Health impacts of WASH & IAP interventions

Issue 40 January 27, 2012 | Year in Review – Health Impacts of WASH and IAP Interventions from 2011

This WASHplus Weekly issue contains nine 2011 studies on the health impacts of water, sanitation, and hygiene (WASH) interventions and seven 2011 studies on the health impacts of interventions to prevent or reduce indoor air pollution.

One WASH study (Water and Sanitation Program) calculates the economic costs to five East Asia countries due to losses related to poor sanitation.

On the IAP side, a study (Dix-Cooper) investigated whether early life chronic exposure to wood smoke is associated with children’s neurodevelopmental and behavioral performance. This seems to be the first study of its kind.

• Link

Liberia’s President signs WASH Compact

Liberia‘s President signs WASH Compact

The President of the Republic of Liberia, Madam Ellen Johnson-Sirleaf has finally signed the much talked about Liberia WASH Compact which was developed at the Multi Donor Conference on Water, Sanitation and Hygiene (WASH) held at the S.K.D Spokes Complex in Paynesville, outside Monrovia last year May.

Liberian President, Madam Ellen Johnson-Sirleaf

The Liberia WASH Compact is a product of the Sanitation and Water for All (SWA) Partnership aimed at ensuring that the Liberian population can have adequate access to safe water and improved sanitation facilities.

A release from the WASH Reporters & Editors Network of Liberia quotes the National Water Sanitation and Hygiene Promotion Committee under the leadership of the Public Works Ministry as saying President Johnson-Sirleaf who is WASH Goodwill Ambassador for Africa, signed the Compact last week.

The Liberia WASH Compact outlines the commitment to meet the MDGs challenges through partnership between Government, the Private Sector, Civil Society, Development Partners and the Media.

Asia: leadership for sanitation needed at both central and local level

The responsibility for sanitation in Asia is fragmented over different agencies, and in most cases the priority given to sanitation is low. Therefore more leadership and political will is needed to make sure that organisational structures function, that plans with good intentions become a reality on the ground and that resources go to the right places. While leadership for sanitation is needed at all levels, it’s most urgent at sub national level, in districts and provinces, because it’s there where the actions take place.

This is the outcome of an email discussion [1] of the WASH Asia Dgroup platform held from 9 August to 9 September 2011. The discussion was moderated by the SNV Asia knowledge network and IRC International Water and Sanitation Centre, and involved 120 WASH practitioners from 5 different countries in Asia.

WASHplus Weekly – Review of Community-led Total Sanitation, 2011

Year in Review – 10 Key Studies on Community-Led Total Sanitation (CLTS) from 2011

This issue of the WASHplus Weekly highlights 10 CLTS reports or studies published in 2011. The reports are reviews or evaluations of CLTS projects or programs in India, Indonesia, Madagascar, and Nigeria. One report (Kar) gives insights about features that have facilitated the rapid spread of CLTS in Africa and also discusses issues that limit its impact and dissemination. Please let WASHplus know if you have other recent resources on CLTS or if you have suggestions for future issues of the Weekly.

• Link

Translating Research into National-Scale Change: A Case Study from Kenya of WASH in Schools

Translating Research into National-Scale Change: A Case Study from Kenya of WASH in Schools, 2011. SWASH Project.

• Full-text (pdf)

Over the past 5 years CARE, Emory University’s Center for Global Safe Water, and Water.org, through the Bill and Melinda Gates Foundation-funded Sustaining and Scaling School Water, Sanitation and Hygiene Plus Community Impact (SWASH+) project, have worked to achieve sustainable and national-scale school WASH services in Kenya through applied research and advocacy. The project tested a multi-armed school WASH intervention through a randomized, controlled trial with multiple policy-relevant sub-studies. Research results were then used to advocate for policy change to bring about sustainable school WASH services nationally. These efforts have focused on improving budgeting for operations and maintenance costs, improving accountability systems with a focus on monitoring and evaluation, and more effectively promoting knowledge of WASH through teacher training and the national curriculum.

Advocacy objectives were developed through a problem-tree analysis and stakeholder analyses. SWASH+ used Outcome Mapping to track progress against these objectives. Specific advocacy goals were to identify important policy intervention areas, work with policymakers to update knowledge and identify learning gaps and then act as a learning adviser to the relevant ministries.

Though the project has not achieved all advocacy objectives, it can claim some advances. Lessons for effective school WASH advocacy gained from the program successes and mistakes are as follows:
1) Having a rigorous evidence base creates large amounts of credibility with policymakers.
2) Significant time and follow-up are needed as well as having staff with appropriate skills.
3) The “ripeness” of the external policy environment is crucial and can make or break efforts to affect national-scale change. Successful advocacy initiatives avoid being insular, focus on the external policy environment at the outset, assess data needs and stakeholder roles and responsibilities, and set
reasonable objectives.

Call for proposals – Global Sanitation Fund Country Programme Monitor for a Sanitation & Hygiene Programme in Senegal

The Water Supply and Sanitation Collaborative Council (WSSCC) established the Global Sanitation Fund (GSF) to provide grant support to scale up successful sanitation and hygiene approaches targeting poor people in areas of greatest need. The GSF, together with the Programme Coordinating Mechanism (PCM) in Senegal, is developing a programme of activities to achieve the objectives of increasing sanitation coverage and improving hygienic behaviours in the country.

WSSCC, therefore is currently inviting suitably qualified firms/organizations to submit a proposal for the role of Country Programme Monitor (CPM) for the GSF grant programme in Senegal. Interested parties must submit their offer as per RFP instructions before 14h00 Geneva time by 13 February 2012. The contract duration is for 3 years with a yearly evaluation of the performance of services. For further information please click here.

Haiti: Twitter data accurately tracked cholera outbreak

Twitter messages were providing data that would have been a quicker way of detecting and tracking the 2010 cholera outbreak in Haiti than traditional methods, according to a study [1] published in the American Journal of Tropical Medicine and Hygiene.

The study found that online social media and news feeds were faster than, and broadly as accurate as, the official records at detecting the start and early progress of the epidemic, which hit Haiti after the earthquake in January 2010 and has killed more than 6,500 people.

[...]

The authors used HealthMap, an automated surveillance platform, to measure the volume of news media generated during the first 100 days of the outbreak, and they also looked at the number of ‘cholera’ posts on Twitter.

Learning Fund – Menstrual Hygiene Management

Menstrual Hygiene Management, Learning Fund.

• Full-text (pdf)

Menstrual hygiene management has long been taboo in many countries. During the learning events, participants talked about their efforts to break the silence, working with women and girls to ensure menstrual hygiene management needs are addressed through WASH programs.

Messages for WASH Sustainability

• Menstrual hygiene management is a critical aspect of WASH service provision and needs to be considered and discussed in a sensitive manner with communities and partners during project planning.
• Talking directly with adolescent girls and female teachers to understand their needs and preferences is essential when designing facilities for schools.
• There are opportunities to support small enterprise providing affordable locally made menstrual hygiene management products, generating income while providing essential services for women.

Research-Based Campaign Messaging is Critical for Sustaining Handwashing Behavior Change

Using data from formative research to focus messaging on mothers’ aspirations for their children and fine-tuning activities based on feedback from the field and household survey data have been key to developing and implementing a handwashing with soap behavior change program in Vietnam.

A new Learning Note, Vietnam: A Handwashing Behavior Change Journey for the Caretakers’ Program published by the Water and Sanitation Program (WSP), describes the steps that were taken to design, implement, and monitor the program to aid program managers in developing other handwashing and hygiene promotion efforts.

Working closely with the Woman’s Union, the program’s activities in Vietnam reached 540 communes in 10 provinces. The project also trained more than 15,000 community motivators who reached more than 1.76 million women through interpersonal communications activities. As the Learning Note reports, these activities evolved over time based on information from the monitoring systems.

“As the target audiences move beyond knowledge to intention to handwash with soap, behavior change messages must also be modified,” the report found, adding that as the project progressed, opportunities arose to “fine-tune the interpersonal communications activities based on feedback from the field and from the household monitoring data.”

Mozambique – Effectiveness of Large Scale Water and Sanitation Interventions

Effectiveness of Large Scale Water and Sanitation Interventions: the One Million Initiative in Mozambique, October 2011.

• Full-text (pdf)

Chris Elbers, et al.

The One Million Initiative of the Government of Mozambique aims at supplying access to clean drinking water and adequate sanitation for one million people. The program has constructed hundreds of new boreholes and implemented trainings on sanitation in communities from three provinces. To evaluate the program, a panel survey design was set up with a baseline in 2008, a midterm in 2010 and an end-line in 2013. The survey covers interviews with 1600 households, focus group discussions about the community and water points in 80 clusters in 9 districts. To our knowledge this is the first rigorous evaluation of such a large scale program in the water and sanitation sector.

This paper summarizes the findings of the baseline and midterm surveys in terms of health impacts, latrine ownership and the use of improved water sources. Our results indicate that the water point intervention had a sizeable impact on the use of improved water sources and on the health outcome of children under 5 but no impact for older individuals, while the sanitation component of the program had a strong impact on latrine ownership and health outcome for older individuals, and a limited impact on hand-washing with soap and the use of improved water sources when it was available in the community