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Will better sanitaton and nutrition reduce stunting?

26 November 2015 8:10 (America/New_York)

Photo: Cornell University

A trial is underway in Zimbabwe to measure the independent and combined effects of improved sanitation and hygiene (WASH) and improved infant diet on stunting and anemia among children 0-18 months old [Cornell University CENTIR Group blog].

The Sanitation, Hygiene and Infant Nutrition Efficacy (SHINE) Trial is led by the Zvitambo Institute for Maternal and Child Health Research in Harare, Zimbabwe in collaboration with the Ministry of Health and Child Care/Government of Zimbabwe. Other contracted experts include Sandy Cairncross, Val Curtis and Peter Morgan.

The SHINE Trial is being undertaken in Chirumanzu and Shurugw, two districts with high HIV prevalence. Besides investigating the effects of sanitation and nutrition, SHINE will also test whether Environmental Enteric Dysfunction (EED)is a major cause of a major cause of child undernutrition. EED, also called environmental enteropathy, is a condition believed to be due to frequent intestinal infections.

SHINE is being being funded by the Bill & Melinda Gates Foundation and the UK Department for International Development (DFID). There are additional contributions from Wellcome Trust, National Institutes of Health, and the Swiss Development Cooperation.

A special open access supplement of Clinical Infectious Diseases is devoted to SHINE containing the following articles:

  • The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) Trial Team, doi:10.1093/cid/civ844
  • Design of an Intervention to Minimize Ingestion of Fecal Microbes by Young Children in Rural Zimbabwe, doi:10.1093/cid/civ845
  • The SHINE Trial Infant Feeding Intervention: Pilot Study of Effects on Maternal Learning and Infant Diet Quality in Rural Zimbabwe, doi:10.1093/cid/civ846
  • Using Geographic Information Systems and Spatial Analysis Methods to Assess Household Water Access and Sanitation Coverage in the SHINE Trial, doi:10.1093/cid/civ847
  • Assessment of Environmental Enteric Dysfunction in the SHINE Trial: Methods and Challenges, doi:10.1093/cid/civ848
  • The Potential Role of Mycotoxins as a Contributor to Stunting in the SHINE Trial, doi:10.1093/cid/civ849
  • Assessing the Intestinal Microbiota in the SHINE Trial, doi:10.1093/cid/civ850
  • Assessing Maternal Capabilities in the SHINE Trial: Highlighting a Hidden Link in the Causal Pathway to Child Health, doi:10.1093/cid/civ851
  • Theory-Driven Process Evaluation of the SHINE Trial Using a Program Impact Pathway Approach, doi:10.1093/cid/civ716

Filed under: Africa, Research, Sanitation and Health Tagged: Bill & Melinda Gates Foundation, DFID, environmental enteropathy, Nutrition, Sanitation, Hygiene and Infant Nutrition Efficacy (SHINE) Trial, WASH nutrition integration, Zimbabwe, Zvitambo Institute for Maternal and Child Health Research

Australia helps carry the can on World Toilet Day

23 November 2015 11:00 (America/New_York)

Article by Steven Ciobo, Australia‘s Minister for International Development and the Pacific

In Australia, we love toilet humour. The 2006 comedy Kenny, which followed a portable toilet man about his daily business, was a local box office hit, and our televisions are awash with advertisements of puppies unravelling toilet tissue rolls around the house.

United Nations staff installed a 15-door-high inflatable toilet to mark the World Toilet Day in front of the UN headquarters in New York on November 19, 2014. Photograph: Jewel Samad/AFP/Getty Images

We can see the funny side of toilets, because we’re able to use a toilet and wash our hands as often as we need. The Australian Department of Social Services publishes an online National Public Toilet Map so we can find, in a matter of seconds, the nearest of some 16,000 public toilets.

Unfortunately, for too many in the world, this is far from the case. According to United Nations estimates around 2.4 billion people, or a third of the world’s population, don’t have access to a basic toilet, leaving them exposed to the many diseases transferred through human waste, such as cholera, typhoid and dysentery. Approximately 946 million people defecate in the open, in fields, streams, forests and open city spaces, which puts entire communities at risk of diarrhoeal diseases.

On 19 November, the world will mark World Toilet Day. This year, the focus is on the link between toilets and nutrition. Regular bouts of diarrhoea caused by open defecation, poor hygiene and unclean water, contribute to poor nutrition, growth stunting and developmental impairment, preventing children from reaching their full potential. In 2014, the World Health Organisation reported 159 million children under five years of age suffer from growth stunting. Nearly 1,000 children die every day from diarrhoeal diseases and poor nutrition, making diarrhoea the world’s second leading disease killer of children . These children are missing valuable time at school and their families are forced to spend their limited incomes on medical care, which exacerbates the cycle of poverty.

Read the full article on the WSSCC Guardian partner zone.

Filed under: Uncategorized

Making the link: Community initiatives for sanitation and health – webinar on 26 Nov. at 10:00 (UTC/GMT) London time

19 November 2015 22:18 (America/New_York)

Poor sanitation has serious implications for health including a large burden of diarrheal diseases, which remains the second leading killer of children under 5 globally, and a large burden of intestinal worms. Improving access to sanitation and hygiene and changing behaviours have enormous health benefits that can also bring many other positive changes in a community, including social, economic and environmental gains.

Deepening our understanding of the linkages between sanitation interventions and health outcomes provides key insight and evidence for decision-makers making investments in sanitation services.

We invite you to join an interactive webinar where experts will discuss how these critical connections at a community level can be improved.

The webinar will bring together an excellent panel of three speakers who will present their approaches in the area of “Community initiatives for sanitation and health”:

The webinar will last one hour, including three 10 minute presentations from the speakers and half an hour time for questions and discussion with webinar participants. The webinar is being hosted by Stockholm Environment Institute and the SuSanA secretariat as part of a grant to SEI funded by the Bill & Melinda Gates Foundation who is also funding part of the work of the three presenters.

Date: Thursday, 26th November 2015
Time: 10:00 (UTC/GMT) – e.g. 10:00 in London, 11:00 in Stockholm, 13:00 in Nairobi and 17:00 in Hanoi. Please check your equivalent time here:

To join the webinar please register by following this link.

A limited number of seats is available (100).

Before and after the webinar, we encourage discussions about this topic on the SuSanA discussion forum here.

Filed under: Uncategorized

Testing CLTS Approaches for Scalability: Nepal Learning Brief

19 November 2015 16:32 (America/New_York)

Pour Flush Toilet in Nepal. Photo Credit: Vidya Venkataramanan

Plan International supports Community-led Total Sanitation (CLTS) implementation in a number of districts in Nepal. In this learning brief, we review Plan International Nepal’s CLTS activities. We found government targets and definitions to be ambitious while decentralized planning allowed a focus on community-led processes. Plan International and other sanitation practitioners can support CLTS outcomes by providing post-triggering training and technical support to community volunteers, focusing on achieving gradual, yet sustained outcomes in program areas, and continuing to work with local governments to ensure that financing mechanisms for the poor are locally developed and equitable.

Link to learning brief:

Citation: Community-led Total Sanitation in Nepal: Findings from an Implementation Case Study. Venkataramanan, Vidya, Alexandra Shannon, and Jennifer Bogle. 2015. Chapel Hill, USA: The Water Institute at UNC.

Filed under: Policy, Progress on Sanitation, Sanitary Facilities, Sanitation and Health, South Asia Tagged: Community-Led Total Sanitation, Nepal, Plan International, scaling-up, UNC

New Video Offers Five Lessons for Sanitation Policy and Practice

19 November 2015 16:16 (America/New_York)

A new video from Plan International and the Water Institute at UNC offers a preview of five exciting lessons on sanitation policy and practice, based on findings from operational research on community-led total sanitation (CLTS). These lessons relate to CLTS planning at the national and local levels, its place in national sanitation systems, and the importance of involving local actors. In particular, government officials, teachers, and natural leaders can play important roles in improving access to basic sanitation, and their involvement can ensure sustainable outcomes over time.

Filed under: Policy, Progress on Sanitation, Sanitation and Health Tagged: CLTS, Plan International, UNC Water Institute

WSSCC increases support to Swachh Bharat Mission

13 November 2015 5:55 (America/New_York)

The Water Supply & Sanitation Collaborative Council (WSSCC) has announced that it will amplify its support to the Swachh Bharat Mission (SBM), the Government of India’s (GOI) programme to achieve a Clean India by 2019, by establishing an in country India Support Unit and bolstering its work linked to the Global Sanitation Fund (GSF).

The government has welcomed these moves, which enhance WSSCC’s normative and implementation work to improve access and use, equality, knowledge and collaboration in sanitation and hygiene. WSSCC has appointed Mr. Vinod Mishra, previously the organization’s volunteer National Coordinator, to the position of National Officer in a new India Support Unit (ISU). Mr. Mishra will lead a WSSCC team of three professionals, including Ms. Kamini Prakash, an Equality and Non Discrimination Officer, and Ms. Sanchita Ghosh, a Knowledge and Learning Officer, based in Delhi. The unit will coordinate WSSCC support to SBM on policy and monitoring guidelines, capacity building and rapid action learning.

Credit: Anil Teegala

In addition, WSSCC’s work through the Global Sanitation Fund-supported programme managed by NRMC India Private Ltd. will include four additional elements: extension of field operations in the States of Jharkhand, Bihar and Assam; support to the Namami Ganga Mission (NGM) within SBM; support to Bihar State on a “District Approach” to collective behaviour change; and facilitation of peer exchanges with neighbouring States in Northern India. Collectively, these additions respond to the Government’s aims to expand and share through successful sanitation programming.

These additional elements build on an already successful GSF programme which, since 2010, has been instrumental working in those three States with high open defecation rates, to establish the modalities for implementing collective behaviour change at scale, an essential pathway to the practical realization of SBM. To date, WSSCC has facilitated open defecation free status for Gram Panchayats in Jharkhand and Bihar. As of July 2015, the GSF programme has empowered 551,000 people to live in open defecation free villages, and 1.4 million people to gain access to improved sanitation in India. “The Swachh Bharat Mission is a call to action for finally ending the practice of open defecation and ensuring equal access to sanitation and hygiene,” says Dr. Chris W. Williams, Executive Director of WSSCC. “We aim to answer that call and work together to solve the serious and deep rooted sanitation challenges for the well-being, prosperity and very survival of India’s 1.2 billion citizens.”

Since 1990, WSSCC has worked closely through its individual members, National Coordinators and partners to support improved access to sanitation and hygiene. In the past five years alone, the Council held the first Global Forum on Sanitation and Hygiene in Mumbai, facilitated innovative sanitation programming through the GSF, and worked with the Government of India and States to transform sanitation policy and practice to include safe menstrual hygiene management with dignity, responding to the demands of hundreds of millions of women whose monthly periods were hitherto linked to pollution and impurity and therefore shame and indignity.

More recently, along with other partners, WSSCC contributed to the design of the SBM to include equity, innovation, rapid action and learning, and sustainability aspects before it was launched in October 2014. In 2015, GOI called upon WSSCC to organize the first ever national workshop to define the verification of open defecation free (ODF) status in India, followed by the first national sharing of innovations, best practices and failures in sanitation and hygiene. On equity, the Indian example and experience has been leveraged systematically to forge partnerships, innovations and guidelines wider in South Asia and in Africa. Inclusive WASH has also been clearly articulated in regional declarations and hygiene and sanitation proposals for the Sustainable Development Goals. “In a country where pervasive caste and gender inequalities threaten life itself, over 300 million women and girls in India try to squat in a sari, while holding a cup of water to cleanse themselves and keeping an eye out for molesters. Imagine how much more complex and impossible this becomes every month during a woman’s menstrual period!” says Ms. Archana Patkar, Programme Manager, WSSCC. “It is time for the entire development community to unite behind this cause.”

Mr. Mishra added: “The deleterious impacts of poor sanitation and hygiene on health, productivity and well-being extend well beyond India, which is responsible for 60% of the world’s total open defecation, and is nothing short of a global emergency. WSSCC’s amplified engagement will therefore lead to successes and solutions which will not only tackle the emergency here, but help elsewhere.”

Find out more about WSSCCs work in India and in other countries:

Filed under: Uncategorized

Interview with Mr. Léo Heller UN Special Rapporteur on the human right to safe drinking water and sanitation, by Guy Norman

13 November 2015 5:26 (America/New_York)

Mr. Léo Heller, special Rapporteur on the human right to safe drinking water and sanitation, talked to PF4WASH about issues such as government budget allocations to WASH, steps towards achieving SDG N. 6 and increasing tax revenue generation.

Mr. Heller, thank you for sharing your time and views with us!

Read the interview here

Filed under: Uncategorized

NEW BLOG! Community-run aqueducts in Colombia promote public policy for scaling up public finance for WASH, By Valeria Llano-Arias

13 November 2015 5:21 (America/New_York)

Community-run aqueducts in Colombia promote public policy for scaling up public finance for WASH

  This blog describes a particular case of an association of community aqueducts in Colombia and the advocacy process to demand increased public investment and support to their work as water service providers.

You can read the blog  here

Filed under: Uncategorized

Livestream of Bonn WASH Nutrition Forum – November 11 & 12, 2015

10 November 2015 9:14 (America/New_York)

The Bonn WASH Nutrition Forum is going to have a livestream on the 11th and 12th November. It will start at 10am CET on the 11th November.

Why should I watch the livestream of the Bonn WASH Nutrition Forum on 11th & 12th November, 10am CET? This innovative forum that will bring WASH experts and their Nutrition Expert counterparts together, but not only in the audience. 

Overcoming malnutrition is a great challenge that will require true collaboration between the WASH and nutrition sectors. The main aim of the forum is to bring together the relevant experts from both sectors.

We intend to have an effective mix of thematic inputs and discussions during so-called “mirror sessions”. Here, relevant sector professionals in similar positions from both the WASH and Nutrition sector will be asked to present their work / perspective.

Hearing about the other respective sector, allows for reflection of one’s own work (hence “mirror”) and inspires further discussion with other experts and participants on complementarity and collaboration between the sectors and the identification of joint indicators.

We are aiming for a concrete set of recommendations, next steps and commitments in terms of viable operational approaches, research, policy and advocacy issues to lead to a more integrated approach for tackling undernutrition and stunting.

Confirmed Speakers

  • Catarina de Albuquerque (Sanitation and Water for All Partnership – Vice Chair)
  • Florence Lasbennes  (Head of Secretariat, Scaling up Nutrition Movement)
  • Gunther Beger (Director General, Federal Ministry of Economic Cooperation and Development of Germany)  
  • Matthias Mogge (Executive Director Programmes, Welthungerhilfe)
  • Bruce Gordon (WHO Technical Officer – Water, Sanitation, Hygiene and Health)
  • Lawrence Haddad (IFPRI Senior Research Fellow – Poverty, Health & Nutrition Division)
  • Dr. Tania Rödiger-Vorwerk (Deputy Director General, BMZ)
  • Peter Mahal (SWA Country Focal Point – South Sudan – Ministry of Water Resources and Irrigation)
  • Dr. Arne Panesar (SuSanA)
  • Tori Timms (EU Advocacy Coordinator, WaterAid)
  • Björn Hofmann (Task Force for Humanitarian Aid, German Federal Foreign Office)
  • Dominique Porteaud (Global WASH Cluster – Coordinator, UNICEF Geneva)
  • Magan Macgarry (Communications and Campaigns Officer- End Water Poverty)
  • Dr. Marie T Benner (Senior Public Health Advisor – Malteser International)
  • Ben Hobbs (International Campaign Manager Generation Nutrition)
  • Dr. Stefan Schmitz (Commissioner, Special Unit “One World No Hunger” – Federal Ministry for Economic Cooperation and Development of Germany)
  • Dr. Jean Lapegue (Senior WASH Advisor – Action Contre La Faim)
  • Dr. Makur M. Kariom (Undersecretary,Ministry of Health, South Sudan)
  • Oliver Cumming  (Lecturer at the Environmental Health Group, London School of Hygiene and Tropical Medicine)
  • Robert Chambers (Institute of Development Studies)
  • Dr. Oliver Hoffmann (Public Health Advisor – The Johanniter)
  • Thilo Panzerbieter (Host of Conference, Chair of German WASH-Network)

Filed under: Sanitation and Health Tagged: WASH nutrition integration

New week NEW BRIEF! Finance Brief N. 8: “A few cents on your water bill: Tana’s (Anatanarivo) surcharge system” By Sylvie Ramanantsoa, Julie Ranaivo and Guy Norman

10 November 2015 5:04 (America/New_York)

    In Madagascar’s capital Antananarivo (Tana), water bills include various surcharges designed to help finance water and sanitation. In recent years, Water & Sanitation for the Urban Poor (WSUP) has been working with local government and with the utility JIRAMA to optimise the use of these revenues to support water supply improvements in low-income communities. This brief describes how this interesting system works, and considers how it might be further developed.


Filed under: Africa, Economic Benefits, Funding, Progress on Sanitation, Publications Tagged: finance, sanitation

Water, Sanitation, Hygiene, and Nutrition in Bangladesh:

9 November 2015 12:48 (America/New_York)

Water, Sanitation, Hygiene, and Nutrition in Bangladesh” Can Building Toilets Affect Children’s Growth? 2015.

Authors: Iffat Mahmud and Nkosinathi Mbuya. World Bank.

This report provides a systematic review of the evidence to date, both published and grey literature, on the relationship between water and sanitation and nutrition. 

We also examine the potential impact of improved water, sanitation, and hygiene (WASH) on undernutrition. This is the first report that undertakes a thorough review and discussion of WASH and nutrition in Bangladesh.

The report is meant to serve two purposes. First, it synthesizes the results/evidence evolving on the pathway of WASH and undernutrition for use by practitioners working in the nutrition and water and sanitation sectors to stimulate technical discussions and effective collaboration among stakeholders.

Second, this report serves as an advocacy tool, primarily for policy makers, to assist them in formulating a multisectoral approach to tackling the undernutrition problem.

Filed under: Sanitation and Health, South Asia Tagged: Bangladesh, WASH nutrition integration

Unilever unveils new film and rural programme about handwashing with soap for newborn survival

5 November 2015 10:51 (America/New_York)

Unilever’s health soap, Lifebuoy introduced ‘Chamki’, a compelling new film to raise awareness of the importance of handwashing with soap for new mums as part of Lifebuoy’s Help A Child Reach 5 handwashing programme.

This year, the campaign focuses on a child’s neonatal period (the first 28 days of life). It also coincides with the launch of a partnership with the Children’s Investment Fund Foundation (CIFF) to scale up Lifebuoy’s handwashing programmes in rural Bihar, India.

The newest Help a Child Reach 5 film was developed by Mullen Lowe Group and shot by the famous feature film director, Anand Gandhi. The film showcases the emotional journey of a real pregnant mother and her aspirations for her child.

It highlights the importance of doing something very simple, yet important during pregnancy and early in the child’s life: washing hands with soap.

Samir Singh, Executive Director, Hindustan Unilever, said: “We are excited to release this film and take the hygiene message to where it matters the most: to new mothers in the first 28 days after delivery. The Help a Child Reach 5 campaign started in Thesgora, a village in Madhya Pradesh that has one of the highest rates of diarrhoea, and showcased remarkable results. We now impact child health at a very large scale in partnership with the Children’s Investment Fund Foundation.”

 CIFF and Hindustan Unilever via The Bhavishya Alliance Child Nutrition Initiatives are announcing a partnership that aims to change the handwashing behaviours of nine million children in Bihar. In the pilot on-the-ground activities, the partnership reached out to 560,000 children in Bihar.  The project aims to reach up to 50,000 government rural primary schools in nearly 30 districts in Bihar. This project will be delivered by almost 600 trained health promoters who will visit villages with targeted materials and activities for children and mothers to reinforce handwashing behaviours. This programme will also educate thousands of pregnant women and new mothers on the benefits of handwashing with soap.

Anagha Khot, Manager – Strategy & Partnerships, South Asia of CIFF, said, “Handwashing with soap is among the most cost-effective ways of preventing common infections in children. We are happy to partner with Unilever to reach millions of children across the state of Bihar.”

Filed under: Multimedia, Sanitation and Health, South Asia, Uncategorized Tagged: handwashing, Unilever

University of Maryland celebrates Global Handwashing Day 2015

30 October 2015 11:38 (America/New_York)

For the fourth year, students from the Global Public Health Scholars program at the University of Maryland, College Park visited the Center for Young Children (CYC), a laboratory school on the UMD campus. 

Children at the CYC arrive in the morning and make their way to the child-sized sinks to wash their hands. They bring the skill home, reminding their families to wash hands after they use the bathroom and before dinner.

Global Public Health Scholars visited the Kindergarten class in the Blue Room, sang handwashing songs, led a handwashing educational activity using the “Glo-Germ,” and worked with the children to make a beautiful Global Handwashing Day banner. 

The activity raised awareness about the importance of handwashing for disease prevention and alerted children, college students, and parents about many events happening to celebrate Global Handwashing Day around the world.

Filed under: Uncategorized Tagged: Global Handwashing Day 2015

Toilet touring in Uganda: experiencing the true spirit of Community-Led Total Sanitation

29 October 2015 10:26 (America/New_York)

Patrick England, who recently joined the Global Sanitation Fund secretariat, travelled to Uganda to participate in a learning exchange mission. The mission turned out to be a unique opportunity to experience the true spirit of community-led total sanitation (CLTS). Read about his experiences below.

Representatives from Madagascar’s Fond d’Appui pour l’Assainissement (FAA) programme demonstrating CLTS facilitation in Amuria District. Credit: Patrick England/WSSCC

When I first entered the field of international development, I had no idea that ‘shit’ would become a standard part of my professional vocabulary. But as a Portfolio Support Analyst with the WSSCC’s Global Sanitation Fund (GSF), my mission is to discover and document everything about shit: how communities are dealing with it, and how to support our programme partners to tackle the world’s growing sanitation and hygiene crisis. So in June 2015, I received my first opportunity to become a professional toilet tourist with the GSF during a cross-programme exchange to Uganda.

Just prior to my Ugandan journey, I was working with Concern Universal, the GSF Executing Agency in Nigeria. I supported the development of case studies and lessons learned for the GSF-supported Rural Sanitation and Hygiene Promotion in Nigeria programme, which carries out Community-Led Total Sanitation (CLTS) activities in the south-east of the country. Similar to Uganda, Nigeria’s GSF-supported programme is fully owned and implemented by government agencies. However, for local officials and civil servants, the participatory, spontaneous, and dynamic ethos of CLTS often runs in direct contrast to decades of enforcing toilet construction. Not only must CLTS trigger improved sanitation and hygiene behaviour in communities themselves, but it must also trigger government authorities to create enabling environments for communities to climb the sanitation ladder.

CLTS learning journeys converge: the GSF cross-programme exchange
Dazed after two days of travel from Calabar to Kampala, I met my new Uganda colleagues in the rural district of Pallisa. Accompanying them was a delegation from Madagascar’s GSF-supported programme. While much could be written on this band of Malagasy medical doctors-cum-sanitation crusaders, let’s just say that they definitely know their ‘shit’. For them, CLTS isn’t just an approach to increase sanitation coverage and reduce under-five mortality; it’s an action-affirmative philosophy that underpins a movement to improve the health of entire countries. Most importantly, this movement must be wholly owned by communities themselves – a point continuously emphasized throughout our district visits in Uganda.

Map of districts visited in Uganda, based on image retrieved on

Our exchange crossed the entire country – from the shores of Lake Victoria to the jungles along the border with the Democratic Republic of the Congo – working alongside District Health Office staff to improve their CLTS approach. Led by the Malagasy doctors, each visit comprised a systematic review of existing practices, a hands-on demonstration of best-practice triggering and follow-up, and a critical self-analysis by health staff to enhance their community engagement. As was the case in Nigeria where decades of latrine enforcement and health sensitization failed to achieve any notable impact, this intensive learning process focused on ‘de-programming’ the old behaviours of local government facilitators.

Compared to Nigeria, where 25 percent of the population practices open defecation, Uganda has a relatively high level of sanitation coverage (where seven percent practice open defecation)[1]. This was made evident by the number of well-built latrines I observed during our visits to rural communities. Until then, I never entertained the notion that a toilet could be beautiful: walls carefully smoothed and polished, meticulously patterned with charcoal and red mud paint, all topped with round thatch roofs. One elderly woman in Koboko District proudly demonstrated how she used a local weed to give her latrine’s mud floor a glossy sheen. However, the presence of toilets – even those ornately designed – did not mean that these communities were open defecation free (ODF). These latrines frequently went unused, especially during planting and harvesting seasons, while a lack of adequate fly-proof covers and handwashing facilities meant that these community members were still unintentionally eating their own, and others’, shit.

Read the full blog on the WSSCC website

Filed under: Uncategorized

Recent WASH studies on NTDS, shared sanitation, detection of E. coli

29 October 2015 9:53 (America/New_York)

The Effect of Hygiene-Based Lymphedema Management in Lymphatic Filariasis-Endemic Areas: A Systematic Review and Meta-analysis. PLoS NTDs, Oct 2015. Authors: Meredith E. Stocks, Matthew C. Freeman, David G. Addiss.

Full text:

For people who already have lymphedema, WHO recommends simple hygiene-based measures that include skin care and limb movement. Yet only a small proportion of those with LF-related lymphedema have been trained in these measures. To determine the effectiveness of hygiene-based lymphedema management, we reviewed the scientific literature. Overall, use of hygiene-based measures was associated with 60% lower odds of inflammatory episodes, known as “acute attacks,” in the affected limb. Hygiene is also effective for managing LF-related lymphedema and reducing suffering caused by acute attacks. Training people with lymphedema in hygiene-based interventions should be a priority for LF programs everywhere.

Evaluation of an Inexpensive Growth Medium for Direct Detection of Escherichia coli in Temperate and Sub-Tropical Waters. PLoS One, Oct 2015. Authors: Robert E. S. Bain , Claire Woodall, John Elliott, Benjamin F. Arnold, Rosalind Tung, Robert Morley, Martella du Preez, Jamie K. Bartram, Anthony P. Davis, Stephen W. Gundry, Stephen Pedley

Full text:

We developed a new low-cost growth medium, aquatest (AT), and validated its use for the direct detection of E. coli in temperate and sub-tropical drinking waters using IDEXX Quanti-Tray®. AT is reliable and accurate for the detection of E. coli in temperate and subtropical drinking water. The composition of the new medium is reported herein and can be used freely.

Slum inhabitants’ perceptions and decision-making processes related to an innovative sanitation service: evaluating the Blue Diversion Toilet in Kampala (Uganda). International Journal of Environmental Health Research, Dec 2015. Authors: Mark O’Keefe, Ulrike Messmer, Christoph Lüthi & Robert Tobias.


In this paper, we gather perspectives from potential clients and investigate how slum inhabitants (1) perceive the current situation and whether they desire improvements of sanitation, (2) how they evaluate a new toilet that is still in development, and how (3) social processes and (4) constraints affect decisions. Data were collected through interviewing 1538 people within a general household survey. People using shared and public latrines desire an improvement of their sanitation facilities. The lack of water for washing is perceived by residents as a the biggest problem when accessing current latrines. The new toilet was mostly evaluated positively: people like it, expect large health benefits from it and it complies with cultural norms.

Neighbour-shared versus communal latrines in urban slums: a cross-sectional study in Orissa, India exploring household demographics, accessibility, privacy, use and cleanliness. Trans R Soc Trop Med Hyg. 2015 Nov. Authors: Heijnen M, Routray P, Torondel B, Clasen T.

Full text:

A growing proportion of the global population rely on shared sanitation facilities, despite their association with adverse health outcomes. We sought to explore differences between neighbour-shared and communal latrines in terms household demographics, accessibility, facilities and use. We found significant differences between neighbour-shared and communal facilities in terms of user demographics, access, facilities and cleanliness that could potentially explain differences in health. These findings highlight the need for a shared sanitation policy that focuses not just on the number of users, but also on maintenance, accessibility, cleanliness and provision of water and hand washing facilities.

Understanding the complex determinants of height and adiposity in disadvantaged daycare preschoolers in Salvador, NE Brazil through structural equation modelling. BMC Public Health, Oct 2015. Authors: Rebecca L. Lander, Sheila M. Williams, et al.


Earlier we reported on growth and adiposity in a cross-sectional study of disadvantaged Brazilian preschoolers. Here we extend the work on these children, using structural equation modelling (SEM) to gather information on the complex relationships between the variables influencing height and adiposity. We hope this information will help improve the design and effectiveness of future interventions for preschoolers. Of the multiple factors influencing preschoolers’ growth, helminth infection was a modifiable risk factor directly and indirectly affecting HAZ and BMIZ, respectively. Hence the WHO de-worming recommendation should include preschoolers living in at-risk environments as well as school-aged children.

Filed under: Sanitation and Health Tagged: neglected tropical diseases

Shared sanitaion for the urban poor: understanding what works

28 October 2015 11:00 (America/New_York)

The MapSan study aims to explore the links between sanitation, population density, and health outcomes in Maputo, Mozambique. The video describes a controlled, before-and-after trial of an urban sanitation intervention to reduce enteric infections in children:

Filed under: Africa, Sanitation and Health Tagged: Mozambique, shared sanitation

Thematic Discussion: Private sector engagement in sanitation and hygiene

27 October 2015 10:51 (America/New_York)

Join the Water Supply and Sanitation Collaborative Council Community of Practice on Sanitation and Hygiene in Developing Countries (WSSCC CoP) and the global Sustainable Sanitation Alliance (SuSanA) in a joint 3-week thematic discussion on engaging the local private sector in sanitation and hygiene.  

For more information, please click here to visit the discussion on the SuSanA Forum.

1. Introduction Sanitation and hygiene interventions have the objective of ending open defecation and enabling access to safe sanitation by households.  This is reflected in the SDG target 6.2 which aims to “achieve access to adequate and equitable sanitation and hygiene for all by 2030”.Sanitation marketing is applicable to both rural and urban settings and combines a behaviour change communication component to encourage the adoption of improved and hygienic latrines with a commercial component for developing the right products and services for consumers that are accessible to households at affordable price points.Sanitation marketing therefore requires strong partnerships and coordination of various government departments, development partners, entrepreneurs and financiers with households/consumers at the centre.

Split into three inter-linked and sequenced sub-themes that explore links between research and practice, the discussion focuses on how and under what circumstances local private sector engagement can ensure sustained health and WASH outcomes. Thematic experts will frame and prompt debates each week as follows:

Theme 1: Raising demand for sanitation and hygiene services: will focus on working with the private sector to raise demand through sanitation marketing and financing options including access to household credit, financing for local entrepreneurs or via other means. We are keen to explore forum members’ insights and experiences on the following:
  1. Considering the SDG target 6.2, how can sanitation marketing approaches be designed most effectively to increase the percentage of populations using safely managed sanitation services in urban and rural settlements?  What are appropriate roles for the local private sector in supporting these efforts?
  2. Experience and formative marketing research has shown that households do not prioritise sanitation financing.  How do we structure micro-credit financing to make it attractive for households to take small loans for sanitation?
  3. In both rural and urban settings, how do we best link CLTS and sanitation marketing in practice and what sequencing of interventions is required?
  4. What approaches to finance can help low-income urban settlements to access safely managed sanitation services?  What are the enablers and barriers to this?

Theme 2: Meeting demand at the household level:will focus on engaging local entrepreneurs to respond to demand through local entrepreneur engagement around toilet construction and emptying.

Theme 3: Engaging private sector further along the chain: will focus on local private sector roles in transport, disposal and reuse

2. Thematic Timeline
  • Theme I: October 26-November 1: Raising demand for sanitation and hygiene services
  • Theme II: November 2-8: Meeting demand at household level
  • Theme III: November 9-15: Engaging private sector further along the chain

For each area, key questions revolve around the business models and financing options that hold promise, the role of government and external agencies in enabling and supporting enterprise development, and the design of appropriate regulation for small and medium enterprises.

3. Experts
  • Dr Amaka Godfrey, WEDC Loughborough University
  • Lillian Mbeki, Consultant
  • Emily Endres, Senior Program Associate, Results for Development Institute
  • Dr. Nicola Greene, Consultant
  • Hung Anh Ta, PhD Candidate, Asian Institute of Technology
  • Magdalena Bäuerl, Project Officer, hydrophil
  • Andreas Knapp, Managing Director, hydrophil
  • Ken Caplan, Director, Partnerships in Practice (Discussion Co-ordinator)
4. Background Readings

Theme I: Raising demand for sanitation and hygiene

Unicef (2010): Sanitation Marketing in Indonisia:

Water and Sanitation Programme (2014): Scaling up Rural Sanitation:

SNF / UNICEF (2013): Rural Kenya Market Research on Sustainable Sanitation Products and Solutions for Low Income Households:

Australian Wash Working Group: Sanitation Marketing Community of Practice – developing skills to build sanitation markets:

Join the discussion here via SuSanA and via the WSSCC COP !

Filed under: Uncategorized

Evaluation of Water and Sanitation for the Urban Poor’s DFID-funded Programme 2012-2015

27 October 2015 9:54 (America/New_York)

WSUP is seeking an experienced consultant to conduct a rigorous end-of-programme evaluation. WSUP’s DFID-funded programme runs from December 2012 – March 2016 and targets the adoption and replication of effective urban water, sanitation and hygiene models by WASH service providers, national governments and international financing institutions across the six countries where WSUP has an established presence (Bangladesh, Ghana, Kenya, Madagascar, Mozambique and Zambia). It is further characterised by a comprehensive programme of research, publications and communications aimed at informing and influencing the international WASH sector. Strong knowledge of methodologies for programme evaluation and experience of evaluating capacity development and institutional influencing interventions are essential. Interested evaluators are encouraged to review the attached terms of reference and submit their proposal to by 12th November 2015.

ToR WSUP’s DFID-funded programme 2012-2015

Filed under: Uncategorized

How can research drive public finance? PF4WASH session at UNC, Thursday 29th Oct 1030!

26 October 2015 5:56 (America/New_York)

Hello everyone!

The Public Finance for WASH initiative is organising a session at the UNC Water and Health Conference.
Our aim with this session is to think about different ideas for a research project that might genuinely drive massive government investment in WASH. Each speaker will propose an outline for a specific project, in a named country, which they think might achieve this end. Participants will decide which proposal gets the funding.

• Clarissa Brocklehurst (UNC)
• Jenna Davis (Stanford)
• Matt Freeman (Emory)
• Tanvi Nagpal (Johns Hopkins)

Date: Thursday 29 October
Location: Sunflower
Time: 10:30 – 12:00

If you are around, come along and join our session convened by WSUP, IRC and Trémolet Consulting.
Everyone welcome! Stay tuned!

Filed under: Uncategorized

How can research drive public finance? PF4WASH session at UNC, Thursday 29th Oct 1030!

26 October 2015 5:56 (America/New_York)

Hello everyone!

The Public Finance for WASH initiative is organising a session at the UNC Water and Health Conference.
Our aim with this session is to think about different ideas for a research project that might genuinely drive massive government investment in WASH. Each speaker will propose an outline for a specific project, in a named country, which they think might achieve this end. Participants will decide which proposal gets the funding.

• Clarissa Brocklehurst (UNC)
• Jenna Davis (Stanford)
• Matt Freeman (Emory)
• Tanvi Nagpal (Johns Hopkins)

Date: Thursday 29 October
Location: Sunflower
Time: 10:30 – 12:00

If you are around, come along and join our session convened by WSUP, IRC and Trémolet Consulting.
Everyone welcome! Stay tuned!

Filed under: Uncategorized


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