Poor Water, Sanitation And Hygiene Research Articles

Water Insecurity and Rights Erosion: A Comprehensive Analysis of Rohingya Refugee Camps in New Delhi

This study presents a comprehensive analysis of the critical issue of water insecurity and its multifaceted impact on and relationship to the human rights and environmental justice conditions within Rohingya refugee camps located in New Delhi, India. A comprehensive mixed-methods approach was employed to investigate water-related challenges within a refugee camp in Madanpur Khadar, region in Delhi. Qualitative methods including focused group discussions and one-on-one household interviews were conducted to allow residents’ perceptions from diverse groups and examine their experiences. Structured surveys were administered to gather quantitative data on water access, sanitation, health, and socio-economic factors. Additionally,, literature surveys and document archival research provided contextual insights. This study underscores the pressing water, sanitation, and hygiene (WaSH) challenges faced by Rohingya refugees in the area, revealing irregular water supply, impacting residents’ daily lives and hygiene practices. The majority of families in the camp, with an average of 6 members in each family, can only collect 30–40 L of water to meet all their needs, from consumption to personal hygiene, which is significantly insufficient. This situation has resulted in severe health consequences for the camp residents. Alarmingly, over 90% of the female respondents reported experiencing issues such as urinary infections. This paper gives a comprehensive analysis of the multidimensionality of rights that intersect with and are affected by WaSH issues. The poor WaSH conditions in the camp directly hinder the fulfillment of fundamental human rights. It not only disrupts the basic sanitation need but has negative economic repercussions and causes mental distress. This study concludes by targeted recommendations aimed at improving the conditions prevailing within the camp.

Knowledge, attitude and practice towards water, sanitation and hygiene (WASH) among holy water users in Amhara regional state Orthodox churches, Ethiopia, 2024: institutional based cross-sectional study

ABSTRACT Sanitation is the quality of living that is expressed in a clean home, a clean firm, a clean business, and a clean community to prevent disease and promote health. Poor water, sanitation, and hygiene (WASH) negatively impacts health, development, economic and social growth, and significantly hinders poverty alleviation. This study aimed to assess the knowledge, attitude, and practices regarding water, sanitation, and hygiene among holy water users in Amhara regional state Orthodox churches, Ethiopia, in 2024. An institutional-based cross-sectional study was conducted in April 2023 in five randomly selected Orthodox Tewahido churches in the Amhara region. The study employed an interviewer-administered structured questionnaire to gather data from 423 study participants. The response rate was 91% and 219 (57% of the respondents) were female. Good knowledge, positive attitudes, and good practice on WASH was found in 39.2, 42.5, and 47.2%, respectively. In conclusion, Ethiopian Amhara Orthodox Tewahido churches, holy water users frequently lacked information, had an unfavorable attitude, and practiced poor WASH. This demands for immediate effort to raise knowledge about health education and hygiene in order to impact holy water user's attitudes toward personal and communal cleanliness and sanitation.

Water, Sanitation, and Hygiene (WASH) practices among residents of different slum settlements in a ward of Kolkata: A mixed-methods study.

Access to safe water, sanitation, and hygiene (WASH) is the most basic need for mankind. Poor WASH practices are associated with various waterborne diseases, especially in developing countries such as India. The aim of the study was to assess WASH practices among residents of different slum settlements in a ward of Kolkata, identify the factors associated with WASH practice, and explore the barriers faced by the families and municipal staff in providing adequate WASH services to the community. An observational study, cross-sectional in design with a convergent parallel mixed-methods approach, was conducted in different slum settlements in a ward of Kolkata. Quantitative data were collected by face-to-face interview, spot observation, and measuring the living area, door, and window spaces. Key informant interviews were conducted with the medical officer, ward vector-control coordinator, and municipal waste handlers, in addition to in-depth interviews with respondents who had unsatisfactory WASH practices. SPSS version 25.0 was used to analyze the quantitative data. Qualitative data were analyzed thematically using Atlas.ti 22. The overall WASH practices were considered satisfactory in 58.8% of the households. Education of the respondents up to the secondary level, presence of overcrowding, and inadequate ventilation in the house had statistically significantly higher odds of unsatisfactory practice. Poor living conditions, difficulty in collecting and storing water, waterlogging, blocked sewage drains, common toilets for men and women, and lack of motivation were the primary obstacles identified by the residents. Unsatisfactory WASH practices were observed among a high proportion of the slum population. Community engagement and education regarding WASH in communities is strongly recommended along with improvement of infrastructure and capacity building.

‘Othering’ the Mothers’ Needs: Pregnant and New Mothers’Access to Water, Sanitation, and Hygiene (WASH) in Bangladesh

Since the turn of the 21st century, water, sanitation, and hygiene (WASH) have been a growing priority in the international development paradigm. This study intends to investigate expecting and new mothers’ experiences in accessing WASH and the long-term effects on their socioeconomic and psychosocial development. It also aims to comprehend the gendered dimension of WASH. The Inequality Approach by Amartya Sen was used as the theoretical framework to assess the study’s findings. Purposive sampling was used to choose respondents, and in-depth interviews were done to collect data. According to the findings, expecting and new mothers who are also academics or professionals suffer a slew of issues owing to poor WASH and which impacts their education, job, and mobility. However, they used to cope with the vulnerabilities in order to continue with their regular activities. Similarly, WASH is more than simply a structural issue; it has several overlapping variables that impede pregnant and new mothers’ development. As a result, policy execution and sound structural design, along with a gender perspective, are essential to improve WASH facilities for pregnant and new mothers in all social institutions.

Implementation of WASH (Water, Sanitation, and Hygiene) with Stunting Incidents in Pujer District, Bondowoso Regency

The Government of Indonesia is working with the United Nations International Children's Emergency Fund (UNICEF) to support a development program for the Water, Sanitation, and Hygiene (WASH) sector. Globally, access to WASH is still inadequate, and diseases resulting from poor WASH contribute to 13% of under-five deaths. Poor sanitation can cause various diseases, including nutritional problems such as stunting. In 2021, Bondowoso will become one of the 10 regencies or cities with the most considerable prevalence of stunting under five in East Java. Therefore, it is essential to research and examine the link between the success of WASH implementation and the stunting rate in Pujer District, Bondowoso Regency. This quantitative descriptive study was conducted in the Pujer District with 67 respondents using a simple random sampling technique. The study used several variables, including the hygiene behaviour of mothers under five, the ownership of access to family sanitation, the physical quality of family drinking water, the incidence of infectious diseases (diarrhoea) in children, and the nutritional status of children based on height and age (TB/U). The analyses were univariate, crosstab, and scoring. There were 16 families (24.4%) with an unsuccessful WASH assessment but no stunting below five, and 33 families (49.25%) with a successful WASH assessment but no stunting below five. It was concluded that the better the WASH was applied, the better the nutritional status of the toddlers; conversely, the worse the WASH was implemented, the worse the nutritional status of the toddlers.

Understanding the social and physical menstrual health environment of secondary schools in Uganda: A qualitative methods study.

Adolescent girls face social, psychological, and physical problems managing menstruation in schools in low-resource settings. This study aimed to evaluate the social and physical menstrual health environment of secondary schools in Wakiso and Kalungu districts, Uganda, in preparation for a subsequent menstrual health intervention trial to improve education, health and wellbeing. We conducted a qualitative rapid assessment in 75 secondary schools in Uganda. This involved conducting in-depth interviews with 150 head/senior teachers and 274 students, 26 Focus Group Discussions with students, and 13 transect walks to observe school Water, Sanitation and Hygiene (WASH) facilities between May and October 2021. Due to COVID-19 related school closures, face-to-face research activities were halted and in-depth interviews were conducted over phone and replaced focus group discussions. We employed a thematic framework analysis approach using the social-ecological model (which focuses on the complex interplay between individual, interpersonal, institutional, and societal factors) to generate themes and key concepts. Participants described the social and physical menstrual health environment of secondary schools at the individual level (knowledge gaps on menstruation before menarche, negative norms and beliefs about menstrual health); interpersonal level (limited psycho-social support, myths and misconceptions about the disposal of sanitary materials and pain relief, menstrual hygiene management (MHM) support from school nurses, peers and senior teachers); institutional level (non-implementation of Government circulars on MHM, lack of school-level guidelines policies and programs on MHM and poor WASH facilities, i.e. lack of soap, safe water and unclean toilets); and societal level (MHM programmes provided by civil society groups, health workers, and students' school associations). The findings showed individual, societal and institutional burdens related to menstrual experiences. Multi-level evidence-based interventions aimed at improving the social and physical environment for menstrual health among school-going girls are needed.

Issues Affecting Almajiri Schools in Nigeria: Water, Sanitation, and Hygiene (WASH) Parameters in Sokoto

Background: There are many dimensions to the consequences of lack of sanitation, that are threat to public health. Diarrhea and relations due to poor WASH kills and put on cost on family and economy at large. Poor WASH affects economy in the sense that, millions of persons are unable to yield maximum productivity due to sickness, millions of working hours lost, and millions of schooling hours lost. Aim: This study performed an assessment of water, sanitation, and hygiene among Almajiri schools in Sokoto state, Nigeria. Method: A survey using a sample size of 300 schools gotten via simple random sampling, analyzed with descriptive statistics and chi-square test. Findings: The Almajiri schools surveyed, 3.3% of them have basic sanitation; 6.7% had limited sanitation; and most of them (90.0%) have no service at all (unimproved sanitation facilities or no sanitation facilities at the school). No Almajiri school had basic hygiene services (that is handwashing water and soap at the latrine vicinity), 33.7% had limited hygiene services, that is, they recorded acquiring of handwashing facilities with water but no soap available at the school at the time of the inspection, 66.6% of the schools had no services, that is no handwashing facilities or no water available at the school during the survey. Chi-square test has shown that there is significant difference in levels of water, sanitation, and hygiene among Almajiri schools in Sokoto state, Nigeria at p<0.05.

Assessing Water, Sanitation and Hygiene Access and Use in Nabilatuk District, Uganda: A Cross-Sectional Study of Different Data Collection Methods

Good access and appropriate use of Water, Sanitation and Hygiene (WASH) is important in the control, elimination and eradication of a number of neglected tropical diseases (NTDs). Poor WASH access and use may explain continued high trachoma prevalence in Nabilatuk district, Uganda. This study aimed to investigate the level of WASH access and use through different WASH data collection methods and the triangulation of their results. A mixed-methods cross-sectional study was conducted in 30 households in Nabilatuk district, from 10 households in each of three nomadic villages. The data collection methods used were: (1) direct observations of routine WASH behaviours; (2) structured quantitative household questionnaires; (3) demonstrations of specific WASH behaviours. With regards to access, observations indicated less WASH access and use compared with questionnaire responses: the questionnaire indicated all households had access to an improved water source, but 70% had a >30-min round-trip, and no households had access to an improved latrine, whereas some observations indicated longer water collection times. In terms of behaviour, there were also differences between the data collection methods, with demonstrations revealing knowledge of good practice, such as thorough handwashing, but this was not routinely observed in the observations. Further systematic investigation of barriers to appropriate WASH access and use in the local context is needed, as is the development of feasible, valid and reliable WASH access and use assessment methods for use in national NTD programmes.

Mapping of cholera hotspots in Kenya using epidemiologic and water, sanitation, and hygiene (WASH) indicators as part of Kenya's new 2022-2030 cholera elimination plan.

Cholera is an issue of major public health importance. It was first reported in Kenya in 1971, with the country experiencing outbreaks through the years, most recently in 2021. Factors associated with the outbreaks in Kenya include open defecation, population growth with inadequate expansion of safe drinking water and sanitation infrastructure, population movement from neighboring countries, crowded settings such as refugee camps coupled with massive displacement of persons, mass gathering events, and changes in rainfall patterns. The Ministry of Health, together with other ministries and partners, revised the national cholera control plan to a multisectoral cholera elimination plan that is aligned with the Global Roadmap for Ending Cholera. One of the key features in the revised plan is the identification of hotspots. The hotspot identification exercise followed guidance and tools provided by the Global Task Force on Cholera Control (GTFCC). Two epidemiological indicators were used to identify the sub-counties with the highest cholera burden: incidence per population and persistence. Additionally, two indicators were used to identify sub-counties with poor WASH coverage due to low proportions of households accessing improved water sources and improved sanitation facilities. The country reported over 25,000 cholera cases between 2015 and 2019. Of 290 sub-counties, 25 (8.6%) sub-counties were identified as a high epidemiological priority; 78 (26.9%) sub-counties were identified as high WASH priority; and 30 (10.3%) sub-counties were considered high priority based on a combination of epidemiological and WASH indicators. About 10% of the Kenyan population (4.89 million) is living in these 30-combination high-priority sub-counties. The novel method used to identify cholera hotspots in Kenya provides useful information to better target interventions in smaller geographical areas given resource constraints. Kenya plans to deploy oral cholera vaccines in addition to WASH interventions to the populations living in cholera hotspots as it targets cholera elimination by 2030.

The Correlation Between Demographic Characteristics With Wash Practices In Stunting Locus

Human factors are very complex in the spread of disease. Stunting is caused by chronic malnutrition and infections in toddlers. Lack of access to clean water, hygiene, and sanitation contributes to stunting. Demographic factors can affect a person’s motivation to maintain hygiene. This study aims to be determined the correlation between demographic characteristics and water, sanitation, and hygiene (WASH) practices at the stunting locus. The method in this study used a correlational quantitative method with a cross-sectional design to be measured demographic characteristic and WASH practices variables. The study population consisted of Sukamulya village residents, and 463 Sukamulya village residents were sampled using total sampling. SPSS Version 26 for Windows was used for univariate and bivariate Chi-Square analysis. The results showed that 228 (49.2%) out of 463 of respondents had poor WASH practices. The results of the correlation test showed that there was a correlation between level of education and WASH practices with a score of Chi-Square 17,564 (p-value = 0,002). There is a correlation between education level and WASH practices at the stunting locus. Education affects a person’s perspective and decision-making, including environmental hygiene and health. Thus, the government and policymakers should hold WASH programs to educate the public about keeping the stunting locus clean.

Enteric infections and management practices among communities in a rural setting of northwest Ethiopia

Infections with enteric pathogens have a high mortality and morbidity burden, as well as significant social and economic costs. Poor water, sanitation, and hygiene (WASH) conditions are the leading risk factors for enteric infections, and prevention in low-income countries is still primarily focused on initiatives to improve access to improved WASH facilities. Rural communities in developing countries, on the other hand, have limited access to improved WASH services, which may result in a high burden of enteric infections. Limited information also exists about the prevalence of enteric infections and management practices among rural communities. Accordingly, this study was conducted to assess enteric infections and management practices among communities in a rural setting of northwest Ethiopia. A community-based cross-sectional study was conducted among 1190 randomly selected households in a rural setting of northwest Ethiopia. Data were collected using structured and pretested interviewers-administered questionnaire and spot-check observations. We used self-reports and medication history audit to assess the occurrence of enteric infections among one or more of the family members in the rural households. Multivariable binary logistic regression model was used to identify factors associated with enteric infections. Statistically significant association was declared on the basis of adjusted odds ratio with 95% confidence interval and p value < 0.05. Out of a total of 1190 households, 17.4% (95% CI: 15.1, 19.7%) of the households reported that one or more of the family members acquired one or more enteric infections in 12 months period prior to the survey and 470 of 6089 (7.7%) surveyed individuals had one or more enteric infections. The common enteric infections reported at household-level were diarrhea (8.2%), amoebiasis (4.1%), and ascariasis (3.9%). Visiting healthcare facilities (71.7%), taking medications without prescriptions (21.1%), and herbal medicine (4.5%) are the common disease management practices among rural households in the studied region. The occurrence of one or more enteric infections among one or more of the family members in rural households in 12 months period prior to the survey was statistically associated with presence of livestock (AOR: 2.24, 95% CI:1.06, 4.75) and households headed by uneducated mothers (AOR: 1.62, 95% CI: (1.18, 2.23). About one-fifth of the rural households in the studied region reported that one or more of the family members had one or more enteric infections. Households in the study area might acquire enteric infections from different risk factors, mainly poor WASH conditions and insufficient separation of animals including their feces from human domestic environments. It is therefore important to implement community-level interventions such as utilization of improved latrine, protecting water sources from contamination, source-based water treatment, containment of domestic animals including their waste, community-driven sanitation, and community health champion.

Application of Health Belief Model in Understanding Wash Behaviour Practices among Mothers of U-5 Children in Lagos Urban Slums

The poor practice of Water, Sanitation, and Hygiene (WASH) supports the spread of disease burdens causing high U-5 children mortality rates in developing countries like Nigeria. Knowledge, perception, attitude and other influencing factors become important in determining WASH practices. This study, guided by the Health Belief Model, assessed the knowledge, perception, and attitude of mothers of U-5 children in Lagos urban slums to WASH behaviour messages in order to understand their WASH practices. The cross-sectional study involved 361 mothers of U-5 children in selected Lagos urban slums. Applying cluster sampling and purposive sampling techniques, the study used a pre-tested structured questionnaire through interviews to collect data on knowledge, perception, attitude, and practice of WASH. IBM SPSS Version (26) was used to analyse the data collected, and the presentation was in percentages, tables and charts. The main objective was analysed using path analysis of the structural equation model (SEM) and logistic regression model. Only 15.2% used improved water sources, 44.3% stored drinking water safely, and 10.3% did not treat home drinking water. Open defecation was high (61.8%); Only 22.4% washed their hands with water and soap at critical times; 36.6% disposed of waste into the river and canal; open dumpsites (33.8%), and 29.6% used waste to fill marshy areas in the environment. The majority (90%) favourably perceived the susceptibility of children to the dangers of unsafe drinking water. The mothers positively perceived the benefits of good WASH practice for children’s health, but (31.1%) had low knowledge of the severity of the risk resulting from poor WASH. The mothers’ positive perceptions did not necessarily reflect in their WASH practices. Age, level of education, marital status, and occupation significantly influenced the respondents’ WASH practice. Economic reasons and limited WASH facilities were barriers, while contributions of community leaders were supportive. Study recommendations include; the provision of WASH facilities and more WASH behaviour education for mothers through participatory communication approaches. The WASH behaviour sensitisation model should be reviewed to have a distinct identity from routine immunization programmes; to enable mothers to understand WASH messages better.

School Water, Sanitation, and Hygiene: A Systematic Review of an Effect on Health, Attendance, Regularity, and Educational Achievements

The review was started aiming to assess the effect of school-based Water, Sanitation, and Hygiene (WASH) facilities on students’ health status, school regularity, and educational achievement. Two major academic and scientific research journals as Springer and PubMed have been selected, where WASH is the search engines, separately. There were 8,443 relevant publications found, with Springer having6, 888 and PubMed having 1,555. Among these publications, author synthesized 17 with abstracts and full articles, including references for this study. The findings of this study indicates that intervention of school WASH facilities have an effect on students’ health status, regularity in school attendance, and educational achievement. It protects students from various infectious diseases caused by poor WASH access; however, ways of handling it is equally important. The intervention in WASH facilities at school improves students’ health, school regularity, and educational achievements. Thus, the study strongly suggests interventions in school-based WASH facilities to make students healthier, more regular, and better academic performer.

Effects of poor water, sanitation, and hygiene on child health in Godawari Municipality, Lalitpur, Nepal, with special reference to diarrheal disease and nutritional status: a cohort study

Malnutrition is one of the global burdens of disease affecting children under-five in the developing world and has a bidirectional relation with diarrhea. This study aimed to determine the water, sanitation, and hygiene (WASH) effects on diarrhea and to assess its relationship with the nutritional status among exposed and non-exposed children under the age of five years. A prospective cohort of 434 children under-five was recruited and followed up for 12 months in Lalitpur. Socio-demographic, clinical, and anthropometric measurements of the participants were recorded using the World Health Organization (WHO) AnthroPlus. The observed incidence of diarrheal illness was 1.81 episodes per child/year (95% Confifence Interval (CI):1.75–1.87). Among poor WASH exposures, 63 (29.2%) children had diarrhea and among non-exposures, 59 (27.1%) had diarrhea. A total of 183 children (42.2%) had linear growth retardation (stunted), and 270 (62.2%) were malnourished. Hazards of diarrhea among exposed groups were 1.235 (95% CI: 0.785-1.943) times higher than in non-exposed groups. Based on the findings, it is recommended that the government and health organizations should plan Safe WASH activities or interventions for local communities. Moreover, they should encourage social support and promote behavioral change for adopting safe WASH practices.

Potential drivers of leprosy infection: A case–control study of parasitic coinfection and water, sanitation, and hygiene in North Gondar, Ethiopia

BackgroundDespite extensive control measures and a declining number of human reservoirs, the incidence of leprosy in excess of 200,000 new cases each year suggests that alternative pathways of transmission may play a role in continued endemicity. Parasitic coinfection and limited water, sanitation, and hygiene (WASH) have been suggested to predispose individuals to Mycobacterium leprae infection and were further explored in this study.MethodsLeprosy cases and uninfected controls were recruited from areas around North Gondar, Ethiopia throughout 2019. Participants completed dietary and WASH surveys in addition to providing stool for helminth microscopic diagnosis and urine for Schistosoma mansoni Point-of-care circulating cathodic antigen (POC-CCA)™ rapid diagnostic testing. A similar methodology was employed for a case–control study of leprosy previously conducted by our research team in North Gondar from May to October of 2018. To more comprehensively evaluate associations between the above exposures and leprosy, data from the present 2019 study and the previous 2018 study were combined in select multivariate logistic regression analyses.ResultsA total of 47 men (59%) and 33 women (41%) participated in this study with an average age of 40 (SD 15.0 years). Most leprosy cases were multibacillary (93%). There was a high prevalence of parasitic coinfection among both cases (71%) and controls (60%). WASH insecurities were also widespread. On multivariate analysis, lack of soap for handwashing [aOR= 2.53, 95% CI (1.17, 5.47)] and the lack of toilet facilities [Adjusted odds ratio (aOR)= 2.32, 95% CI (1.05, 5.12)] were significantly associated with leprosy. Positive directionality was identified for a number of other inputs, including helminth infection [aOR= 3.23, 95% CI (0.85, 12.35)].ConclusionsTaken together, these findings strengthen previous research conducted in 2018 implicating poor WASH conditions as a driver of leprosy infection. Leprosy remains the leading infectious cause of disability in the world. As such, future research should explore the above susceptibilities in more depth to curtail the global burden of disease.

Water, sanitation, and hygiene (WASH) coverage and practices of children from five public primary schools in Guinea

Abstract The water, sanitation, and hygiene (WASH) coverage and practices in and out of primary schools are crucial to the well-being of children. Using a questionnaire analysis method, this study focuses on the WASH coverage and practices of children from five public primary schools in the city of N'Zerekore, the second-largest city in Guinea. Our results reveal that the WASH coverage and practices in all five schools are inadequate. Our data indicated that 100% (n=1,048) of pupils don't wash their hands with soap after defecation in school, and over 87.9% (n=922) of students do not wash their hands before eating. The poor WASH coverage, inadequate hygiene practices, and other activities and/or causes result in a higher incidence of diseases among children, such as malaria, typhoid, and diarrhea. Some effective interventions, including the provision of clean water, sanitation and hygiene infrastructure, and widespread and effective health education, should be implemented to address these health issues among young African students.

Effects of Menstrual Health and Hygiene on School Absenteeism and Drop-Out among Adolescent Girls in Rural Gambia.

Poor knowledge and management of menstruation impacts girls’ school attendance and academic performance. This paper aims to explore how menstrual hygiene management practices and related factors influence school absenteeism and drop-out among primary and secondary school girls in rural Gambia. Mixed-method studies were conducted among students and key informants from 19 schools from July 2015–December 2017. Focus group discussions, in-depth interviews, cross-sectional surveys, menstrual diaries, and school water, sanitation and hygiene (WASH) facility observations were used. Key findings from the interviews were that menstrual pain, cultural beliefs, fear of peers knowing menstrual status, and poor school WASH facilities led to school absenteeism, however, they had no impact on school drop-out. Of the 561 girls surveyed, 27% reported missing at least one school day per month due to menses. Missing school during the most recent menstrual period was strongly associated with menstrual pain (extreme pain adjusted odds ratio (AOR) = 16.8 (95% CI: 7.29–38.74)), as was having at least one symptom suggestive of urinary tract infection (AOR = 1.71 (95% CI: 1.16–2.52)) or reproductive tract infection (AOR = 1.99 (95% CI: 1.34–2.94)). Clean toilets (AOR = 0.44 (95% CI: 0.26–75)), being happy using school latrines while menstruating (AOR = 0.59 (95% CI: 0.37–0.93)), and soap availability (AOR = 0.46 (95% CI: 0.3–0.73)) were associated with reduced odds of school absenteeism. This study suggests menstrual pain, school WASH facilities, urogenital infections, and cultural beliefs affected school attendance among menstruating girls in rural Gambia.

Practical system approaches to realise the human rights to water and sanitation: results and lessons from Uganda and Cambodia

Abstract The United Nations General Assembly's 2010 legal recognition of the human rights to water and sanitation shaped approaches of many actors working to improve access to water, sanitation and hygiene (WASH). Persistent challenges of poor WASH sustainability, scale and inclusion are increasingly being tackled through system thinking and system strengthening. However, little has been written about how participatory system analysis and monitoring can equip and empower WASH actors to apply system thinking, self-assess and course-correct in their own work to improve sustainable WASH for all. WaterAid's Sustainable WASH Services at Scale (SusWASH) programme applies a system approach, underpinned by human rights principles. In this paper, we share perceptions of local stakeholders, engaged in empowerment evaluation in Cambodia and Uganda, and lessons learned for future initiatives that seek to catalyse WASH system improvements for the realisation of the human rights to water and sanitation. We argue that a system approach, underpinned by human rights principles, can help advance progress towards inclusive and sustainable WASH for all. Working in this way fosters inclusive, locally led decision-making about how system blockages can be overcome, strengthening local ownership of a shared vision for change and the capacities and skills required to achieve it.

Trends of Water, Sanitation, and Hygiene (WASH) Research in Indonesia: A Systematic Review.

This study provides an overview of water, sanitation, and hygiene (WASH) research trends in Indonesia from 1975 until April 2021. The systematic review compiled 272 articles related to the Sustainable Development Goals 6.1 and 6.2 in Indonesia, which were published in the Web of Science and Scopus databases. The results showed that the water-related topic (41%) was discussed more often than sanitation (22%) or hygiene (13%). Furthermore, the social theme (39%) was dominantly found in all these articles, mostly finding determinants of WASH-related behavior. However, few WASH implementation studies or behavioral change interventions were recorded in Indonesia, suggesting a gap between science and policy or implementation. On the other hand, hygiene-related topics (14%) and WASH-related financial themes (6%) were the least studied in Indonesia. Combinations of topics (23%) and themes (15%) were also often conducted in Indonesia, suggesting that WASH researchers started to recognize the need to analyze WASH problems holistically, i.e., from multiple perspectives. In addition, the distribution of WASH research was still dominated in the central part of Indonesia, whereas the WASH-related problems, i.e., poor WASH services, and behavior, often occur in this area. This study also offers some research gaps, both in terms of topics, themes, and regional distribution, that need to be considered for the design of future WASH research in Indonesia.

Interventions promoting uptake of water, sanitation and hygiene (WASH) technologies in low- and middle-income countries: An evidence and gap map of effectiveness studies.

Interventions promoting uptake of water, sanitation and hygiene (WASH) technologies in low- and middle-income countries: An evidence and gap map of effectiveness studies.