COVID-19 pandemic in Africa: Is it time for water, sanitation and hygiene to climb up the ladder of global priorities?
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ABSTRACT:
SUBMITTER: Marcos-Garcia P
PROVIDER: S-EPMC8173594 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:MotivationSanitation and Water for All (SWA) is a global partnership addressing challenges to universal water, sanitation, and hygiene (WaSH) access. Shortly following adoption of the United Nations' Sustainable Development Goals, the Research and Learning (R&L) constituency of SWA undertook a systematic study to determine global research priorities and learning needs.PurposeWe aimed to identify priority topics where improved knowledge would aid achievement of Goal 6, by developing a global WaSH research agenda, and to describe evidence-use challenges among WaSH professionals.Approach and methodsWe delivered a tailored, semi-structured electronic questionnaire to representatives from countries, R&L institutions, and other SWA partners (external support agencies, civil society, and private sector). The survey gathered views from 76 respondents working in an estimated 36 countries across all world regions. Data were analyzed quantitatively and qualitatively to identify patterns and themes.FindingsMost responses indicated lowered confidence on at least one Goal 6 target area, especially managing untreated wastewater and faecal sludge. Both brief and lengthy information formats were valued. WaSH information was perceived as conflicting or unreliable among non-R&L constituencies, suggesting differences in perceptions and information-seeking approaches. While the R&L constituency appeared saturated with learning and training opportunities, others perceived barriers to participating (e.g. not receiving notice or invitation). Research and other WaSH activities were frequently constrained by upward accountability to funders, while stakeholders were inconsistently included in research processes.Policy implicationsThis study offers insight into perceived research and decision challenges related to Goal 6 targets. It develops a unified research agenda focused on high priority topics, and recommends renewed attention to evidence synthesis, learning and implementation support, research engagement, and multisectoral coordination.
| S-EPMC7546406 | biostudies-literature
Project description:Accessing the status of clean drinking water, sanitation, and hygiene remains a challenge in sub-Saharan Africa (SSA). The current article contributes to the progress made by the WASH initiatives in ten SSA countries in eliminating open defecation by 2030, using theoretical data from 2017 to 2019. The authors used regression trend estimation to observe that rural and urban population growth had a statistically significant detrimental influence on the elimination of open defecation by 2030. According to the predicted data model, by 2030-2035, the urban population of SSA would be 65, 25, and 10 million in all the three categories of income groups. An increase in the number of modern pit users (C1) shows no improvement at the annual rate of change. The unimproved toilets and open-pit latrines (C2 and C3) show a linear growth rate, which expanded over time. Population growth, higher unemployment, and teen pregnancies contribute to this increase. Under current conditions, the curve of modern pit latrine users will increase linearly. Nigeria has the most significant number of spread pit latrine users, which has decreased linearly from 25 to 20% since 2017. It was evident that the power-law trend in Nigeria would increase the usage of unimproved pit latrines and open-pit latrines. Ghana had the highest rate (50%) of open-pit latrine users, while the data show that this situation remained stable (2001-2017). In the Democratic Rep. Congo, annual rates increased linearly from 25 to 33% (2000-2017), while Burundi was one of the countries in the region with the lowest number of open-pit latrine users, although the annual rate has increased from 6.13 to 11.75% since 2017 to 2019.Supplementary informationThe online version contains supplementary material available at 10.1007/s10668-022-02620-z.
| S-EPMC9440466 | biostudies-literature
Project description:A healthy and a dignified life experience requires adequate water, sanitation, and hygiene (WaSH) coverage. However, inadequate WaSH resources remain a significant public health challenge in many communities in Southern Africa. A systematic search of peer-reviewed journal articles from 2010 -May 2022 was undertaken on Medline, PubMed, EbscoHost and Google Scholar from 2010 to May 2022 was searched using combinations of predefined search terms with Boolean operators. Eighteen peer-reviewed articles from Southern Africa satisfied the inclusion criteria for this review. The general themes that emerged for both barriers and facilitators included geographical inequalities, climate change, investment in WaSH resources, low levels of knowledge on water borne-diseases and ineffective local community engagement. Key facilitators to improved WaSH practices included improved WaSH infrastructure, effective local community engagement, increased latrine ownership by individual households and the development of social capital. Water and sanitation are critical to ensuring a healthy lifestyle. However, many people and communities in Southern Africa still lack access to safe water and improved sanitation facilities. Rural areas are the most affected by barriers to improved WaSH facilities due to lack of WaSH infrastructure compared to urban settings. Our review has shown that, the current WaSH conditions in Southern Africa do not equate to the improved WaSH standards described in SDG 6 on ensuring access to water and sanitation for all. Key barriers to improved WaSH practices identified include rurality, climate change, low investments in WaSH infrastructure, inadequate knowledge on water-borne illnesses and lack of community engagement.
| S-EPMC9345477 | biostudies-literature
Project description:Herd immunity arises when a communicable disease is less able to propagate because a substantial portion of the population is immune. Nonimmunizing interventions, such as insecticide-treated bednets and deworming drugs, have shown similar herd-protective effects. Less is known about the herd protection from drinking water, sanitation, and hand hygiene (WASH) interventions. We first constructed a transmission model to illustrate mechanisms through which different WASH interventions may provide herd protection. We then conducted an extensive review of the literature to assess the validity of the model results and identify current gaps in research. The model suggests that herd protection accounts for a substantial portion of the total protection provided by WASH interventions. However, both the literature and the model suggest that sanitation interventions in particular are the most likely to provide herd protection, since they reduce environmental contamination. Many studies fail to account for these indirect effects and thus underestimate the total impact an intervention may have. Although cluster-randomized trials of WASH interventions have reported the total or overall efficacy of WASH interventions, they have not quantified the role of herd protection. Just as it does in immunization policy, understanding the role of herd protection from WASH interventions can help inform coverage targets and strategies that indirectly protect those that are unable to be reached by WASH campaigns. Toward this end, studies are needed to confirm the differential role that herd protection plays across the WASH interventions suggested by our transmission model.
| S-EPMC5094239 | biostudies-literature
Project description:IntroductionSub-Saharan Africa has the highest under-five mortality rate and is among the regions where people have the least access to adequate Water, Sanitation, and Hygiene (WASH) services. The work aimed to investigate the effects of WASH conditions faced by children on under-five mortality in Sub-Saharan Africa.MethodsWe carried out secondary analyses using the Demographic and Health Survey datasets of 30 countries in Sub-Saharan Africa. The study population consisted of children born within 5 years preceding the selected surveys. The dependent variable was the child's status (1 = deceased versus 0 = alive) on the survey day. The individual WASH conditions in which children live were assessed in their immediate environment, i.e., at the level of their households of residence. The other explanatory variables were related to the child, mother, household, and environment. Following a description of the study variables, we identified the predictors of under-five mortality using a mixed logistic regression.ResultsThe analyses involved 303,985 children. Overall, 6.36% (95% CI = 6.24-6.49) of children died before their fifth birthday. The percentage of children living in households with access to individual basic WASH services was 58.15% (95% CI = 57.51-58.78), 28.18% (95% CI = 27.74-28.63), and 17.06% (95% CI = 16.71-17.41), respectively. Children living in households using unimproved water facilities (aOR = 1.10; 95% CI = 1.04-1.16) or surface water (aOR = 1.11; 95% CI = 1.03-1.20) were more likely to die before five than those coming from households with basic water facilities. The risk of under-five mortality was 11% higher for children living in households with limited sanitation facilities (aOR = 1.11; 95% CI = 1.04-1.18) than for those with basic sanitation services. We found no evidence to support a relationship between household access to hygiene services and under-five mortality.ConclusionInterventions to reduce under-five mortality should focus on strengthening access to basic water and sanitation services. Further studies are needed to investigate the contribution of access to basic hygiene services on under-five mortality.
| S-EPMC10173862 | biostudies-literature
Project description:The Sustainable Development Goals (SDGs) 6.1 and 6.2 measure the progress of urban and rural populations in their access to different levels of water, sanitation and hygiene (WASH) services, based on multiple sources of information. Service levels add up to 100%; therefore, they are compositional data (CoDa). Despite evidence of zero value, missing data and outliers in the sources of information, the treatment of these irregularities with different statistical techniques has not yet been analyzed for CoDa in the WASH sector. Thus, the results may present biased estimates, and the decisions based on these results will not necessarily be appropriate. In this article, we therefore: i) evaluate methodological imputation alternatives that address the problem of having either zero values or missing values, or both simultaneously; and ii) propose the need to complement the point-to-point identification of the WHO/UNICEF Joint Monitoring Program (JMP) with other robust alternatives, to deal with outliers depending on the number of data points. These suggestions have been considered here using statistics for CoDa with isometric log-ratio (ilr) transformation. A selection of illustrative cases is presented to compare performance of different alternatives.
| S-EPMC7316445 | biostudies-literature
Project description:Endemic issues of sustainability in the water, sanitation, and hygiene (WASH) sector have led to the rapid expansion of 'system approaches' for assessing the multitude of interconnected factors that affect WASH outcomes. However, the sector lacks a systematic analysis and characterization of the knowledge base for systems approaches, in particular how and where they are being implemented and what outcomes have resulted from their application. To address this need, we conducted a wide-ranging systematic literature review of systems approaches for WASH across peer-reviewed, grey, and organizational literature. Our results show a myriad of methods, scopes, and applications within the sector, but an inadequate level of information in the literature to evaluate the utility and efficacy of systems approaches for improving WASH service sustainability. Based on this analysis, we propose four recommendations for improving the evidence base including: diversifying methods that explicitly evaluate interconnections between factors within WASH systems; expanding geopolitical applications; improving reporting on resources required to implement given approaches; and enhancing documentation of effects of systems approaches on WASH services. Overall, these findings provide a robust survey of the existing landscape of systems approaches for WASH and propose a path for future research in this emerging field.
| S-EPMC7037755 | biostudies-literature
Project description:The previous paucity of data and research on water, sanitation and hygiene (WASH) in schools in Brazil have been preventing an assessment of how safe and healthy schools are to reopen during the COVID-19 pandemic. This study aimed first to assess the current situation of WASH in schools in Brazil and, second, to evaluate to what extent Brazilian schools have been making any progress in providing WASH since the beginning of the COVID-19 pandemic. Data on WASH conditions in schools in Brazil was retrieved from the 2020 and 2021 Brazilian National School Census (BNSC). For the first objective, frequencies of 31 variables were calculated for the whole country and regions, considering all 173,700 schools from BNSC of 2021. Five main variables were considered as indicators of adequate WASH infrastructure in schools. T-test and ANOVA were used to assess differences in these five variables according to the locality, management model and regions. For the second objective only schools presented in both datasets (n = 170,422) were considered to compare WASH in schools pre- and peri-COVID-19 pandemic. Frequencies of 31 variables were calculated for the whole country and regions before and during the pandemic. Paired t-tests were conducted when differences in variables across the years were observed. At the present moment, the majority of schools in Brazil have bathrooms (97%), drinking water with quality suitable for human consumption (95%), improved sanitation facilities (78%) and solid waste collection (70%). Between 2020 and 2021, there was a mix of improvements and deterioration in the school's WASH infrastructure in all regions of the country. Overall, solely considering the WASH infrastructure, schools in the South and Southeast regions of the country are better prepared for the safe reopening. Nevertheless, public schools, schools located in rural areas and the North and Northeast regions of the country, are more in need of WASH interventions. Results indicate that little progress was achieved, and schools in Brazil are still in need of improvements. Graphical abstract Image 1
| S-EPMC9637527 | biostudies-literature
Project description:Background:Vietnam declared its national roadmap towards Sustainable Development Goals number 6 by 2030. However, specific supporting programmes and financial means to proceed with the roadmap have not been passed on. Evidence on the financing for water, sanitation, and hygiene (WASH) being allocated or spent has not been well documented in Vietnam. This study aimed to obtain an overview and assessed the public funding across the WASH sector of Vietnam in 3 fiscal years 2016, 2017, and 2018. Methods:A cross-sectional study was conducted for information about the public financing for WASH at both national and sub-national levels. An activity-based costing approach was applied to determine WASH-related public expenditure. Fourteen focus group discussions with key stakeholders were used to identify the WASH activities and to access financial reports of these relevant institutions. TrackFin methodology was used to assemble the public financing for WASH in Vietnam. Results:The public expenditure of WASH declined by about 30.7% over the 3 fiscal years, from US $2016 million in 2016 to US $1397 million in 2018. Meanwhile, this expenditure allocated to the poor or mountainous areas increased by 3 folds. The highest proportion of WASH public funding was invested in sanitation through large network systems (59.07% of the total public expenditure), whereas the lowest was in hygiene promotion and handwashing facilities. The domestic budget was still the main source of public financing for WASH services, with 2 largest shares coming from government revenues (47.24%) and repayable loans (20.49%). Conclusion:The main source of financing for WASH was from the government, yet its public expenditure has been decreased. A refined roadmap with specific steps for a sustainable WASH financing system in Vietnam, particularly to leverage government and private sector resources, is required to ensure no one is left behind.
| S-EPMC7338735 | biostudies-literature
Project description:IntroductionAdequate menstrual health and hygiene (MHH) is necessary for women's health and equity of all menstruators. Female sex workers (FSW) require good MHH to prevent discomfort and exposure to pathogens. No studies have evaluated water, sanitation, and hygiene (WASH) conditions of FSW. We report on a cross-sectional WASH assessment at FSW venues in Kisumu, western Kenya.MethodsStakeholders identified 77 FSW venues in Kisumu, of which 47 were randomly sampled and visited between April-May 2023. A standardized structured survey of WASH conditions was deployed by trained research staff using Android tablets after proprietor's consent. WASH scores ranging 0-3 were computed based on point each for direct observation of water available, soap available, and acceptable latrine. MHH scores ranging between 0-4 were computed (one point each) for direct observation of: currently available soap and water, locking door on a usable latrine, functional lighting, and a private area for changing clothes or menstrual materials, separate from the latrine(s). WASH and MHH scores were compared by venue type using non-parametric Kruskal-Wallis tests, and non-parametric Spearman rank tests.ResultsFull WASH criteria was met by 29.8% of venues; 34.0% had no adequate WASH facilities; 46.8% had no female latrine; and 25.5% provided soap and water in private spaces for women. While 76.6% had menstrual waste disposal only 14 (29.8%) had covered bins. One in 10 venues provided adequate MHM facilities. Poorest WASH facilities were in brothels and in bars, and three-quarters of bars with accommodation had no MHH facilities.DiscussionWASH and MHH services were sub-optimal in the majority of FSW venues, preventing menstrual management safely, effectively, with dignity and privacy. This study highlights the unmet need for MHH support for this population. Poor MHH can deleteriously impact FSW health and wellbeing and compound the stigma and shame associated with their work and ability to stay clean. Acceptable and cost-effective solutions to sustainably improve WASH facilities for these populations are needed.Trial registrationClinicaltrial.gov NCT0566678.
| S-EPMC10936742 | biostudies-literature