergency.
2. Prevent, mitigate, and prepare for health risks from all hazards and respond to all health emergencies.
3. Advance the primary health care approach and essential health system capacities for universal health coverage.
To achieve these objectives, the strategy employs the “Five C” framework which refers to:
• Collaborative Surveillance: Enhancing collaborative efforts for effective monitoring.
• Community Protection: Implementing community-based protection measures.
• Safe and Scalable Care: Ensuring care that is both secure and scalable.
• Access to Countermeasures: Facilitating access to necessary countermeasures.
• Emergency Coordination: Coordinating emergency responses efficiently.
These proactive approaches are designed to be more anticipatory and preemptive rather than reactive, aiming to meet the needs of the crisis-affected population by providing lifesaving interventions, enhancing preventive and anticipatory actions, and ensuring the resilience of the health system. All actions are guided by International Humanitarian Standards and the Humanitarian Principles.
The implementation of the health humanitarian response strategy will involve collaboration with local authorities, non-governmental organizations (NGOs), and international organizations. The strategy emphasizes localization and resource mobilization, efficient logistics and supply chain management, mainstreaming protection, and the deployment and training of healthcare workers. Continuous monitoring and periodic evaluation will ensure the effectiveness of the response. Cross-sector collaboration with sectors such as WASH, Nutrition, Education, and Protection will be crucial to enhance the quality and reach of health interventions. Additionally, sustainability and transition approaches will ensure long-term health outcomes and benefits, bridging the gap from humanitarian to development efforts.
By adopting this comprehensive approach, the humanitarian response in northeastern Nigeria, particularly in BAY States, can be effectively guided, ultimately reducing the suffering of affected populations.
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Conditioned domestic financing policy, referring to the domestic financing of health projects, programs, and national responses conditioned by global health funding agencies and recipient country governments, is one mechanism to promote sustainabili
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ty and country ownership. We aim to understand how the concept is defined and operationalized by agencies and how such policies relate to overall health spending patterns.
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Integrated Outbreak Analytics (IOA) applies a multidisciplinary approach to understanding outbreak dynamics and to inform outbreak response. It aims to drive comprehensive, accountable, and effective public health and clinical strategies by enabling communities, and
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national and subnational health authorities to use data for operational decision-making. IOA embraces a holistic perspective of outbreak dynamics throughout: from the trigger questions to the data that are collected or accessed, to the interpretation of results and the recommendations that follow. In addition, IOA promotes co-development and monitoring of evidence informed actions.
The IOA toolkit aims to provide a clear understanding of IOA and highlight the importance of using an integrated, holistic approach to manage outbreak responses. It provides step-by-step guidance for setting up IOA and putting IOA principles into action. Finally, this toolkit provides guidance on applying IOA in humanitarian and emergency contexts, offering a practical and adaptable approach to informing public health emergency responses.
Developed based on the model from the Democratic Republic of the Congo (DRC), its creation involved extensive consultation with experts experienced in IOA applications. The toolkit was piloted in Tanganyika Province, DRC, as well as Somalia and Sudan, demonstrating its adaptability to diverse emergency scenarios. It builds upon an existing array of tools, templates, reports, case studies, animations, and publications used by stakeholders in diverse contexts.
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On 4 September 2025, the Ministry of Health of the Democratic Republic of the Congo (DRC) declared an outbreak of Ebola Virus Disease (EVD) in Kasai Province, following confirmation of Zaire ebolavirus by the National Institute of Biomedical Researc
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h (INRB) in Bulape and Mweka Health Zones. As of 19 September, there have been 48 total cases (38 confirmed, 10 probable) with 31 deaths (21 confirmed, 10 probable) and a CFR of 64.5%. Among laboratory confirmed cases, 16 deaths were recorded (CFR: 45.7%). Four deaths occurred among health workers, underscoring the risk of nosocomial transmission. Most cases (39.7%) are among adults aged 20 years and above, in a densely populated, remote, and under-resourced area.
The outbreak is driven by multiple risk factors, including transmission in health facilities with limited infection prevention and control (IPC) measures and personal protective equipment (PPE), incomplete contact tracing, delayed detection, and unsafe burial practices. High population mobility between Bulape and Tshikapa, reliance on traditional healers, and the concurrent mpox outbreak are further straining the fragile health system and increasing the risk of geographic spread.
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This document highlights landmarks and key milestones in the development and implementation of the global agenda for noncommunicable diseases (NCDs) over the last two decades. It summarizes where the world was in 2000, where it is in 2022, and where the world wants to be in terms of NCD prevention a
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nd control by 2030. It recalls the commitments made by heads of state and governments, and outlines the technical guidance provided by the World Health Organization (WHO) in support of national efforts to achieve the internationally agreed NCD targets for 2025 and 2030.
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This manual describes methods for investigating clusters or outbreaks that may be of chemical origin and describes the importance of a structured, coordinated, collaborative multidisciplinary, multi-agency approach at local, regional, national and i
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nternational levels.
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Management of Dead Bodies After Disasters: A Field Manual For First Responders. Second Edition
recommended
Proper and dignified management of the dead in disasters is one of the three key pillars of humanitarian response and a fundamental factor in facilitating identification of the deceased and helping families discover the fate of their loved ones. This second and updated edition of this hugely success
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ful manual provides practical and easy-to-follow guidelines on the recovery, documentation and storage of the remains of individuals who have died in disasters, helping first responders ensure that the dead are treated with respect and that information crucial for their subsequent identification is recorded. This revised edition incorporates experience gained in recent catastrophes, such as the 2013 Typhoon Haiyan in the Philippines, the 2014/15 Ebola epidemic in West Africa and the 2015 earthquake in Nepal.
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Specific action sheets offer useful guidance on mental health and psychosocial support and cover the following areas coordination assessment monitoring and evaluation protection and human rights standards human resources community mobilisation and support health services education dissemination of i
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nformation food security and nutrition shelter and site planning and water and sanitationthe guidelines include a matrix with guidance for emergency planning actions to be taken in the early stages of an emergency and comprehensive responses needed in the recovery and rehabilitation phases
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Evaluation of Community Management of Acute Malnutrition (CMAM)
Sheila Reed, Camille Eric Kouam, Krishna Belbase et al.
United Nations Children’s Fund (UNICEF) Evaluation Office
(2013)
This evaluation is the first systematic effort by UNICEF to generate evidence on how well its global as well as country level Community Management of Acute Malnutrition (CMAM) strategies have worked, including their acceptance and ownership in various contexts and appropriateness of investments in c
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apacity development and supply components. Overall, the evaluation recommends that UNICEF continue to promote and support CMAM as a viable approach to preventing and addressing severe acute malnutrition (SAM), with an emphasis on prevention through strengthening community outreach and integrating CMAM into national health systems and with other intervention
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This clinical management manual for Ebola Viral Disease in Liberia was developed after several ETUs were established in the country following the outbreak early this year. As the outbreak evolved, it became evident that different SOPs were being used by clinicians across these treatment facilities.
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As a result of discussions held by the National Case Management Committee of the Incident Management System, various stakeholders were brought together to contribute their time and expertise to the development of this manual.
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In light of the decline in new Ebola cases, strategies are now needed to scale down the activities and bed capacities in Ebola care facilities. These facilities include Ebola treatment units, community care centres, Ebola treatment centres and isolation centres. The Governments of Guinea, Liberia an
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d Sierra Leone; WHO; CDC; ICAN and UNICEF have jointly developed this rapid guidance and checklist to assist national governments and partners as they begin this process. This rapid guidance pertains to protecting the safety and repurposing of infrastructures and resources previously used for the Ebola outbreak to care for Ebola patients.
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