Promoting WASH-nutrition integration in Cambodia

It has been estimated that half of the burden of child undernutrition is attributable to poor sanitation and hygiene (50% point estimate, 95% CI 39%–61%) (Prüss-Üstün A, Corvalán C. Preventing disease through healthy environments: Towards an estimate of the environmental burden of disease. Geneva: World Health Organization, 2006.).

Yet the nutritional significance of poor water, sanitation and hygiene (WASH) is often underestimated, overlooked or misunderstood.

Cambodia has very high rates of undernutrition as well as poor WASH outcomes by regional standards, and it is recognised that a substantial proportion of the undernutrition burden is likely attributable to WASH. Integrating efforts to improve WASH and nutrition is therefore an emerging national priority.

However, integration across sectors – such as WASH and nutrition – is a major policy and implementation challenge.

Established challenges to cross-sectoral integration include:

  • siloed, sector-specific knowledge
  • different time and resource requirements for multi-sectoral compared with single-sector approaches
  • staff time, interest and technical capacity to work across more than one sector
  • sector-specific financing mechanisms and funding streams
  • separate design, implementation and monitoring processes
  • a policy environment, as well as leadership and governance mechanisms, that are structured according to sector-specific approaches.

In the context of these challenges, a stakeholder consultation has been commissioned to draw out lessons from past experience and identify opportunities for future integration.


  1. To identify the current barriers to WASH and nutrition integration in Cambodia;
  2. To identify potential solutions to these barriers; and
  3. To indicate how WASH and nutrition could, and should, be integrated in Cambodia.


  • Desk-based literature review; and
  • Key informant interviews with WASH and nutrition stakeholders in Cambodia at national and sub-national level.


1 December 2015 - Ongoing


The Council for Agricultural and Rural Development (CARD) is the Cambodian government body mandated to facilitate coordination, policy guidance, monitoring and information management relating to nutrition. CARD is planning to host a conference to discuss and highlight the links between WASH and nutrition and advocate for more integrated actions. As a critical input to the workshop, CARD plans to hold a briefing on the current barriers to integrated WASH and nutrition interventions, and the potential solutions to these barriers. The initial application of findings from this study is to inform WASH and nutrition integration discussions at the CARD national workshop.


WaterAid Cambodia; Plan International Cambodia; Council of Agricultural and Rural Development (CARD)

Contact Details

For any general enquiries relating to this project, please contact:

Liz Comrie-Thomson

Women's and Children's Health Specialist




[email protected]