Author Archives: WASHplus

Water, sanitation, hygiene, and nutrition: successes, challenges, and implications for integration

Water, sanitation, hygiene, and nutrition: successes, challenges, and implications for integration. Int J Public Health, 2014 Jul 11.

Authors: Teague J, Johnston EA, P Graham J.
Author email: jteague@washadvocates.org

OBJECTIVES: This study explores the integration of water, sanitation, and hygiene (WASH) and nutrition programming for improved child health outcomes and aims to identify barriers to and necessary steps for successful integration.

METHODS: Sixteen semi-structured in-depth interviews were conducted with key stakeholders from both the WASH and nutrition sectors, exploring barriers to integration and potential steps to more effectively integrate programs.

RESULTS: Key barriers included insufficient and siloed funding, staff capacity and interest, knowledge of the two sectors, coordination, and limited evidence on the impact of integrated programs. To achieve more effective integration, respondents highlighted the need for more holistic strategies that consider both sectors, improved coordination, donor support and funding, a stronger evidence base for integration, and leadership at all levels.

CONCLUSIONS: Organizations desiring to integrate programs can use these results to prepare for challenges and to know what conditions are necessary for successfully integrated programs. Donors should encourage integration and fund operational research to improve the efficiency of integration efforts. Knowledge among sectors should be shared and incentives should be designed to facilitate better coordination, especially where both sectors are working toward common goals.

Multi-level sanitation governance: Understanding and overcoming the challenges in the sanitation sector in Sub-Saharan Africa

Multi-level sanitation governance: Understanding and overcoming the challenges in the sanitation sector in Sub-Saharan Africa, 2014.

Nelson Ekane, Björn Nykvist, Marianne Kjellén, Stacey Noel and Nina Weitz. Stockholm Environment Institute.

This paper shows how analysis of multi-level governance, path dependency, and institutional inertia can be used to improve understanding of some of the challenges in the sanitation sector in SSA, and discusses approaches that can contribute to improving the sanitation situation in a sustainable way. In addition, the paper asserts that demand-driven strategies and private sector involvement in the sanitation sector is paramount for establishing new sanitation paradigms and socio-technical regimes. We conclude that a good understanding of actors at all levels – that is, their various roles as well as interactions and the way they interpret and respond to policies – is key to accelerating progress in sustainable sanitation coverage in SSA.

Poor Sanitation in India May Afflict Well-Fed Children With Malnutrition

Poor Sanitation in India May Afflict Well-Fed Children With Malnutrition | Source: by Gardiner Harris, New York Times, July 13, 2014.

Excerpts: A long economic boom in India has done little to reduce the vast number of children who are malnourished and stunted, leaving them with mental and physical deficits that will haunt them their entire lives. Now, an emerging body of scientific studies suggest that many of the 162 million children under the age of 5 in the world who are malnourished are suffering less a lack of food than poor sanitation. sanitation-nytimes

Two years ago, Unicef, the World Health Organization and the World Bank released a major report on child malnutrition that focused entirely on a lack of food. Sanitation was not mentioned. Now, Unicef officials and those from other major charitable organizations said in interviews that they believe that poor sanitation may cause more than half of the world’s stunting problem.

“Our realization about the connection between stunting and sanitation is just emerging,” said Sue Coates, chief of water, sanitation and hygiene at Unicef India. “At this point, it is still just an hypothesis, but it is an incredibly exciting and important one because of its potential impact.”

This research has quietly swept through many of the world’s nutrition and donor organizations in part because it resolves a great mystery: Why are Indian children so much more malnourished than their poorer counterparts in sub-Saharan Africa?

WASHplus Weekly: Focus on Fecal Sludge Management

Issue 153 | July 11, 2014 | Focus on Fecal Sludge Management

This issue focuses on studies, reports, and other materials that have been published so far in 2014 on fecal sludge management (FSM). Included is a just-published and comprehensive guide on planning and organizing the entire fecal sludge management service chain. A WASTE report evaluates FSM methods in emergency situations, and a Water and Sanitation Program  report examines FSM in 12 cities. washplus

EVENTS

3rd International Faecal Sludge Management Conference, Jan 18-22, 2015, Hanoi, Vietnam(3rd Conference Link) | (2nd Conference Presentations)
Building on the success of the two previous International FSM Conferences in Durban (2011 and 2012), FSM3 will bring together world-class research and science and donors, cities, utilities, investors, consultants, governments, service providers, and industries with the aim of fostering an effective dialogue on solving the problem of dealing with human waste.

GUIDES

Faecal Sludge Management (FSM): Systems Approach for Implementation and Operation, 2014. L Strande, ed., EAWAG. (Link)
This guide compiles the current state of knowledge of this rapidly evolving field and presents an integrated approach that includes technology, management, and planning. It addresses the planning and organization of the entire FSM service chain, from the collection and transport of sludge and treatment options, to the final end use or disposal of treated sludge.

Emergency Sanitation: Faecal Sludge Treatment, 2014. J Spit, WASTE. (Link)
This research aims to expand the knowledge of possible simple fecal sludge treatment technologies that could be rapidly deployed in the event of an emergency and are effective under challenging physical conditions such as unstable soils, high water tables, and flood-prone areas. Three fecal sludge sanitization methods—lactic acid fermentation, urea treatment, and hydrated lime treatment—were investigated by undertaking small scale field trials with pit latrine sludge in Blantyre, Malawi.

Facilitation Manual: Sanitation Entrepreneur Training, 2014. Water and Sanitation Program (WSP). (Link)
A WSP team felt there was a growing need for a standard reference for implementing sanitation entrepreneur training and developed a training program and guide that could be replicated and carried out independently by interested stakeholders.

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Further co-funding for the SuSanA Discussion Forum

The Bill & Melinda Gates Foundation has provided co-funding for the Sustainable Sanitation Alliance (SuSanA) Discussion Forum for the past 1.5 years via a grant to Stockholm Environment Institute (SEI). The Forum has catalyzed knowledge exchange amongst experts and engaged citizens within the sanitation, water and hygiene sector.

sei2

On the 3rd anniversary of the SuSanA Discussion Forum, SEI is pleased to announce that the Gates Foundation has provided a follow-up grant for “Extension of the SuSanA Discussion Forum”, supporting online knowledge management, dissemination and peer discussions of the Gates Foundation’s Water, Sanitation and Hygiene projects. The size of the grant is 250,000 US$ and it will span a period of 18 months.

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Umande Trust Sanitation Payment Innovations

Umande Trust Sanitation Payment Innovations being used at the Bio-Centers within the Urban Informal settlements.

What we can learn from Brazil’s wastepickers

What we can learn from Brazil’s wastepickers | by Kyle Wiens

Excerpts: By the time the World Cup ends on July 13, experts estimate that World Cup spectators will generate a staggering 320 tons of trash. Enter the catadores—waste pickers who earn a living by collecting recyclables from the nation’s trash heap, men and women who will dig through the garbage and pick out each aluminum can, plastic bottle, and glass container. And while their jobs may seem humble, their sweat and solidarity are helping to transform Brazil into a true world power in recycling.

Illustrations by Ben Sanders

Illustrations by Ben Sanders

The movement to organize waste pickers in Brazil began in São Paulo in 1980, when the Catholic Church helped start the Association of Paper Pickers, but it only came into the spotlight nine years later, when association members began protesting on behalf of their right to collect material from public roadways. The association’s work inspired other cities around Brazil to start similar organizations, which (among other things) is helping to end child labor in Brazilian dumps.

A Future in Recycling

In 2009, filmmaker Sean Walsh spent a month following Claudinês Alvarenga, a carroceiro, or cart hauler, for his documentary Hauling. Alvarenga, a father of 27, drove the streets of São Paulo in an old Volkswagen bus, recovering materials from curbsides, businesses, and dumpsters. He fixed what he could, resold what was salvageable, and recycled all the rest.

“Haulers such as Claudinês and his family are the most vital and also the most marginalized group in this immense [recycling] industry,” Walsh says. “They are also the agents of a new environmental world order, which is growing ever more important to our sustainable survival.”

The truth is, catadores and carroceiros are remarkably good at what they do. Necessity has turned them into reuse masters, repair geniuses, and recycling experts. They can sort recyclables more precisely and comprehensively than a machine can, right down to different grades of paper. Because of catadores, Brazil is a world leader in recycling: The country has the highest recycling rates for used aluminum cans—around 98 percent—and is second in world for recycling PET, a plastic used in food packaging.

Estimates on the WASH-related Global Burden of Disease

Below are abstracts and links to the full-text of articles in the August 2014 issue of  Tropical Medicine and International Healthtmih

Focus on the Global Burden of Disease from Water
While the methods of Global Burden of Disease (GBD) study continue to evolve, recent changes raise questions about the basis of new estimates of the risk associated with water, sanitation and hygiene and warrant consideration of alternative approaches.

  • ​Inadequate water, sanitation and hygiene are estimated to have caused 842,000 deaths from diarrhoea in 2012, i.e., 1.5% of deaths worldwide. These include 361,000 deaths of children under five years.
  • ​A systematic review of the global prevalence of handwashing with soap and its effect on diarrhoeal diseases estimates that only 19% of the world’s population washes hands with soap after contact with excreta and that handwashing reduces the risk of diarrhoeal disease by 23%–40%.
  • ​Based on over 300 studies from a systematic review, an estimated 1.1 billion people are exposed to a drinking water source of moderate to high risk.
  • ​A meta-regression shows that risks of diarrhoea from inadequate drinking water and sanitation could be reduced considerably through targeted interventions. Risk differences depend on type of intervention.

1 – Authors:  Clasen, Thomas, Pruss-Ustun, Annette, Mathers, Colin D., et al.

TI  - Estimating the impact of unsafe water, sanitation and hygiene on the global burden of disease: evolving and alternative methods
Abstract - http://onlinelibrary.wiley.com/doi/10.1111/tmi.12330/abstract
AB  - The 2010 global burden of disease (GBD) study represents the latest effort to estimate the global burden of disease and injuries and the associated risk factors. Like previous GBD studies, this latest iteration reflects a continuing evolution in methods, scope and evidence base. Since the first GBD Study in 1990, the burden of diarrhoeal disease and the burden attributable to inadequate water and sanitation have fallen dramatically. While this is consistent with trends in communicable disease and child mortality, the change in attributable risk is also due to new interpretations of the epidemiological evidence from studies of interventions to improve water quality. To provide context for a series of companion papers proposing alternative assumptions and methods concerning the disease burden and risks from inadequate water, sanitation and hygiene, we summarise evolving methods over previous GBD studies. We also describe an alternative approach using population intervention modelling. We conclude by emphasising the important role of GBD studies and the need to ensure that policy on interventions such as water and sanitation be grounded on methods that are transparent, peer-reviewed and widely accepted.

2 – Authors: Prüss-Ustün, Annette, Bartram, Jamie, Clasen, Thomas,  et al.

TI  - Burden of disease from inadequate water, sanitation and hygiene in low- and middle-income settings: a retrospective analysis of data from 145 countries

Objective - To estimate the burden of diarrhoeal diseases from exposure to inadequate water, sanitation and hand hygiene in low- and middle-income settings and provide an overview of the impact on other diseases.

Methods - For estimating the impact of water, sanitation and hygiene on diarrhoea, we selected exposure levels with both sufficient global exposure data and a matching exposure-risk relationship. Global exposure data were estimated for the year 2012, and risk estimates were taken from the most recent systematic analyses. We estimated attributable deaths and disability-adjusted life years (DALYs) by country, age and sex for inadequate water, sanitation and hand hygiene separately, and as a cluster of risk factors. Uncertainty estimates were computed on the basis of uncertainty surrounding exposure estimates and relative risks.

Results - In 2012, 502 000 diarrhoea deaths were estimated to be caused by inadequate drinking water and 280 000 deaths by inadequate sanitation. The most likely estimate of disease burden from inadequate hand hygiene amounts to 297 000 deaths. In total, 842 000 diarrhoea deaths are estimated to be caused by this cluster of risk factors, which amounts to 1.5% of the total disease burden and 58% of diarrhoeal diseases. In children under 5 years old, 361 000 deaths could be prevented, representing 5.5% of deaths in that age group.
Conclusions - This estimate confirms the importance of improving water and sanitation in low- and middle-income settings for the prevention of diarrhoeal disease burden. It also underscores the need for better data on exposure and risk reductions that can be achieved with provision of reliable piped water, community sewage with treatment and hand hygiene.

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WEDC – Managing hygiene promotion in WASH programmes

Managing hygiene promotion in WASH programmes, 2014. WEDC.

Managers of water, sanitation and hygiene (WASH) programmes normally acknowledge that people need to behave in a hygienic manner to protect water supplies and ensure that sanitation facilities are used properly. Hygiene-promotion-3

However, promoting hygienic behaviour differs from the construction of infrastructure, with indicators of progress being less concrete. This means campaigns need to be planned and carried out in a suitable manner.

Contents of this guide
Background
What is hygiene?
Principles of hygiene promotion
Planning a hygiene promotion programme
Participatory tools
Analysis of the data
Implementation of the action plan
Methods of hygiene and sanitation promotion
Selecting and training facilitators
Monitoring and evaluation

Focus on Violence and Gender in the WASH and Household Energy Sectors

WASHplus Weekly | Issue 151 | June 27, 2014 | Focus on Violence and Gender in the WASH and Household Energy Sectors

There have been several new initiatives to deal with the problem of violence and gender. In the WASH sector, several key organizations have worked together to publish a recent toolkit that discusses how to make WASH safer and more effective. In the household energy sector, the SAFE strategy, or the Global Strategy for Safe Access to Fuel and Energy was recently launched by the UN High High Commissioner for Refugees. The SAFE strategy principally addresses technology and program management and provides guidance on a holistic approach to the safety challenge in humanitarian settings. USAID has also published a new toolkit to support the implementation of the U.S. Strategy to Prevent and Respond to Gender-based Violence Globally.

WASH RESOURCES/STUDIES

TOOLKITS

Violence, Gender and WASH: A Practitioner’s Toolkit, 2014. (Link)
The toolkit has been developed by Sarah House, Suzanne Ferron, Marni Sommer and Sue Cavill on behalf of WaterAid with contributions from a wide range of actors. It was funded by the Department for International Development (DFID) of the British Government through the Sanitation and Hygiene Applied Research For Equity (SHARE) Consortium. By recognizing both the risks of violence associated with WASH and the potential benefits of WASH, this toolkit aims to shine a light on this problem and encourage practitioners to recognize their capacity to make WASH safer and more effective.

Toolkit for Monitoring and Evaluating Gender-Based Violence Interventions along the Relief to Development Continuum, 2014. USAID. (Link)
USAID developed this toolkit to support the implementation of the U.S. Strategy to Prevent and Respond to Gender-based Violence Globally. It provides guidance to USAID staff, implementing partners and the larger community of international relief and development practitioners on how to monitor and evaluate gender-based violence interventions along the Relief to Development Continuum (RDC). The RDC is divided broadly into three phases: (1) the pre-crisis phase, (2) the crisis phase, and (3) the post-crisis phase. The toolkit identifies opportunities for doing monitoring and evaluation along the RDC and gives advice on how to address constraints and challenges relating to each phase.

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