Author Archives: usaidwaterckm

Susan Davis – What’s the problem with WASH innovation?

What’s the problem with WASH innovation? Improve International, March 8, 2018.

Susan Davis’s thoughts on water innovations are included in Kelli Roger’s recent article in Devex (you have to be a member to read the full article, but here are some excerpts).

…For years, Susan Davis heard the same reports of failed or broken water systems presented at water and sanitation conferences all over the world. Innovations presented at most gatherings, meanwhile, usually focused on gadgets or “things” — often versions of the latrines, filters or dispensers that were failing elsewhere. 


Low-tech innovation: water service delivery mechanism in Ethiopia (photo by Susan Davis)

…The issue, Davis and other WASH experts tell Devex, is not willingness to solve these problems, but the hyperfocus on gadgets to achieve sustainable results at scale. It’s data, service delivery, and overall process improvement that should more equally or more often claim the spotlight — and the funding.

…It’s “stuff that sounds simple and basic until you realize no one else was doing it” that is really going to change the WASH game, Davis said.

…In the meantime, Improve International’s Davis plans to continue to unearth WASH products and systems innovations that are working — “If you’re not asking the right questions, you’re probably never going to hear about it,” she said — and encouraging the sector to learn from its well intentioned mistakes.

If you’re a Devex member, you can read the full article hereGet in touch if you want to learn more about WASH innovations.



Olivia Onyemaobi, the Nigerian social entrepreneur improving menstrual hygiene management education in her country

Olivia Onyemaobi, the Nigerian social entrepreneur improving menstrual hygiene management education in her country. Lionesses of Africa, March 1, 2018.

Personal experiences and the desire to make a difference in the lives of others are often the two key drivers of social entrepreneurs when it comes to starting up their businesses. For Nigerian social entrepreneur, Olivia Onyemaobi, founder of Pad-Up Creations, her inspiration came from the need to help women and girls to manage their menstrual hygiene and fulfill their potential.


Olivia Onyemaobi, founder of Pad-Up Creations (Nigeria)

What does your company do?

We are a social enterprise in Nigeria manufacturing affordable and eco-friendly washable/reusable sanitary pads to help keep girls in schools during their menstrual cycle and also improve women’s economic involvement in society. We also organize menstrual hygiene management and reproductive health education in schools and women groups.

Read the complete article.

Sanitary Napkin PadBank: Here’s How Some Women Are Pushing The Menstrual Hygiene Cause

Sanitary Napkin PadBank: Here’s How Some Women Are Pushing The Menstrual Hygiene Cause. Banega Swachh India, March 7, 2018.

From an MLA initiating India’s first sanitary PadBank to a 16-year-old coming forward to help the girls of her age, PadBanks being run by different women are emerging to be an important mechanism to provide sanitary napkins to women without means. Here are five such PadBanks

Move over PadMan, PadBanks are now what many are adopting to reach out to women with no access or awareness about menstrual hygiene. These PadBanks retain the basic functionality of a bank, but instead of money these dispense sanitary pad, either from free or charge a discounted rate.

While some women are providing sanitary napkins at a cheaper rate, others are breaking the myths and taboos associated with menstruation by making people aware. These women are not only challenging the societal norms, but have also made it their mission to raise the level of menstrual hygiene in Indiaindia

In India, 88 per cent of menstruating women do not use sanitary napkins. Be it ignorance or lack of affordability, the fact is that majority of women in India rely on unhygienic alternatives during periods.

In a bid to change this reality, women in India are providing sanitary napkins to less fortunate women and girls.

Read the complete article.

Recent WASH research on sanitation, cholera, MHM and other topics

In addition to the studies and resources below, there are new blog posts, Ethiopian Summit Focuses on Participatory Co-Design to Develop Low-Cost WASH Products, and other resources on the website.


How to reach everyone with safe water and sanitation by 2030. WaterAid, Feb 2018. As the first review of SDG 6 begins, we urge governments and donors to fight WASH inequality with urgent action on finance, integration and sustainability.

WaterAid’s reflections on the results of the WASH Benefits Trials – Kenya and Bangladesh. WaterAid, February 2018. This note has been put together to help WaterAid staff and actors working on nutrition and water, sanitation and hygiene (WASH) to understand the results and implications of these studies, and to interpret the results in light of the full body of evidence on WASH and nutrition.

Clean Hands for All: A toolkit for hygiene advocacy. GHP, Feb 28, 2018. This toolkit includes an overview of why hygiene matters in the context of the Sustainable Development Goals, a short advocacy introduction, and suggestions on audiences, delivery mechanisms, and objectives for hygiene advocacy.

Turning promises into action: Gender equality in the 2030 Agenda for Sustainable Development. UN Women, Feb 2018. The report monitors global and regional trends in achieving the SDGs for women and girls based on available data.

MENSTRUAL HYGIENE MANAGEMENT AND FEMALE GENITAL MUTILATION: CASE STUDIES IN SENEGAL. WSSCC, 2018. The research that is the focus of this paper is a pioneering study: it explores the links between menstrual hygiene management and female genital mutilation, for the first time.


Innovative sanitation approaches could address multiple development challenges. Water Science & Technology, Feb 2018. Nevertheless, a better understanding of driving forces and enabling environments, new organizational models based on more service-oriented sanitation provision, and highlighting potential multiple societal benefits to attract investments from new sectors are identified areas that need further attention.

Mapping the burden of cholera in sub-Saharan Africa and implications for control: an analysis of data across geographical scales. Lancet, March 1. Although cholera occurs throughout sub-Saharan Africa, its highest incidence is concentrated in a small proportion of the continent. Prioritising high-risk areas could substantially increase the efficiency of cholera control programmes.

Preliminary assessment of the computer-based Taenia solium educational program ‘The Vicious Worm’ on knowledge uptake in primary school students in rural areas in eastern Zambia. Trop Med Intl Health, March 1. Preliminary assessment of ‘The Vicious Worm’ indicates it is an effective tool for the short-term T. solium education of primary school students in Zambia.

Impact of the scale-up of piped water on urogenital schistosomiasis infection in rural South Africa. eLife, Feb 20. High coverage of piped water in the community decreased a child’s risk of urogenital schistosomiasis infection eight-fold.

Locally produced hydrogen sulphide detecting water quality test kits increase household level monitoring in rural Tanzania. Journal Water & Health, Feb 22. The H2S test was widely accepted, with 94% of those surveyed willing to buy the test in the future. This will enable households to monitor their own water sources and make informed choices about water safety and treatment.

Effectiveness of a Household Water, Sanitation and Hygiene Package on an Outpatient Program for Severe Acute Malnutrition: A Pragmatic Cluster-Randomized Controlled Trial in Chad. AJTMH, Feb 26. Our results showed that adding a household WASH package did not decrease post-recovery relapse rates but increased the recovery rate among children admitted in OTP.

Enteropathogens and Gut Inflammation in Asymptomatic Infants and Children in Different Environments in Southern India. AJTMH, Feb 2018. Viral and bacterial infections, including enteroviruses, adenoviruses, Campylobacter spp., and diarrhegenic Escherichia coli were more common and fecal biomarkers of inflammation were higher in the poor neighborhood.



Toward a Hygienic Environment for Infants and Young Children: A Review of the Literature – USAID/WASHpals

Toward a Hygienic Environment for Infants and Young Children: A Review of the Literature. USAID Water, Sanitation, and Hygiene Partnerships and Learning for Sustainability (WASHPaLS), February 2018.

 For nearly six decades, the routes of pathogen transmission from human excreta to a new host have been reflected in the seminal “F-diagram” via fluids, fingers, flies, fields (floors, earth, dirt), and fomites (surfaces).

The WASHPaLS project conducted a review of the scientific and grey literature, complemented by dozens of key informant interviews with researchers and practitioners, to re-examine the F-diagram, highlighting the underemphasized sources of pathogens and transmission pathways that are of particular relevance to the health of infant and young children (IYC) and not disrupted by the traditional suite of WASH measures.

These are:

  • domestic animal excreta as a source of risk, and
  • direct ingestion of pathogens via eating feces, dirt (geophagy) or through mouthing behaviors as additional pathways.

Research updates from the SHARE project

Below are links to 2017 and 2018 articles from the SHARE project

Oral Contact Events and Caregiver Hand Hygiene: Implications for Fecal-Oral Exposure to Enteric Pathogens among Infants 3–9 Months Living in Informal, Peri-Urban Communities in Kisumu, Kenya – Childhood diarrhea is one of the leading causes of morbidity and mortality in children under five in low and middle-income countries, second only to respiratory illness. The mouthing behavior that is common in children exposes them to fecal-orally transmitted pathogens that can result in diarrhea; however, there is a need for further evidence on specific exposure routes. This study describes the frequency and diversity of two important routes of enteric pathogen exposure among infants 3–9 months of age: infant oral contact behavior and caregiver handwashing behavior. The combined implication of data from observing oral contact behavior in children and hand hygiene of caregivers suggests that caregiver hand hygiene prior to feeding events and after cleaning a child are priority interventions.

From menarche to menopause: A population-based assessment of water, sanitation, and hygiene risk factors for reproductive tract infection symptoms over life stages in rural girls and women in India – Women face greater challenges than men in accessing WASH resources to address their daily needs, and may respond to these challenges by adopting unsafe practices that increase the risk of reproductive tract infections (RTIs). WASH practices may change as women transition through socially-defined life stage experiences, like marriage and pregnancy. Thus, the relationship between WASH practices and RTIs might vary across female reproductive life stages. This cross-sectional study conducted by Baker et al. assessed the relationship between WASH exposures and self-reported RTI symptoms in 3,952 girls and women from two rural districts in India, and tested whether social exposures represented by reproductive life stage was an effect modifier of associations.

Estimating the Health Risk Associated with the Use of Ecological Sanitation Toilets in Malawi – Main exposure pathways were through poor storage of sludge, contamination of foods during drying, walking barefoot on the ground contaminated with sludge, pit emptying without protection, and application of sludge in the fields. Estimated annual risk for Ascaris lumbricoides, Taenia, and hookworms was approximately over 5.6 × 10−1 for both Fossa Alternas (FAs) and Urine Diverting Dry Toilet (UDDTs). Risk from E. coli and Salmonella was 8.9 × 10−2 and above. The risks were higher than WHO acceptable risk for use of faecal sludge in crops of 10−4 infections per year. Promoters and users of EcoSan latrines need to consider advocating for strict guidelines to reduce the risk.

Role, ownership and presence of domestic animals in peri-urban households of Kisumu, Kenya – The research demonstrates the high prevalence of animal ownership in a low-income and high-density peri-urban neighbourhood of Kisumu, which may facilitate zoonotic disease transmission. Further research should assess if and to what extent animal ownership in such communities is associated with disease risk.

High prevalence of ESBL-Producing E. coli in private and shared latrines in an informal urban settlement in Dar es Salaam, Tanzania – Almost a quarter of private and shared latrines in an informal urban settlement in Tanzania are contaminated with ESBL-producing microorganisms, suggesting a high prevalence of human ESBL faecal carriage in the community. Shared latrines may serve as a reservoir for transmission in urban community settings in Tanzania.

Contributing to the debate on categorising shared sanitation facilities as ‘unimproved’: An account based on field researchers’ observations and householders’ opinions in three regions, Tanzania – Having an ‘improved’ latrine remains important as JMP recommends, but based on our study findings, we argue that possessing a non-shared latrine neither guarantees safety to its users nor its categorisation as ‘improved’. Instead, the state of the latrine, the construction technology used and the behaviours of the users may be more important.

Immunogenicity of rotavirus vaccine (RotarixTM) in infants with environmental enteric dysfunction – Deployment of rotavirus vaccines has contributed to significant declines in diarrheal morbidity and mortality globally. Unfortunately, vaccine performance in low-middle income countries (LMICs) is generally lower than in developed countries. The cause for this has been associated with several host and maternal factors including poor WASH status, which are predominant in LMICs. More recently, environmental enteric dysfunction (EED) has specifically been hypothesized to contribute to poor vaccine uptake and response. The aim of this study was to examine the association between serological biomarkers of EED and seroconversion to rotavirus vaccine in Zambian infants.

Using Network Analysis to Understand and Strengthen WASH Systems

With the ultimate goal of increasing the sustainability of WASH services, the Sustainable WASH Systems (SWS) Learning Partnership is using network analysis to better understand the complex interactions and interdependencies of actors in a local WASH system.

This webinar will provide an introduction to network analysis as a systems tool, and present early lessons learned from analyses conducted in Ethiopia, Uganda, and Cambodia as part of SWS.