Horizontal challenges: WASH and nutrition integration

Vertical development programming is not delivering the results or progress that countries need to develop and thrive. At the household level, undernutrition in all its forms is estimated to contribute to 3.1 million child deaths each year. Collaboration among sectors such as WASH, nutrition, and health is necessary and recognised but is only beginning and as in all integration efforts, presents challenges. Recent emphasis on integrative and comprehensive approaches has the implicit hypothesis that by integrating we can make headway and perhaps achieve cost efficiencies as well. Yet evidence is still scant, this paper begins to document several modalities for integrated WASH programming, using experiences in two countries, Mali and Uganda to highlight the challenges we have encountered to integration while trying to make programming more horizontal and true to life.