Tag Archives: hygiene

Sanitation and Hygiene Policy – Stated Beliefs and Actual Practice: Burera District, Rwanda

Sanitation and Hygiene Policy – Stated Beliefs and Actual Practice: A Case Study in the Burera District, Rwanda, 2012.

Nelson Ekane, Madeleine Fogde, Marianne Kjellén and Stacey Noel. Stockholm Environment Institute.

In Rwanda, sanitation and hygiene are high on the government’s development agenda, and it prescribes a range of guidelines and standards for toilet technologies appropriate for different regions. This working paper presents these prescribed guidelines and standards, specifically those pertaining specifically to urine diversion dry toilets (UDDTs), as well as those on the use of treated human excreta as fertilizer, and on pit latrines (“drop and store”). It then describes how these guidelines and standards are enforced at the community level – specifically in the Rugarama sector, Burera District – and presents the prevailing sanitation and hygiene norms and practices, moving on to discuss how and why the prescribed guidelines and standards match or do not match prevailing practices. The United Nations Children’s Fund (UNICEF) in Rwanda is carrying out a water, sanitation and hygiene (WASH) in the dostrict of Burera and three other districts in the country.

This study shows that health, hygiene, convenience, and safety aspects of sanitation in the study area remain unsatisfactory, and are not aligned with national guidelines and standards. Most of the toilets in these communities are neither properly constructed nor properly used. Reasons for the contradictions between prevailing practice and national guidelines and standards include the following: people do not place a high priority on toilets; financial constraints limit household investment in toilets; there is a lack of proper understanding of prescribed sanitation and hygiene guidelines and standards; and there are challenges in carrying out sanitary inspections. For the productive sanitation system in particular, poor understanding of how the system works was identified as the main cause of the mismatch between standards and practice. This study posits that a common understanding of prescribed guidelines and standards at all levels of society is vital to ensure health and safety, improved livelihoods, and to maintain minimum hygiene and sanitation standards.

Impact of Infectious Diseases on Cognitive Development in Childhood and Beyond: Potential Mitigational Role of Hygiene

The Open Infectious Diseases Journal, 2012, 6, 65-70

Impact of Infectious Diseases on Cognitive Development in Childhood and Beyond: Potential Mitigational Role of Hygiene

M. Khalid Ijaz and Joseph R. Rubino

Enteric infections in the early years of childhood can exacerbate underlying malnutrition and, if not addressed, can lead to a vicious and synergistic cycle of malnutrition-enteric infection-malnutrition. Cognitive impairment is a key detrimental outcome associated with this cycle of malnutrition and enteric infection. Mechanistically, diversion of metabolic resources away from the developing brain under conditions of nutritional stress may underlie the impairment of cognitive function. Evidence indicates that the effects of the synergy between malnutrition and enteric pathogens last far beyond the time of infection and can lead to long-term effects on cognition. Indeed, emerging evidence suggests a potential for later-life vulnerability to neurodegenerative diseases as a consequence of enteric infectious diseases on early-life brain development. Simple interventions for improving hygiene have proven to lessen the burden of enteric infectious disease. The mitigational role of good hygiene practices has the potential to break the vicious cycle of malnutrition and enteric infection, and contribute to improving the cognitive development potential of children at risk.

New job at WSSCC: Senior Monitoring and Evaluation Officer P4

ImageWSSCC has an exciting senior-level (P4) monitoring and evaluation (M&E) position based in Geneva, Switzerland. The application deadline is 30 December 2012. The purpose of the post is to coordinate the effective monitoring and evaluation of WSSCC’s work in line with its Medium Term Strategic Plan (MTSP)for the period 2012-2016. The incumbent is expected to establish a conceptual framework for the monitoring & evaluation practice, provide leadership to strengthen WSSCC’s capacity, and to develop systems and engagement strategies to enable WSSCC to:

  • Effectively monitor and evaluate progress against its MTSP for the period 2012-2016, and regularly derive evidence-based data and information feeding into organizational and wider sector knowledge and learning.  
  • Identify and collaborate on evaluation research initiatives of relevance to the sector as a whole.    
  • Represent WSSCC in inter-agency meetings and high-level forums on monitoring and evaluation.
  • Develop partnerships and facilitate inter-institutional relations with key research institutions specializing in water, sanitation and hygiene.

WSSCC’s mission is to ensure sustainable sanitation, better hygiene and safe drinking water for all people.  Good sanitation and hygiene lead to economic and social development, yielding health, productivity, educational and environmental benefits. WSSCC manages the Global Sanitation Fund, facilitates coordination at national, regional and global levels, supports professional development, and advocates on behalf of the 2.5 billion people without a clean, safe toilet to use.  WSSCC is hosted by UNOPS, supports coalitions in more than 30 countries and has members around the world.

For information on the United Nations salary scale and post adjustment formula, visit here: http://www.un.org/Depts/OHRM/salaries_allowances/salary.htm.

 

Links to WASHplus Weeklies on Sanitation

Below are links to WASHplus Weeklies on sanitation-related topics:

Behavioral Determinants of Handwashing with Soap in Senegal and Peru: Emergent Learning

A new Water and Sanitation Program (WSP) Learning Note found that beliefs and ease of access to soap and water were correlated with handwashing with soap behaviors for given proxy measures among mothers and caretakers in Peru and Senegal.

“Behavioral Determinants of Handwashing with Soap Among Mothers and Caretakers: Emergent Learning from Senegal and Peru,” is based on survey data from nearly 3,500 households in Peru and 1,500 households in Senegal. This data was analyzed using FOAM, a conceptual framework developed by WSP to help identify factors that might facilitate or impeded handwashing with soap practices at critical times.

The analysis revealed that the impact of different determinants varies depending on the chosen proxy measure, such as the presence of a handwashing station or its distance from kitchen or latrine facilities. Given this variability, the Learning Note found that program managers must clearly define the exact behavior they seek to improve before choosing which determinant to focus on in their formative research.

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The effect of cord cleansing on neonatal mortality in rural Bangladesh

The Lancet, Early Online Publication, 8 February 2012

The effect of cord cleansing with chlorhexidine on neonatal mortality in rural Bangladesh: a community-based, cluster-randomised trial

Shams El Arifeen DrPH, et al.

Background – Up to half of neonatal deaths in high mortality settings are due to infections, many of which can originate through the freshly cut umbilical cord stump. We aimed to assess the effectiveness of two cord-cleansing regimens with the promotion of dry cord care in the prevention of neonatal mortality.

Design – We did a community-based, parallel cluster-randomised trial in Sylhet, Bangladesh. We divided the study area into 133 clusters, which were randomly assigned to one of the two chlorhexidine cleansing regimens (single cleansing as soon as possible after birth; daily cleansing for 7 days after birth) or promotion of dry cord care. Randomisation was done by use of a computer-generated sequence, stratified by cluster-specific participation in a previous trial. All livebirths were eligible; those visited within 7 days by a local female village health worker trained to deliver the cord care intervention were enrolled. We did not mask study workers and participants to the study interventions. Our primary outcome was neonatal mortality (within 28 days of birth) per 1000 livebirths, which we analysed on an intention-to-treat basis. This trial is registered with ClinicalTrials.gov, number NCT00434408.

Results – Between June, 2007, and September, 2009, we enrolled 29 760 newborn babies (10 329, 9423, and 10 008 in the multiple-cleansing, single-cleansing, and dry cord care groups, respectively). Neonatal mortality was lower in the single-cleansing group (22·5 per 1000 livebirths) than it was in the dry cord care group (28·3 per 1000 livebirths; relative risk [RR] 0·80 [95% CI] 0·65—0·98). Neonatal mortality in the multiple-cleansing group (26·6 per 1000 livebirths) was not statistically significantly lower than it was in the dry cord care group (RR 0·94 [0·78—1·14]). Compared with the dry cord care group, we recorded a statistically significant reduction in the occurrence of severe cord infection (redness with pus) in the multiple-cleansing group (risk per 1000 livebirths=4·2 vs risk per 1000 livebirths=1·2; RR 0·35 [0·15—0·81]) but not in the single-cleansing group (risk per 1000 livebirths=3·3; RR 0·77 [0·40—1·48]).

Interpretation – Chlorhexidine cleansing of a neonate’s umbilical cord can save lives, but further studies are needed to establish the best frequency with which to deliver the intervention.

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.”

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