Category Archives: Research

Journal of Water, Sanitation & Hygiene for Development, September 2017

Below are links to open access articles in the September 2017; Vol. 7, No. 3 issue.

Editorial – Limited services? The role of shared sanitation in the 2030 Agenda for Sustainable Development
Authors: Barbara Evans, Andrés Hueso, Richard Johnston, Guy Norman, Eddy Pérez, Tom Slaymaker and Sophie Trémolet

The role of packaged water in meeting global targets on improved water access
Authors: Sridhar Vedachalam, Luke H. MacDonald, Elizabeth Omoluabi, Funmilola OlaOlorun, Easmon Otupiri and Kellogg J. Schwab

Investigation on microbial inactivation and urea decomposition in human urine during thermal storage
Authors: Xiaoqin Zhou, Yajie Li, Zifu Li, Yue Xi, Sayed Mohammad Nazim Uddin and Yang Zhang

Cultural preferences for the methods and motivation of sanitation infrastructure development
Authors: Miriam E. Hacker and Jessica A. Kaminsky

Sanitation value chains in low density settings in Indonesia and Vietnam: impetus for a rethink to achieve pro-poor outcomes
Authors: Juliet Willetts, Anna Gero, Akhmad Akbar Susamto, Ryan Sanjaya, Thanh Doan Trieu, Janina Murta and Naomi Carrard


The impact of sanitation on infectious disease and nutritional status: A systematic review and meta-analysis

The impact of sanitation on infectious disease and nutritional status: A systematic review and meta-analysis. International Journal of Hygiene and Environmental Health
Volume 220, Issue 6, August 2017, Pages 928-949.

Authors: Matthew Freeman, Joshua Garn, Gloria Sclar, et al.

Background – Sanitation aims to sequester human feces and prevent exposure to fecal pathogens. More than 2.4 billion people worldwide lack access to improved sanitation facilities and almost one billion practice open defecation. We undertook systematic reviews and meta-analyses to compile the most recent evidence on the impact of sanitation on diarrhea, soil-transmitted helminth (STH) infections, trachoma, schistosomiasis, and nutritional status assessed using anthropometry.

Methods and findings – We updated previously published reviews by following their search strategy and eligibility criteria. We searched from the previous review’s end date to December 31, 2015. We conducted meta-analyses to estimate pooled measures of effect using random-effects models and conducted subgroup analyses to assess impact of different levels of sanitation services and to explore sources of heterogeneity. We assessed risk of bias and quality of the evidence from intervention studies using the Liverpool Quality Appraisal Tool (LQAT) and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach, respectively. A total of 171 studies met the review’s inclusion criteria, including 64 studies not included in the previous reviews. Overall, the evidence suggests that sanitation is protective against diarrhea, active trachoma, some STH infections, schistosomiasis, and height-for-age, with no protective effect for other anthropometric outcomes. The evidence was generally of poor quality, heterogeneity was high, and GRADE scores ranged from very low to high.

Conclusions – This review confirms positive impacts of sanitation on aspects of health. Evidence gaps remain and point to the need for research that rigorously describes sanitation implementation and type of sanitation interventions.


Recent WASH research – September 7, 2017





WSSCC Releases New Global Sanitation Fund Equality and Non-Discrimination Study

How can WASH programmes leave no one behind, as called for in the Sustaionable Development Goals? WSSCC’s new study, Scoping and Diagnosis of the Global Sanitation Fund’s Approach to Equality and Non-Discrimination, helps answer this question.

The study reveals that many people who may be considered disadvantaged have benefited positively from WSSCC’s Global Sanitation Fund (GSF)-supported programmes, particularly in open defecation free verified areas. In addition, a range of positive outcomes and impacts related to empowerment, safety, convenience, ease of use, self-esteem, health, dignity, an improved environment and income generation were reported by people who may be considered disadvantaged.

Photo Credit: WSSCC

However, the study finds that GSF has not yet systematically integrated EQND throughout the programme cycle. Across all countries, there are people who have either fallen through the net or whose lives have become more difficult after being unduly pressured, or after taking out loans and selling assets to build toilets. More proactive attention is needed throughout the programme cycle to build on current successes and ensure that people are not left behind or harmed through the actions or omissions of supported programmes.

GSF is in the process of putting the study’s recommendations into practice through revised guidelines, minimum standards, practical tools and other mechanisms.

Download the full study, plus a summarized version with GSF reflections, and annexes

Recent WASH research – August 30, 2017

3ie Systematic reviews & Scoping papers

Promoting handwashing and sanitation behaviour change in low- and middle-income countries A mixed-method systematic review, June 2017. This systematic review shows which promotional approaches are effective in changing handwashing and sanitation behaviour and which implementation factors affect the success or failure of such interventions.

Promoting latrine use in India, August 2017. The major barriers to use appear to be poor latrine quality and certain inhibiting knowledge, attitudes and practices (e.g. perceived convenience and pleasure of open defecation, despite knowing the health consequences). The importance of the design and location of the latrine appear to carry significant implications for use.


Multipathway Quantitative Assessment of Exposure to Fecal Contamination for Young Children in Low-Income Urban Environments in Accra, Ghana: The SaniPath Analytical Approach. AJTMH, August 21, 2017. Although we observed variation in estimated exposure (108–1016 CFU/day for Escherichia coli) between different age groups and neighborhoods, the greatest contribution was consistently from food. Hands played a pivotal role in fecal microbe transfer, linking environmental sources to oral ingestion.

Clean and Green: a new implementation framework for sustainable rural sanitation. SEI, 2017. Clean and Green is the first rural sanitation implementation framework that explicitly addresses efficient local resource management, including waste reuse, in parallel with sanitation and hygiene promotion. The framework centres on certifications to reward progress along parallel Clean (risk management) and Green (resource management) tracks.

Black Soldier Fly Biowaste Processing. EAWAG, 2017. The grown larvae make an excellent protein source in animal feed and their sale can, thus, contribute to lower treatment cost and to a lucrative business with organic waste.

Beyond Scarcity: Water Security in the Middle East and North Africa. World Bank, August 2017. This report shows that achieving water security means much more than coping with water scarcity. It means managing water resources in a sustainable, efficient, and equitable way.

Effectiveness of table top water pitcher filters to remove arsenic from drinking water. Environmental Research, October 2017. Thus, the ZeroWater® pitcher filter is a cost effective and short-term solution to remove arsenic from drinking water and its use reduces plastic waste associated with bottled water.

Recent WASH research, updates to Global Waters




Recent WASH research – August 9, 2017


Understanding open defecation in rural India: Untouchability, pollution, and latrine pits. Diane Coffey, Aashish Gupta, Payal Hathi, Dean Spears, Nikhil Srivastav, Sangita Vyas, December 2016.

Human Rights and Taxation of Menstrual Hygiene Products in an Unequal World. book chapter in HUMAN RIGHTS AND TAX IN AN UNEQUAL WORLD (Philip G. Alston and Nikki Reisch eds., Oxford University Press, forthcoming 2018.

UNICEF Field Notes on Community Approaches to Total Sanitation: LEARNING FROM FIVE COUNTRY PROGRAMMES. UNICEF, June 2017.

EXPLORING CROSS-SECTOR LINKAGES BETWEEN POPULATION, HEALTH, ENVIRONMENT, NUTRITION AND FOOD SECURITY: A Review of Best Practices and Lessons Learned. ABCG, June 30, 2017. Incorporate WASH into nutrition and food security programming to enhance outcomes of the nutrition programs and to build a more comprehensive program to improve health.


Does depression moderate handwashing in children? BMC Public Health, August 1, 2017.

Antibacterial efficacy of local plants and their contribution to public health in rural Ethiopia. Antimicrobial Resistance & Infection Control, July 28, 2017. Proper hand hygiene with soap and detergents prevents the transmission of many infectious diseases. This study aims to determine the antibacterial activities of some of the plants against bacteria isolated from humans.

Human Health Risk Assessment Applied to Rural Populations Dependent on Unregulated Drinking Water Sources: A Scoping Review. Int. J. Environ. Res. Public Health, July 28, 2017.

The global burden of disease study 2013: What does it mean for the NTDs? PLoS NTDs, August 3, 2017.

Empirical evidence of the public health benefits of tropical forest conservation in Cambodia: a generalised linear mixed-effects model analysis. Lancet Planetary Health, August 2017. Strictly managed protected areas in Amazonia seem to have reduced biophysical disruption from deforestation and restricted people’s exposure to disease sources, which might have reduced the incidence of malaria, acute respiratory infections, and diarrhea.

Animal-related factors associated with moderate-to-severe diarrhea in children younger than five years in western Kenya: A matched case-control study. PLoS NTDs, August 4, 2017.