Sanitation Coverage Research Articles

GESTÃO DE RECURSOS PÚBLICOS: PRÁTICAS DE REGULAÇÃO DOSANEAMENTO BÁSICO NO MUNICÍPIO DE PORTO VELHO- RO

This article analyzes the management and regulation practices of basicsanitation in the municipality of Porto Velho, Rondônia, focusing on the application ofpublic resources and the inspection of the Municipal Basic Sanitation Plan (PMSB).The research seeks to identify the main flaws and challenges in the administration andapplication of resources allocated to basic sanitation, in addition to understanding howregulatory practices are being implemented in the municipality. Through research anddocumentary analysis, it was observed that deficiencies in monitoring works andinspection compromise the effectiveness of the project. The objective is to verifywhether water supply, sewage collection and treatment and solid waste managementservices are being carried out in an efficient and sustainable manner, as provided for bythe Municipal Basic Sanitation Plan (PMSB). The research also intends to describe theinspection measures adopted, evaluating whether they are guaranteeing the quality anduniversalization of these services for the population. Furthermore, the investigationseeks to reveal the obstacles faced in the implementation of these public policies, suchas the lack of infrastructure, low sanitation coverage in urban and rural areas, to improveplanning, monitoring and transparency in the management of public resources.

Insights into water insecurity in Indigenous communities in Canada: assessing microbial risks and innovative solutions, a multifaceted review.

Canada is considered a freshwater-rich country, despite this, several Indigenous reserves struggle with household water insecurity. In fact, some of these communities have lacked access to safe water for almost 30 years. Water quality in Canadian Indigenous reserves is influenced by several factors including source water quality, drinking water treatments applied, water distribution systems, and water storage tanks when piped water is unavailable. The objective of this multifaceted review is to spot the challenges and consequences of inadequate drinking water systems (DWS) and the available technical and microbiological alternatives to address water sanitation coverage in Indigenous reserves of Canada, North America (also known as Turtle Island). A comprehensive literature review was conducted using national web portals from both federal and provincial governments, as well as academic databases to identify the following topics: The status of water insecurity in Indigenous communities across Canada; Microbiological, chemical, and natural causes contributing to water insecurity; Limitations of applying urban-style drinking water systems in Indigenous reserves in Canada and the management of DWS for Indigenous communities in other high-income countries; and the importance of determining the microbiome inhabiting drinking water systems along with the cutting-edge technology available for its analysis. A total of 169 scientific articles matched the inclusion criteria. The major themes discussed include: The status of water insecurity and water advisories in Canada; the risks of pathogenic microorganisms (i.e., Escherichia coli and total coliforms) and other chemicals (i.e., disinfection by-products) found in water storage tanks; the most common technologies available for water treatment including coagulation, high- and low-pressure membrane filtration procedures, ozone, ion exchange, and biological ion exchange and their limitations when applying them in remote Indigenous communities. Furthermore, we reviewed the benefits and drawbacks that high throughput tools such as metagenomics (the study of genomes of microbial communities), culturomics (a high-efficiency culture approach), and microfluidics devices (microminiaturized instruments) and what they could represent for water monitoring in Indigenous reserves. This multifaceted review demonstrates that water insecurity in Canada is a reflection of the institutional structures of marginalization that persist in the country and other parts of Turtle Island. DWS on Indigenous reserves are in urgent need of upgrades. Source water protection, and drinking water monitoring plus a comprehensive design of culturally adapted, and sustainable water services are required. Collaborative efforts between First Nations authorities and federal, provincial, and territorial governments are imperative to ensure equitable access to safe drinking water in Indigenous reserves.

Disparities in access to water, sanitation, and hygiene (WASH) services and the status of SDG-6 implementation across districts and states in India

IntroductionAccess to affordable and improved Water, Sanitation, and Hygiene (WASH) facilities is essential for people's daily lives, and it is the primary goal of Sustainable Development Goal 6 (SDG-6). However, achieving this goal is a significant challenge for many countries, including India. The aim of this study is to assess the progress made towards achieving SDG-6 targets in Indian districts, states, and Union Territories (UTs) and to identify clusters by measuring spatial inequality of WASH coverage in India. Aim and objectiveThe primary objective of this study is to measure the progress made towards achieving the SDG-6 targets for WASH facilities in Indian districts, states, and UTs. To fulfill this objective, the study used the household data of the National Family Health Survey-5 (NFHS-5) conducted from 2019 to 21. Data and methodsThe study used the household data of NFHS-5, which is a nationally representative survey that provides information on household and individual-level characteristics related to health and nutrition. The study identified the variables associated with WASH and created a composite index to measure WASH coverage separately and combined. The study used Gini coefficient to show WASH inequality, and Moran's statistics were used to show spatial dependency. ResultThe study found that the inequality of improved water coverage sources in Indian districts was high. Western and northeastern districts need to catch up in terms of achieving the SDG-6 targets. The value of the Gini coefficient (0.29) indicates that inequality in sanitation coverage is also high. All states have reached close to SDG-6 achievement in hygiene indicators. Goa, Sikkim, Andaman & Nicobar Islands, and Lakshadweep are close to the overall WASH coverage achievements of SDG-6. However, Jharkhand, Orissa, Tripura, Assam, and Rajasthan are behind in meeting the goal of SDG-6. ConclusionThe study suggests that more government initiatives and investments are needed to increase the availability, accessibility, and affordability of WASH facilities to improve WASH conditions in western and northeastern Indian districts. The localization or bottom-up approach by giving responsibility to rural and urban local bodies can also help enforce the achievement of SDG-6. The findings of this study can be used to guide policymakers in developing targeted interventions to improve WASH conditions and reduce inequality in India.

Households’ access to basic sanitation services and associated factors in Geshiyaro project study sites in Ethiopia

BackgroundAccess to basic sanitation services is essential to enhance public health and well-being. However, ensuring adequate sanitation coverage is difficult in many parts of Ethiopia, including the Geshiyaro Project implementation sites. The Geshiyaro project is part of monitoring and evaluation activities aimed at assessing access to water and basic sanitation services. Hence, research on access to basic sanitation services and the associated risk factors in the Geshiyaro project sites is lacking. Thus, the purpose of this study was to fill this gap.MethodsA community-based cross-sectional study was conducted from June to July 2023. A total of 7995 households were included in this study. A structured questionnaire was used to collect the data. STATA version 16 was used to conduct both descriptive and multivariable analysis.ResultsThe study reported that 8.4% of households had basic sanitation services. The following factors were significantly associated with the availability of basic sanitation services: residence (AOR = 0.31, 95% CI 0.25–0.37), education (AOR = 1.36, 95% CI 1.12–1.66), occupation (AOR = 0.44, 95% CI 0.33–0.57), annual income (AOR = 0.66, 95% CI 0.55–0.80), age (AOR = 1.77, 95% CI 1.10–2.84), awareness creation about WASH services (AOR = 0.58, 95% CI 0.49–0.70), family size (AOR = 1.22, 95% CI 1.01–1.46), and water source type (AOR = 0.27, 95% CI 0.13–0.57).ConclusionHouseholds’ access to basic sanitation services in Ethiopia’s Geshiyaro project site is a significant public health concern. Many factors that affect access to basic sanitation services have been identified. The study highlights the importance of targeted interventions to address sociodemographic disparities and improve sanitation facilities. Similarly, the findings of this research will contribute to the achievement of Sustainable Development Goals (SDG) target 3.3 to eradicate the epidemics of AIDS, neglected tropical diseases, tuberculosis, and malaria, as well as combat hepatitis and water-borne illnesses and Sustainable Development Goals (SDG) target 6.2, which deal with the elimination of open defecation, access to sufficient and equitable sanitation and hygiene for everyone, and reducing infectious diseases.

Quantitative evaluation of water, sanitation, and hygiene measures on COVID-19 pandemic peak reduction in the Philippines

New cases of coronavirus disease 2019 (COVID-19) are continually being recorded worldwide, despite global efforts in implementing non-pharmaceutical interventions and establishing vaccination programs. This trend highlights the need to identify the factors associated with the continued spread of COVID-19. The World Health Organization recommends hand washing as a cost-effective intervention for preventing COVID-19, indicating that water, sanitation, and hygiene (WaSH) are central to the prevention of the disease. However, low- and middle-income countries lack adequate access to WaSH, which increases the risk of contracting COVID-19. The aim of this study was to identify the WaSH factors associated with the incidence of COVID-19 and quantitatively estimate the effects of improvements in WaSH on reducing the incidence of COVID-19 during the peak of the pandemic. Lasso regression and extreme gradient boosting models were used to identify the WaSH factors. Distinct estimation models were developed to assess the effect of WaSH in rural regions under two assumptions: increasing regional basic sanitation coverage up to 25 % and 50%. The reduction in the incidence of COVID-19 during the peak of the pandemic was calculated for each rural region. The results of the analyses indicated that basic sanitation is important for reducing the incidence of COVID-19 in rural regions compared to urban regions in the Philippines. In addition, the results suggested that increasing basic sanitation coverage could reduce the incidence of COVID-19 by 2–66 %, alleviating the burden on healthcare facilities. This study indicates that improved basic sanitation infrastructure are needed in rural Philippines. The results of this study emphasise the significance of WaSH as an indicator of COVID-19 incidence, highlighting the need for its enhancement to enable the achievement of sustainable disease prevention and pandemic preparedness goals.

Lot quality assurance sampling survey for water, sanitation and hygiene monitoring and evidence-based advocacy in Bentiu IDP camp, South Sudan.

Every year, 60% of deaths from diarrhoeal disease occur in low and middle-income countries due to inadequate water, sanitation, and hygiene. In these countries, diarrhoeal diseases are the second leading cause of death in children under five, excluding neonatal deaths. The approximately 100,000 people residing in the Bentiu Internally Displaced Population (IDP) camp in South Sudan have previously experienced water, sanitation, and hygiene outbreaks, including an ongoing Hepatitis E outbreak in 2021. This study aimed to assess the gaps in Water, Sanitation, and Hygiene (WASH), prioritise areas for intervention, and advocate for the improvement of WASH services based on the findings. A cross-sectional lot quality assurance sampling (LQAS) survey was conducted in ninety-five households to collect data on water, sanitation, and hygiene (WASH) coverage performance across five sectors. Nineteen households were allocated to each sector, referred to as supervision areas in LQAS surveys. Probability proportional to size sampling was used to determine the number of households to sample in each sector block selected using a geographic positioning system. One adult respondent, familiar with the household, was chosen to answer WASH-related questions, and one child under the age of five was selected through a lottery method to assess the prevalence of WASH-related disease morbidities in the previous two weeks. The data were collected using the KoBoCollect mobile application. Data analysis was conducted using R statistical software and a generic LQAS Excel analyser. Crude values, weighted averages, and 95% confidence intervals were calculated for each indicator. Target coverage benchmarks set by program managers and WASH guidelines were used to classify the performance of each indicator. The LQAS survey revealed that five out of 13 clean water supply indicators, eight out of 10 hygiene and sanitation indicators, and two out of four health indicators did not meet the target coverage. Regarding the clean water supply indicators, 68.9% (95% CI 60.8%-77.1%) of households reported having water available six days a week, while 37% (95% CI 27%-46%) had water containers in adequate condition. For the hygiene and sanitation indicators, 17.9% (95% CI 10.9%-24.8%) of households had handwashing points in their living area, 66.8% (95% CI 49%-84.6%) had their own jug for cleansing after defaecation, and 26.4% (95% CI 17.4%-35.3%) of households had one piece of soap. More than 40% of households wash dead bodies at funerals and wash their hands in a shared bowl. Households with sanitary facilities at an acceptable level were 22.8% (95% CI 15.6%-30.1%), while 13.2% (95% CI 6.6%-19.9%) of households had functioning handwashing points at the latrines. Over the previous two weeks, 57.9% (95% CI 49.6-69.7%) of households reported no diarrhoea, and 71.3% (95% CI 62.1%-80.6%) reported no eye infections among children under five. The camp's hygiene and sanitation situation necessitated immediate intervention to halt the hepatitis E outbreak and prevent further WASH-related outbreaks and health issues. The LQAS findings were employed to advocate for interventions addressing the WASH gaps, resulting in WASH and health actors stepping in.

Jumping up the sanitation ladder in rural Cambodia: The role of remittances and peer-to-peer pressure in adopting high-quality latrines

Over the last 50 years, a combination of factors has driven sanitation improvements in rural areas of low-income and emerging economies in Asia. While open defecation remains an important challenge in many countries, Cambodia has rapidly increased rural sanitation coverage in the last 20 years. Using data collected via 92 interviews and seven focus group discussions, this qualitative study analysed the macro-level, community, and individual factors that motivated rural households to invest in high-quality latrines in seven villages in Cambodia that achieved and sustained open defecation free status with at least 85% latrine coverage. Local demand for adoption of high quality latrine was stimulated by a number of factors which include: a) NGO-led interventions that included behaviour change communication, sanitation marketing, and community-led total sanitation, all magnified by the strong support of local leaders at the village and commune levels; b) an increased proportion of rural households engaging in factory work, with access to raising wages, higher disposable incomes, and remittances; and c) subsidies and microcredit. Furthermore, migrants not only transferred financial resources to their home villages, but also transferred a set of ideas, norms, expectations, information, and behaviors back to their communities that reflect the migrants’ new ways of life, and economic possibilities. We provide evidence that new habits among factory workers, and ownership and display of new technologies and consumer commodities as symbols of modern success and social status facilitated high-quality latrine adoption. Peer-to-peer pressure at the village level, and among adult children commuting to factories or visiting their rural hometown ensured widespread adoption.

Microfiber Fragment Pollution: Sources, Toxicity, Strategies, and Technologies for Remediation

With the pervasive consumption (currently >65% of total market shares and steadily increasing) of petroleum-derived synthetic textiles, the escalating concern of microfiber fragment (MF) pollution has emerged as a formidable menace to our ecological equilibrium. Over the lifetime (pre- and post-consumption) of these textiles, they shed tiny fibers recognized as MFs. These MFs are carriers of persistent organic pollutants and have been linked to cytotoxicity, oxidative stress, and genotoxicity, even at minimal exposures via air and water sources. Grounded in the state-of-the-art literature, this review discusses the primary and secondary sources of MF release, their fate, transport, environmental impacts, and novel technologies for MF pollutant remediation. Our results infer that MF pollution is a multifactorial issue with serious environmental and public health implications, as studies reported their presence in human blood, feces, and urine samples. We recommend a multifaceted approach to increase sanitation coverage, ensuring adequate wastewater treatment prior to environmental discharge for MF pollution mitigation. Additionally, transformation is warranted for consumers’ use, care, and purchase behavior of textile products. Government regulation of fast fashion (a major user of synthetic textiles), exemplified by recent French legislation, is essential to preventing microfiber pollution. We urge similar policy-making efforts globally to safeguard public health.

Environmental injustice in the privatization of Brazilian sanitation: an empirical analysis

This study analyzes whether the low rate of universalizing water supply and sanitation services in Brazil is related to the low participation of private companies in the concession of these services in municipalities in the country. To this end, it discusses basic sanitation in Brazil and its current scenario, its problems from the point of view of environmental injustice, and the existing public/private conflicts. The empirical analysis conducted a data survey of eight municipalities defined in four population groups, comparing data from 13 operational, efficiency, quality, and cost indicators of the services provided. Each population group compared two municipalities providing water and sewerage services, one provided by a public company and the other by a private company. The compared data were from 2021, obtained through the Brazilian National Sanitation Information System (SNIS). As a result of the comparative analyses, it was shown that the performance of public companies was more positive for most indicators, compared to private companies. It is concluded that the main challenge to overcome the social and environmental injustice resulting from the deficit in basic sanitation coverage lies in the promotion of public management instruments that enable the articulation of public and private investments in the expansion of basic sanitation services, in the improvement of the quality of services with the inclusion of social control through popular participation.

Examining toilet use and menstrual hygiene practices among beneficiary households of Swachh Bharat Abhiyaan (Clean India Mission) in rural areas of Mayurbhanj district of Odisha, India.

Basic sanitation and waste management have always remained a central issue in India. The country launched its flagship sanitation program - Swachh Bharat Abhiyan (SBA) (Clean India Mission) in 2014 to abolish open defecation and achieve universal sanitation coverage. This study aimed to examine barriers to toilet use and women's menstrual hygiene practices in relation to the availability of toilets among rural residents. Using a cross-sectional design and multi-stage sampling method, 120 households were selected from rural villages of the Mayurbhanj district of Odisha. Structured questionnaires and direct observation methods were used for data collection. All the houses had SBA latrines, yet 25% population defecated outside. About 40% households reportedly never cleaned their toilets. Most menstruating women (86.2%) preferred to change their menstrual pads/cloths in their bedroom instead of bathrooms. Incomplete construction was reported as the major reason for not using toilets. Large family size and low caste were found to be other predictors of non-use of toilets. Rural women did not use toilets for menstrual purposes as they do not consider these places as clean and safe. This study clearly suggests that constructing toilets without adequate behaviour change interventions would not solve the problem of hygiene and sanitation in India, particularly in rural areas. There must be adequate monitoring of SBA scheme and utilization of funds for toilet usage. Development and implementation of suitable behaviour change strategies for toilet use in rural areas are essential to achieve the goal of open defaecation-free India.

High Child Mortality and Interventions Coverage in the City of Dar es Salaam, Tanzania: Are the Poorest Paying an Urban Penalty?

The 'urban penalty' in health refers to the loss of a presumed survival advantage due to adverse consequences of urban life. This study investigated the levels and trends in neonatal, post-neonatal and under-5 mortality rate and key determinants of child survival using data from Tanzania Demographic and Health Surveys (TDHS) (2004/05, 2010 and 2015/16), AIDS Indicator Survey (AIS), Malaria Indicator survey (MIS) and health facility data in Tanzania mainland. We compared Dar es Salaam results with other urban and rural areas in Tanzania mainland, and between the poorest and richest wealth tertiles within Dar es Salaam. Under-5 mortality declined by 41% between TDHS 2004/05 and 2015/2016 from 132 to 78 deaths per 1000 live births, with a greater decline in rural areas compared to Dar es Salaam and other urban areas. Neonatal mortality rate was consistently higher in Dar es Salaam during the same period, with the widest gap (> 50%) between Dar es Salaam and rural areas in TDHS 2015/2016. Coverage of maternal, new-born and child health interventions as well as living conditionswere generally better in Dar es Salaam than elsewhere. Within the city, neonatal mortality was 63 and 44 per 1000 live births in the poorest 33% and richest 33%, respectively. The poorest had higher rates of stunting, more overcrowding, inadequate sanitation and lower coverage of institutional deliveries and C-section rate, compared to richest tertile. Children in Dar es Salaam do not have improved survival chances compared to rural children, despite better living conditions and higher coverage of essential health interventions. This urban penalty is higher among children of the poorest households which could only partly be explained by the available indicators of coverage of services and living conditions. Further research is urgently needed to understand the reasons for the urban penalty, including quality of care, health behaviours and environmental conditions.

Determinants of Open Defecation Among Rural Women in Ghana: Analysis of Demographic and Health Surveys.

Open defecation continuously remains a major global sanitation challenge, contributing to an estimated 1.6 million deaths per year. Ghana ranks second in Africa for open defecation and had the fourth-lowest sanitation coverage in 2010. Evidence indicates that about 32% of the rural Ghanaian population still practice open defecation due to lack of access to basic sanitation facilities, drifting the country from achieving universal access to sanitation by 2030. Women, particularly those in rural areas, are disproportionately affected by open defecation, facing heightened health risks, harassment, and a loss of dignity. Even though previous studies on open defecation in Ghana exist, they lack national representation and neglect women in rural residents who are disproportionally affected by the repercussions of open defecation. Examining that rural women will contribute to heightening their own vulnerability to health risks by practising open defecation is essential to bridging the literature gap on open defecation practices among rural women. The study investigated determinants of open defecation among rural women in Ghana using data from the female files of the 2003, 2008 and 2014 Demographic and Health Surveys (DHS). A total of 4,284 rural women with complete information on variables of interest were included in the study. The outcome variable was 'open defecation', whilst 14 key explanatory variables (e.g., age, education, wealth status, among others) were used. Two logistic regression models were built, and the outputs were reported in odds ratio. Descriptively, 42 in every 100 women aged 15 to 49 practiced open defecation (n = 1811, 95% CI = 49-52). Open defecation (OD) significantly correlated with educational attainment, wealth status, religion, access to mass media, partner's education, and zone of residence. The likelihood of practicing open defecation reduced among those with formal education [aOR = 0.69, CI = 0.56-0.85], those whose partners had formal education [aOR = 0.64, CI = 0.52-0.80], women in the rich wealth quintile [aOR = 0.12, CI = 0.07-0.20], the traditionalist [aOR = 0.33, CI = 0.19-0.57], and those who had access to mass media [aOR = 0.70, CI = 0.57-0.85]. Residents in the Savannah zone had higher odds of openly defecating [aOR = 21.06, CI = 15.97-27.77]. The prevalence of open defecation is disproportionately pro-poor, which indicates that impoverished rural women are more likely to perform it. Public health initiatives should aim to close the rich-poor divide in OD practice among rural women.

Inclusion of persons living with disabilities in a district-wide sanitation programme: A cross-sectional study in rural Malawi.

Community-led total sanitation (CLTS) is embraced as a key strategy to achieve universal sanitation coverage (Sustainable Development Goal 6.2). Although inclusion is identified as a predictor of CLTS success, people living with disabilities are often excluded from community sanitation programmes and there is limited research exploring CLTS participation amongst people living with disabilities. This study aims to explore the extent to which people living with disabilities participated in a CLTS intervention delivered in rural Malawi using standard approaches. This cross-sectional study was conducted in the Chiradzulu district of Malawi. A household questionnaire was administered to collect information about CLTS participation. Multivariable logistic regression was performed to compare participation in different CLTS activities between households with (n = 80) and without a member with a disability (n = 167), and between household members with (n = 55) and without a disability (n = 226). No difference in CLTS participation was observed at the household-level, but there were marked differences in CLTS participation between household members with and without a disability. Household members without a disability felt they could give more input in triggering activities (OR = 3.72, 95%CI 1.18-11.73), and reported higher participation in the transect walk (OR = 4.03, 95%CI 1.45-11.18), community action planning (OR = 2.89, 95%CI 1.36-6.13), and follow-up visits (OR = 3.37, 95%CI 1.78-6.40) compared to household members with disabilities. There was no difference in the likelihood of being invited to triggering (OR = 0.98, 95%CI 0.41-2.36), attending triggering (OR = 2.09, 95%CI 0.98-4.46), or participating in community mapping (OR = 2.38, 95%CI 0.71-7.98) between household members with and without a disability. This study revealed intra-household inequalities in CLTS participation. To improve participation in CLTS interventions, facilitators should be trained on action steps to make CLTS more inclusive. Further research could include an in-depth analysis of predictors of CLTS participation amongst people living with disabilities, including disability types, severity and age.

Water and Sanitation Services Have a Profound Effect on the Life of Metropolis

The critical global issue of inadequate access to clean water, sanitation, and hygiene for a significant portion of the world's population, amounting to approximately 40%. In India, disparities exist in water and sanitation access between urban and rural areas. While 97% of urban regions have upgraded water supplies and 58% improved sanitation, rural areas show lower access rates at 90% for water and a mere 23% for sanitation. India's rivers suffer from severe water quality degradation due to untreated sewage, with inadequate sewage treatment infrastructure, particularly in swiftly growing urban areas like Delhi. Despite initiatives like the Ganga and Yamuna Action Plans, major rivers remain highly polluted. The flush toilet system further exacerbates the water crisis by consuming significant volumes of fresh water for waste disposal. This paper also underscores the link between water supplies, sanitation, and health, citing classifications of water-related infections and the pressing need to bridge the disparities in access. However, reports note progress in drinking water and sanitation coverage globally since 1990. The analysis concludes that India's cities struggle to meet basic living standards amidst rapid urbanization, emphasizing the profound impact of education, awareness, and service availability on residents' lives. Water, Sanitation, Hygiene, Population, Access, Rural, Urban Rivers, Sewage, Pollution, Infrastructure, Health, Flush toilets, Disparities Key Words: Water, Sanitation, Hygiene, Population, Access, Rural, Urban Rivers, Sewage, Pollution, Infrastructure, Health, Flush toilets, Disparities

The Status Quo of Fecal Sludge Treatment Plant at Khulna and Its Future Prospec-tive About Biomass Energy (Briquette)

As many developing countries are moving towards increased sanitation coverage, Bangladesh has been striding successfully towards full sanitation coverage with the proper management of fecal sludge city-wide. Following the situation, Khulna City Corporation built a Fecal Sludge Treatment Plant (FSTP) with six units of CW (constructed wetlands) and six units of drying beds in 2017. The main objective of this study is to discuss the current situation of Khulna FSTP based on treatment efficiency and its future perspective on biomass energy (briquette). In Khulna FSTP, the collected fecal sludge from septic tanks and pits is treated, and finally, its effluent is discharged into the environment, satisfying the disposal standards. The removal efficiency of final effluent for Biochemical Oxygen Demands (BOD5) and Total Solids was found to vary between 97.8% - 97% and 98% - 93% in the previous year to the present, respectively. Total Suspended Solis and Fecal Coliform never exceeded the allowable limit 100gm/L and 1000 N/100ml in final effluent. Furthermore, dried sludge is used as handmade processing biomass energy (briquette) without further treatment, which has some procedural problems such as loose compaction and pathogenic contamination.

What works in sanitation promotion?

Promotion appears to be the least effective but is nevertheless often the only available, means to achieve increased access to sanitation services, especially at scale, in lower-income countries. A cursory examination of the history of past and present approaches to sanitation promotion, including sanitation marketing, community development, community-led total sanitation and public health, shows that they have a variety of features and characteristics which make them distinctive. Unfortunately, rigorous evaluation has not kept pace with this proliferation of approaches, so it is difficult to recommend any one approach over the others, based on empirical performance in a range of circumstances. However, I argue that a 'hybrid' approach which exhibits a number of salient features from all of the previous approaches is likely to be a good bet. I present a recent example of such a hybrid programme which proved to significantly increase the rate of improved sanitation coverage through promotion (without subsidy of any kind) at scale in Tanzania. I suggest other sanitation promotion programs may want to think about adopting similar practices in their own programming going forward.

The Biofactory: Quantifying Life Cycle Sustainability Impacts of the Wastewater Circular Economy in Chile

The wastewater circular economy (WW-CE) represents a solution to improving sanitation coverage and management worldwide. However, the transition to circular wastewater treatment plants (WWTPs) requires facilitation to enhance decision-makers’ understanding of the integral sustainability impacts of the WW-CE. This research implemented a Life Cycle Sustainability Assessment (LCSA), combining Life Cycle Assessment, Social Life Cycle Assessment and Life Cycle Costing with a Multi-criteria Decision Making (MCDM) model to quantify the environmental, social, and economic impacts of different WWTPs technologies. Two real WWTPs (Plant A and Plant B) in Chile have embraced alternative WW-CE configurations, adopting the title Biofactories, and are considered as case studies in this investigation. A comparative LCSA considered the service of a 1,000,000-population equivalent, under three scenarios: wastewater discharge without treatment, conventional WWTPs, and biofactory WW-CE configurations. The results demonstrate that the transition to WW-CEs improved integral sustainability, and decreased integrated environmental, social, and economic impacts by 30% in Plant A, demonstrating better performance in terms environmental and social impacts. However, a 58% decrease in integral sustainability impacts for Plant B was achieved via the economic advantage of the thermal hydrolysis pre-treatment of sludge. The urgent need to adopt sustainable decision-making models to improve sanitation coverage and sustainability performance of the sanitation industry across the globe is discussed. The WW-CE in Chile presents an opportunity for this to be achieved.

Impact of targeted subsidies on access to resilient sanitation for climate-vulnerable households in rural Cambodia

Abstract Access to safe sanitation is a basic requirement for human well-being and is critical for protecting public health and preventing environmental contamination at the community level. The increasing global risk of climate-related disasters exacerbates the likelihood of traditional sanitation solutions failing and exposing communities to harmful pathogens. This risk is ubiquitous in Cambodia's flood-prone Tonle Sap Lake region, which has some of the lowest rates of sanitation coverage in the country. This study sought to design and test a targeted mechanism in the region to deliver sanitation subsidies to households in a vulnerable position due to climate and socioeconomic characteristics. Subsidy eligibility was evaluated using the poverty probability index for Cambodia, with thresholds set according to households' individual and community-level climate vulnerability. In a randomized controlled trial, offering subsidies increased the likelihood of successful sales conversions for climate-resilient latrine products among targeted households by 32 percentage points, indicating effectiveness for increasing market-based sanitation uptake. The research did not find evidence of widespread or sustained market distortion due to the subsidy program.

Examining Water Use and Sanitation Practices in Rural Schools of Chegutu District, Mashonaland West Province, Zimbabwe

Access to water, sanitation and hygiene (WASH) in schools is integral to the well-being of children and their right to quality education. The study examines water use and sanitation practices of selected rural secondary schools in Ward 11 and 29 of Chegutu District in Zimbabwe. Data were collected using questionnaires, interviews and published data. A total of 81 questionnaires investigating students’ hygiene practices, as well as their perceptions on service delivery, were issued to students. Data collected were analyzed using tables, graphs, pie chart, and descriptive statistics. The study concluded that the present WASH practices in many of the schools were not adequate. The reasons for low water and sanitation coverage included lack of a comprehensive policy and government will to effectively manage water and sanitation services, which to some extent affected the capacity of local authorities and schools to manage water and sanitation supply services in the past years. Despite support by community, civic society and Government, the impact of their contributions remains significant though insufficient. Inadequate capital to support and maintain WASH standards in schools, and lack of monitoring systems remain key challenges. Further support is required to meet international recommendations for healthy and gender-equitable schools.

Lessons from a successful national sanitation programme: the case of Nyumba ni Choo in Tanzania.

Universal access to hygienic sanitation is a Sustainable Development Goal for international development. However, many countries are liable to miss this target by the deadline of 2030. As provision and subsidy are prohibitively expensive, promotion is the tactic commonly taken by governments and stakeholders in many countries, even though it is often not effective at generating significant changes in sanitation coverage. A recent 5-year programme used an international consortium made up of organizations' experts in consumer research, creative communication, programme management and event implementation, media monitoring and programme evaluation, to achieve significant increases in the coverage of improved sanitation facilities throughout Tanzania, using adaptive programming. A number of lessons, outlined here, can be drawn from this experience which are likely to be applicable to promotion efforts in other countries and contexts and which can hopefully help countries to reach their sanitation targets. These lessons include the use of motivation and targeted expertise rather than reliance on training, the use of the theory of change to guide development processes, targeting of high-level government support, collaboration with private sector actors, testing and refreshing of messaging, continuous monitoring of on-ground conditions, use of multiple modes of outreach and branding of all programme outputs.