Poor Water, Sanitation And Hygiene Research Articles

Gender Violence as a Water, Sanitation, and Hygiene Risk: Uncovering Violence Against Women and Girls as It Pertains to Poor WaSH Access

The purpose of this study was to better understand the gender violence risks that exist in communities where poor water, sanitation, and hygiene (WaSH) access is a known problem. Focus groups and key informant interviews were used to capture the lived experiences of community and health care practitioners from Rwanda, Tanzania, Uganda, and Kenya. This article provides lived narratives of the various cultural and environmental conditions leading to assaults directly attributable to inadequate WaSH. The results shed light on the complex intersections between water access and violence and have significant implications for achieving gender equity and universal access to WaSH.

Water, Sanitation, and Hygiene Practices Associated with Nutritional Status of Under-Five Children in Semi-Pastoral Communities Tanzania.

Undernutrition among under-five children is a public health concern in developing countries and has been linked with poor water, sanitation, and hygiene (WASH) practices. This study aimed at assessing WASH practices and its association with nutritional status of under-five children in semi-pastoral communities of Arusha. The study was cross-sectional in design. Mother-child pairs from 310 households in four villages of Monduli and Longido were involved. Weight and height of children were measured using weighing scale and length/height board, respectively. Children's age was recorded using clinic cards. Hemoglobin level of each child was tested using Hemo Cue® Hb 201 + photometer (HemoCue AB, Ängelholm, Sweden) machine. Structured questionnaire was used to gather information on WASH, child morbidity, demographic, and sociocultural characteristics. Prevalence of stunted, underweight, wasted, anemia, and diarrhea were 31.6%, 15.5%, 4.5% 61.2%, and 15.5%, respectively. Children with diarrhea 2 weeks preceding the survey (P = 0.004), children using surface water for domestic purposes (P < 0.001), and those with uneducated mothers (P = 0.001) had increased risk of being stunted and underweight. Children introduced to complementary foods before 6 months of age (P = 0.02) or belonging to polygamous families (P = 0.03) had increased risk of being stunted. Consumption of cow's milk that is not boiled (P = 0.05) or being a boy (P = 0.03) was associated with underweight. Prevalence of undernutrition among under-five children in the population under study was alarming and it could be associated with poor WASH practices and other sociocultural factors. This study underlines the importance of incorporating WASH strategies in formulation of interventions targeting on promotion of nutrition and disease prevention in pastoral communities.

Exposure to environmental microbiota explains persistent abdominal pain and irritable bowel syndrome after a major flood

BackgroundAfter an environmental disaster, the affected community is at increased risk for persistent abdominal pain but mechanisms are unclear. Therefore, our study aimed to determine association between abdominal pain and poor water, sanitation and hygiene (WaSH) practices, and if small intestinal bacterial overgrowth (SIBO) and/or gut dysbiosis explain IBS, impaired quality of life (QOL), anxiety and/or depression after a major flood.ResultsNew onset abdominal pain, IBS based on the Rome III criteria, WaSH practices, QOL, anxiety and/or depression, SIBO (hydrogen breath testing) and stools for metagenomic sequencing were assessed in flood victims. Of 211 participants, 37.9% (n = 80) had abdominal pain and 17% (n = 36) with IBS subtyped diarrhea and/or mixed type (n = 27 or 12.8%) being the most common. Poor WaSH practices and impaired quality of life during flood were significantly associated with IBS. Using linear discriminant analysis effect size method, gut dysbiosis was observed in those with anxiety (Bacteroidetes and Proteobacteria, effect size 4.8), abdominal pain (Fusobacteria, Staphylococcus, Megamonas and Plesiomonas, effect size 4.0) and IBS (Plesiomonas and Trabulsiella, effect size 3.0).ConclusionDisturbed gut microbiota because of environmentally-derived organisms may explain persistent abdominal pain and IBS after a major environmental disaster in the presence of poor WaSH practices.

Can water, sanitation and hygiene help eliminate stunting? Current evidence and policy implications.

Stunting is a complex and enduring challenge with far‐reaching consequences for those affected and society as a whole. To accelerate progress in eliminating stunting, broader efforts are needed that reach beyond the nutrition sector to tackle the underlying determinants of undernutrition. There is growing interest in how water, sanitation and hygiene (WASH) interventions might support strategies to reduce stunting in high‐burden settings, such as South Asia and sub‐Saharan Africa. This review article considers two broad questions: (1) can WASH interventions make a significant contribution to reducing the global prevalence of childhood stunting, and (2) how can WASH interventions be delivered to optimize their effect on stunting and accelerate progress? The evidence reviewed suggests that poor WASH conditions have a significant detrimental effect on child growth and development resulting from sustained exposure to enteric pathogens but also due to wider social and economic mechanisms. Realizing the potential of WASH to reduce stunting requires a redoubling of efforts to achieve universal access to these services as envisaged under the Sustainable Development Goals. It may also require new or modified WASH strategies that go beyond the scope of traditional interventions to specifically address exposure pathways in the first 2 years of life when the process of stunting is concentrated.

Can a Specially Designed Information Intervention Around the Wash-Agriculture Linkages Make Any Difference? Experimental Evidence of Behavioral Changes and Health Impacts

This paper attempts to evaluate the effectiveness of the specially designed packages of water, sanitation and hygiene (WASH) interventions with ‘student brigades’ (student teams tasked with maintaining hygiene in school) on household WASH behavior and practices in both a household and farm setting. In addition, household members’ health and developmental productivity outcomes were also examined. A randomized control trial (RCT) involving student brigades (SBs) was carried out in six sub-districts (hotspots) characterized by comparatively poor WASH indicators. The specially designed WASH-agriculture treatment consisted of three interventions: (1) informing the households about the prior water testing results; (2) delivering hygiene messages with the help of posters; (3) equipping SB members with water quality test kits and asking them to test the water quality at different places and report their findings to their household. Employing the difference-in-difference (DID) multivariate regression technique, the analysis revealed that the BRAC WASH treatment performed well in terms of effecting behavioral changes and improving hygiene practices. In addition, the results suggested that informing households of their drinking water quality and conveying WASH-agriculture hygiene messages to them could have a significant incremental impact over the existing BRAC WASH treatment in changing household hygiene behavior and practices at home and on farms. This research provides evidence that students can act as agents of change in improving water quality, sanitation and health in a rural setting.

Inadequate water, sanitation and hygiene in the South Pacific: how might it be impacting children?

It is detrimental to anyone's health to live with conditions of inadequate water, sanitation and hygiene (WaSH). Research suggests that the impact is greatest on children, and that poor WaSH conditions during the formative years can lead to decreased physical, mental and social well-being throughout one's life. Little research has investigated how such poor WaSH conditions are negatively impacting children in the South Pacific region, and hence contributing to disease and social burden. To increase children's opportunities to develop physically and intellectually in a healthy and sustained manner, it is important that practitioners take a holistic approach to improving WaSH by acknowledging it as a core component of environmental health.

Getting the basic rights - the role of water, sanitation and hygiene in maternal and reproductive health: a conceptual framework.

ObjectiveTo explore linkages between water, sanitation and hygiene (WASH) and maternal and perinatal health via a conceptual approach and a scoping review.MethodsWe developed a conceptual framework iteratively, amalgamating three literature-based lenses. We then searched literature and identified risk factors potentially linked to maternal and perinatal health. We conducted a systematic scoping review for all chemical and biological WASH risk factors identified using text and MeSH terms, limiting results to systematic reviews or meta-analyses. The remaining 10 complex behavioural associations were not reviewed systematically.ResultsThe main ways poor WASH could lead to adverse outcomes are via two non-exclusive categories: 1. ‘In-water’ associations: (a) Inorganic contaminants, and (b) ‘water-system’ related infections, (c) ‘water-based’ infections, and (d) ‘water borne’ infections. 2. ‘Behaviour’ associations: (e) Behaviours leading to water-washed infections, (f) Water-related insect-vector infections, and (g-i) Behaviours leading to non-infectious diseases/conditions. We added a gender inequality and a life course lens to the above framework to identify whether WASH affected health of mothers in particular, and acted beyond the immediate effects. This framework led us to identifying 77 risk mechanisms (67 chemical or biological factors and 10 complex behavioural factors) linking WASH to maternal and perinatal health outcomes.ConclusionWASH affects the risk of adverse maternal and perinatal health outcomes; these exposures are multiple and overlapping and may be distant from the immediate health outcome. Much of the evidence is weak, based on observational studies and anecdotal evidence, with relatively few systematic reviews. New systematic reviews are required to assess the quality of existing evidence more rigorously, and primary research is required to investigate the magnitude of effects of particular WASH exposures on specific maternal and perinatal outcomes. Whilst major gaps exist, the evidence strongly suggests that poor WASH influences maternal and reproductive health outcomes to the extent that it should be considered in global and national strategies.

Policy and provision of WASH in schools for children with disabilities: A case study in Malawi and Uganda

There is a growing body of evidence on the correlation between improving access to water, sanitation and hygiene (WASH) in schools and positive health and educational outcomes for students. Similar evidence on the impact of school WASH facilities on health, enrolment and absence for children with disabilities is not available. The limited data have revealed that children with disabilities are burdened by poor WASH in schools access, and even prevented from attending school due to inaccessible WASH facilities. We conducted two case studies of policy and provision of school WASH services for children with disabilities in Uganda and Malawi. We found a robust policy environment in Uganda and Malawi with policies and guidelines in place for WASH in schools for children with disabilities. However, provision of services and facilities are low and focused primarily on sanitation.