Cambodia Integrated Nutrition, Hygiene, and Sanitation Project (NOURISH) Impact Evaluation

Despite strong economic growth and rising living standards in the last two decades, high levels of undernutrition persist in Cambodia. Tackling childhood undernutrition requires a broad range of ‘nutrition specific’ and ‘nutrition sensitive’ interventions that act to ensure adequate dietary intake and address the multiple underlying or enabling determinants. However, when rigorously evaluated, interventions to improve dietary intake alone have not been successful in reducing stunting. Acute and persistent infections associated with unsafe water, poor sanitation, and inadequate hygiene may impact gut health and therefore overall nutrition and growth. Thus, complementary water, sanitation and hygiene (WASH) interventions aimed at reducing diarrheal disease and exposure to fecal bacteria may be an important means to securing optimal nutritional outcomes for children.

USAID/Cambodia's Integrated Nutrition, Hygiene, and Sanitation (NOURISH) Project promotes essential WASH and nutrition behaviors with the aim of reducing stunting in children under two years old and improving the nutritional status of mothers in rural areas. The WASH interventions consist primarily of community-led total sanitation, coupled with supply-side support for sanitation and hygiene products, and social and behavior change communication. The nutrition interventions include complementary feeding activities and education through community-based growth promotion sessions, caregiver groups, and home visits, as well as conditional cash transfers linked to the utilization of key health and nutrition services focusing on first 1,000 days of life. The NOURISH project is implemented in the provinces of Battambang, Pursat, and Siem Reap. In 2021, NOURISH completed an addendum to this evaluation, which you can read here.