Category Archives: Research

Shared Sanitation versus Individual Household Latrines: A Systematic Review of Health Outcomes

Shared Sanitation versus Individual Household Latrines: A Systematic Review of Health Outcomes. PLoS One, April 2014.

Authors: Marieke Heijnen, Oliver Cumming, Rachel Peletz, Gabrielle Ka-Seen Chan, Joe Brown, Kelly Baker, Thomas Clasen.

Background: More than 761 million people rely on shared sanitation facilities. These have historically been excluded from international sanitation targets, regardless of the service level, due to concerns about acceptability, hygiene and access. In connection with a proposed change in such policy, we undertook this review to identify and summarize existing evidence that compares health outcomes associated with shared sanitation versus individual household latrines.

Methods and Findings: Shared sanitation included any type of facilities intended for the containment of human faeces and used by more than one household, but excluded public facilities. Health outcomes included diarrhoea, helminth infections, enteric fevers, other faecal-oral diseases, trachoma and adverse maternal or birth outcomes. Studies were included regardless of design, location, language or publication status. Studies were assessed for methodological quality using the STROBE guidelines. Twenty-two studies conducted in 21 countries met the inclusion criteria. Studies show a pattern of increased risk of adverse health outcomes associated with shared sanitation compared to individual household latrines. A meta-analysis of 12 studies reporting on diarrhoea found increased odds of disease associated with reliance on shared sanitation (odds ratio (OR) 1.44, 95% CI: 1.18–1.76).

Conclusion: Evidence to date does not support a change of existing policy of excluding shared sanitation from the definition of improved sanitation used in international monitoring and targets. However, such evidence is limited, does not adequately address likely confounding, and does not identify potentially important distinctions among types of shared facilities. As reliance on shared sanitation is increasing, further research is necessary to determine the circumstances, if any, under which shared sanitation can offer a safe, appropriate and acceptable alternative to individual household latrines.

Extra funding for “breathable membrane” linings for pit latrines

Roof latrine

Roof latrine. Photo: Steve Dentel, University of Delaware

A team at the University of Delaware has received US$ 250,000 in additional funding to continue its research on “breathable membrane” linings for pit latrines.

The breathable fabric helps to prevent groundwater pollution, while also protecting sanitation workers from exposure to pathogens. Heat from biodegradation of the feces or from the sun gradually expels water vapour, but prevents the escape of particulate or dissolved constituents.

Professor Steve Dentel, who leads the research, explained how it all works in webinar held in February 2014. A  write-up of the presentation and discussion was posted on the SuSanA forum.

The first phase of the research (November 2011 – October 2013)  was funded through the Bill & Melinda Gates Foundation’s Grand Challenges Explorations Fund.

Dentel is piloting the membrane technology in the slums of Kanpur, India, in collaboration with WaterAid. He wants to get them in place before the beginning of the rainy season in June. Since the membrane is reusable, the cost of using susch a sophisticated technology can be reduced.

At the same time, Dentel is working with UD engineering colleagues Daniel Cha and Paul Imhoff to apply the technology in wastewater treatment facilities in the USA and South Korea.

For more information you can follow and take part in a discussion about the research with Prof Dentel on the SuSan Forum.

Source:  Karen B. Roberts, Bacteria fighting fabric, UDaily, 17 Apr 2014

 

 

Modernising urban sanitation in Southern Bangladesh

SNV-Modernising-Urban-SanitationA new project promises to provide one million people in Bangladesh with an improved living environment and access to safe faecal sludge management. The project will also give 250,000 people access to improved sanitation facilities and use market-based solutions to generate biogas from sludge.

SNV Bangladesh and Khulna City Corporation (KCC) launched the “Demonstration of pro-poor market- based solutions for faecal sludge management in urban centres of Southern Bangladesh” project on March 31, 2014. The Bill & Melinda Gates Foundation and the UK Department for International Development (DFID) are funding the project.

Launch of SNV project Modernising Urban Sanitation in Bangladesh

Photo: SNV

Currently Khulna has no designated dumping sites or treatment facilities for faecal sludge. The city has an estimated population of 1.6 million, while 1.2 million more people live in the surrounding 36 smaller towns.  By developing faecal sludge management services in KCC, and the two small towns of Khustia and Jhenaidah in Khulna division, the four-year project aims to reform human waste management in Bangladesh.

Read more in the project brochure.

Source: SNV, 4 Apr 2014

 

 

Interventions to improve disposal of child faeces for preventing diarrhoea and STH infection

Interventions to improve disposal of child faeces for preventing diarrhoea and soil-transmitted helminth infection, (Protocol)Cochrane Database of Systematic Reviews,  2014, Issue 4. Art. No.: CD011055. DOI:10.1002/14651858.CD011055.

Authors: Majorin F, Torondel B, Ka Seen Chan G, Clasen TF.

Objectives: To assess the effectiveness of interventions to improve the disposal of child feces for preventing diarrhoea and soil-transmitted helminth infections. logo_wide

Interventions: Interventions can include the provision of hardware (for example, nappies (diapers), potties, fecal collection devices, cleaning products to hygienically remove feces, child-friendly squatting slabs or latrines used by children) software (for example, promotion of safe disposal practices), or both. It will include interventions that combine the safe disposal of child feces with other interventions, such as hygiene  promotion interventions, and employ subgroup analysis to investigate the impact of these additional interventions.

BRAC WASH releases video on faecal sludge management

The BRAC WASH programme has released a short video about their ongoing study in Bangladesh on the use  of faecal sludge from double pit latrines as organic fertiliser.

The final evaluation of BRAC WASH I programme identified pit emptying and the safe final disposal of sludge as a key ‘second generation’ challenge for the near future. To address this, BRAC is undertaking action research to ensure the safe reuse of faecal sludge in the BRAC WASH II programme, answering the following questions:

  • Does the faecal sludge comply with the WHO Guidelines on microbiological quality after one year of storage?
  • What is the nutrient content of the faecal sludge?
  • Is it possible to make faecal sludge-based organic fertiliser production commercially viable?

In 2013, the UK-based School of Civil Engineering at the University of Leeds won a BRAC WASH II research call for secondary treatment options for faecal sludge. Their project is called Value at the end of the Sanitation Value-chain (VeSV).

The University of Leeds is working together with three other partners: Bangladesh University of Engineering and Technology (BUET), NGO Forum for Public Health (Bangladesh), and IWMI International Water Management Institute (Sri Lanka).

More information:

 

 

 

Study examines sustainability of CLTS programmes in Africa

Plan-ODF-sustainability-coverDespite the widespread implementation of Community Led Total Sanitation (CLTS) programs and many claims of success, there has been very little systematic investigation into their sustainability.  A new study, which aims to change that, is creating a stir in the WASH sector.

A study commissioned by Plan International on the sustainability of CLTS programs in Africa revealed that 87% of the households still had a functioning latrine. This would indicate a remarkably low rate of reversion (13%) to open defecation (OD) or “slippage”.

However, if the criteria used to originally award open defecation free (ODF) status to villages are used, then the overall slippage rate increased dramatically to  92%. These criteria are:

  • A functioning latrine with a superstructure
  • A means of keeping flies from the pit (either water seal or lid)
  • Absence of excreta in the vicinity of the house
  • Hand washing facilities with water and soap or soap-substitute such as ash
  • Evidence that the latrine and hand washing facilities were being used

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Tropical plant Moringa provides alternative to soap for handwashing

Moringa oleofera leaves and powde

Moringa oleofera leaves and powder. Photo: New Flavor House Inc.

SHARE-funded research [1] has found that Moringa oleifera, a common plant in many tropical and subtropical countries, can be an effective handwashing product if used in the correct concentration. Laboratory tests show that the plant has antibacterial activity against different pathogen, but its potential effect as a hand washing product had not been studied before.

By testing the effect of Moringa oleifera leaf powder on hands artificially contaminated with E. coli and comparing this to the effect of non-medicated liquid soap, the researchers from the London School of Hygiene and Tropical Medicine and SBI Consulting Ltd in Mozambique found that four grams of Moringa oleifera powder had the same effect as non-medicated soap when used for hand washing.

The next step will be to try this product in real conditions and study its acceptability and convenience for potential users.

To take part in a discussion on the use of Moringa as soap visit the SuSanA  Forum.

SHARE stands for Sanitation and Hygiene Applied Research for Equity, and is a five year initiative (2010-2015) funded by the UK Department for International Development

[1] Torondel, B., Opare, D., Brandberg, B., Cobb, E. and Cairncross, S., 2014. Efficacy of Moringa oleifera leaf powder as a hand- washing product : a crossover controlled study among healthy volunteers. BMC complementary and alternative medicine, 14 (57), pp. 1-7.   doi:10.1186/1472-6882-14-57

Source: SHARE, 21 Feb 2014

Impact of WASH in improving health of school children reviewed

More attention should be given to the assessment of nutrition practices when assessing the impact of WASH on the health of school children. We also don’t know enough about the long term impact of WASH interventions on child health. These are some of the conclusions that researchers from the Center for Global Health and Development at the the University of Nebraska Medical Center (UNMC) drew from a review of the literature [1].

Dr. Ashish Joshi and research assistant Chioma Amadi reviewed the impact of water treatment, hygiene, and sanitary interventions on improving child health outcomes such as absenteeism, infections, knowledge, attitudes, and practices and adoption of point-of-use water treatment.  For their final analysis they selected 15 peer-reviewed English-language studies published between 2009 and 2012 that focused on the effects of access to safe water, hand washing facilities, and hygiene education among school-age children.

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New DIV Grantee will Test the “Tiger Toilet” that uses Worms for Good!

The Tiger Roars: New DIV Grantee will Test the “Tiger Toilet” that uses Worms for Good! | Complete article/source: USAID Development Innovation Ventures

Excerpts – DIV is delighted to announce a new Stage 1 award of over $170,000 to Bear Valley Ventures Ltd  to conduct a field trial of the Tiger Toilet in India, Uganda, and Burma. The Tiger Toilet is a latrine system that has the potential to be an affordable, compact, and superior alternative to pit latrines and septic tanks. It harnesses the capabilities of composting worms such as the Tiger Worm (Eisenia fetida), to digest the solids within the system, making it very compact and particularly suitable to high density urban environments.

The project aims to address the global challenge of providing access to adequate sanitation; worldwide, over 4 billion people currently use latrines that can be unpleasant and unhygienic or lack sanitation provisions entirely. Sewered systems will never be a reality for many around the world; therefore an on-site (i.e. a system that does not require piping the waste off-site for treatment) option is needed. Presently the best on-site option is a septic tank, which is often financially out of  reach. tiger-toilet

Walter Gibson, Director of Bear Valley Ventures, adds that “Vast numbers of people in the world have to put up with inadequate sanitation every day of their lives. It’s imperative that we develop better, more affordable solutions that address their needs and aspirations for a decent toilet. We believe the Tiger Toilet represents one such option. We are very grateful to USAID for this support which allows us to test its potential.”

The Tiger Toilet is linked to a normal pour flush system, so the user experience is therefore the same as using a septic tank or a pour flush latrine. The waste then enters a tank which contains the worms and a drainage layer. The solids are trapped at the top of the system where the worms consume it, and the liquid is filtered through the drainage layer.  Extensive laboratory scale trials found that the worms reduce the solids in the system by above 80%, and the effluent quality is higher than that from a septic tank. An initial prototype has been running at the Centre for Alternative Technology in Wales, UK for over a year.

Undoing inequity: water, sanitation and hygiene programmes that deliver for all

UK Under Secretary of State for International Development Lynne Featherstone visiting SHARE-funded Undoing Inequity programme in Uganda. Photo: SHARE/WaterAid

WaterAid is currently carrying out a SHARE-funded action research project in Zambia and Uganda in collaboration with WEDC and the Leonard Cheshire Disability and Inclusive Development Centre (LCD), called Undoing Inequity: water, sanitation and hygiene programmes that deliver for all.  The project aims to generate rigorous evidence about how a lack of safe water, sanitation and hygiene (WASH) impacts on the lives of disabled, older persons and people living with a chronic illness; understand the barriers they face, develop and test an inclusive WASH approach to address those barriers and influence key policy and decision makers to mainstream inclusive WASH within development.

As part of this project, Hazel Jones (WEDC) has written a report titled Mainstreaming disability and ageing in water, sanitation and hygiene programmes.  This report recognises that progress on the MDGs is not happening in an equitable way.  A drive for increasing coverage of basic services, such as WASH has meant that people who are ‘harder to reach’, such as disabled and older people often remain un-served.

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