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Home 》Committees 》CHP 》CHP・SWAN
CHP(Center for Health Promotion)

Project SWAN (Safe Water and Nutrition)

Safe water and Nutrition project (Project SWAN) works to improve safe drinking water supply and nutrition/health environments in developing countries.

Activity up-to-date
Presented during a poster session at the 21st International Congress of Nutrition

The outcomes of the “Project to support educational activities for mothers to improve the quality of complementary food in rural Vietnam” were presented during a poster session at the IUNS 21st International Congress of Nutrition (ICN) which was held in Argentina in October 2017. The project was implemented between April 2014 and March 2017 in collaboration between ILSI Japan CHP and National Institute of Nutrition (NIN), Vietnam, with the financial support of AIN (Ajinomoto International Cooperation for Nutrition and Health). The summary of the presentation are as follows: As an undernutrition prevention service of the commune health centers, trained village health workers provided nutrition and food safety information for mothers who have children between 6 and 23 month olds by using several communication channels such as periodical loudspeaker announcements, cooking classes, flip chart communication during household visits. Then, ILSI Japan CHP and NIN evaluated whether mothers became capable to prepare nutritionally balanced and safe complementary food for their children as results of these information, communication and education (IEC) activities. Subsequently, we measured the following 6 outcome indicators at baseline and endline: i) Minimum Dietary Diversity, ii) Minimum Meal Frequency, iii) Minimum Acceptable Diet, iv) Handwashing with soap (children), v) Handwashing with soap (mothers), and vi) food hygiene behaviors of mothers. The study involved 329 mother and child pairs in the baseline survey and 376 pairs in the endline survey. As this is a repeated cross-sectional study where we randomly selected different mother and child pairs between baseline and endline, it allows us to evaluate if the nutrition services have reached entire communities over time. As results, the IEC activities were effective in altering the minimum dietary diversity, minimum acceptable diet, children and mothers’ handwashing with soap over time. In addition, a combination of more than two IEC channels tends to lead nutritionally balanced and safe complementary food preparations. These findings suggest that the IEC activities on complementary feeding and hand hygiene were successful in reaching the target populations in all communities studied.


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Achievements to date
With an emphasis on rural areas in developing countries in Asia, where public water works are lacking, ILSI Japan CHP has since 2001 been investigating the quality of drinking water and the needs of local residents toward safe water supplies, food safety and hygienic environment. Through experiments we have confirmed that the water quality can be improved to meet the Vietnamese standards for drinking water by optimizing the operation of existing water treatment facilities. Based on the preliminary investigations, we conducted the safe water and nutrition project for 6 years (phase1: 2005-2008 and phase2: 2010-2013) with a financial support from JICA (Japanese International Cooperation Agency). In the project, the Water Management Union composed of a technical group and an IEC group has been working to generate a synergistic effect to improve the water supply and health communication system. SWAN1 was implemented in 3 communes in Hanoi and Nam Dinh Province and obtained a community level achievements in terms of the improvements of water supply, food hygiene practice and the reduction of childhood diarrhea. SWAN2 enabled to enhance cross-sector collaboration between water and heath sectors and to improve a community-support system.

Partner: National Institute of Nutrition (NIN)
Situation analysis 1 (2001-2004)
Water quality monitoring was conducted in selected water sources in the Red River Delta Region for a period of one year (November 2001 - October 2002). Among the total eighteen monitored parameters, the concentrations of ammonia, arsenic, iron, total coliform, E.coli were higher than the Vietnamese Drinking Water Hygienic Standards. Consequently through experiments, we confirmed that the water quality could be improved to meet the standards by optimizing operation of existing water treatment facilities. According to a formative community needs survey using focus group discussions conducted at the selected sites in May 2004, community members knew little about the benefits of safe drinking water, WTF water quality, the role of WTF and water management. Also we confirmed a strong willingness to participate in activities for improving and sustaining water quality.
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SWAN1: Model development (Nov 2005 - Nov 2008)

Based on the preliminary investigations, a proposal titled "Participatory approach for improving safe water supply, nutrition and health environment" was proposed and approved by JICA (Japanese International Cooperation Agency) as a 3-year grassroots technical assistance project. In November 2005, the project was started in three communities (Tam Hiep Commune in Hanoi, Dai Mo Commune in Hanoi, and Quang Trung Commune in Nam Dinh Province) in the Red River Delta Region northern Vietnam where 2,500 households are supplied from local water treatment facilities. The Water Management Union composed of a technical group and an IEC group worked to generate a synergistic effect to improve the water supply and health management system. Positive outcomes included decreases in the childhood diarrhoea prevalence and the underweight prevalence, as well as improvements in the community members' food hygiene behaviour and child feeding practices. The quality of water from water treatment facilities was improved, and the quantity of distributed water was substantially increased by renovation, training of workers and proper management of water treatment operations. The improvements have been sustained by enhancing the capability of local water management unions. Project SWAN1 was completed with great success in November 2008.

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・Related publications and presentations (1), (2), (3), (4)

Situation analysis 2 (2010-2011)

One of the strategies of the National Target Program of Rural Water Supply and Sanitation (Center for Rural Water Supply and Sanitation, Ministry of Agriculture and Rural Development) includes a cross-sector approach with the Ministry of Health in the area of hygiene and sanitation improvements through IEC activities. In parallel, the National Nutrition Strategy 2001-2010 includes importance of safe drinking water supply, food hygiene and safety, and environmental sanitation interventions to improve nutritional status. Vietnam has made remarkable achievements in increasing access to safe drinking water and improving health and nutritional status of the population. Among rural populations, access to "clean water" was an estimated 30% in 2000, 62% in 2005, and increased to 75% in 2010 (5). However, an estimated 30-40% of population remains at risk from drinking unhygienic water from "improved drinking water sources"(6). By the end of 2007, more than 8,300 piped water supply systems existed in rural areas of Vietnam covering an estimated 35 million people (40% of population). However, their quality is still a concern and the ability of local personnel to identify and solve problems leaves room for improvement. Nationwide undernutrition in children under five was 45% in 1990 (7) and 33.8% in 2000, but was reduced to 17.5% in 2010 (8). However, knowledge of safe drinking water, food hygiene, safe behavior and safe child feeding practices still needs to improve further. This can be achieved through effective information, education and communication programs. The outcomes and remaining issues from SWAN1 and the situation analysis concluded that enhancing the capacities of provincial, district and community personnel is crucial to project sustainability and extending coverage to an even wider population.

SWAN2: Verification of models through the build-up of local capabilities (Apr 2010- Mar 2013)

Project SWAN2 started in April 2010. The second phase aims to establish a community support system in much wider areas to sustain safe water supply and nutritional improvements through enhancing the capabilities of local authorities. A proposal titled "Contributions to the improvements of nutritional status and clean water supply through increasing the capacity of local authorities in Vietnam" was approved by JICA to implement a 3 year project in 16 communes in Hanoi and Nam Dinh Province. To strengthen local capabilities, a working team (composed from central governments: National Center for Rural Water Supply and Sanitation-MARD, Preventive Medicine Provision on Environment-MOH, National Institute of Nutrition-MOH) and ILSI Japan CHP provided technical assistance and trainings to a support team (composed members from the district and provincial health sector, the water sector and the people's committees). The trained support team conducts the technical program and the IEC program with water management unions at the commune level to reach households and thus effect safe drinking water supply and health gains. By the end of the project, we expect such cross-sector collaboration and capacity building will ensure project sustainability and approximately 110,000 people will benefit from the project.
Partner: Southeast Asia Ministries of Education Organization (SEAMEO)

Situation analysis (2011)
To be up-dated

Reports and articles related to Project SWAN
Japan International Corporation of Welfare Services (JICWELS) 2012, Study Report on Multi-Sector Collaboration for Achievement of MDGs, Commissioned by Ministry of Health, Labour and Welfare, Government of Japan
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Takanashi, et. al., Survey of food-hygiene practices at home and childhood diarrhoea in Hanoi, Viet Nam, J Health Popul Nutr. 2009 Oct;27(5):602-611.
Takanashi, Safe Water Supply - A Community Approach in Vietnam with Project SWAN 5th Asian Conference on Food & Nutrition Safety "Science-based Solutions -Sustainable Actions", 6 November, 2008, Cebu, Philippines, Oral presentation.
3 Jimba, Bottom up facilitation to improve water management in Vietnam, Community Development Journal, London, United Kingdom, September 2009, Oral presentation.
4 Takanashi, et. al., Improved food selection of mothers on complementary feeding practice in Vietnam, 41st Asia-Pacific Academic Consortium for Public Health (APACPH) Conference, 3-6 December, 2009, Taipei, Taiwan, Poster presentation.

CERWASS, 2006, National Target Program for Rural Water Supply and Sanitation.
MOH/UNICEF, 2011, Study on the correlation between sanitation, household water supply, mother's hygiene behaviours for children under 5 and the status of child nutrition in Vietnam.
7 Khan et. al., Reduction in childhood malnutrition in Vietnam from 1990 to 2004. Asia Pac J Clin Nutr. 2007,16: 274-278.
8 National Nutrition Strategy, For 2011-2020, with a vision toward 2030.

Donors and supporting organizations for Project SWAN (Alphabetic order)
The programs of ILSI CHP Japan have been supported by donations from the public and private sector. ILSI CHP Japan very much appreciates the generous contributions.

Ebara Vietnam Corporation
Japan International Cooperation Agency (JICA)
Ministry of Foreign Affairs (MOFA)

Scientific advisors
Prof. Masamine Jimba, Department of Community and
Global Health, The University of Tokyo
Mr. Tsutomu Takehana, Water Technology Expert

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(July 2015)

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