Tag Archives: sanitation coverage

No evidence that current sanitation interventions stop faecal exposure

A systematic review [1] of 29 studies found “little to no effect from sanitation interventions” on “faecal-oral transmission of enteric and other pathogens”. The transmission pathways reviewed included “faecal pathogens or indicator bacteria in drinking water, hand contamination, sentinel toys, food, household and latrine surfaces and soil, as well as flies and observations of human faeces”.

There was some evidence showing the association of sanitation “with reductions in flies and a small effect on observations of faeces”. There was also evidence showing “an inverse relationship between the distance of a water supply from a latrine and level of faecal contamination of such water supply”.

The authors of the review conclude that current sanitation efforts in low-income countries are ineffective and unable to prevent contamination along well-known pathways. This may be because “interventions often fail to achieve universal coverage or use”, which is the subject of another systematic review [2].

As expected from researchers, they are also recommend that more rigorous studies are required to investigate the impact of sanitation interventions on multiple transmission pathways.

Unfortunately this important study is not available as an open access article.

[1] Sclar GD, Penakalapati G, Amato HK, Garn JV, Alexander K, Freeman MC, Clasen T. Assessing the impact of sanitation on indicators of fecal exposure along principal transmission pathways : a systematic review. International Journal of Hygiene and Environmental Health. 2016 Oct 1.DOI:10.1016/j.ijheh.2016.09.021

[2] Garn, J.V., Sclar, G.D., Freeman, M.C., Alexander, K.T., Penakalapati, G., Brooks, P.,Rehfuess, E.A., Clasen, T.F. The impact of sanitation interventions on latrine coverage and latrine use : a systematic review and meta-analysis. International Journal of Hygiene and Environmental Health. 2016 Oct 11.DOI: 10.1016/j.ijheh.2016.10.001

India census: more people have a mobile phone than a household toilet

Nearly half of India’s 1.2 billion people have no toilet at home, but more people own a mobile phone, according to the latest census data.

Only 46.9% of the 246.6 million households have lavatories while 49.8% defecate in the open. The remaining 3.2% use public toilets.

Census of India 2011 – Availability and Type of Latrine Facility: 2001-2011

Census 2011 data on houses, household amenities and assets reveal that 63.2% of homes have a telephone. More than half the population – 53.2% – have a mobile phone.

Continue reading

Advances in sanitation bypassing the poor and rural communities

The UN’s latest Millennium Development Goals Report notes that progress in sanitation has largely bypassed the poor while rural populations remain disadvantaged.

An analysis of trends over the period 1995-2008 for three countries in Southern Asia shows that improvements in sanitation disproportionately benefited the better off, while sanitation coverage for the poorest 40 per cent of households hardly increased. Although gaps in sanitation coverage between urban and rural areas are narrowing, rural populations remain at a distinct disadvantage in a number of regions.

Continue reading

Uruguay: legislation approved to make sewerage connections compulsory

All households in Uruguay must now have a  sewerage connection. Uruguay’s House of Representatives passed a bill making sewerage connections compulsory on 5 July 2011.

The new bill includes provisions to provide subsidies and grants to those who cannot afford a connection, as well as fines for those who fail to comply with the new law.

In the capital Montevideo, the local government will administer the new law, while state water utility OSE will be responsible for the rest of the country.

While improved rural sanitation coverage was estimated to be 99% in 2008 (WHO/UNICEF, 2010), some 50,000 households are still not connected to a sewerage network. In some areas only 15% of households have sewerage connections.

Source: La Republica [in Spanish], 05 Jul 2011

Bangladesh: government’s sanitation claim trashed

The finance minister’s claim that 90.6 percent families in Bangladesh are using sanitary latrines has been dismissed by experts. The Bangladesh Bureau of Statistics (Multiple Indicator Cluster Survey Report 2010) data shows the sanitary latrine coverage in Bangladesh is only 51.5 per cent (which is consistent with the 53 per cent coverage figure given by the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation in 2010). Wateraid Bangladesh’s country director Dr Md Khairul Islam that there was ‘no way’ such huge coverage has been achieved as claimed by the finance minister and he was provided with ‘misleading’ data was provided to the minister.

Minister A.M.A. Muhith named the 90.6 per cent coverage figure while presenting the budget for fiscal year 2011-2012 year. In his 2009-2010 budget speech the minister announced a plan to construct 500,000 new latrines so that total sanitation coverage would be achieved by 2013.

Source: bdnews24.com, 10 Jul 2011

Burkina Faso: race to achieve goals on sanitation

The government of Burkina Faso has embarked on the construction of 55,000 latrines each year to improve access to proper sanitation for the population from the present 10 percent to 54 percent by 2015.

According to the authorities, the average rate of access to sanitation in urban areas is currently 20 percent, while in rural areas, it is as low as one percent in some areas.

Burkina Faso will invest 24 million dollars in each of the next five years. The government, which now spends $8 million a year thanks to support from donors, plans to double, even triple its own annual contribution of around $2 million from the national budget.

“When you look at all sectors, things are moving. But on sanitation, a domain so fundamental to quality of life, we can see that we are very far behind,” Laurent Sédogo, Burkinabé minister for agriculture, water and fisheries resources told IPS.

“To put it plainly, out of every 1,000 people, only 100 have adequate (sanitation) infrastructure. The other 900 must take to the bush and, to protect their modesty, many wait until the dead of night because of the loss of vegetation,” Sédogo said.

Amélie Ouédraogo, a resident of the Tanghin neighbourhood of the Burkinabé capital Ouagadougou, said that construction of latrines will permit the dead to regain their peace. “Even the cemeteries are not safe when night falls. We see people headed there, but we cannot prevent them from relieving themselves.”

According to Ouédraogo, the situation is even more dire during the rainy season, because the water which flows through the streets, a favourite playground for children, is polluted. “We have cases of diarrhoea, but people refuse to make the link between these illnesses and their causes.”

Mahamoudou Sana, a merchant in one of Ouaga’s livestock markets said, “Once we have latrines, both we and our customers can make ablutions and wash ourselves before prayers. Previously, we had to hide ourselves in tall bush to relieve ourselves during the day.”

The ministry of health underlines that the absence of toilets leads to illness, notably diarrhoea, which is responsible for 58 percent of child deaths in Burkina.

According to non-governmental organisation WaterAid, some 2,000 children die every day. The NGO adds that simply using toilets could reduce the incidence of diarrhoea by 40 percent; clean toilets, combined with safe drinking water and good hygiene, cases of diarrhoea could be reduced by 90 percent.

WaterAid is worried that 90 percent of African nations will not achieve the Millennium Development Goal on sanitation, and says that African heads of state – who re-committed themselves to promoting maternal health at the July summit of the African Union – to resolve questions of sanitation if they want to reduce child and maternal mortality.

In rural areas, where 80 percent of Burkina Faso’s population lives, the government’s plan is for 395,000 households to build toilets, as well as the construction of 12,300 public latrines. The programme also foresees 222,000 new household toilets in urban centres, alongside 900 public latrines in schools, health centres, markets and public transit points.

The Burkinabé president, Blaise Compaoré, personally participated in the launch of the campaign, with an eye to enlisting both the general population and international financial partners to make sanitation a national priority.

The government offensive comes after finding that the pace of progress is insufficient to attain the goal on sanitation in a context of rapid population growth. According to the last census in 2006, Burkina Faso’s growth rate of three percent is one of the highest in sub-Saharan Africa and the world.

“Across West and Central Africa, coverage in urban areas varies between 30 and 60 percent, while in rural areas the rate is from 1 to 22 percent,” says Armah Klutsé, of the Regional Centre for Low-cost Water Supply and Sanitation (known by its French acronym, CREPA).

With headquarters in Ouagadougou, CREPA is active in 17 West and Central African countries, where it supports governments in the design and implementation of policy on sanitation and potable water.

“With this display of political will, it seems that action will be taken to achieve (sanitation goals),” Klutsé says.

Source: Brahima Ouédraogo, Inter Press Service / allAfrica.com, 31 July 2010

Pakistan: ‘24% of country’s hospital beds occupied by waterborne disease patients’

In Pakistan, 38.5 million people do not have access to safe drinking water and 50.7 million do not have the facility of proper sanitation. These high statistics result in more than 24 percent of Pakistan’s hospital beds being occupied by the people suffering from waterborne diseases. Moreover, diarrhoea is the leading cause of mortality and second leading cause of morbidity among children under five years of age, said experts at a meeting in Karachi.

Addressing the session of the first day of Aga Khan University’s 13th National Health Sciences Research Symposium on ‘Impact of Water and Sanitation on Health: Our Problems and Our Solutions“, Pakistan government Health Director General Dr Rashid Jooma said that the work being done on the water and sanitation sectors in Pakistan is not like that being done in other countries, such as India, worsening the sanitation conditions.

Jooma said that the bad sanitation conditions are not only affecting human health but the environment too. He added that the estimated cost of environmental degradation in Pakistan is Rs 365 billion per year, of which Rs 112 billion [US$ 1.34 billion] is caused by inadequate water supply, sanitation and hygiene conditions.

Talking about the government’s response to these challenges, including legislation and policy, and initiatives for safe drinking water, sanitation and hygiene, he said there are several projects in the pipeline and more is yet to be done.

Senior Architect and Urban Town Planner Arif Hassan underlined the fact that over the last 50 years the government has invested considerable money, including aid, in drinking water and sanitation programmes. However, these projects have not been successful and have increased Pakistan’s foreign debt considerably. Some NGO projects have delivered positive results but unless their methodology becomes a part of the official policy, planning and implementation procedures, they cannot be successful to the extent required for servicing the growing demand for water and sanitation. In the past two years, the government has legislated a sanitation and drinking water policy which, to be successful, will need to relate to ground realities.

[…] Aga Khan Program for Islamic Architecture at MIT Professor Dr James Wescoat said landscape planning has an increasing role to play in helping expand household and neighbourhood water and sanitation solutions to rural and urban areas. “Environmental design has played a vital role in linking water and health, from Mohenjo Daro to Boston,” he said.

Addressing the Symposium via the Internet from India, Dr Bindeshwar Pathak, founder of the Sulabh Sanitary Movement, said low-cost sanitation technology is available and by adopting these technologies, any country can improve the sanitation sector. Sharing his experience of introducing a two-pit pour flush toilet that uses only 1-1.5 litres of water, he said that the technology is flexible and affordable and can be implemented at costs starting from USD 30, depending on the quality.

AKU’s Dr Iqtidar A Khan said that in Pakistan 90 percent of water is used for agriculture and less than 10 percent for drinking and sanitation. He said the water availability has fallen from 5,000 cubic metres per capita in the early 1950s to less than 1,500 cubic metres today. Quoting the words of former United Nations Secretary General Kofi Annan, he said that AIDS, tuberculosis, malaria and other infectious diseases will not be defeated until the battles for safe drinking water, sanitation and basic health care are won.

Source: Amar Guriro, Daily Times, 28 Oct 2009

Asian sanitation data book 2008 – achieving sanitation for all

The overall city sanitation picture in Asia is not bright. Sanitation has not been given sufficient priority and certainly lags behind provision of drinking water. This is one of the findings of a survey of 27 cities published by the Asian Development Bank in the “Asian sanitation data book 2008“.

Asian-sanitation-data-book-2008-cover The first data book on sanitation for the Asia and Pacific region, this book features raw data and analyses on the sanitation situation in 27 cities. The cities are members of CITYNET and participants in the Water for Asian Cities Program of the Asian Development Bank (ADB) and the United Nations Human Settlements Programme (UN-HABITAT).

Of the 27 cities, 1 is in Bangladesh, 3 are in the People’s Republic of China, 4 are in India, 1 in Indonesia, 3 in the Lao People’s Democratic Republic (Lao PDR), 5 in Nepal, 3 are in the Philippines, 2 in Sri Lanka, and 5 in Viet Nam

Although the information collected was not complete for all cities, the book draws a number of conclusions from the data.

Based on the survey, the key findings are the following:

  • Lack of sanitation and household wastewater treatment facilities is polluting ground and surface waters.
  • Sustaining public health is an expected outcome of having adequate sanitation, but over half of the cities were unable to report key health statistics. Those that did reveal increasing diarrheal cases when the share of household wastewater increases.
  • Far too many cities still have incidences of open defecation (ranging from 10%–40%) and sanitation coverage depends on private householders investing in toilets and septic tank systems.
  • Although almost all cities are aware of their sanitation problems, only 40% of responding cities have sanitation plans, and few were able to provide information on capital expenditure and operations and maintenance costs.
  • Most cities that provide sanitation services rely on government funding to pay for capital and operating costs, with only 10% indicating that sanitation fees and charges can cover their costs.
  • Multiple agencies have responsibilities for some aspects of sanitation. However, local government seems to be the primary organization. These organizations were operating under at least several national laws and one local law. These institutional arrangements may frustrate action and reduce accountability.

The findings, despite qualifications about data quality, point to several priority actions that government and other stakeholders need to undertake:

  • Initiate city sanitation plans, including setting targets for sanitation outcomes and coverage.
  • Simplify institutional arrangements to strengthen accountability and avoid multiple-agency involvement that can cause delays in taking action; set in place a coordinating mechanism.
  • Review operation and maintenance expenditures and cost recovery policies to ensure sanitation providers can sustain operations and extend services.
  • Improve sanitation benchmark indicators and set in place a sanitation information management system that will be regularly updated to help planners and decision makers make investment and operations decisions.
  • As significant investment is needed, consider sourcing funds from beyond government sources—such as the private sector and user fees, and other revenue-generating mechanisms.

ADB (2009). Asian sanitation data book 2008 : achieving sanitation for all. Manila, Philippines, Asian Development Bank. x, 134 p. : 2 fig., 27 tab. ISBN 978-971-561-808-3
Download full document

Uganda, Kasese: unwashed hands cause cholera

Persistent outbreaks of cholera in Kasese District have been blamed on poor hand-washing practices and bad eating habits. This was noted at a one-day advocacy meeting for district councillors on water and sanitation held in Kasese Catholic Social Hall on Thursday [01 October 2009].

Presenting a latrine coverage and hand-washing situational analysis in Kasese, the district health inspector also the disease surveillance officer, Ericana Bwambale, said washing hands among the people of Kasese ranged from 17% to 34%. He named the sub-counties where people rarely wash their hands as Muhokya with 17%, followed by Kitswamba at 18% and Rukoki at 20%.

He said Kyabarungira Sub-county has the lowest latrine coverage at 57%, followed by Rukoki at 60% and Kisinga at 65%. Kyondo Sub-county had the highest latrine coverage of 88%, followed by Maliba Sub-county at 87%.

He said the majority of the people in Kasese eat whatever food they come across without considering its cleanliness.

Since March [2009], 500 cases of cholera have been reported in Kasese with about 10 deaths. The Busongora County health inspector, Steven Bagonza, said cholera cases have been reported in all the four constituencies in the district.

The district councillors on the technical and social services committee blamed the sub-county health assistants for the deteriorating health conditions in the district. They said health workers were not sensitising the community on the need to improve sanitation and hygiene in their homes.

The head of the district technical and social services committee, Mustafa Kikusa, said all the sub-county health assistants should be summoned before the district committee and explain why they are failing to do their work. He noted that the Government was doing all it could to improve people’s standards of living but was being frustrated by civil servants who are failing to deliver as expected.

During the meeting, it was reported that people of Kasese were feeding on animal offals and fish skeletons from Kampala that have some times compromised the health of the people.

The furious councillors promised to move a motion to ban the sale of offals and skeleton fish in the district, saying they were unhygienic and partly responsible for the deteriorating health conditions.

However, some councillors on the committee, especially women said that they would block the motion if brought to council, adding that majority of the people in the district were surviving on offals and fish skeletons because they were cheap and some people cannot afford meat.

Source: Bernard Masereka, New Vision / allAfrica.com, 03 Oct 2009

Brazil: World Cup cities need US$3.4bn to provide 100% sanitation coverage

A total of 6.7bn reais (US$3.4bn) is needed to provide 100% sanitation coverage in the 12 Brazilian cities selected to host matches during the 2014 World Cup, according to a study requested by NGO Instituto Trata Brasil (ITB).

The study showed the cities of Belo Horizonte (Minas Gerais), São Paulo, Salvador (Bahia) and Rio de Janeiro have the highest number of people with sewage collection services with 97.1%, 88.5%, 87.8% and 83.7% respectively.

Brasília has 80.2% coverage, Curitiba (Paraná) 79.4% and Fortaleza (Ceará) 54.6%, an ITB release said.

Collection rates below 50% were reported in Porto Alegre (Rio Grande do Sul), Recife (Pernambuco) and Cuiabá (Mato Grosso) with 49.3%, 47.1% and 41.2% respectively. Manaus (Amazonas) and Natal (Rio Grande do Norte) came in with the lowest coverage of 35.0% and 21.3%.

The study was carried out by economic think tank Fundação Getúlio Vargas (FGV).

Source: BNamericas [subscription site], 07 Jul 2009