Basic Handwashing Facilities Research Articles

School sanitation and student health status: a literature review

Introduction. UNESCO 2019 said that Indonesia’s education has ranked 54 to 120 countries. The Sustainable Development Goals (SDGs) contain goals 4, target 4a, indicator 4.a.1. Quality education can be achieved with basic drinking water during school hours, basic sanitation facilities, and basic handwashing facilities. School sanitation is covered at targets 3, 4, and 6 of SDGs. The objective of this review is to identify school sanitation, determination of disease, and students’ health status-related school sanitation. Materials and Methods. This research was based primarily on a literature review. Boolean technic was used to define the keywords. The database used for the searching within these documents were School Sanitation, Health, and Students. Data were found from search engines PubMed, Science Direct, Springer, and Google scholar. The literature review of this search was done by the publication range 2019-2022. The search data were conducted on 8 October 2022, which Acquired 7 articles that meet predefined criteria. Results and Discussions. Schools’ sanitation was identified in water supply, drinking water supply, rest room, sanitary facilities, toilet/ latrine, hand washing facilities, cleaning policy, clean and functional toilet, Water Sanitation and Hygiene Programs, and the knowledge of sanitation. The effect of health-related school sanitation was gastrointestinal illness, diarrhea, cholera, dehydration, cavities in teeth, undernutrition, stunting, soil-transmitted helminths, intestinal parasitic infection, toothache, decay missing, filled permanent teeth status, and health status of students. Conclusions. School sanitation affected the student health status, absenteeism at school, and students’ concentration. Sanitation facilities are suggested to include laws and policies.

Trachoma, the world's leading infectious cause of blindness: The remaining gap in care and access to basic handwashing facilities.

Trachoma, the world's leading infectious cause of blindness, has been targeted by the WHO for elimination through the SAFE strategy: surgery, antibiotics, facial cleanliness, and environmental improvement. Although significant progress has been made, there remains a gap in care. This project studied the association of geographical distribution of the remaining need for trachoma intervention and its association with access to basic handwashing facilities at home, as an indicator of water/sanitation infrastructure. We hypothesized that poor water sanitation would correspond to areas where trachoma intervention is still required. Retrospective analysis using the WHO Global Health Observatory. Spatial, correlation, and simple and multivariable regression analyses were used. Using data from the WHO Global Health Observatory, a total of 194 countries were analyzed. Two choropleth maps were created, with inset maps focused on the South Pacific region, where the top 5 countries with the greatest population proportion requiring trachoma intervention are located. Correlations and the simple regression model of total population with access to handwashing facilities as the only risk factor were insignificant. However, the multivariable regression models with access to handwashing facilities (total, urban, and rural) and population density as risk factors for trachoma intervention were significant. Poor water/sanitation infrastructure correlates with trachoma burden. Therefore, water/sanitation infrastructure improvement is a worthwhile target in the efforts toward trachoma elimination, but further research on the association between these important public health indicators is warranted.

Access to Drinking Water, Sanitation, and Hand Hygiene Facilities in the Peri-Urban and Informal Settlements of Hosanna Town, Southern Ethiopia.

Access to water, sanitation, and hygiene (WASH) facilities and practices have been extensively studied in urban and rural areas. However, there is a paucity of information on the coverage of water, sanitation, and hygiene facilities in the peri-urban and informal settlement areas, which could potentially exacerbate the spread of water, sanitation, and hygiene-related diseases. Therefore, this study was designed to examine access to drinking water, sanitation, and hand hygiene facilities and their determinant factors in the peri-urban and informal settlements of Hosanna town. A community-based cross-sectional study involving 292 households was conducted in 3 kebeles of Hosanna town. The primary data was collected using a pretested structured questionnaire and an observational checklist. Bivariate and multivariable logistic regressions were used to analyze the data. All the households (100%) had access to piped water on and off-premises, but the reliability of the water sources was a big challenge. Findings revealed that only 35.1% and 16.8% of the households had basic sanitation and basic handwashing facilities, respectively. Households with a middle income were identified as a determinant factor for the presence of piped water on premises (AOR = 2.23; 95% CI = 1.24-4.00), improved sanitation (AOR = 2.17; 95% CI = 1.17-4.03) and handwashing facilities (AOR = 4.36; 95% CI = 1.98-9.62). Piped water on premises was also another strong predictor of the availability of improved sanitation (AOR = 3.34; 95% CI = 1.99-5.62) and handwashing facilities (AOR = 8.18; 95% CI = 4.08-16.42). The majority of the studied households living in the selected peri-urban and informal settlements had access to unreliable drinking water sources. The study also revealed that households had poor access to basic sanitation and basic handwashing facilities. Hence, the findings call for solid government interventions to improve the reliability of the drinking water sources, basic sanitation coverage, and availability of basic handwashing facilities.

Assessment of indicators on drinking water, sanitation, and hygiene (WASH) practices from rural schools of Kathua.

Safe and adequate water supply and sanitation in schools are prerequisites for right to basic education for school children. The provision of water, sanitation, and hygiene (WASH) facilities has been linked to the achievement of Sustainable Development Goals. The objective of this study is to assess the indicators of WASH in schools falling under the Rural Health and Training Centre (RHTC), Budhi, GMC Kathua. A cross-sectional study was conducted during a period of two months in the month of September 2019 to October 2019. It was done in the rural area under CHC Nagri Parole Kathua. The total number of schools under CHC is 981. Interview of the head of the school was done using world health organization (WHO) and united nations international children's emergency fund (UNICEF) Standardized Questionnaire for WASH Practices. The Questionnaire includes core and expanded questions on drinking water, sanitation, and hygiene practices. Data were entered in Microsoft Excel and descriptive statistics was analyzed in the form of number and percentages. Out of total 139 schools, 57.72% schools had basic drinking water facilities. Only 29.11% schools have basic hand-washing facilities with soap and water; 81.29% of the schools have improved toilets. Political will and financing and effective delivery of interventions will be required to ensure universal access to WASH in schools.

Safe water supply challenges for hand hygiene in the prevention of COVID-19 in Southern Nations, Nationalities, and People's Region (SNNPR), Ethiopia

BackgroundProper hand hygiene practices are critical in disease prevention and control, including preventing the spread of the COVID-19 pandemic, but according to a recent global report, three billion people lack access to basic hand washing facilities (soap and water) at home. Therefore, this study aimed to determine the challenges related to safe and adequate water provision for hand hygiene in the prevention of COVID-19 in Gedeo Zone, SNNPR, Ethiopia. MethodsAn institutional-based cross-sectional study design was used to assess the challenges associated with safe water supply in the prevention of COVID-19 in Gedeo Zone. Simple random sampling was used. The water sector's challenges were assessed using in-depth interviews with key informants. Water samples were collected from hand washing stations using a sterile bottle and the standard tap water sampling procedure. Bacterial analysis was carried out using membrane filtration techniques. The Wagtech Palin test and the Delagua portable water testing kit procedure was used to analyze World Health Organization (WHO) critical physicochemical parameters. ResultThe physicochemical analysis of the sample water from the hand washing facilities reveals that the pH (6.5–8) is within the WHO guideline in all samples except Gedeb town (11.1%). The residual chlorine in the samples was less than 0.2 mg/l, which is below the standard in all towns, but 15.8% of the samples in Wonago town were between 0.2–0.5mg/l. Faecal coliforms were not found in 27.5%, 21.0%, 16.6%, and 40.7% of the samples collected in Dilla, Wonago, Yirgachefe, and Gedeb town, respectively. The remaining samples were all positive for faecal coliforms. Unbalanced demand versus supply, inaccessibility, supply interruptions, financial constraints, a scarcity of competent human resources, a lack of regular water quality assessments, and a lack of stakeholder support were all identified as major challenges by all water sectors of the study towns. The majority of hand washing water samples from all of the study towns were bacteriologically unsafe. The water sector must work hard to ensure that the community has safe drinking water. All responsible bodies and potential stakeholders must support the water sectors in the Gedeo zone.

Availability and factors influencing community level handwashing facility in Ethiopia: Implication for prevention of infectious diseases.

Handwashing is one of the most effective ways to prevent transmission of infectious diseases. A substantial body of research has examined the status and determinants of handwashing facilities in healthcare settings and schools. However, its status at home in the community, especially in developing countries, remains unclear. This study aimed to examine the availability and factors influencing basic handwashing facilities at households in Ethiopia. We analysed the 2016 Ethiopian Demographic and Health Survey (EDHS) data. EDHS employed a two-stage stratified cluster sampling technique. Data were collected from the lowest administrative unit (kebele). A multivariable logistic regression model that allowed cluster-level random effects was employed to examine factors that affect the availability of basic handwashing facilities (water plus soap) at households. Estimates from the regression model are reported as odds ratios (ORs) with standard errors clustered at the DHS cluster level to account for a sampling methodology. In our sample, only 1292 (8% [95% CI, 7.6%-8.4%]) of the households had basic handwashing facilities. Compared with head of household who had no formal education, the odds of having basic handwashing facilities was higher among head of household who completed secondary level of education (adjusted odds ratio [AOR] = 1.83; 95% CI: 1.35-2.49) and higher level of education (AOR = 2.35; 95% CI: 1.63-3.39). Odds of having basic handwashing facilities was increased with having radio (AOR = 1.32; 95% CI: 1.10-1.63) and television (AOR = 1.49; 95% CI: 1.10-2.02) at home. Households that had improved latrine were two times more likely to have basic handwashing facilities (AOR = 2.09; 95% CI: 1.56-2.80). Being at higher household wealth quintiles was associated with increased odds of having basic handwashing facilities. Very low basic handwashing facilities was demonstrated by this study, whereas, awareness and socio-economic related factors were identified as a determinants for its availability in the household. Greater efforts are needed to increase the coverage of community-level handwashing facilities.

Factors associated with water quality, sanitation, and hygiene in rural schools in 14 low- and middle-income countries

Improving access to water, sanitation, and hygiene (WaSH) and menstrual hygiene management (MHM) in schools is important to achieve Sustainable Development Goals (SDGs) 3 and 6. Inadequate WaSH and MHM in schools adversely affect student health and educational performance, as well as teacher satisfaction. However, there is little evidence describing factors associated with WaSH services and MHM in schools. We conducted 2690 surveys and collected 1946 water samples at randomly selected schools in rural areas of 14 low- and middle-income countries (LMICs). We developed multilevel mixed-effects logistic regression models to identify factors associated with basic water services, water quality, basic sanitation facilities, basic handwashing facilities, and availability of MHM materials. We found that 51% of schools had at least a basic, on-premises water service. Twenty-eight percent of schools had at least basic sanitation services, 12% had at least a basic handwashing facility, and 26% had MHM materials available. Four percent of schools had all basic WaSH services. Half (52%) of schools had drinking water compliant with the WHO guideline value for E. coli. In regression models, we found that schools that did not share their water point with a community, had a parent-teacher association that supported WaSH, or had support from an external WaSH program were more likely to have access to basic, continuous, on-premises water service versus worse access. Schools with an on-premises water point, water available on the day of survey, a health club, or handwashing stations near toilets were more likely to have a basic sanitation service versus a lower service. Schools with limited or basic sanitation, health clubs, an MHM curriculum, a designated MHM focal person, or school funds for WaSH were more likely to have MHM materials. We conclude that improved institutional management and external support, accountability mechanisms, and enhanced training and hygiene curriculum will support sustained WaSH service delivery in schools in LMICs.

ESTABLISHING SUSTAINABLE HANDWASHING WATER STRATEGIES TO MANAGE THE SPREAD OF COVID-19

ABSTRACT As the pandemic of COVID-19 spread across the world, Ethiopia undertook monetary and fiscal stimulus packages and also attempted to shoulder various preventive health-related measures such as staying at home, handwashing with clean water, mask-wearing, and maintaining proper social distancing to suppress the spread of the COVID-19 virus. The objective of the study was to review the effectiveness of monetary, fiscal stimulus packages, and assess the health-related preventive measures that have been used to mitigate the economic outbreaks caused by the COVID-19 pandemic. The primary questions of the study included: 1) Do monetary and fiscal stimulus packages minimize the economic shocks caused by the coronavirus pandemics? and 2) Do health-related preventive measures alleviate the damages from COVID-19? The sole sources of information for study were based on secondary data. The principal findings of study include that since Ethiopia, prior to COVID-19, was faced with a fragile economic environment and poor health infrastructure, the demand management policies that it undertook had limited impact to spark the subdued Ethiopia’s economy. As the costs of the stringent health-related preventive measures applied to Ethiopian situation outstripped their benefits, their effects were less fruitful. The staying-at-home policy contributed to the deaths of poor people from starvation. Maintaining social distancing did not slow the threat the coronavirus in Ethiopia because 4 to 5 family members share one room. Mask-wearing of mouth and eyes is the only affordable and feasible device that could be implemented to fight against COVID-19 in Ethiopia. Given that Tigray has limited access to basic handwashing facilities, policy makers need to design a combination of on-site water recycling or water downcycling and rainwater harvesting to reduce water shortage in Tigray and combat the future occurrence and spread of disease like the COVID-19, while staying vigilant of the second wave of infections. Keywords Coronavirus, COVID-19, Monetary and Fiscal Policies Stimulants, Staying at home, Hand washing, Mask-wearing, Social distancing

Addressing the challenges that affect COVID-19 prevention in the rural areas of Abia State, Nigeria

Background: Using directives have been the standard approach of changing public behavior. But studies have shown that directives fail because people hate being told what to do. Telling individuals to use limited resources and other social amenities in rural areas to prevent coronavirus disease 2019 (COVID-19) infection may lead to skepticism in practice of public health recommendations on COVID-19 prevention. Even non-availability of basic hand washing facilities (soap and clean water) which form fundamental mechanism to prevent COVID-19 can expose people to infection. Study assesses factors and conditions that influence the practice of Center for disease control (CDC) preventive measures against COVID-19 in rural areas.Methods: This is a qualitative study that utilized information from 36 health care professionals under the aegis of committee for COVID-19 prevention. These committee members are working together in partnership with state government to provide services to control, prevent and cushion effects of COVID-19 pandemic.Results: Findings from 36 health care professionals made up of 10 (27.8%) females and 26 (72.2%) males showed that factors such as denial of existence of the virus, labeling virus as only urban limited, poor knowledge of mode of transmission, terming virus as ploy politicians use to siphon resources meant for rural development contributed to non-observation of CDC guidelines for COVID-19 prevention.Conclusions: Denying existence of COVID-19 and not observing CDC guidelines will increase community transmission thereby, expose people in communities to infection. Therefore, education is needed to enlighten people in communities on benefits of observing CDC guidelines.

Corona virus response: narrative on how the virus transformed lives in the rural areas of Abia state, Nigeria

Background: Many people in communities especially children and elderly are at risk of losing their lives to pneumonia, diarrhoeal diseases, malaria, HIV and other preventable diseases unless urgent action is taken to mitigate the spread of COVID-19. For instance, disruptions in immunization services for fear of getting infected with the virus will result in more children dying from pneumonia, which already kills many children in rural areas. Limited resources in rural areas may result to lack of basic hand washing facilities at home which form the fundamental mechanism to prevent COVID-19, thereby, expose already vulnerable people in rural areas to infection. Study assessed the extent to which individuals in rural areas effectively practiced preventive measures of COVID-19 infection as outlined by centre for disease control (CDC).Methods: This is qualitative study that utilized collaborative information from 36 health care professionals under the aegis of members of COVID-19 committee working together in partnership with state government to ensure that best quality services are available to control, prevent and cushion effects of COVID-19 during and after the COVID-19 crisis. This study is therefore, snapshot of activities individuals in rural areas take to prevent COVID-19 infection. Results: Findings showed that preventive measures like lockdown and social distancing rules, wearing of face mask, hand washing with soap, and environmental cleanliness were slightly observed thereby, exposing the rural areas to COVID-19 infection. The study observed that public and private life like sexual life, marital life, income, education, employment and social interaction were negatively affected.Conclusion: From the findings of the study, governments’ financial support during the lockdown was insignificant. Therefore, there is need for the governments to provide social amenities to alleviate the numerous socio-economic problems of individuals in the rural areas.

Estimates of the COVID-19 Infection Fatality Rate for 48 African Countries: A Model-based Analysis

Introduction: The infection fatality rate (IFR) is key to determining the effect of the pandemic at population level, as well as the effects of public policies and regulations. We examine global data from 48 African countries to estimate the SARS-CoV-2 IFR. Methods: We analyzed time series data on the confirmed cases and deaths from COVID-19 disease outbreak across Africa. We define IFR as the ratio of the number of deaths caused by COVID-19 (numerator) and the total number of people in the population who were infected by the virus (denominator). We controlled for the upward bias associated with the denominator, to accommodate for the untested individuals by adjusting for population density, population aged 65 years and older, population with basic handwashing facilities, extreme poverty, diabetes prevalence, and death rate from cardiovascular disease in a Bayesian prediction model based on the technique of Monte Carlo. Results: We analyzed data on the 135,126 confirmed cases and 3,922 deaths from COVID-19 disease outbreak in Africa through May 30, 2020. After adjusting for potential risk factors in the Bayesian model, we predicted a total of 1,686,879 COVID-19 infections, corresponding to 13 infections per confirmed case. The IFR in Africa was estimated to be 0.23% (95%CI: 0.14% to 0.33). Country-specific rates varied from 0.004% in Botswana and Central African Republic, to 1.53% in Nigeria, respectively. The estimated IFR is twelvefold higher than WHO reported estimate (0.02%) from the 2009 H1N1 influenza pandemic. The inverse distance weighted (IDW) interpolation map shows concentrations of extreme IFR in four countries: Morocco, Nigeria, Cameroon, and South Africa. Conclusion: The infection fatality rate of COVID-19 can vary substantially across different locations, and this may reflect differences in demographics, underlying health issues in the population, capacity of the healthcare system, positive health seeking behavior, as well as other factors. Variability in testing and cause-of-death data across African countries might have impacted on the results. Our model and our estimates can help disease and policy modelers to obtain more accurate predictions for the epidemiology of the disease and the effect of alternative policy strategies to contain this pandemic.

Improving water harvesting efficiency of fog collectors with electrospun random and aligned Polyvinylidene fluoride (PVDF) fibers

People worldwide suffer from poor access to water, with more than 3 billion lacking basic handwashing facilities and more than 2 billion without water services at their homes. This global problem needs new, cost-effective and efficient solutions that can be employed in places with scarce water sources. One potential sustainable solution is fog water collection, inspired by the way nature harvests water from humid air via condensation processes or from fog. Currently, a common medium to collect fog with the highest water collection efficiency is the Raschel mesh. By incorporating electrospun polyvinylidene fluoride (PVDF) fibers we improved water collecting efficiency of commercial Raschel mesh by more than 300%. We show a relatively simple to implement and inexpensive system that builds on top of already applied solutions and expands the capabilities of existing designs.

The Water, Soap, Sanitation, and Handwashing Facilities are Associated with COVID-19 Transmission in 44 Countries

Coronavirus 2019 (COVID-19) is currently a global pandemic. Public awareness about washing hands is important in preventing the spread of COVID-19. The purpose of this study was to determine the relationship between increased water sources, basic water services, improved sanitation facilities, basic hand washing facilities, soap and water availability with COVID-19 transmission in 44 countries. Using Demographic and Health Survey Data in 44 countries including data on populations living in households using improved water sources, basic water services, improved sanitation facilities, hand washing practices, basic hand washing facilities with soap and water availability, ownership of electricity, television, cellphones , and households consisting of only those aged> 65 years. Data is downloaded in the form of Excel. The COVID-19 case was reported by the Johns Hopkins University Center for Science and Systems Engineering (CSSE) on April 28, 2020 in 44 countries. DHS program data from 44 countries that are relevant to the CSSE Johns Hopkins University data are carried out linear regression tests and alternatives (spearman test) using SPSS 22. Relationships between variables by looking at the correlation coefficient and p value for each variable. The results of the study are presented in tabular form. Results: Increased water sources, basic water services, improved sanitation facilities, basic hand washing facilities, soap and water available in relation to COVID-19 transmission, with each correlation coefficient of 0.421, 0.506, 0.374, 0.243 and 0.399.

Does communicable diseases (including COVID-19) may increase global poverty risk? A cloud on the horizon

Coronavirus epidemic can push millions of people in poverty. The shortage of healthcare resources, lack of sanitation, and population compactness leads to an increase in communicable diseases, which may increase millions of people add in a vicious cycle of poverty. The study used the number of factors that affect poverty incidence in a panel of 76 countries for a period of 2010–2019. The dynamic panel GMM estimates show that the causes of death by communicable diseases, chemical-induced carbon and fossil fuel combustion, and lack of access to basic hand washing facilities menace to increase poverty headcounts, whereas, an increase in healthcare expenditures substantially decreases poverty headcounts across countries. Further, the results show the U-shaped relationship between economic growth and poverty headcounts, as economic growth first decreases and later increase poverty headcount due to rising healthcare disparities among nations. The causality estimates show that lack of access to basic amenities lead to increase of communicable diseases including COVID-19 whereas chemical-induced carbon and fossil fuel emissions continue to increase healthcare expenditures and economic growth in a panel of selected countries. The rising healthcare disparities, regional conflicts, and public debt burden further ‘hold in the hand’ of communicable diseases that push millions of people in the poverty trap.

Establishing Sustainable Development Goal Baselines for Household Drinking Water, Sanitation and Hygiene Services

The World Health Organization (WHO) and United Nations Children’s Fund (UNICEF), through the Joint Monitoring Programme (JMP), are responsible for global monitoring of the Sustainable Development Goal (SDG) targets for drinking water, sanitation and hygiene (WASH). The SDGs represent a fundamental shift in household WASH monitoring with a new focus on service levels and the incorporation of hygiene. This article reflects on the process of establishing SDG baselines and the methods used to generate national, regional and global estimates for the new household WASH indicators. The JMP 2017 update drew on over 3000 national data sources, primarily household surveys (n = 1443), censuses (n = 309) and administrative data (n = 1494). Whereas most countries could generate estimates for basic drinking water and basic sanitation, fewer countries could report on basic handwashing facilities, water quality and the disposal of waste from onsite sanitation. Based on data for 96 and 84 countries, respectively, the JMP estimates that globally 2.1 billion (29%) people lacked safely managed drinking water services and 4.5 billion (61%) lacked safely managed sanitation services in 2015. The expanded JMP inequalities database also finds substantial disparities by wealth and sub-national regions. The SDG baselines for household WASH reveal the scale of the challenge associated with achieving universal safely managed services and the substantial acceleration needed in many countries to achieve even basic services for everyone by 2030. Many countries have begun to localise the global SDG targets and are investing in data collection to address the SDG data gaps, whether through the integration of new elements in household surveys or strengthening collection and reporting of information through administrative and regulatory systems.