Category Archives: Sanitation and Health

What Kenya Can Teach The U.S. About Menstrual Pads

What Kenya Can Teach The U.S. About Menstrual Pads | Source: NPR, May 10, 2016 |

The United States is only just starting to get periods — or, at least, acknowledging that products for “that time of the month” aren’t optional for menstruating women.

In 40 states, plus the District of Columbia, pads and tampons are subject to sales tax. Earlier this year, when President Obama was asked why they haven’t been exempted like other necessities, he said, “I suspect it’s because men were making the laws when those taxes were passed.”

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Faith Wanjoki of ZanaAfrica gives a lesson on how to use a sanitary pad in a classroom in Kisumu, Kenya. Her colleague, Catherine Onyango, sits by her side. ZanaAfrica Foundation

But there’s a movement to fight these taxes, and several states have eliminated them. Next up: New York, which has just passed a bill that’s awaiting Gov. Andrew Cuomo’s signature.

Meanwhile, one country is way ahead of the U.S. when it comes to understanding that pads and tampons shouldn’t be taxed.

It’s Kenya.

Kenya repealed its value added tax on pads and tampons back in 2004 to lower the price consumers pay. And since 2011, the Kenyan government has been budgeting about $3 million per year to distribute free sanitary pads in schools in low-income communities.

That’s not to say Kenya is an ideal place to get one’s period. Many Kenyan girls still don’t have access to sanitary products, so they use unhygienic materials like chicken feathers, cheap mattresses and newspapers to fashion makeshift pads, says Megan White Mukuria.

Mukuria is the founder of ZanaAfrica Foundation, which delivers health education — and sanitary pads — to help girls stay in school. A girl who is embarrassed to stain her uniform (or has an infection) is one who is likely to skip class and eventually drop out, Mukuria explains. UNESCO estimates that more than two million Kenyan girls need support in order to get menstrual hygiene products.

Read the complete article.

Startup Turns Plastic Collected By Waste Pickers Into 3D Printer Ink

Startup Turns Plastic Collected By Waste Pickers Into 3D Printer Ink | Source: Huffington Post, May 5 2016 |

Trash collectors would be able to earn 20 times more than they do now.

Millions of waste collectors in developing countries spend their days sifting through garbage. It’s a task that’s dangerous and unhealthy, yet pretty critical considering that most of it is dumped illegally and there’s minimal private waste collection.

India Daily Life

A homeless child rag picker waits to cross a road after collecting recyclable material from a garbage dump in Gauhati, India, Sunday, Sept. 28, 2014. (AP Photo/Anupam Nath)

But they only earn about $2 a day and often burn the plastic in a way that’s deleterious to the environment.

Reflow, a startup out of Amsterdam, has found a way to disrupt that model, and help these workers earn 20 times more than do now.

The company partners directly with waste pickers and converts the plastic they amass into high quality print filament, which is what 3D printers use instead of ink.

Waste pickers, or those who make money by gathering and selling recyclable items, often live below the poverty line, the company pointed out on its Kickstarter page.

“Everywhere you go, you can find huge groups of people collecting waste barely being able to feed their family, plastic being burned in open air and plastic waste clogging drains, causing floods and spread disease,” the page reads. “Seeing this broke our hearts, and we were determined to help break this cycle.”

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If These Kids From MP Find Someone Defecating In Open, There’s A Funny Way They Tackle It – WaterAid India

Published on Apr 5, 2016

An inspiring story of a group of children from Sehore in Madhya Pradesh who set off at the crack of dawn to prevent people from defecating in the open using a unique method. See how these young crusaders in the fight against open defecation are inspiring their communities to stop open defecation.

WASH studies in the May 2016 Amer Jnl Trop Med & Hyg

American Journal of Tropical Medicine and Hygiene, 4 May 2016; Vol. 94, No. 5

Sanitation and Hygiene-Specific Risk Factors for Moderate-to-Severe Diarrhea in Young Children in the Global Enteric Multicenter Study

The current issue of PLoS Medicine has an important review on sanitation and hygiene and also below is an analysis of the review by Jonny Crocker and Jamie Bartram.

Sanitation and Hygiene-Specific Risk Factors for Moderate-to-Severe Diarrhea in Young Children in the Global Enteric Multicenter Study, 2007–2011: Case-Control Study. PLoS Med, May 2016. Authors: Kelly K. Baker, Ciara E. O’Reilly, Myron M. Levine, Karen L., et al.

Full text: http://goo.gl/z0h9P0

Background – Diarrheal disease is the second leading cause of disease in children less than 5 y of age. Poor water, sanitation, and hygiene conditions are the primary routes of exposure and infection. Sanitation and hygiene interventions are estimated to generate a 36% and 48% reduction in diarrheal risk in young children, respectively. Little is known about whether the number of households sharing a sanitation facility affects a child’s risk of diarrhea. The objective of this study was to describe sanitation and hygiene access across the Global Enteric Multicenter Study (GEMS) sites in Africa and South Asia and to assess sanitation and hygiene exposures, including shared sanitation access, as risk factors for moderate-to-severe diarrhea (MSD) in children less than 5 y of age.

Methods/Findings – The GEMS matched case-control study was conducted between December 1, 2007, and March 3, 2011, at seven sites in Basse, The Gambia; Nyanza Province, Kenya; Bamako, Mali; Manhiça, Mozambique; Mirzapur, Bangladesh; Kolkata, India; and Karachi, Pakistan. Data was collected for 8,592 case children aged <5 y old experiencing MSD and for 12,390 asymptomatic age, gender, and neighborhood-matched controls. An MSD case was defined as a child with a diarrheal illness <7 d duration comprising ≥3 loose stools in 24 h and ≥1 of the following: sunken eyes, skin tenting, dysentery, intravenous (IV) rehydration, or hospitalization. Site-specific conditional logistic regression models were used to explore the association between sanitation and hygiene exposures and MSD. Most households at six sites (>93%) had access to a sanitation facility, while 70% of households in rural Kenya had access to a facility. Practicing open defecation was a risk factor for MSD in children <5 y old in Kenya. Sharing sanitation facilities with 1–2 or ≥3 other households was a statistically significant risk factor for MSD in Kenya, Mali, Mozambique, and Pakistan. Among those with a designated handwashing area near the home, soap or ash were more frequently observed at control households and were significantly protective against MSD in Mozambique and India.

Conclusions – This study suggests that sharing a sanitation facility with just one to two other households can increase the risk of MSD in young children, compared to using a private facility. Interventions aimed at increasing access to private household sanitation facilities may reduce the burden of MSD in children. These findings support the current World Health Organization/ United Nations Children’s Emergency Fund (UNICEF) system that categorizes shared sanitation as unimproved.

Interpreting the Global Enteric Multicenter Study (GEMS) Findings on Sanitation, Hygiene, and Diarrhea. PLoS Med, May 2016. Author: Jonny Crocker, Jamie Bartram

Full text: http://goo.gl/6SzZmr

The draft sanitation ladder for measuring SDG progress allows sharing of improved facilities by fewer than five households to count towards ending open defecation [19]. Higher rungs refer to private facilities and safe excreta management. The indicators also interpret access as including use, which was not included in GEMS. Future research should include indicators on use of facilities and excreta management.

Baker and colleagues provide valuable evidence that confirms that private sanitation often provides greater benefits than shared sanitation. Prior evidence suggests health benefits for use of any sanitation facility (including shared) when compared to open defecation [8–10]. This study will inform policy and programming, yet shared facilities may still have a role in addressing open defecation in challenging settings. For reasons beyond just health such as dignity and gender equity [20,21], we should advocate for private access whenever possible.

Baker and colleagues present the best dataset yet on diarrheal disease associated with sanitation and hygiene. They provide compelling evidence on sanitation and hygiene risk factors for MSD and variability in that risk. Importantly, they also demonstrate the feasibility and value of rigorous data collection on health outcomes, something that future studies should develop yet further.

Recent studies on sanitation acess & violence,and others

Below are links to the abstracts or full text of recently published articles:

Access to sanitation and violence against women: evidence from Demographic Health Survey (DHS) data in Kenya. Int J Environ Health Res. 2016 June.
Abstract: http://www.ncbi.nlm.nih.gov/pubmed/26593879

This study analyzed 2008 Kenya Demographic Health Survey’s data and found women who primarily practice open defecation (OD), particularly in disorganized communities, had higher odds of experiencing recent non-partner violence

Untangling the Impacts of Climate Change on Waterborne Diseases: a Systematic Review of Relationships between Diarrheal Diseases and Temperature, Rainfall, Flooding, and Drought. Environ Sci Technol. 2016 Apr 25.
Abstract: http://pubs.acs.org/doi/abs/10.1021/acs.est.5b06186

Key areas of agreement include a positive association between ambient temperature and diarrheal diseases, with the exception of viral diarrhea and an increase in diarrheal disease following heavy rainfall and flooding events. Insufficient evidence was available to evaluate the effects of drought on diarrhea. There is evidence to support the biological plausibility of these associations, but publication bias is an ongoing concern.

The Impact of a School-Based Water, Sanitation, and Hygiene Program on Absenteeism, Diarrhea, and Respiratory Infection: A Matched–Control Trial in Mali. Amer Jnl Trop Med Hyg, Current issue
Abstract – http://www.ajtmh.org/content/early/2016/04/21/ajtmh.15-0757.abstract

We found that a school-based WASH intervention can have a positive effect on reducing rates of illness, as well as absence due to diarrhea. However, we did not find evidence that these health impacts led to a reduction in overall absence. Higher absence rates are less likely attributable to the intervention than the result of an imbalance in unobserved confounders between study groups.

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Policy Note: Should Public Toilets Be Part of Urban Sanitation Solutions for Poor Families Living in Slums?

Policy Note: Should Public Toilets Be Part of Urban Sanitation Solutions for Poor Families Living in Slums? April 2016. Emory University’s Center for Global Safe Water, Sanitation, and Hygiene.

Although households would prefer to have private facilities, conditions suggest that shared public toilets will, for the foreseeable future, continue to be the main available option for defecation in the slums of Accra. In this context, efforts are needed to improve existing and new public toilets to make them hygienic and safely managed in order to provide sanitation services that result in public health benefits.

Since public toilets do not meet the JMP criteria for an improved toilet, they also do not meet current government of Ghana standards. This in turn creates a disincentive for local governments to invest in public toilets and related safe management of the fecal sludge as part of their urban sanitation services.

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