Implementation considerations ƒ WASH interventions are expected to provide modest benefits in limiting Schistosoma transmission, but these benefits extend also to reducing risk for multiple infectious diseases. ƒ Behavioural change interventions should be implemented from the start of any preventive chemotherapy programme. ƒ Coordination and joint planning between programmes for control of schistosomiasis and WASH are essential. Inclusion of WASH in the schistosomiasis strategy will require mapping and sharing of epidemiological information alongside WASH coverage to ensure prioritization of water and sanitation services to areas that are endemic for schistosomiasis. ƒ Similarly, schistosomiasis education and health programme delivery should include inputs to WASH programme design, collaboration on behavioural change interventions and integration of behavioural change promotion. ƒ Where persistent hot spots of transmission emerge during the course of preventive chemotherapy campaigns, control of intermediate host snail populations should be prioritized especially if the programme is already achieving high levels of treatment coverage. ƒ Co-implementation of snail control with mass treatment campaigns is expected to hasten achievement of WHO goals for morbidity control and elimination as a public health problem. ƒ Snail control will be essential to ultimately eliminate local transmission, in combination with WASH interventions. ƒ Sensitization and public health awareness campaigns will be necessary to ensure high acceptance of snail control interventions. ƒ Development of snail control programmes will require a larger and less expensive global supply of molluscicides. ƒ Skilled and dedicated snail control workers will be essential to the success of snail control initiatives. ƒ Deworming should be delivered together with promotion of health and hygiene to reduce transmission by encouraging healthy behaviours such as proper disposal of faeces.