Category Archives: Research

Measuring the Safety of Excreta Disposal Behavior in India with the New Safe San Index: Reliability, Validity and Utility

Measuring the Safety of Excreta Disposal Behavior in India with the New Safe San Index: Reliability, Validity and Utility. Int. J. Environ. Res. Public Health 2014, 11(8), 8319-8346.

Marion W. Jenkins 1,2,*, Matthew C. Freeman 3 and Parimita Routray 2
1 Department of Civil and Environmental Engineering, University of California Davis, One Shields Ave., Davis, CA 95616, USA
2 Environmental Health Group, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
3 Department of Environmental Health, Rollings School of Public Health, Emory University, Atlanta, GA 30322, USA
* Author to whom correspondence should be addressed.

Abstract: Methods to assess household excreta disposal practices are critical for informing public health outcomes of efforts to improve sanitation in developing countries. We present a new metric, the Safe San Index (SSI), to quantify the hygienic safety of a household’s defecation and human feces disposal practices in India, where behavioral outcomes from on-going public expenditures to construct household sanitation facilities and eliminate open defecation are poorly measured. We define hygienic safety of feces disposal as capture in a hygienic sanitation facility.

The SSI consists of 15 self-report items and two sub-scales, Latrine Use Frequency and Seven-Day Open Defecation Rate. Households are scored on a standardized scale from 0 (no defecation safely captured) to 100 (all defecation safely captured). We present results of a pilot study in Odisha, India to apply the Index to assess excreta disposal behaviors among rural households and evaluate the reliability and validity of the Index for estimating the rate of correct and consistent sanitation facility usage of household with an improved latrine.

iDE Cambodia hits 100,000 toilet sales in 2 years

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iDE Cambodia has facilitated the sale of 100,000 Easy Latrines in two years through sanitation marketing, reaching an estimated 470,000 people, according to a June 14 press release.

The iDE Sanitation Marketing Scale Up (SMSU) project operates in seven Cambodian provinces. It started with a pilot project in 2009 and scaling-up began in September 2011. So far total latrine sales including the pilot is 118,000.

The average latrine coverage in the seven provinces where the project is taking place inceased by 11% to 40% over the two years since scale up began. Coverage for the poor increased 6% overall. In Kandal province alone, 18% of project-linked sales went to poor households, nearly doubling poor coverage in that province from 15%  to 29%.

The three-year SMSU project is funded by the Bill & Melinda Gates Foundation and the Stone Family Foundation, and technically supported by the Water and Sanitation Program (WSP) of the World Bank. The project is supported by the Ministry of Rural Development.

For every latrine sold through a small business trained by iDE, another latrine is sold through a non-connected business, creating a ripple effect. The average latrine sells for US$ 41.50.

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Female parliamentarians want free sanitary pads for Uganda’s schoolgirls

Uganda’s female parliamentarians led by controversial Speaker of Parliament Hon. Rebecca Kadaga have called on the government to provide sanitary pads for all schoolgirls in the Universal Primary Education (UPE) programme. Kadaga launched her call at the Annual General Meeting  of the Uganda Women Parliamentary Association (UWOPA) on 16 May 2014.

Cover MHM study UgandaThe call was spurred by IRC’s research with SNV in Ugandan schools, which showed there is a higher likelihood of adolescent girls staying home during their periods. Girls in the 140 schools surveyed reported missing from 8 to 24 school days per year, resulting in lagging behind or some dropping out of school.

In August this year, IRC will present results from the Uganda study at the Menstrual Hygiene Management Conference taking place in Kampala, Uganda. NETWAS Uganda and partners are organising this event to encourage learning about what can be done to improve menstrual management in schools, institutions and communities.

Source:

  • Marielle Snel and Carmen da Silva Wells, Why focus on menstrual hygiene management?, IRC,, 27 May 2013
  • Olive Eyotaru, Include girls’ sanitary pads in UPE pack, Kadaga says, Daily Monitor, 18 May 2014
  • Editorial, Support low-cost sanitary pad drive, Daily Monitor, 20 May 2014
  • Support Uganda’s low-cost sanitary pad drive, SNV Uganda, 23 May 2014

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.