Category Archives: Research

Recent WASH research

Community Based Problem Solving on Water Issues: Cross-Border “Priority Initiatives” of the Good Water Neighbors (GWN) ProjectEcoPeace, November 2016. This publication describes the 2016 efforts of EcoPeace’s GWN project team to identify environmental challenges and provide feasible solutions for “Priority Initiatives” in participating communities in Palestine, Jordan, and Israel.

A Long Way to Go—Estimates of Combined Water, Sanitation and Hygiene Coverage for 25 Sub-Saharan African CountriesPLoS One, February 2017. The authors state that estimates in this study help to quantify the scale of progress required to achieve universal water, sanitation, and hygiene (WASH) access as envisaged under the water and sanitation Sustainable Development Goal (SDG). Monitoring and reporting changes in the proportion of the national population with access to WASH may be useful in focusing WASH policy and investments toward the areas of greatest need.

Recycling and Reuse of Treated Wastewater in Urban India: A Proposed Advisory and Guidance DocumentWater and Sanitation ProgramInternational Water Management Institute, 2016. This document on wastewater recycling and reuse in urban India focuses on identifying the economic benefits of wastewater recycling from the perspective of public spending. The note also provides supporting information on the evolution and current practices of wastewater recycling internationally.

Participatory Science and Innovation for Improved Sanitation and Hygiene: Process and Outcome Evaluation of Project SHINE, a School-Based Intervention in Rural TanzaniaBMC Public Health, February 2017. The Project SHINE model shows promise as an innovative capacity-building approach and for engagement and empowerment of youth and communities to develop locally sustainable strategies to improve sanitation and hygiene.

Business Models for Fecal Sludge ManagementInternational Water Management Institute, 2016. Based on the analysis of more than 40 fecal sludge management (FSM) cases from Asia, Africa, and Latin America, this report shows opportunities as well as bottlenecks that FSM is facing from an institutional and entrepreneurial perspective.

Chickens Don’t Use Toilets: Why Managing Animal Feces Helps Children Grow TallerWorld Bank Water Blog, February 2017. The authors recommend that the predominant WASH focus on reducing exposure to human feces needs updating by including animal feces.

Nonrandomized Trial of Feasibility and Acceptability of Strategies for Promotion of Soapy Water as a Handwashing Agent in Rural BangladeshAmerican Journal of Tropical Medicine & Hygiene, February 2017. Soapy water may increase habitual handwashing by addressing barriers of cost and availability of handwashing agents near water sources. Further research should inform optimal strategies to scale-up soapy water as a handwashing agent to study health impact.

Rushing into solutions without fully grasping the problem

Which factors in the enabling environment and which links between actors are key to achieving reliable sanitation services?

Tanzania did not reach the Millennium Development Goal (MDG) concerning improved sanitation facilities in 2012 (JMP Report 2014). Several years later – in the era of the Sustainable Development Goals (SDGs) – there is still a lot to be done in the sanitation sector.

Angela Huston (IRC Programme Officer) and Dr Sara Gabrielsson (Assistant Professor at Lund University) are working on an upcoming book chapter about deconstructing the complexities that perpetuate poor water, sanitation and hygiene (WASH) services in East Africa. Departing from Sustainability Science, the chapter aims to identify which factors in the enabling environment are key to achieving reliable WASH services. This article highlights Huston’s and Gabrielsson’s insights into this topic.

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Recent sanitation research

Children with Access to Improved Sanitation but Not Improved Water Are at Lower Risk of Stunting Compared to Children without Access: A Cohort Study in Ethiopia, India, Peru, and Vietnam. BMC Public Health, January 2017. Results from this study indicate that access to improved sanitation is more frequently associated with reduced stunting risk than access to improved water. However, additional studies are needed before drawing definitive conclusions about the impact of toilets relative to water.

Soil-Transmitted Helminth Infections Fact Sheet. WHO, January 2017. With the goal of meeting the global target of eliminating soil-transmitted helminth infections by 2020, WHO updated this fact sheet with information on its strategy for control. It also provides information on global prevalence, transmission, and symptoms.

Universalising Water and Sanitation Coverage in Urban Areas: From Global Targets to Local Realities in Dar es Salaam, and Back. IIED, December 2016. This paper demonstrates how global monitoring often fails to reflect and support local efforts to improve water and sanitation in low-income settlements.

Solar Water Pumping: What You Need to Know. The World Bank, December 2016. The World Bank has developed an accessible and interactive knowledge base on photovoltaic water pumping (PVP). This online repository aims to raise awareness about the technology and provide resources that help incorporate PVP into operations.

Water and U.S. National Security: A CFR Discussion Paper. Council on Foreign Relations, January 2017. The author states that pragmatic policies are necessary to address global water issues, such as elevating the importance of water at the highest levels in the U.S. Government and developing public-private partnerships to increase water supplies, water conservation, and to waterproof at-risk infrastructure.

On the Identification of Associations between Five World Health Organization Water, Sanitation and Hygiene Phenotypes and Six Predictors in Low and Middle-Income Countries. PLoS One. January 2017. Using comprehensive WHO data on drinking water quality and sanitation in the developing world, this study seeks to determine which kinds of WASH interventions are most effective in improving public health outcomes, and an important corollary–whether the right things are being measured

School WASH Reports. WaterAid, December 2016. WaterAid recently published four reports that analyze the status of WASH in schools in Bangladesh, Nepal, India, and Pakistan. Each report draws policy and practice recommendations to contribute to sustainable and inclusive WASH services in schools.

Tracking Progress and Sustainability: Monitoring, Verification and Certification of CLTS. CLTS Knowledge Hub, January 2017. This learning brief considers the issues and challenges that are emerging around monitoring, verification, and certification as CLTS is being used at scale. While there has been progress, significant gaps in practice still remain.

Recent WASH research

Estimating the Cost and Payment for Sanitation in the Informal Settlements of Kisumu, Kenya: A Cross Sectional Study. International Journal of Environmental Research and Public Health, January 2017. This study aimed to estimate the cost of sanitation and investigated the social and economic dynamics within Kisumu’s informal settlements that hinder provision and uptake of sanitation facilities.

WASH’Nutrition: A Practical Guidebook on Increasing Nutritional Impact through Integration of WASH and Nutrition Programs. ACF International, January 2017. This operational guidebook demonstrates the importance of both supplementing nutrition programs with WASH activities and adapting WASH interventions to include nutritional considerations (i.e., making them more nutrition-sensitive and impactful on nutrition). It has been developed to provide practitioners with usable information and tools so that they can design and implement effective WASH and nutrition programs.

A Mobile Platform Enables Unprecedented Sanitation Uptake in Zambia. PLoS Neglected Tropical Diseases, January 2017. Akros, in partnership with Zambia’s Ministry of Local Government and Housing and UNICEF, has developed an innovative community-led total sanitation (CLTS) monitoring system called CLTS M2W. It uses mobile phones and engagement of traditional leaders to provide communities with the ability to clearly see their progress toward sanitation goals. CLTS M2W paved the way for unprecedented CLTS uptake in Zambia, facilitating the creation of over 1,500,000 new users of sanitation in 18 months.

Measuring Global Water Security towards Sustainable Development GoalsEnvironmental Research Letters, December 2016. In this study, the authors present a spatial multi-criteria analysis framework to provide a global assessment of water security. The selected indicators are based on Goal 6 of the Sustainable Development Goals.

Disposal of Children’s Stools and its Association with Childhood Diarrhea in IndiaBMC Public Health, January 2017. Researchers found significant statistical association between children’s stool disposal and diarrhea. They conclude that gains in the reduction of childhood diarrhea can be achieved in India through the complete elimination of unsafe disposal of children’s stools.

Place and Child Health: The Interaction of Population Density and Sanitation in Developing Countries. Demography, January 2017. In this study, researchers assessed whether the importance of dense settlement for infant mortality and child height is influenced by exposure to local sanitation behavior.

Towards “Sustainable” Sanitation: Challenges and Opportunities in Urban AreasSustainability, December 2016. This paper reviews challenges associated with providing sanitation systems in urban areas and explores ways to promote sustainable sanitation in cities. It focuses on opportunities to stimulate sustainable sanitation approaches from a resource recovery perspective, generating added value to society while protecting human and ecosystem health.

Publications on Water, Sanitation and Health: 2016. WHO, 2016. This page provides links to WHO 2016 reports on quantitative microbial risk assessment, protecting surface water for health, and household water treatment.

Recent sanitation/WASH studies

UNICEF-WHO-The World Bank Group: Joint Child Malnutrition Estimates – Levels and Trends: Key Findings of the 2016 Edition . UNICEF ; WHO , September 2016. This report gives new estimates of child stunting, overweight, underweight, wasting, and severe wasting. Malnutrition rates remain alarming: stunting is declining too slowly while overweight continues to rise.

Increasing Block Tariffs: WASH Policy Research Digest #5 . UNC Water Institute , December 2016. This is a detailed review of a recent publication : Increasing Block Tariffs Perform Poorly at Targeting Subsidies to the Poor . It includes a literature review on increasing block tariffs and subsidy targeting.

Risk Management for Drinking Water Safety in Low and Middle Income Countries: Cultural Influences on Water Safety Plan (WSP) Implementation in Urban Water Utilities . Science of the Total Environment , January 2017. Few researchers have considered cultural influences on WSP implementation. A thematic analysis of three WSP pilots in India, Uganda, and Jamaica elicited the views of WSP implementers, promoters, and customers. Twelve cultural themes emerged that enable, limit, or are neutral to WSP implementation.

Papua New Guinea (PNG): Rural WASH Sustainability Study . Water and Sanitation Program , 2016. The purpose of this study was to gather evidence about the sustainability of rural WASH activities in PNG. The objectives were to identify and develop practical approaches to improve both the sustainability and equitable delivery of rural water supply and sanitation schemes and make recommendations on the potential for information communication technology (monitoring systems for rural water supply).

Real-Time Learning and Documentation in the Cambodia Rural Sanitation and Hygiene Improvement Program (CRSHIP) . Water Supply and Sanitation Collaborative Council , November 2016. The Cambodia Rural Sanitation and Hygiene Improvement Program aims to increase access to safe sanitation and promote the sustainable practice of key sanitation and hygiene behaviors in rural Cambodia. This video explains how the project’s learning and documentation component helps solve complex project implementation issues.

Review of Self-Supply and its Support Services in African Countries: Synthesis Report . Skat Foundation , April 2016. Supported self-supply of rural water supplies is a very cost-effective service delivery approach, which is complementary to communal supplies and aligned with human rights principles, supports equity and inclusiveness, and achieves several SDGs. This synthesis report summarizes the results of a UNICEF-funded review of supported self-supply in Zambia and Zimbabwe that was conducted in 2015.

Burden of Diarrhea in the Eastern Mediterranean Region, 1990–2013: Findings from the Global Burden of Disease Study 2013 . American Journal of Tropical Medicine and Hygiene , December 2016. The results highlighted a highly inequitable burden of diarrheal diseases, mainly driven by the lack of access to proper resources such as water and sanitation. These findings will guide prevention and treatment interventions that are based on evidence with the ultimate goal of reducing the diarrheal disease burden.

Financing Options for the 2030 Water Agenda . The World Bank , November 2016. A new sector financing paradigm is required based on four broad themes. The sector has to realign itself around actions that: improve sector governance and efficiency (i.e., improving creditworthiness); crowd in or blend private finance (i.e., leveraging capital); allocate sector resources more effectively to deliver the maximum benefit for every dollar invested (i.e., targeting capital); and improve sector capital planning to reduce unit capital costs.

New WHO estimates on stunting; Dec 2016 WASH studies

UNICEF-WHO-The World Bank Group: Joint child malnutrition estimates – levels and trends: Key findings of the 2016 edition. WHO; UNICEF. In September 2016 the inter-agency team released new joint estimates of child stunting, overweight, underweight, wasting and severe wasting.

Trop Med Intl Health – Dec 2016

Is pregnancy a teachable moment to promote handwashing with soap among primiparous women in rural Bangladesh? Follow-up of a randomised controlled trial (Abstract/order)

Potential sources of bias in the use of Escherichia coli to measure waterborne diarrhoea risk in low-income settings(Abstract/order)

Rapid dipstick detection of Vibrio cholerae in household stored and municipal water in Dhaka, Bangladesh: CHoBI7 trial (Abstract/order)

Environmental Health Perspectives – December 2016

Salting the Earth: The Environmental Impact of Oil and Gas Wastewater Spills

Am Jnl Trop Med Hyg – Nov 2016

Effectiveness of Membrane Filtration to Improve Drinking Water: A Quasi-Experimental Study from Rural Southern India (Full text)

Early Childhood Diarrhea Predicts Cognitive Delays in Later Childhood Independently of Malnutrition(Abstract/order)

Herd Protection from Drinking Water, Sanitation, and Hygiene Interventions (Abstract/order)

Improved Sanitation Facilities are Associated with Higher Body Mass Index and Higher Hemoglobin Concentration Among Rural Cambodian Women in the First Trimester of Pregnancy (Abstract/order)

Int. J. Environ. Res. Public Health 2016, 13(12)

Assessment of Macro-Level Socioeconomic Factors That Impact Waterborne Diseases: The Case of Jordan (Full text)

An Annotated Bibliography on Shared Sanitation – November 28, 2016

An Annotated Bibliography of 2015 and 2016 Studies and Reports on Shared Sanitation – November 28, 2016

 2016 Studies and Reports

1 – Shared sanitation: to include or to exclude? Trans Roy Soc Trop Med & Hygiene, May 2016. Duncan Mara.  (Abstract/order)
Recent research has shown that neighbor-shared toilets perform much better than large communal toilets. The successful development of community-designed, built and managed sanitation-and-water blocks in very poor urban areas in India should be adapted and adopted throughout urban slums in developing countries, with a caretaker employed to keep the facilities clean. Such shared sanitation should be classified as ‘basic’, sometimes as ‘safely-managed’, sanitation, so contributing to the achievement of the sanitation target of the Sustainable Development Goals.

2 – Can behaviour change approaches improve the cleanliness and functionality of shared toilets? A randomised control trial in Dhaka, Bangladesh. WSUP, May 2016.
(Full text)
This project demonstrated that a behavior change communication intervention built upon in-depth qualitative understanding of the perspective and constraints of local residents could improve toilet cleanliness, even in the setting of severe constraints: notably water shortages and the absence of fecal sludge management systems. The most important step towards improving environmental sanitation in Dhaka is to address the absence of any fecal sludge management system. To improve the quality and cleanliness of shared facilities, behavior change strategies targeting the central role that landlords and community managers play can be particularly effective. Future research might explore: 1) how compound managers and/or landlords can make improvements to toilet cleanliness without project-funded hardware; 2) how to leverage mass media approaches to reduce the cost of behavior change communication; 3) how the effectiveness of specific behavior change strategies varies by gender; and 4) further evaluations to assess the sustainability of these efforts to improve toilet cleanliness.

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