Author Archives: WASHplus

The role of water, sanitation, and hygiene in reducing schistosomiasis: a review

The role of water, sanitation, and hygiene in reducing schistosomiasis: a review. Parasites & Vectors, March 2015.

Authors: Jack ET Grimes, David Croll, et al

Schistosomiasis is a disease caused by infection with blood flukes of the genus Schistosoma. Transmission of, and exposure to, the parasite result from faecal or urinary contamination of freshwater containing intermediate host snails, and dermal contact with the same water. The World Health Assembly resolution 65.21 from May 2012 urges member states to eliminate schistosomiasis through preventive chemotherapy (i.e. periodic large-scale administration of the antischistosomal drug praziquantel to school-aged children and other high-risk groups), provision of water, sanitation and hygiene (WASH) and snail control.

However, control measures focus almost exclusively on preventive chemotherapy, while only few studies made an attempt to determine the impact of upgraded access to safe water, adequate sanitation and good hygiene on schistosome transmission. We recently completed a systematic review and meta-analysis pertaining to WASH and schistosomiasis and found that people with safe water and adequate sanitation have significantly lower odds of a Schistosoma infection. Importantly though, the transmission of schistosomiasis is deeply entrenched in social-ecological systems, and hence is governed by setting-specific cultural and environmental factors that determine human behaviour and snail populations.

Here, we provide a comprehensive review of the literature, which explores the transmission routes of schistosomes, particularly focussing on how these might be disrupted with WASH-related technologies and human behaviour. Additionally, future research directions in this area are highlighted.

WASHplus Weekly: Focus on Community-Led Total Sanitation (CLTS)

Issue 181| March 6, 2015 | Community-Led Total Sanitation

This issue focuses on recent CLTS studies, reports, blog posts, and videos. Included is a new issue of Frontiers of CLTS on sustainability; reports on the health impacts of open defecation; videos and reports on CLTS programs in Ethiopia, Ghana, India, Indonesia, and Kenya; and other studies/resources.

JUST PUBLISHED

Sustainability and CLTS: Taking Stock. Frontiers of CLTS: Innovations and Insights, Issue 4, Feb 2015. S Cavill. Link clts
There are multiple and complex challenges associated with achieving sustainability. Habits are hard to break and so sustainability of behavior change continues to be a major preoccupation. The CLTS and WASH communities need to continue to share learning and insights and to draw practical conclusions that lead to better practice. Action learning that is grounded in field realities, open-mindedness, mutual respect, and sharing is the way forward. The accessibility of the four evaluations in the opening pages of Frontiers sets a good precedent.

Other issues covered in this series of Frontiers of CLTS are: Issue 1: Participatory Design Development for Sanitation | Issue 2: How to Trigger for Handwashing with Soap | Issue 3: Disability—Making CLTS Fully Inclusive |

UPCOMING EVENTS

Webinar on Participatory Design Development for Sanitation – March 26, 2015, 6–8 a.m. EDT. Link
Ben Cole will be discussing his experiences in applying participatory design to accompany and extend Malawi’s national CLTS program since 2012.  Participatory design is a natural extension to the processes applied in CLTS programs. Mr. Cole’s work in three rural districts of Malawi demonstrates the immense potential that participatory design can offer to CLTS programming. It offers a low-cost engagement tool that can support traditional follow-up approaches to CLTS programming.

2015 STUDIES/RESOURCES

Talking Shit: Is Community-Led Total Sanitation a Radical and Revolutionary Approach to Sanitation? Wiley Interdisciplinary Reviews: Water, Jan/Feb 2015. M Galvin.Link
In contrast to past approaches, one of CLTS’s main tenets is strictly no subsidies of finance or materials. In the absence of monitoring and evaluation systems, it is not clear whether its immediate achievements are sustainable. In addition to questioning its sustainability, it is essential to examine CLTS through the analytical lens of power dynamics and human rights.

Lessons from Pakistan’s Approach to Total Sanitation. CLTS Blog, Feb 2015. J Myers, CLTS Knowledge Hub. Link
Pakistan represents an excellent example of adaptations being made to the traditional CLTS process due to local conditions. It is due to conducting CLTS in areas recovering from the 2010 floods that some of these adaptations have been made.

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Why Latrines Are Not Used: Communities’ Perceptions and Practices Regarding Latrines in a Taenia solium Endemic Rural Area in Eastern Zambia

Why Latrines Are Not Used: Communities’ Perceptions and Practices Regarding Latrines in a Taenia solium Endemic Rural Area in Eastern Zambia. PLoS Neg Trop Dis, Mar 2015.

Authors: Séverine Thys , Kabemba E. Mwape, et al.

Livestock owners from small scale farms are most vulnerable for Neglected Zoonotic Diseases (NZD) in developing countries and their risk behavior leads to more intense and complex transmission patterns. Studies in Africa have shown that the underuse of sanitary facilities and the widespread occurrence of free-roaming pigs are the major risk factors for porcine cysticercosis. However the socio-cultural determinants regarding its control remain unclear. We hypothesize that via a bottom-up culture-sensitive approach, innovative control strategies can be developed that are more adapted to the local reality and more sustainable than current interventions.

By assessing the communities’ perceptions, practices and knowledge regarding latrines in a T. solium endemic rural area in Eastern Zambia, we found that more than health, seeking privacy underlies motivation to use latrines or not. The identified taboos related to sanitation practices are in fact explained by the matri- or patrilineal descent and because men are responsible for building latrines, sanitation programs should focus more often on men’s knowledge and beliefs. In order to contribute to breaking the vicious cycle between poverty and poor health among livestock owners in developing countries, disease control strategies should always consider the socio-cultural context.

How Bangladesh turns toilet waste into high-value compost – in pictures

How Bangladesh turns toilet waste into high-value compost – in pictures |Source: The Guardian, Feb 27 2015 |

Scientists in Bangladesh are working on ways to treat toilet waste in rural areas and use it to develop safe, nutritious compost for food crops. Led by the school of civil engineering at Leeds University, the Value at the End of the Sanitation Value-Chain (VESV) project aims to help reduce reliance on imported inorganic fertilisers and provide potential business opportunities for waste transporters and compost producers in a country where access to sanitation is now widespread but challenges of managing waste remain.

Farmers tend their cabbage crops in Manikganj district. Bangladesh has benefited from major improvements in rural sanitation with the spread of pit toilets – holes dug in the ground. guardian-sanitation

These bypass the problem of installing sewerage infrastructure in densely populated rural areas, but the challenge is what to do with the waste when the pits are full. If treated carefully, this waste could provide a local source of organic matter and plant nutrients such as nitrogen, potassium and phosphorus. All photographs by Neil Palmer/IWMI.

Feb/March 2015 selected studies on sanitation, hygiene & handwashing

TROPICAL MEDICINE & INTERNATIONAL HEALTH – FEB/MAR 2015

Household-Level Risk Factors for Influenza among Young Children in Dhaka, Bangladesh: A Case-Control Study(Abstract/order)

To identify household-level factors associated with influenza among young children in a crowded community in Dhaka, Bangladesh. Case households were more likely than controls to have crowded (≥4 persons) sleeping areas and cross-ventilated cooking spaces. Case and control households had similar median 24-hour geometric mean PM2.5 concentrations in the cooking and sleeping spaces. Handwashing with soap was practiced infrequently, and was not associated with pediatric influenza in this community. Interventions aimed at crowded households may reduce influenza incidence in young children.

Getting the basic rights – the role of water, sanitation and hygiene in maternal and reproductive health: a conceptual framework. (Full text)
WASH affects the risk of adverse maternal and perinatal health outcomes; these exposures are multiple and overlapping and may be distant from the immediate health outcome. Much of the evidence is weak, based on observational studies and anecdotal evidence, with relatively few systematic reviews. New systematic reviews are required to assess the quality of existing evidence more rigorously, and primary research is required to investigate the magnitude of effects of particular WASH exposures on specific maternal and perinatal outcomes.

LANCET INFECTIOUS DISEASES – FEB 2015

Editorial – Prioritising clean water and sanitation (Free full text but registration required)
Sanitation is the single greatest human achievement with regard to health, yet in much of the world it is underappreciated or inaccessible. Talha Burki investigates. “Currently, the popular approaches to sanitation place a lot of responsibility on individuals and households and not as much on governments”, adds WaterAid’s Yael Velleman. In the UK, it was legislation that led to universal access to improved sanitation. “Ultimately, it was political will and public finance that pushed that drive—I wonder whether we now expect low-income countries to do something we have never done ourselves”, said Velleman. Pollock advocates a return to a health-for-all approach, attending to the building blocks of public health, such as sanitation and nutrition, and directing major investment into infrastructure and monitoring systems. “I can’t understand why we’re prioritising clinical trials in Africa, and not prioritising clean water”, she told The Lancet Infectious Diseases.

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Frontiers of CLTS Issue 4: Sustainability and CLTS- Taking Stock

Frontiers of CLTS Issue 4: Sustainability and CLTS- Taking Stock, 2015.

Sustainability is without doubt one of the most burning subject matters that subsumes many of the issues that we are seeing in CLTS and wider WASH practice. clts

There have been several useful studies on sustainability that have highlighted some of the different aspects as well as the complexities involved. However, it is unclear how much of the learning from these studies has been built into current and future programming and practice.

Based on existing research and our own understanding, this issue of Frontiers of CLTS is an attempt at an up to date synthesis of where we are at the beginning of 2015.

In the issue, we identify some priority areas for learning: How to phase in sanitation marketing; Post-ODF engagement of government, NGOS, donors and others; How to ensure equity and inclusion; How to transform social norms; Monitoring, learning, changing.

WASHplus Weekly: Focus on WASH & Nutrition

Issue 179| Feb 20, 2015 | Focus on WASH & Nutrition

This weekly contains recent webinars, articles, and reports on issues related to WASH and nutrition integration. Included are a policy brief on food hygiene, a handwashing and sanitation study in Tanzania, an overview of the nutrition situation in Asia, a review of the health impact of household water treatment, and other resources.

UPCOMING EVENTS

Global Maternal Newborn Health Conference, Oct. 18–21, 2015, Mexico City. Link
The year 2015 is a critical milestone in international development: the deadline for the Millennium Development Goals (MDGs) and the anticipated adoption of an ambitious new agenda, the Sustainable Development Goals. This USAID– and Government of Mexico–sponsored conference will offer the first opportunity for the global maternal and newborn health communities to discuss and strategize the new goals. The conference will have a technical focus, highlighting strategies and lessons from programs, policies, research, and advocacy for improving both maternal and newborn health.

WEBINARS/BLOG POSTS/TRAINING MATERIALS

Integrating Safe Water, Sanitation, and Hygiene into Infant and Child Nutrition Programmes: A Training and Resource Pack for Uganda, 2014. WASHplus. Link
The overall objective of this resource pack is to facilitate the training of village health teams, community knowledge workers, peer support groups, and other outreach workers on how they can help household and community members overcome, or change, the many daily obstacles to improved water, sanitation, and hygiene (WASH) practices in the home.

Webinar on Multi-Sectoral Approaches to Improve Child Growth through WASH, Nutrition, and Early Childhood Development, Jan 2015. WASHplus; CORE Group; Clean, Fed & Nurtured. Link
WASHplus collaborated with the CORE Group’s Nutrition and Social and Behavior Change working groups to host a one-hour webinar on multisectoral approaches to improve child growth and development, with a focus on improving the community knowledge of practice and sharing integration efforts for early childhood development, nutrition, and WASH integration. The Clean, Fed & Nurtured community of practice explained why WASH, nutrition, and early childhood development should be integrated.

Progress in Reducing Child Under-Nutrition: Evidence from Maharashtra. Economic & Political Weekly, Jan 2015. S Jose. Link
Assessing the progress made in reducing under-nutrition among children who are less than 2 years old in Maharashtra between 2005–2006 and 2012, this article points out that child under-nutrition, especially stunting, declined significantly in the state during this period. It holds that this decline can be associated with the interventions initiated through the Rajmata Jijau Mother-Child Health and Nutrition Mission, which began in 2005, and that this indicates the critical role the state can play in reducing child under-nutrition in India.

REPORTS

Policy Brief: Complementary Food Hygiene—An Overlooked Opportunity in the WASH, Nutrition and Health Sectors, 2015. SHARE. Link
This policy brief highlights the often overlooked opportunity to improve health outcomes by addressing complementary food hygiene. It outlines SHARE’s contribution to narrowing the evidence gap concerning the relationship between food hygiene and child health, indicates opportunities for future research, and offers insights that could influence policy and improve programming in the WASH, nutrition, and health sectors globally.

WASH and Nutrition Case Studies, 2014. WASHplus. Link
These 12 case studies were collected as part of putting together a joint donor document on Integrating Water, Sanitation, and Hygiene into Nutrition Policies and Programmes, which will soon be published by UNICEF, USAID, and the World Health Organization. In selecting these case studies, priority was given to activities that achieved measurable nutrition-related impact.

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