Author Archives: WASHplus

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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Trémolet Consulting – Toilets on Credit, 2015 (video)

Published on Feb 3, 2015

Can microfinance help increase access to sanitation? Today, 2.5 billion people do not use proper sanitation facilities. Essential services for maintaining latrines and treating faecal sludge are also underdeveloped. In many places, toilets can cost up to one year of income for poor households. Private operators of sanitation services do not have enough capital to acquire more equipment and respond to growing demand.

Since 2010, Trémolet Consulting and research partners based in Kenya MicroSave have been exploring the potential of microfinance for helping sanitation markets to develop. The research, funded by SHARE/DFID, culminated with an action-research in Tanzania in which financial institutions were trained to provide financial services for sanitation. This film explains why microfinance should be explored further, and potentially, included in sanitation programmes.

The film also presents what has been done in Tanzania under the action-research and takes the views of households, sanitation entrepreneurs, microfinance institutions and researchers.

 

Copenhagen Consensus Center – WASH targets in the Post-2015 Development Agenda

Link to reports: www.post2015consensus.com/water-and-sanitation 

Here, Copenhagen Consensus Center has just released its latest research on water and sanitation targets for the post-2015 development agenda. Guy Hutton, Senior Economist, at the Water and Sanitation Program (WSP), World Bank writes the main report, with research assistance provided by Mili Varughese, Operations Analyst at WSP. water_assessment_01_sml (1)

Guy Hutton, Senior Economist for the World Bank’s Water and Sanitation Program, writes a paper examining the costs and benefits of ending open defecation and providing universal access to water and sanitation. He finds that in general, it is more cost-beneficial to serve rural populations since they save more time from having improved access to water and sanitation facilities. Additionally, it is more effective to provide for the poorest, because they start with poorer health and have greater capacity to improve from access. Regardless of location and income, providing water and sanitation passes a cost-benefit test.

Dale Whittington, Professor, Departments of Environmental Sciences & Engineering at University of North Carolina, makes a critical examination of the assessment paper, noting several challenges with the benefit-cost calculations. In particular, he outlines concerns with how time savings are calculated, the likelihood of 100% take up of the interventions, assumptions around the cost base and how sensitivity analysis is applied in the paper. Despite these issues, Whittington agrees that water and sanitation interventions are likely to be cost-beneficial, though very sensitive to local conditions.

Dale Whittington also writes a stand-alone paper on water resources management targets. In a thought-provoking discussion he argues that global average benefit-cost ratios for water resource management investments are not useful because investments must be analyzed at the local level. Secondly, he suggests that it would be wrong for low-income countries to prioritize health interventions over large scale water infrastructure, since the latter are a necessary pre-requisite for the former.

Mary Ostrowski and Allan Jones of the World Chlorine Council present their views on the ‘safely managed drinking water service’ aspect of the proposed WASH targets. They argue that the most effective way to check drinking water quality is testing for the chlorine residual to ensures that the water is safe and free from disease causing germs.​

Waterlines, Jan 2015 issue on Menstrual Hygiene Management

WATERLINES – JANUARY 2015 (Complete issue)

Selected articles: 

Guest editorial: tackling the stigma and gender marginalization related to menstruation via WASH in schools programmes (abstract/order info)
Menstrual hygiene management has been defined as: ‘Women and adolescent girls using a clean menstrual management material to absorb or collect blood that can be changed in privacy as often as necessary for the duration of the menstruation period, using soap and water for washing the body as required, and having access to facilities to dispose of used menstrual management materials’ (UNICEF and WHO, 2014). However, menstrual hygiene is not just about the management of the menstrual period but also the need to address societal beliefs and taboos surrounding the issue. waterlines

Until recently, the development sector including WASH (water, sanitation and hygiene) had not explored and attempted to address the challenges related to Menstrual Hygiene Management (MHM), an important issue affecting the health, dignity and privacy of millions of girls and women on a daily basis. It is great to have a whole issue of Waterlines dedicated to MHM, as it will help us, the maledominated, engineering-based sector, to increase our understanding of this aspect of the development work we do on a daily basis.

Putting the men into menstruation: the role of men and boys in community menstrual hygiene management (full text)
This paper examines how men and boys have an essential role in effective menstrual hygiene programmes and describes an initiative to engage men and boys in Uttar Pradesh, India. As a result of the initiative, men and boys have begun to talk about menstruation more freely and are better able to support the MHM needs of women and girls within the household, community, and school.

Adolescent schoolgirls’ experiences of menstrual cups and pads in rural western Kenya: a qualitative study (full text)
A randomized controlled feasibility study was conducted among 14–16-year-old girls, in 30 primary schools in rural western Kenya, to examine acceptability, use, and safety of menstrual cups or sanitary pads. Focus group discussions (FGDs) were conducted to evaluate girls’ perceptions and experiences six months after product introduction.

Mainstreaming menstrual hygiene management in schools through the play-based approach: lessons learned from Ghana (full text)
The study objective was to identify and document the effectiveness of the play-based approach in promoting menstrual hygiene management (MHM) in schools and share lessons learned. The study used a mix of approaches including qualitative and quantitative techniques. The author carried out an exploratory evaluation on the promotion of MHM activities as part of WASH in Schools programmes in 120 public schools in Ghana. Comparison was drawn between 60 schools currently using the play-based approach in promoting MHM, and 60 schools which are not using the play-based approach.

Developing games as a qualitative method for researching menstrual hygiene management in rural Bolivia (abstract/order info)
In 2012, Emory University and UNICEF conducted a multi-country formative study to gain a global perspective of girls’ experiences. A compendium of tools was created to ensure investigation of common themes across all settings. This paper describes the process of adapting the focus group discussion (FGD) tool for Bolivia into a board game as a method to ease girls’ discomfort discussing menstruation and elicit richer data.

WaterSHED – Rural Consumer Sanitation Adoption Study in Cambodia

Rural Consumer Sanitation Adoption Study: An Analyis of Rural Consumers in the Emerging Sanitation Market in Cambodia, 2014.

WaterSHED has published the findings from its comprehensive review of rural consumer sanitation adoption in Cambodia. The study evaluates WaterSHED’s Hands-Off sanitation marketing program, which was designed to catalyze the market for improved sanitation in rural Cambodia by stimulating household demand and improving the supply of affordable sanitation options for rural households. watershed-1

The study confirms that the WaterSHED program has resulted in a substantial acceleration in improved latrine coverage and usage in the study areas. Household consumers are now able to access an improved latrine more easily and more cheaply than before.

New distribution and sales mechanisms are increasing household awareness of and exposure to more affordable latrine products and increasing motivation to invest in an improved latrine.

Enterprises are demonstrating that they serve at least some segments of the previously unserved rural market.

Nonetheless, significant challenges still remain. The study reveals a number of opportunities to break down remaining barriers to uptake of improved latrines and to further evolve WaterSHED’s market-based approach.