When Water Doesn’t Flow: Why Lack of Water Matters in Healthcare Facilities. PLoS Global Health Blog, June 29, 2017.
Why Lack of Water Matters in Healthcare Facilities
Water, as well as the availability of sanitation and hygiene infrastructure, are essential to providing safe, quality healthcare. Without water, surfaces remain unclean and medical equipment cannot be sterilized. Water shortages within healthcare facilities are particularly concerning when thinking about the water needed for surgery or in maternity units.
When water does not flow from the piped water supply within the hospital, jerry cans (the yellow containers shown) are used to collect water from a nearby lake
According to the World Health Organization’s Essential Environmental Health Standards in Health Care, 100 liters of water are needed per medical intervention preformed in healthcare facilities. As an example, if one hospital in Ghana reported that 138 babies were born in one month then 13,800 liters of water would be needed to ensure safe delivery of all babies. Based on my experiences as a researcher and a patient in a rural Ghana hospital, meeting this requirement would be virtually impossible.
During my hospitalization, water did not flow through the pipes within the hospital and the donated water treatment system was not operating due to water scarcity and intermittent power in the region.
The lack of water sparked a series of managerial decisions, which in turn affected patients’ access to toilets and handwashing facilities, which led to clinical staffing shortages. Without adequate water in the hospital, management locked the bathrooms within the wards and rationed water for staff handwashing.
My infirmed neighboring bedmates were told to use an open area behind the ward to relieve themselves. In a few cases, these sick patients were too weak to do so, and the floor next to their beds quickly became soiled contributing to environmental contamination. The hospital would then dispatch valuable nursing staff to a lake –located half a mile away to get water in order to clean floors.
Read the complete article.
Think tank for sanitation management inaugurated. Graphic, June 28, 2017.
An environmental sanitation think tank to serve as a focal point for providing long-term solutions to sustainable and environmental sanitation management in Ghana has been inaugurated in Accra.
Mr Joseph Kofi Adda, the Minister of Sanitation and Water Resources, swearing in the board of the Tersus Ghana Environmental Sanitation Think Tank at the Ghana Academy of Arts and Science conference room in Accra. Picture: EMMANUEL QUAYE
The think tank, called Tersus Ghana, will provide input and guidance for rigorous empirical research that will produce environmental sanitation-related information relevant to the sector and the nation as a whole.
Tersus, a Latin word for ‘clean-up’, will operate as a not-for-profit, non-partisan group with a membership made up of government, academia, as well as non-governmental organisations (NGO) and industry-based experts.
Read the complete article.
Plan International USA and The Water Institute at UNC have conducted the first study to present comprehensive, accurate, disaggregated costs of a WaSH behaviour-change programme. The study calculated programme costs, and local investments for four community-led total sanitation (CLTS) interventions in Ghana and Ethiopia.
Jonny Crocker, Darren Saywell, Katherine F. Shields, Pete Kolsky, Jamie Bartram, The true costs of participatory sanitation : evidence from community-led total sanitation studies in Ghana and Ethiopia. Science of The Total Environment, vol. 601–602, 1 Dec 2017, pp: 1075-1083. DOI: 10.1016/j.scitotenv.2017.05.279 [Open access]
Evidence on sanitation and hygiene program costs is used for many purposes. The few studies that report costs use top-down costing methods that are inaccurate and inappropriate. Community-led total sanitation (CLTS) is a participatory behaviour-change approach that presents difficulties for cost analysis. We used implementation tracking and bottom-up, activity-based costing to assess the process, program costs, and local investments for four CLTS interventions in Ghana and Ethiopia. Data collection included implementation checklists, surveys, and financial records review. Financial costs and value-of-time spent on CLTS by different actors were assessed. Results are disaggregated by intervention, cost category, actor, geographic area, and project month. The average household size was 4.0 people in Ghana, and 5.8 people in Ethiopia. The program cost of CLTS was $30.34–$81.56 per household targeted in Ghana, and $14.15–$19.21 in Ethiopia. Most program costs were from training for three of four interventions. Local investments ranged from $7.93–$22.36 per household targeted in Ghana, and $2.35–$3.41 in Ethiopia. This is the first study to present comprehensive, disaggregated costs of a sanitation and hygiene behaviour-change intervention. The findings can be used to inform policy and finance decisions, plan program scale-up, perform cost-effectiveness and benefit studies, and compare different interventions. The costing method is applicable to other public health behaviour-change programs.
Posted in Africa, Publications, Research, Sanitary Facilities
Tagged Community-Led Total Sanitation, direct support costs, Ethiopia, Ghana, local investment, Plan International, programme costs, UNC Water Institute
GHANA WASH PROJECT: Lessons Learned: Hybrid CLTS Approach to Improving Sanitation, 2014.
USAID’s Ghana Water, Sanitation and Hygiene (GWASH) Project aimed to improve rural sanitation access through the provision of household latrines to households in targeted communities. In the beginning of the project, GWASH used a “high-subsidy” approach for household latrine provision, providing households with a 60 percent subsidy per latrine.
It was in this vein that GWASH aimed to meet its project target of constructing 4,680 household latrines over the course of a four-year period. During the second year of the project, the Government of Ghana (GOG) implemented a new sanitation policy that promoted a pure Community-Led Total Sanitation (CLTS) approach.
The strategy is a no-subsidy approach that emphasizes community-level demand creation for sanitation improvements aimed at stopping open defecation and supporting household and community efforts to independently construct improved household latrines.
Published on Oct 10, 2016
Many low-income residents of Kumasi and Ga West (Accra) live in compound housing where they share the same living space with more than 20 people. The vast majority will have no access to in-house sanitation, instead relying on the high number of public toilets which typify Ghana’s urban centres.
Kumasi Metropolitan Assembly (KMA) and Ga West Municipal Authority (GWMA) are responding to this challenge through a 5-year compound sanitation strategy, now being implemented with support from the USAID Sanitation Service Delivery (SSD) program.
This webinar presented the learning we’ve had so far, and the successes and failures of the strategy.
Presenters: Georges Mikhael (Head of Sanitation, WSUP), Frank Romeo Kettey (Project Manager, WSUP Ghana) and Richard Amaning (WASH Financing Expert, SNV). Moderated by Sam Drabble (Research and Evaluation Manager, WSUP).
Improving the quality of public toilet services in Kumasi, 2016. Water and Sanitation for the Urban Poor.
Public toilets are the leading form of sanitation in urban Ghana: in Kumasi, 700,000 people use one each day. This Note presents the activities of Kumasi Metropolitan Assembly (KMA) to raise the standard of these services.
To assist KMA in promoting greater private sector involvement, PPIAF commissioned the consultancy Ernst & Young (EY) to conduct a feasability study. The study recommended that toilets participating in the scheme be operated under a Build, Own, Operate, Transfer (BOOT) model, presented in Figure 2. Key features of the model are: 1) a Public-Private Partnership (PPP) Project Company would design, build, finance, operate and maintain the toilets for a 20-year concession period, after which the assets would be transferred back to KMA; 2) the Company would directly collect user fees and use it to cover their costs; 3) the Company would pay a monthly franchise fee to KMA, calculated as a percentage of revenue; 4) revenues 10% higher than assumptions made in the financial model would be paid to KMA; and 5) donor funding and cover to insure KMA’s termination guarantee may be sought.
There is a clear need for improved standards of public toilets in Kumasi. Progress has already been made, with training and improved monitoring impacting positively on the level of service. While rehabilitation and construction under the BOOT scheme will take time to complete, the resulting improvements should reduce waiting times for consumers, improve overall service quality and enhance financial viability.
KMA recognises that PLBs are not the long-term solution — a five-year compound sanitation strategy is being implemented in parallel, to achieve universal access to in-house sanitation in the long term — but the steps now being taken by KMA will ensure that public toilets provide the best possible service in the interim.