Category Archives: Sanitation and Health

Shifting the perspective: how urban CLTS can contribute to achieving universal access to sanitation

Shifting the perspective: how urban CLTS can contribute to achieving universal access to sanitation. Source: CLTS Blog, July 6 2016 |

Author: Sue Cavill

Urban sanitation differs from rural sanitation in many ways however one of the fundamental differences is that in urban areas one group, (usually the wealthy), benefits from the public provision of sanitation at the expense of others  (usually the poor). Poor households in urban areas must often find their own solutions to failures in sanitation services. During a workshop on urban CLTS (U-CLTS) held in Ethiopia and hosted by Plan International, we explored the potential of CLTS to support safely managed, city-wide sanitation. clts

We heard how communities in Ethiopia, Mauritania, India, Madagascar, Kenya and Nepal have participated in the design and management of sanitation services and exerted influence over public and private service providers through a U-CLTS approach. The examples highlighted how the collective nature of sanitation means that community structures, rather than individual choices, are critical to sanitation service delivery. The case studies illustrated how the ‘community-led’ aspect of U-CLTS has resulted in: (1) provision of sanitation facilities to substitute for public/private sanitation providers and to compensate for weak government institutions, (2) collaboration between communities and government to coproduce a range of services across the sanitation chain as well as (3) increasing poor people’s ability to make demands on government for universal access.

Read the complete article.

 

Trash and treasure in Brazil’s Jóquei landfill – in pictures

Trash and treasure in Brazil’s Jóquei landfill – in pictures | Source: The Guardian, July 6 2016 |

The Lixão do Jóquei is one of the largest open landfills in Latin America. Under a 2010 federal law, all solid waste in Brazil should be put in modern landfills that have been lined to stop toxins soaking into the soil. brazil

Jóquei, which does not meet those requirements, is scheduled to be closed this year, but hundreds of people still make a dangerous living from scavenging amid its mounds of trash.

Exact numbers of people working at the site are hard to come by. According to municipal authorities, about 600 people sort rubbish here, but the workers themselves, known as catadores, put the figure at more than 2,600.

Read the complete article.

Duncan Mara – Disease Priorities in Zambia

Disease Priorities in Zambia. Am Jnl Trop Med Hyg, July 2016.

Author: Duncan Mara. School of Civil Engineering, University of Leeds, Leeds, United Kingdom. E-mail: d.d.mara@leeds.ac.uk

An excerpt: Neonatal disorders are very important. Deaths due to neonatal sepsis and other neonatal infections have been rising steadily from 2,121 in 2000 to 2,704 in 2013. This may reflect poor WASH, the difficulty of accessing even basic-level health-care facilities in rural areas, and/or rural mothers not recognizing early symptoms of these diseases. Poor WASH should be addressed, as it is known to adversely affect maternal, infant, and child mortality. There also needs to be improved rural health care and targeted health/hygiene education for mothers and mothers-to-be.

Diarrheal diseases caused significantly fewer deaths in 2013 than in 2000. This parallels the decrease in unsafe water, unsafe sanitation, and unsafe hand hygiene, which must be sustained. The most dramatic decrease, nearly 60%, was seen in the number of human immunodeficiency virus, acquired immune deficiency syndrome, and tuberculosis deaths during 2010–2013. This truly excellent performance needs, of course, to continue.

As highlighted in this letter, an initial broad-brush approach using GBD Compare (or similar tools) is likely to produce good guidance on health priorities, especially in rural areas and periurban slums. Targeted detail can then follow.

 

 

 

 

Beyond Survival: The Case for Investing in Young Children Globally

Beyond Survival: The Case for Investing in Young Children Globally, 2016. National Academy of Medicine.

Authors: G. Huebner, N. Boothby, et. al.

Currently, U.S. government foreign assistance remains fragmented, with little focus on or cross-sectoral funding for holistic child development and with limited mechanisms in place to ensure effective coordination across sectors. Without a proactive effort to integrate programs for young children, harmonize implementation, and synchronize the measurement of results, program and outcome siloes are created, and an important opportunity to maximize results for children is lost.

Young children’s needs and risks are multidimensional. Tackling one issue at a time, divorced from a more complex reality, is ultimately a disservice to time- and resource-strapped vulnerable families. Young children require integrated support, including health,
nutrition, education, care, and protection. The science explains why. By turning attention and resources toward coordinated investments and delivery platforms, it is possible to close the gap between what is known and what is done to support young children globally.

Environmental Transmission of Diarrheal Pathogens in Low and Middle Income Countries

Environmental Transmission of Diarrheal Pathogens in Low and Middle Income Countries. Environmental Science: Processes & Impacts, June 2016.

Author: Timothy R. Julian. Pathogens and Human Health, Department of Environmental Microbiology, Swiss Federal Research Institute of Aquatic Science and Technology (Eawag), 8600 Dübendorf, Switzerland.

Globally, more than half a million children die every year from diarrheal diseases. Recent studies have identified the diarrheal disease agents most responsible for moderate-to-severe diarrheal disease and diarrhea-related mortality. The agents – enterotoxigenic and enteropathogenic E. coli, Shigella spp., rotavirus, norovirus, and Cryptosporidium spp. – are characterized by high infectivity, high fecal shedding, and transmission through a wide range of environmental reservoirs.

This Perspective provides insight into the ecology of the diarrheal disease agents with emphasis on their relationship to environmental reservoirs. Based on this insight, the Perspective advocates for comprehensive interventions targeting exposure reductions across multiple environmental reservoirs. Single interventions are often inadequate, and this may be partly attributed to their failure to reduce environmental exposures below thresholds needed to initiate infection.

 

Handwashing, sanitation and family planning practices are the strongest underlying determinants of child stunting in rural India

Handwashing, sanitation and family planning practices are the strongest underlying determinants of child stunting in rural indigenous communities of Jharkhand and Odisha, Eastern India: a cross-sectional study. Maternal & Child Nutrition, June 2016.

Authors: Jennifer Saxton, Shibanand Rath, et. al.

The World Health Organisation has called for global action to reduce child stunting by 40% by 2025. One third of the world’s stunted children live in India, and children belonging to rural indigenous communities are the worst affected. We sought to identify the strongest determinants of stunting among indigenous children in rural Jharkhand and Odisha, India, to highlight key areas for intervention.

We analysed data from 1227 children aged 6–23.99 months and their mothers, collected in 2010 from 18 clusters of villages with a high proportion of people from indigenous groups in three districts. We measured height and weight of mothers and children, and captured data on various basic, underlying and immediate determinants of undernutrition. We used Generalised Estimating Equations to identify individual determinants associated with children’s height-for-age z-score (HAZ; p < 0.10); we included these in a multivariable model to identify the strongest HAZ determinants using backwards stepwise methods.

In the adjusted model, the strongest protective factors for linear growth included cooking outdoors rather than indoors (HAZ +0.66), birth spacing ≥24 months (HAZ +0.40), and handwashing with a cleansing agent (HAZ +0.32). The strongest risk factors were later birth order (HAZ −0.38) and repeated diarrhoeal infection (HAZ −0.23).

Our results suggest multiple risk factors for linear growth faltering in indigenous communities in Jharkhand and Odisha. Interventions that could improve children’s growth include reducing exposure to indoor air pollution, increasing access to family planning, reducing diarrhoeal infections, improving handwashing practices, increasing access to income and strengthening health and sanitation infrastructure.

Scientists put $177 billion price tag on cost of poor child growth

Scientists put $177 billion price tag on cost of poor child growth | Source: Yahoo News, June 29 2016 |

LONDON (Thomson Reuters Foundation) – Children born in developing countries this year will lose more than $177 billion in potential life-time earnings because of stunting and other delays in physical development, scientists said on Wednesday.

Children who have poor growth in their first years of life tend to perform worse at school which usually leads to poorer earning power later on.

The Harvard scientists calculated that every dollar invested in eliminating poor early growth would yield a $3 return.

“$177 billion is a big pay cheque that the world is missing out on – about half a percentage point of GDP of these countries,” said Peter Singer, head of Grand Challenges Canada, which funded the research through its Saving Brains program.

“We have to stop wasting the world’s most precious economic and social asset and ensure children thrive.”

Poor nutrition, premature birth, low breastfeeding rates and early exposure to infection are among several causes of stunting which affects three in 10 children in the developing world.

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