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Redefining shared sanitation

7 May 2015 10:22 (America/New_York)

Redefining shared sanitation. WHO Bulletin, April 2015.

Authors: Thilde Rheinländer, Flemming Konradsen, Bernard Keraita, Patrick Apoya & Margaret Gyapong

Current definitions do not account for the diversity of shared sanitation: all shared toilet facilities are by default classified as unimproved by JMP because of the tendency for shared toilets to be unmanaged and unhygienic. However, we argue that shared sanitation should not be automatically assumed to be unimproved. We also argue that it is necessary to have a new look at how we define shared sanitation and use specific sub-categories including household shared (sharing between a limited number of households who know each other), public toilets (intended for a transient population, but most often the main sanitation facility for poor neighbourhoods) and institutional toilets (workplaces, markets etc.).

This sub-classification will identify those depending on household shared sanitation, which we consider to be only a small step away from achieving access to private and improved sanitation. This sub-category of shared sanitation is, therefore, worth discussing in greater detail. Experiences from Ghana and other sub-Saharan African countries illustrate how household shared sanitation may well fit with culturally acceptable sanitation choices and not necessarily be unhygienic. Indeed, household shared sanitation may be the only realistic option that brings people the important first step up the sanitation ladder from open defecation to a basic level of sanitation.

 

 

 

The Relationship between Inadequate Sanitation Facilities and the Economic Well-Being of Women in India

7 May 2015 10:17 (America/New_York)

The Relationship between Inadequate Sanitation Facilities and the Economic Well-Being of Women in India. Journal of Economics and Development Studies, March 2015.

Authors: Mark Gius & Ramesh Subramanian

The present study attempts to ascertain the relationship between inadequate sanitation facilities and two key measures of the economic well-being of women in India: literacy rates and labor force participation rates. A two-stage regression model and correlation analysis are employed. All data is district-level for the year 2011. Results from a simple correlation analysis suggest that there is a positive correlation between latrine availability and female literacy rate but a negative correlation between latrines and the female labor force participation rate.

Results from a two stage analysis, however, indicates that latrine availability is positively related to both female labor force participation and female literacy rates. These results suggest that the availability of latrines positively impacts the economic well-being of women. This is one of the first studies that examines the relationships between latrine availability and female labor force participation and literacy rates in India, and this is one of the few studies on this topic to use district-level data. Hence, these results are significant and suggest that the government of India should invest more in proper sanitation facilities for all of its citizens. These types of investments would greatly improve the economic lives of India’s women.

Urban Sanitation Research Programme: Consolidated findings

7 May 2015 10:12 (America/New_York)

Urban Sanitation Research Programme: Consolidated findings, 2015. WEDC.

Authors: Louise Medland, Andrew Cotton and Rebecca Scott

This report aims to present the synthesised findings of the SPLASH Urban Sanitation research Programme. This comprised five projects which conducted research in eight urban centres of seven countries of sub-Saharan Africa between 2011 and 2014. The research aimed to improve understanding and thus delivery of sanitation service provision in urban areas which include informal settlements.

Knowledge gaps highlighted through the research

  • Transport and Treatment: Very little is known about the transport and treatment stages of the urban sanitation service chain and these gaps in knowledge make effective city wide planning challenging.
  • Private sector capacities: More work should be conducted to understand the capacities of thetanker operators and their staff. Given that the private sector is likely to fill the gaps in serviceprovision that cannot be covered by public operators, it is useful to understand what capacities tanker owners and operators have to take on larger responsibilities for service provision and what is stopping them from doing it now.
  • Treatment of faecal sludge for end-use options: There is relatively little information about the treatment of faecal sludge for end-use options that can be scaled up. Potential industrial users need to see more evidence of the technology used to produce solid fuel from faecal sludge working at scale. Treatment technologies and decision support tools need to be developed foreach faecal sludge end product (e.g. solid fuel, biogas, protein).
  • Market conditions for treated faecal sludge end products: The market conditions for end products are also largely unknown. The starting point is a better understanding of the market potential for each end product, for example: what factors, such as price, quality or quantity, do the products have to compete on? What other similar products/sources do they compete against? What are the circumstances under which preference and use for each end product can increase?
  • Financing of both the capital infrastructure and recurrent operation and maintenance costs: Financing for faecal sludge management (FSM) remains a challenge for city wide planning. The research findings from FaME in particular provide a starting point for developing afunding plan for faecal sludge management (FSM), including capital and operational expenditure and income but much more information on the reliable financial flows within the sanitation service chain is needed.

Sharing reflections on inclusive sanitation

28 April 2015 13:09 (America/New_York)

Sharing reflections on inclusive sanitation. Environment & Urbanization, April 2015.

Authors: Barbara Evans, Patrick Chikoti, et al.

This paper draws on sanitation innovations in  Blantyre (Malawi), Chinhoyi (Zimbabwe), Dar es Salaam (Tanzania) and Kitwe (Zambia) driven by slum(1)/shack dweller federations to consider what an inclusive approach to sanitation would involve. This includes what is possible for low-income households when there is little or no external support, no piped water supply and no city sewers to connect to.

The paper discusses low-income households’ choices in situations where households can only afford US$ 3–4 per month for sanitation (for instance between communal, shared and household provision). It also considers the routes to both spatial and social inclusion (including the role of loan finance in the four cities) and its political underpinnings. In each of the four cities, the community engagement in sanitation intended from the outset to get the engagement and support of local authorities for city-wide sanitation provision.

Slum Sanitation and the Social Determinants of Women’s Health in Nairobi, Kenya

28 April 2015 12:57 (America/New_York)

Slum Sanitation and the Social Determinants of Women’s Health in Nairobi, Kenya. Journal of Environmental and Public Health, April 2015.

Authors: Jason Corburn and Chantal Hildebrand

Inadequate urban sanitation disproportionately impacts the social determinants of women’s health in informal settlements or slums. The impacts on women’s health include infectious and chronic illnesses, violence, food contamination and malnutrition, economic and educational attainment, and indignity. We used household survey data to report on self-rated health and sociodemographic, housing, and infrastructure conditions in the Mathare informal settlement in Nairobi, Kenya. We combined quantitative survey and mapping data with qualitative focus group information to better understand the relationships between environmental sanitation and the social determinants of women and girls’ health in the Mathare slum.

We find that an average of eighty-five households in Mathare share one toilet, only 15% of households have access to a private toilet, and the average distance to a public toilet is over 52 meters. Eighty-three percent of households without a private toilet report poor health. Mathare women report violence (68%), respiratory illness/cough (46%), diabetes (33%), and diarrhea (30%) as the most frequent physical burdens. Inadequate, unsafe, and unhygienic sanitation results in multiple and overlapping health, economic, and social impacts that disproportionately impact women and girls living in urban informal settlements.

Community satisfaction with the urban health extension service in South Ethiopia and associated factors

28 April 2015 12:22 (America/New_York)

Community satisfaction with the urban health extension service in South Ethiopia and associated factors. BMC Health Serv Res. April 2015; 15: 160.

Authors: Ephrem Lejore Sibamo and Tezera Moshago Berheto

Background - The urban health extension program (UHEP) is an innovative government plan to ensure health equity by creating demand for essential health services through the provision of appropriate health information at a household level. It aims to improve the overall health of a community through active participation and utilization of services, which depends on satisfaction and acceptance of the program. However, there is no study on community satisfaction with the services provided by the UHEP in Ethiopia. This study was aimed to assess the level of community satisfaction with the UHEP in Hadiya Zone, South Ethiopia, and the associated factors with it.

Methods - A community based cross-sectional study, using quantitative and qualitative methods of data collection, was employed. Quantitative data were collected from 407 respondents using a structured questionnaire. Descriptive statistics, bivariate and multiple regression analyses were performed. P-value less than 0.05 and 95% confidence intervals were used to determine an association between independent and dependent variables. Qualitative data were collected through focus group discussions with village health committee members and model families in Hadiya Zone.

Results - The majority (67.4%) of respondents were satisfied with the services provided by the UHEP. The communities’ perceptions of technical competency (ß = 0.425; 95% CIs 0.084, 0.34), interpersonal relationships (ß = 0.506; 95% CIs 0.216, 0.797), and perceived accessibility of services (ß = 0.752; 95% CIs 0.064, 0.86) were independent predictors of satisfaction (P < 0.05). In addition, the marital status, knowledge, and attitudes of the respondents were associated with community satisfaction.

Conclusion - A community’s satisfaction with UHEP has supposed to have a significant influence on the community’s utilization of the services and implementation of the program. The present study have clearly shown that majority of the respondents were satisfied with the services provided by urban health extension program.

USAID’s urban sanitation website

28 April 2015 12:12 (America/New_York)

USAID’s Urban Sanitation Website – Link

Sanitation has been called the urgent problem, and nowhere do we see this urgency more than the sprawling, rapidly expanding urban environments of the developing world. In the next three decades, 2.5 billion people will migrate into the world’s urban areas, 90 percent of them in Africa and Asia. Rapid urbanization will pose development challenges unlike those the global community has faced in the past. This is why USAID, through its U.S. Global Development Lab, is making urban sanitation a new global priority. 

On the Urban Sanitation Frontlines: India, Ghana and Indonesia

The challenges posed by two, interrelated 21st century trends—poor sanitation and rapid urbanization—are best told by three African and Asian countries on the front lines of the global urban sanitation challenge.

Urban Sanitation in India
The world’s second most populous country has lifted hundreds of millions out of extreme poverty. But poor sanitation infrastructure and rapid urbanization make India an essential piece of the puzzle in the search for effective urban sanitation solutions. Insufficient sanitation coverage negatively affects India’s GDP by approximately 6.4 percent per year. Sanitation and clean water are the Government of India’s top development priority. In support of this effort, USAID will seek partners to collaborate on urban sanitation solutions in India in early 2015.


Urban Sanitation in Ghana

One of the strongest economies in Africa, Ghana demonstrates significant prospects for long-term economic growth. However, only 18-20 percent of the 10 million urban Ghanaians have access to improved sanitation facilities. Ghana is one of three West African countries in which USAID will support a new urban sanitation initiative, launching in November 2014.

Urban Sanitation in Indonesia

Indonesia’s hard-won status as a middle income country has not translated into urban sanitation gains. Half of the country’s urban residents have access to improved sanitation; fourteen percent practice open defecation. The third most populous country in Asia, 51 percent of Indonesians live in urban areas. USAID is collaborating with Indonesian partners to provide improved sanitation to 250,000 Indonesians.

 

Mobile solutions for urban health challenges

28 April 2015 12:05 (America/New_York)

Mobile solutions for urban health challenges by Lin Fabiano, Director, Worldwide Corporate Contributions, Johnson & Johnson | Source: Skoll World Forum, April 24, 2015

In Kibera, a settlement within Nairobi, Kenya, one is enveloped by the fast-paced energy and constant buzz of activity, with shopkeepers displaying cloth, food stall owners preparing meals, and children in school uniforms rushing down the street. With up to a million people living within a five-kilometer radius, one is never really alone, but it is easy to feel lonely.

Many people flock to cities seeking economic opportunities, and by most accounts, fare better than their rural counterparts. However, low-income city dwellers, especially women, are often vulnerable to the harsh realities of urban living that can affect their health and well-being. Urban areas often lack appropriate sanitation, good air quality, clean water and regular electricity, which are important components of good health. And while cities can offer women more choices in terms of access to health care, they often don’t foster the strong, deep social networks that provide support in most rural settings.

We are also learning that in an urban setting, a woman’s preferences and needs are different. The urban woman is more likely employed outside the home in order to provide for herself and her family. Unfortunately, young women who leave their rural villages for cities are often detached from their traditional networks of close female family and friends and must forge new  relationships to seek guidance on the day-to-day rigors of city living. Mobile devices can provide access to the kind of information typically shared through those missing social networks.

We learned from our work with the Mobile Alliance for Maternal Action (MAMA), a partnership with USAID, United Nations Foundation, and BabyCenter, that gaining a woman’s trust is the critical factor in achieving scale in mobile health programs in urban environments. Using mobile phones to deliver health information to new and expectant mothers has been shown to be an effective way to offer tips and advice on what to eat during pregnancy, early warning signs, and how to care for a newborn – just as a friend or companion would.

Jacaranda Health, a Johnson & Johnson partner, has adapted to these changing lifestyles and responsibilities of urban working women through a patient-centered model. Differentiating itself from health facilities where women must often wait a whole day for antenatal care, Jacaranda offers women specific appointment times and keeps clinics open later so women can more easily weave getting health services into their already busy lives.

With high mobile phone penetration in Nairobi, Jacaranda deploys digital health programs to help women get the information they need to stay healthy. For example, Jacaranda recently started tracking and sending reminders to women through their phones to increase the number of women who return, after delivery, for counseling.

By 2017 experts estimate that most people on our planet will be living in urban areas, with much of that growth concentrated in less-developed regions of the world. As the development community moves to adopt the Sustainable Development Goals, we must continue to emphasize the health and well-being of women, adolescents and children. Johnson & Johnson believes that strong partnerships should continue to focus on empowering women and children to attain better access quality healthcare when and where they need it.

Together, we can take the lessons of MAMA and Jacaranda into account, and adapt them to help more women in an increasingly urbanized world.

Building Social Networks for Maternal and Newborn Health in Poor Urban Settlements: A Cross-Sectional Study in Bangladesh

28 April 2015 11:59 (America/New_York)

Building Social Networks for Maternal and Newborn Health in Poor Urban Settlements: A Cross-Sectional Study in Bangladesh. PLoS One, April 2015.

Authors: Alayne M. Adams , Herfina Y. Nababan, S. M. Manzoor Ahmed Hanifi

Background - The beneficial influence of social networks on health and wellbeing is well-established. In poor urban settlements in Bangladesh, BRAC’s Manoshi programme trains community health workers (CHWs) to support women through pregnancy, delivery and postpartum periods. This paper test the hypothesis that the introduction of CHWs as weak ties into the social networks of Manoshi members mediates improvements in maternal and neonatal health (MNH) best practices by providing support, facilitating ideational change, connecting mother to resources, and strengthening or countering the influence of strong ties.

Methods - 1000 women who had given birth in the last three months were identified and interviewed as part of ongoing monitoring of 5 poor urban settlements in Dhaka, Bangladesh. A social networks questionnaire was administered which elicited women’s perceived networks around pregnancy, delivery and post-partum periods. Mediation analysis was performed to test the hypothesis that penetration of Manoshi CHWs into women’s perceived networks has a beneficial effect on MNH best practises.

Results - The presence and influence of Manoshi CHWs in women’s networks significantly mediated the effect of Manoshi membership on MNH best practices. Respondents who were Manoshi members and who listed Manoshi CHWs as part of their support networks were significantly more likely to deliver with a trained birth attendant (OR 3.61; 95%CI 2.36–5.51), to use postnatal care (OR 3.09; 95%CI 1.83–5.22), and to give colostrum to their newborn (OR 7.51; 95%CI 3.51–16.05).

Conclusion - Manoshi has succeeded in penetrating the perceived pregnancy, delivery and post-partum networks of poor urban women through the introduction of trained CHWs. Study findings demonstrate the benefits of moving beyond urban health care delivery models that concentrate on the provision of clinical services by medical providers, to an approach that nurtures the power of social networks as a means to support the poorest and most marginalized in changing behaviour and effectively accessing appropriate maternal services.

Municipal finance for sanitation in African cities

28 April 2015 11:56 (America/New_York)

Municipal finance for sanitation in African cities: briefing note, 2015.

Authors: Norman, G., Tremolet, S. Public Finance for WASH, Water & Sanitation for the Urban Poor (WSUP).

In cities in low and low-middle-income countries throughout the world, municipal budget allocations to sanitation are typically very low. Furthermore, detailed information on exactly how much money is budgeted, and how exactly it is spent, is very hard to obtain.

This brief summarises recent data on budget allocations to sanitation in four African municipalities. The data is patchy and incomplete, but as far as we know this is the only published information currently available on municipal budget allocations to sanitation in African cities.

Identical Assemblage of Giardia duodenalis in Humans, Animals and Vegetables in an Urban Area in Southern Brazil Indicates a Relationship among Them

10 April 2015 11:42 (America/New_York)

Identical Assemblage of Giardia duodenalis in Humans, Animals and Vegetables in an Urban Area in Southern Brazil Indicates a Relationship among Them. PLoS One, March 2015.

Authors: Cristiane Maria Colli , Renata Coltro Bezagio, et al.

This is the first study in Brazil that reports the connection among humans, dogs and vegetables in the transmission dynamics of G. duodenalis in the same geographic area finding identical assemblage. BIV assemblage was the most frequently observed among these different links in the epidemiological chain.

Prevalence of Endemic Pig-Associated Zoonoses in Southeast Asia: A Review of Findings from the Lao People’s Democratic Republic

10 April 2015 11:37 (America/New_York)

Prevalence of Endemic Pig-Associated Zoonoses in Southeast Asia: A Review of Findings from the Lao People’s Democratic Republic. Am Jnl Trop Med Hyg, Mar 2015.

Authors: Anna L. Okello,  Stephanie Burniston, et al.

The increasing intensification of pork production in southeast Asia necessitates an urgent requirement to better understand the dual impact of pig-associated zoonotic disease on both pig production and human health in the region. Sharing porous borders with five countries and representing many regional ethnicities and agricultural practices, Lao People’s Democratic Republic (Lao PDR) appears well placed to gauge the levels of pig-associated zoonoses circulating in the wider region.

All things zoonotic: An ‘Urban Zoo’ research project tracks livestock-based pathogen flows in and around Nairobi

10 April 2015 11:31 (America/New_York)

All things zoonotic: An ‘Urban Zoo’ research project tracks livestock-based pathogen flows in and around Nairobi, March 2015. International Livestock Research Institute.

An Urban Zoo research project in Kenya (more formally called ‘Epidemiology, Ecology and Socio‐Economics of Disease Emergence in Nairobi’) is tracking pathogen flows in and around Kenya’s capital city. Urban Zoo researchers are investigating mechanisms leading to the introduction and subsequent spread of pathogens into urban populations through livestock commodity value chains. The focus of the project is on livestock as sources of these pathogens because emerging diseases are likely to be zoonotic in origin (that is, able to spread from animals to people) and because livestock pathogens, through the close interactions between livestock, their products and people, are at high of risk crossing the species barrier.

 

One Health: The Theory and Practice of Integrated Health Approaches

10 April 2015 11:26 (America/New_York)

One Health: The Theory and Practice of Integrated Health Approaches, March 2015.

Edited by J Zinsstag, Swiss Tropical and Public Health Institute, Switzerland, E Schelling, Swiss Tropical and Public Health Institute, Switzerland, M Whittaker, University of Queensland, Herston, Australia, M Tanner, Swiss Tropical and Public Health Institute, Switzerland, D Waltner-Toews, Professor Emeritus. University of Guelph, Canada.

The One Health concept of combined veterinary and human health continues to gain momentum, but the supporting literature is sparse. In this book, the origins of the concept are examined and practical content on methodological tools, data gathering, monitoring techniques, study designs, and mathematical models is included. Zoonotic diseases, with discussions of diseases of wildlife, farm animals, domestic pets and humans, and real-world issues such as sanitation, economics, food security and evaluating the success of vaccination programmes are covered in detail. Discussing how to put policy into practice, and with case studies throughout, this book combines research and practice in one broad-ranging volume.

The role of wildlife in the transmission of parasitic zoonoses in peri-urban and urban areas

10 April 2015 11:19 (America/New_York)

The role of wildlife in the transmission of parasitic zoonoses in peri-urban and urban areas. International Journal for Parasitology: Parasites and Wildlife, Apr 2015.

Authors: Ute Mackenstedt, et al.

Highlights

  • Urbanization has a huge impact on the transmission of zoonotic parasites.
  • Adaptable wild animals are attracted by peri-urban and urban areas.
  • Composition of wildlife communities differs between rural and urban areas.
  • The transmission of parasites from wild animals to humans and domestic animals in peri-urban and urban environments is far from being understood.

The roles of water, sanitation and hygiene in reducing schistosomiasis: a review

10 April 2015 11:14 (America/New_York)

The roles of water, sanitation and hygiene in reducing schistosomiasis: a review. Parasites & Vectors (2015) 8:156.

Jack ET Grimes, et al.

We recently completed a systematic review andmeta-analysis pertaining to WASH and schistosomiasis and found that people with safe water and adequate sanitationhave significantly lower odds of a Schistosoma infection. Importantly though, the transmission of schistosomiasis isdeeply entrenched in social-ecological systems, and hence is governed by setting-specific cultural and environmentalfactors that determine human behaviour and snail populations. Here, we provide a comprehensive review of theliterature, which explores the transmission routes of schistosomes, particularly focussing on how these might bedisrupted with WASH-related technologies and human behaviour. Additionally, future research directions in thisarea are highlighted.

Trends in Causes of Adult Deaths among the Urban Poor: Evidence from Nairobi Urban Health and Demographic Surveillance System, 2003–2012

23 March 2015 11:34 (America/New_York)

Trends in Causes of Adult Deaths among the Urban Poor: Evidence from Nairobi Urban Health and Demographic Surveillance System, 2003–2012. Journal of Urban Health, March 2015.

Authors: Blessing Mberu, Marylene Wamukoya, Samuel Oti, and Catherine Kyobutung

In this paper, we examine the trends in the causes of death among the urban poor in two informal settlements in Nairobi by applying the InterVA-4 software to verbal autopsy data. Over the 10-year period, the three major causes of death are tuberculosis (TB), injuries, and HIV/AIDS, accounting for 26.9, 20.9, and 17.3 % of all deaths, respectively. In 2003, HIV/AIDS was the highest cause of death followed by TB and then injuries. However, by 2012, TB and injuries had overtaken HIV/AIDS as the major causes of death. When this is examined by gender, HIV/AIDS was consistently higher for women than men across all the years generally by a ratio of 2 to 1. In terms of TB, it was more evenly distributed across the years for both males and females. We find that there is significant gender variation in deaths linked to injuries, with male deaths being higher than female deaths by a ratio of about 4 to 1. Emerging at this stage is evidence that HIV/AIDS, TB, injuries, and cardiovascular disease are linked to approximately 73 % of all adult deaths among the urban poor in Nairobi slums of Korogocho and Viwandani in the last 10 years. While mortality related to HIV/AIDS is generally declining, we see an increasing proportion of deaths due to TB, injuries, and cardiovascular diseases. In sum, substantial epidemiological transition is ongoing in this local context, with deaths linked to communicable diseases declining from 66 % in 2003 to 53 % in 2012, while deaths due to noncommunicable causes experienced a four-fold increase from 5 % in 2003 to 21.3 % in 2012, together with another two-fold increase in deaths due to external causes (injuries) from 11 % in 2003 to 22 % in 2012. It is important to also underscore the gender dimensions of the epidemiological transition clearly visible in the mix. Finally, the elevated levels of disadvantage of slum dwellers in our analysis relative to other population subgroups in Kenya continue to demonstrate appreciable deterioration of key urban health and social indicators, highlighting the need for a deliberate strategic focus on the health needs of the urban poor in policy and program efforts toward achieving international goals and national health and development targets.

Who serves the urban poor? A geospatial and descriptive analysis of health services in slum settlements in Dhaka, Bangladesh

23 March 2015 11:27 (America/New_York)

Who serves the urban poor? A geospatial and descriptive analysis of health services in slum settlements in Dhaka, Bangladesh. Health Policy Plan. (2015) 30 (suppl 1): i32-i45. doi: 10.1093/heapol/czu094.

Authors: Alayne M Adams, Rubana Islam and Tanvir Ahmed

In Bangladesh, the health risks of unplanned urbanization are disproportionately shouldered by the urban poor. At the same time, affordable formal primary care services are scarce, and what exists is almost exclusively provided by non-government organizations (NGOs) working on a project basis. So where do the poor go for health care? A health facility mapping of six urban slum settlements in Dhaka was undertaken to explore the configuration of healthcare services proximate to where the poor reside.

Three methods were employed: (1) Social mapping and listing of all Health Service Delivery Points (HSDPs); (2) Creation of a geospatial map including Global Positioning System (GPS) co-ordinates of all HSPDs in the six study areas and (3) Implementation of a facility survey of all HSDPs within six study areas. Descriptive statistics are used to examine the number, type and concentration of service provider types, as well as indicators of their accessibility in terms of location and hours of service. A total of 1041 HSDPs were mapped, of which 80% are privately operated and the rest by NGOs and the public sector. Phamacies and non-formal or traditional doctors make up 75% of the private sector while consultation chambers account for 20%.

Most NGO and Urban Primary Health Care Project (UPHCP) static clinics are open 5–6 days/week, but close by 4–5 pm in the afternoon. Evening services are almost exclusively offered by private HSDPs; however, only 37% of private sector health staff possess some kind of formal medical qualification. This spatial analysis of health service supply in poor urban settlements emphasizes the importance of taking the informal private sector into account in efforts to increase effective coverage of quality services. Features of informal private sector service provision that have facilitated market penetration may be relevant in designing formal services that better meet the needs of the urban poor.

Sharing reflections on inclusive sanitation

23 March 2015 11:22 (America/New_York)

Sharing reflections on inclusive sanitation. Environment & Urbanization, Feb 2015.

Authors: Evans Banana, Patrick Chikoti, Chisomo Harawa, Gordon Mcgranahan, Diana Mitlin, Stella Stephen, Noah Schermbrucker, Farirai Shumba, Anna Walnycki

This paper draws on sanitation innovations in Blantyre (Malawi), Chinhoyi (Zimbabwe), Dar es Salaam (Tanzania) and Kitwe (Zambia) driven by slum(1)/shack dweller federations to consider what an inclusive approach to sanitation would involve. This includes what is possible for low-income households when there is little or no external support, no piped water supply and no city sewers to connect to.

The paper discusses low-income households’ choices in situations where households can only afford US$ 3–4 per month for sanitation (for instance between communal, shared and household provision). It also considers the routes to both spatial and social inclusion (including the role of loan finance in the four cities) and its political underpinnings. In each of the four cities, the community engagement in sanitation intended from the outset to get the engagement and support of local authorities for city-wide sanitation provision.

Co-producing inclusive city-wide sanitation strategies: lessons from Chinhoyi, Zimbabwe

23 March 2015 11:17 (America/New_York)

Co-producing inclusive city-wide sanitation strategies: lessons from Chinhoyi, Zimbabwe. Environment & Urbanization, Mar 2015.

Authors: Evans Banana, Beth Chitekwe-Biti, Anna Walnycki

This paper explores how communities in Chinhoyi, Zimbabwe have used community-led mapping and enumerations(1) to build partnerships with local government to support the development and co-production of innovative pro-poor city-wide sanitation strategies as part of the SHARE City-Wide Sanitation Project. This action research project is being conducted in four cities across sub-Saharan Africa: Chinhoyi (Zimbabwe), Kitwe (Zambia), Blantyre (Malawi) and Dar es Salaam (Tanzania).

This programme of work responds to the failure of conventional approaches to urban sanitation to meet the needs of low-income urban communities in sub-Saharan Africa. Over three years it has supported Shack/Slum Dwellers International affiliates to develop and test pro-poor sanitation strategies that can be adopted and driven by networks of community organizations and residents’ associations, and supported by public authorities and private providers.

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