EOH Researchers Explore the Gap Between Science and Practice

Research by recent EOH MPH graduate Wilbert Quintanilla and his faculty advisor, Assistant Professor Jay Graham, has brought to light important information about how water, sanitation and hygiene (WASH) programs in sub-Saharan Africa can help safeguard the region’s estimated 23.5-million adults and children infected with HIV. In an article published in Waterlines, they point out that HIV/AIDS programs would benefit from a greater focus on WASH interventions to help protect this vulnerable population from the enteric infectious diseases to which their compromised immune systems make them highly susceptible.

Previous research has shown that the prevalence of diarrhea among people living with HIV is two to six times higher than those not infected with the disease. The thorough literature review that Quintanilla conducted as part of this project underscored what scientists have long known:  that WASH interventions can reduce the burden of diarrhea in the general population. Some more recent research has shown that key WASH interventions can also help reduce the ailment among people with HIV. 

The new research focuses on the gap between science and what’s happening on the ground in public health practice, Graham explains. “We conduct rigorous studies to determine whether an intervention has an effect on health outcomes and then practitioners come along and take that data and hopefully apply it,” he says. 

To explore how the integration of WASH and HIV/AIDS takes place in reality, Quintanilla reviewed the literature to identify nongovernmental organizations that integrate WASH into their HIV/AIDS programs.  Of the nine organizations that Quintanilla found and contacted, six participated in the study to describe their implementation practices. Quintanilla conducted interviews via Skype with four of these organizations.

What Quintanilla and Graham found is that each of the six organizations for which they obtained data integrated at least one of the three key WASH interventions into their HIV/AIDS programs.  However, no organization implemented all three, and sanitation-related activities were the least common. 

“We’d hoped that we would find more organizations involved in sanitation behavior change, but I think that these organizations are fairly representative of the reality of these programs,” Graham says.  He adds that he hopes to see more students undertake projects that investigate the link between scientific knowledge and the reality of how activities aimed at protecting public health are carried out.  

Quintanilla, who graduated in 2013, found that the project helped prepare him for his current occupation as a public health consultant in Burundi.