Water, Sanitation, And Hygiene Facilities Research Articles

Multi-level factors associated with utilization of water, sanitation and hygiene services by mothers in Nepal.

Providing improved water, sanitation, and hygiene (WASH) at a household level remains one of the major public health challenges in Nepal. Household mothers are likely to have limited access to combined WASH services, this is influenced by individual, and community factors. Individual components of an improved water source, sanitary toilet, fixed place for handwashing, and availability of soap and water were merged into one and called combined WASH. This paper aimed to identify the individual and community factors associated with combined WASH facilities and practices among mothers with children under five years in Nepal. A cross-sectional study was conducted using data from the Nepal Demographic and Health Survey (NDHS), 2016. The weighted sample size of this study was 4887 mothers with children under five years. The independent variables within the mothers included age, education, occupation, and caste/ethnicity in addition to education of the husband, wealth index, exposure to the newspaper, radio and television, residence, ecological zones, provinces, distance and participation in health mother groups were analyzed with the outcome variable of combined WASH. A multi-level mixed effects logistic regression model was used to assess the relationship of explanatory variables with WASH. At an individual level, a rich wealth index was positively associated with combined WASH (AOR = 6.29; 95%CI: 4.63-8.54). Higher education levels and exposure to television had higher odds of having combined WASH. At the community level, the hill zone, urban residence, and Sudurpashim Provinces were positively associated with combined WASH while Madesh and Karnali Provinces and distance to water source greater than 31 minutes were associated with lower access to combined WASH. Educated and rich household have positive association with combined WASH. It is recommended that both the health and other sectors may be instrumental in improving the combined WASH service for mothers at households.

Centring participant experience: a realist evaluation of a menstruator-friendly facility design project in a refugee settlement, Lebanon

IntroductionMenstrual health in humanitarian contexts is a neglected topic. Its taboo nature presents difficulties for participants in menstrual health projects in these particularly challenging settings. Namely, their experiences may be concealed or overlooked in projects that are typically outcome focused. Realist Evaluation is a useful method to unearth and explore the hidden mechanisms and their causes, which lead to positive or negative participant experiences. The authors have applied this approach to a robust humanitarian menstrual health project to explore how to centre the emotional wellbeing of participants at all stages: prior to, during, and post-participation.Study settingThe project studied was led by the International Federation of Red Cross and Red Crescent Societies who piloted their adaptable manual for menstruator–friendly water, sanitation and hygiene (WaSH) facility design in humanitarian contexts. It was conducted by the Lebanese Red Cross in an informal tented settlement hosting Syrian refugees in Qaa, Lebanon.MethodsThe authors collected interview and focus group data on the contextual factors and processes within the project from nine project staff and 16 settlement inhabitants. They used a realist process of theory development, testing, and consolidation to understand how and under what circumstances the project inputs affected participants’ wellbeing.ResultsThe contextual factors and causal mechanisms promoting participant experience comprised individual (choices influencing and experience during participation), interpersonal (group dynamics and the role of non-menstruators), and organisational (expertise and knowledge, relationship to participants and cultural differences) factors.ImplicationsThe research uses a case study from a renowned humanitarian organisation who provided a well-delivered project in a conducive environment to explore the mechanisms and contexts that can promote wider learning and refine understanding and programming in this under-researched and -theorised space. Specifically, it informs which contextual factors and project inputs must be present within a menstrual health project to ensure participant satisfaction whilst efficiently delivering well-designed menstruator-friendly WaSH facilities.

Improved water, Sanitation and Hygiene Facilities at School and their effect on educational achievement in basic level students in Nepal

ABSTRACT Schools with Water, Sanitation, and Hygiene (WASH) facilities can contribute to the well-being and educational achievements of pupils. The study aims to assess whether introducing WASH facilities in schools influences the educational achievements of pupils in Nepal. This research utilized a controlled before-and-after study with a quantitative, causal-comparative design. The research was conducted among 768 respondents, split between 384 in the schools with improved WASH facilities and 384 in the schools without improved school group. This study applied a stratified random sampling design, and the data were collected using a face-to-face method and administered through the structured survey tool. School WASH facilities have a significant association with educational achievements. Similarly, gender, ethnicity, grade, score, subjective norms, and intention have also significant association with educational achievements as do religion, attitudes, and self-efficacy. Students from improved school WASH facilities are more likely to obtain higher educational achievement (crude Odds Ratio (cOR) = 2.77; 95% confidence intervals (CI): 2.06 to 3.72, p < 0.001), even after adjusting for attitude, subjective norms, self-efficacy, and intention (adjusted OR (aOR) = 2.70; 95% CI: 1.99 to 3.67, p < 0.001), than those who are from the unimproved schools, keeping all socio-demographic characteristics constant. The effect is approximately four times larger (aOR = 8.31; 95% CI: 5.08 to 13.59, p < 0.001) than that exhibited by the above model, after adjusting for all socio-covariates and theory-based variables. In conclusion, improving school WASH facilities may need additional school interventions to overcome low educational achievements among students.

Progress Towards Elimination of Trachoma in Kenya 2017–2020

ABSTRACT Purpose Trachoma is endemic in Kenya. Since baseline trachoma surveys in 2004, a concerted programme has been undertaken to reduce the prevalence of disease. Here, we report on trachoma prevalence surveys carried out between 2017 and 2020 after interventions were implemented in some areas for trachoma elimination purposes. Methods A total of 48 cross-sectional population-based trachoma prevalence surveys were conducted in 39 evaluation units (EUs; covering 45 subcounties) of Kenya between 2017 and 2020. Thirty EUs were surveyed once and nine EUs were surveyed twice over this period. Individuals ≥ 1 year old were assessed for trachomatous inflammation–follicular (TF), trachomatous inflammation–intense (TI) and trichiasis. Data were collected on household access to water, sanitation and hygiene (WASH). Results A total of 147,573 people were examined. At the end of 2020, in the 39 EUs surveyed, the prevalence of TF in 1–9-year-olds was ≥5% in 11 EUs and the prevalence of trichiasis unknown to the health system in individuals aged ≥15 years was ≥0.2% in 25 EUs. A small minority of households (median <50% for all indicators) had access to improved WASH facilities. Conclusion Kenya has made excellent progress towards elimination of trachoma as a public health problem. However, there is more work to do. Between one and three rounds of antibiotic mass drug administration are required in 11 EUs. Sustained investment in surgical provision, continued TT case-finding, promotion of facial cleanliness and environmental improvement are required throughout the surveyed area.

Analysis of water, sanitation, and hygiene facilities using the WASH-FIT approach and its relation to patient satisfaction and maternal mortality at hospitals in Indonesia.

The provision of Water, Sanitation, and Hygiene (WASH) is critical to reducing infection and enhancing the quality of health care services. The study aims to assess WASH facilities in Indonesian hospitals using the Water, Sanitation, and Hygiene Facility Improvement Tool (WASH-FIT) approach and examine their association with customer satisfaction and maternal mortality owing to infection. We utilized the national scale Health Facilities Research dataset in Indonesian hospitals in 2019. WASH status is determined using WASH-FIT indicators, i.e., water, sanitation, waste management, hand hygiene, environmental cleaning, and management services, and then divided into three levels: poor, adequate, and good categories. The majority of hospitals in Indonesia had a good category, i.e., the range of hospitals with a good category was 79-97% nationally, in 6 aspects: water, sanitation, hand hygiene, environmental cleaning, and management services, except for waste management services (13%). Good WASH service facilities are more frequently found in government hospitals than in private and specialized hospitals, while lower-level hospitals tend to have poor levels of all WASH-FIT indicators. There are significant relationships between adequate sanitation services (β = 0.724), adequate and good categories of hand hygiene services (β = 0.712 and 0.866, respectively), environmental cleaning (β = -0.501 and -0.503, respectively), and management (β = -0.645 and 0.446, respectively), with the proportion of maternal mortality owing to infection. Furthermore, there was no relationship between WASH-FIT indicators and patient satisfaction, except for good hand hygiene services (β = 0.453). Despite good conditions in almost all WASH-FIT indicators, the improvement of waste management is urgently needed to improve the WASH services in hospitals in Indonesia, as also found in other developing countries.

Assessment of water, hygiene, and sanitation practice and associated factors among Bihari refugee camp in Bangladesh: A cross-sectional study.

The global significance of water, sanitation, and hygiene (WASH) cannot be overstated, extending far beyond the confines of developing nations and encompassing even the most developed ones. This study, rooted in the Bihari refugee camp in Bangladesh, seeks to underscore the universality of WASH concerns. Using a cross-sectional design and a structured questionnaire, we conducted a meticulous evaluation of WASH practices with 313 participants selected through random sampling. Findings shows the water practice, among all of them, only 4.8% of the respondents were very happy with the water supply system and 16.0% of the respondents were happy with this. A total of 29.7% of the respondents were satisfied with safe drinking water and only 4.8% of the respondents were very satisfied with safe drinking water. Regarding the hygiene practice, among all respondents, 10.2% of them were satisfied with using the same bathroom by multiple people. Only 5.4% respondents were happy in their living environment. Regarding sanitation practice, only 31.3% had private toilet facilities. Among all of the respondents, 13.7% of the respondents were satisfied with using the same toilet by multiple people. Respondents who were illiterate (p < 0.01) and self-employed (p < 0.04) were satisfied with the water supply. Similarly, respondents who were illiterate (p < 0.03) and self-employed (p < 0.00) were satisfied with safe drinking water. Respondents who were illiterate (p < 0.02) and whose monthly income was below 8000 BDT (p < 0.00) were satisfied using same bathroom by multiple people. Respondents who were self-employed (p < 0.01), whose monthly income 8000-12,000 BDT (p < 0.01) and having single room (p < 0.00) were satisfied using the same toilet by multiple people. Enhanced access to safe WASH facilities, coupled with a comprehensive understanding of the study's findings, have the potential to serve as vital signposts for the development and implementation of policies and interventions.

Estimation of Rotavirus Associated Diarrheal Disease Burden Amongst Primary School Children of Sindh

Introduction: Human Rotavirus Virus (HRV) is amongst the common enteric viral diarrheal diseases that indirectly or directly influence school-going children in low-income countries. Inadequate information exists on the presence of rotavirus, with reference to drinking water supplies of primary schools in Sindh, Pakistan. Aims &amp; Objectives: We estimated the risk of rotavirus-associated diarrhea through drinking water. The study further compared the HRV-associated risk of diarrheal disease by a type of water source. Place and Duration of Study: A cross-sectional survey was conducted in ten representative districts of Sindh from February 2022 to December 2022. The samples for drinking water were collected from primary schools of ten representative districts of Sindh. This study was a part of the WASH Project funded by USAID (USPCASW Seed Grant P-II) Material &amp; Methods: We selected 425 samples of drinking water from primary schools based on pre-defined selection criteria. We used a Quantitative Microbial Risk Analysis using indicator organisms, i.e., E. coli, to predict the possible health risks of rotavirus. Data was entered and analyzed on SPSS version 26. The graphs were developed using Arc GIS version 3. Morbidity and mortality were predicted using the Quantitative Microbial Risk Assessment (QAMRA) model. Results: Our data revealed that the highest daily risk of HRV-associated diarrhea amongst school children was 11 per 10,000 schoolchildren, resulting in 8.4% annual risk, and the minimum risk was estimated to be 1 in 10,000 children. The burden of diseases for rotavirus using the QAMRA model revealed the severity of the diarrhea. Majority of the children presented with mild diarrhea (86%) followed by severe, and the probability of death was less than &lt;1%. The daily risk of HRV infection was highest (estimated to be 7 and 11%) in pupils of Southern Sindh, with an annual risk of 17.4% to 40%. Conclusion: Our study concluded that the children in the primary schools of Sindh were exposed to poor drinking water quality. The surface water source poses the highest risk of HRV-related diarrhea to school children. Thus, it is highly recommended that point-of-use drinking water treatment systems be adopted. The water sanitation and hygiene (WASH) resources are interlinked, so each resource impacts the other; hence, schools urgently need to invest in providing adequate WASH facilities to stop enteric virus transmission through drinking water sources.

Overview of Water Sanitation and Hygiene in School (WinS) Urban Areas, Indonesia

Objective: Indonesia is a developing country that still has water, sanitation and hygiene (WASH) problems. Only 16% of education units have access to all basic services such as water, sanitation and hygiene and as many as 43.5 million Indonesian children do not have access to basic drinking water, basic sanitation and hygiene at school. This can have an impact on increasing disease transmission in children at school. This study aimed to analyse the coverage of school WASH in Bekasi City so as to identify the constraints and problems of WASH in schools. Methodology: This type of research used a cross sectional design approach. The samples of this study were 30 schools in Bekasi City. The indicator data measured consists of 3, namely sanitation, hygiene and air. Results: The results of this study indicate that school WASH in Bekasi is good, this can be seen from the availability of WASH facilities in schools such as the availability of drinking water, easy access, waste management facilities, the availability of hand washing facilities and the existence of toilets that have been widely separated between men and women. Suggestions: The role of stakeholders and school sanitation programme holders is very important in the implementation of school WASH.

Baseline Prevalence of Trachoma in 13 Local Government Areas of Borno State, Nigeria

ABSTRACT Purpose We set out to determine the baseline prevalence of trachoma in 13 Local Government Areas (LGAs) of Borno State, Nigeria. Methods A population-based cross-sectional survey was conducted in each of 13 LGAs from 2017 to 2019, with the support of Tropical Data (TD). World Health Organization (WHO)-recommended protocols were used. With a probability-proportional-to-size systematic sampling method, 25 villages were selected per LGA in 2017 and 30 villages per LGA in 2019; in each village, 25 households were enrolled for 2017 surveys, while 30 were enrolled for 2019 surveys. All present, consenting residents aged ≥1 year were examined by TD-certified graders for trachomatous inflammation—follicular (TF) and trachomatous trichiasis (TT) using the WHO simplified grading scheme. Additionally, we collected data on household-level access to water, sanitation and hygiene (WASH) facilities. Results One LGA (Magumeri) had TF prevalence in 1–9-year-olds ≥10%; two other LGAs (Monguno and Kaga) had TF prevalence between 5.0% and 9.9%. The prevalence of TT unknown to the health system was ≥0.2% in six LGAs. The proportion of households with access to improved water sources ranged from 30% (Kwaya Kusar) to 95% (Monguno); household-level access to improved latrines was lowest in Shani (7%) and highest in Maiduguri (95%). Conclusion Active TT case finding and strengthening of TT surgical services are needed in six LGAs. Mass drug administration (MDA) of antibiotics is needed in three LGAs to reduce the prevalence of active trachoma to below elimination thresholds. The trachoma elimination programme should engage WASH agencies to augment access to improved WASH facilities.

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.

Association Among Household Water, Sanitation, and Hygiene (WASH) Status and Typhoid Risk in Urban Slums: Prospective Cohort Study in Bangladesh.

Typhoid fever, or enteric fever, is a highly fatal infectious disease that affects over 9 million people worldwide each year, resulting in more than 110,000 deaths. Reduction in the burden of typhoid in low-income countries is crucial for public health and requires the implementation of feasible water, sanitation, and hygiene (WASH) interventions, especially in densely populated urban slums. In this study, conducted in Mirpur, Bangladesh, we aimed to assess the association between household WASH status and typhoid risk in a training subpopulation of a large prospective cohort (n=98,087), and to evaluate the performance of a machine learning algorithm in creating a composite WASH variable. Further, we investigated the protection associated with living in households with improved WASH facilities and in clusters with increasing prevalence of such facilities during a 2-year follow-up period. We used a machine learning algorithm to create a dichotomous composite variable ("Better" and "Not Better") based on 3 WASH variables: private toilet facility, safe drinking water source, and presence of water filter. The algorithm was trained using data from the training subpopulation and then validated in a distinct subpopulation (n=65,286) to assess its sensitivity and specificity. Cox regression models were used to evaluate the protective effect of living in "Better" WASH households and in clusters with increasing levels of "Better" WASH prevalence. We found that residence in households with improved WASH facilities was associated with a 38% reduction in typhoid risk (adjusted hazard ratio=0.62, 95% CI 0.49-0.78; P<.001). This reduction was particularly pronounced in individuals younger than 10 years at the first census participation, with an adjusted hazard ratio of 0.49 (95% CI 0.36-0.66; P<.001). Furthermore, we observed an inverse relationship between the prevalence of "Better" WASH facilities in clusters and the incidence of typhoid, although this association was not statistically significant in the multivariable model. Specifically, the adjusted hazard of typhoid decreased by 0.996 (95% CI 0.986-1.006) for each percent increase in the prevalence of "Better" WASH in the cluster (P=.39). Our findings demonstrate that existing variations in household WASH are associated with differences in the risk of typhoid in densely populated urban slums. This suggests that attainable improvements in WASH facilities can contribute to enhanced typhoid control, especially in settings where major infrastructural improvements are challenging. These findings underscore the importance of implementing and promoting comprehensive WASH interventions in low-income countries as a means to reduce the burden of typhoid and improve public health outcomes in vulnerable populations.

An exploratory investigation into the status of water, sanitation and hygiene (wash) of schools in Enugu State, Nigeria

The status of water, sanitation and hygiene (WASH) facilities was investigated in sixty schools in seven local government areas of Enugu State, Nigeria. A total of sixty schools comprising of twenty-four (24) private schools, twenty (20) government schools and Sixteen (16) mission schools were investigated in this study. Using questionnaire and on-the-spot assessment, WASH facilities in the selected schools were subjected to in-depth scrutiny. The highest number of schools that do not have a water source within the school premises are government schools (10), followed by private schools (7) and then mission schools (2). About seventy-one percent (71%) of the schools investigated rely on self-help water supply sources such as water vendors, rainwater harvesting and private boreholes. Fifty-seven (57) or 95% of the sixty (60) schools of all the schools have toilet facilities ranging from improved pit latrine (10%), flush toilet (31.7%) and pour flush toilet (53.3%). With respect to toilet cleaning, 33%, 17% and 50% of private, government and mission school clean their toilets every day. Fifty-five percent (55%) of all schools always provide handwashing facilities while 13.3% never provide handwashing facilities. Based on school category, the distribution of schools that provide handwashing facilities are as follows: private schools – 54.2%, government schools – 40% and mission schools – 75%. There was a significant correlation (r = 0.85) between availability of toilet facilities and provision of handwashing facilities. There was also a significant correlation (r = 0.555) between the provision of handwashing facilities and the provision of soap.

Better Existing Water, Sanitation, and Hygiene Can Reduce the Risk of Cholera in an Endemic Setting: Results From a Prospective Cohort Study From Kolkata, India.

Global cholera control efforts rely heavily on effective water, sanitation, and hygiene (WASH) interventions in cholera-endemic settings. Using data from a large, randomized controlled trial of oral cholera vaccine conducted in Kolkata, India, we evaluated whether natural variations in WASH in an urban slum setting were predictive of cholera risk. From the control population (n = 55 086), baseline WASH data from a randomly selected "training subpopulation" (n = 27 634) were analyzed with recursive partitioning to develop a dichotomous ("better" vs "not better") composite household WASH variable from several WASH features collected at baseline, and this composite variable was then evaluated in a mutually exclusive "validation population" (n = 27 452). We then evaluated whether residents of better WASH households in the entire population (n = 55 086) experienced lower cholera risk using Cox regression models. Better WASH was defined by a combination of 4 dichotomized WASH characteristics including safe source of water for daily use, safe source of drinking water, private or shared flush toilet use, and always handwashing with soap after defecation. Residence in better WASH households was associated with a 30% reduction in risk of cholera over a 5-year period (adjusted hazard ratio, 0.70 [95% confidence interval, .49-.99]; P = .048). We also found that the impact of better WASH households on reducing cholera risk was greatest in young children (0-4 years) and this effect progressively declined with age. The evidence suggests that modest improvements in WASH facilities and behaviors significantly modify cholera risk and may be an important component of cholera prevention and elimination strategies in endemic settings. Clinical Trials Registration. NCT00289224.

Water, sanitation and hygiene challenges of forcibly displaced Myanmar nationals in Rohingya camps in Bangladesh.

Improved water, sanitation and hygiene (WASH) facilities in water-scarce areas is one of the most important barriers to improving the standards of people's life, which is even worse in a locality with forcibly displaced people (e.g., nearly 1 million Rohingya refugees in Bangladesh). In attempting to understand the extent of vulnerability and risks of WASH facilities, their impacts, and adaptive practices in the communities, an exploratory study has been carried out in five selected camps (13, 15, 16, 24 and 27) in Cox's Bazar, Bangladesh. Examination of water facilities shows that households in camps 13, 15 and 16 suffered from an adequate supply of water during summer as there is no direct access to surface water from adjacent water reservoirs, while camps 24 and 27 have such facilities. The frequency of water shortage for drinking purposes in camps 13, 15 and 16 was not so severe as in camps 24 and 27. Drinking water collectors had to spend 3-5 h in queues. All latrines were communal/shared latrines, which made users feel uncomfortable and vulnerable. This study implies that WASH facilities need to be reinforced, and community sensitization on WASH behavior needs to be strengthened to reduce WASH-related health hazards.

Water, sanitation, and hygiene facilities: enabling or impeding handwashing? An assessment of a primary school infrastructure in Palwal, India

AbstractThe importance of water, sanitation, and hygiene (WASH) facilities in school cannot be ignored in protecting children from communicable diseases. However, reports from UNICEF suggest that there is a lack of adequate WASH facilities and a dearth of adequate data on available facilities, particularly from developing countries. The present study sought to address this gap and build on the evidence-base of school hygiene and sanitation facilities in rural India. The study also assessed the association between available facilities and the handwashing behavior of students. Data were collected from 28 schools using a modified Joint Monitoring Program (JMP) observation checklist and a self-administered questionnaire. Results indicate a universal coverage of WASH facilities in the sampled schools, though the sufficiency and usability of the infrastructure were inadequate. The study also found better hand hygiene KAP scores among students in schools that had handwashing stations closer to toilets (p = 0.018). We conclude that while India has improved access to facilities under the recent National policy push, there needs to be a continued focus on increasing sufficiency, maintenance and usability of the facilities. Additionally, health promotion activities that include teachers, parents and the community are required to improve the hygiene and sanitation behavior of school children.

Water, Sanitation, and Hygiene Policies and the Enhancement of Quality Education in Lower and Upper Basic Schools within Region One Education Directorate, The Gambia

This study focused on the importance of School Water, Sanitation, and Hygiene (WASH) policy in enhancing the quality of education in Lower and Upper Basic Schools within Region One Education Directorate of The Gambia. The study utilised a mixed-methods approach, combining qualitative analysis of policy documents with quantitative data obtained from questionnaires administered to head teachers. The Human Rights-Based Approach (HRBA) and Systems Thinking provide valuable theoretical lenses to analyse the lack of WASH policies. The HRBA emphasises the recognition of WASH as a fundamental human right, while the Systems Thinking approach considers the interconnectedness and complexity of the WASH system. The findings indicated that a significant number of schools in the region lack a WASH policy or rely on general directives, leading to inconsistent approaches and practices in addressing WASH issues. This inconsistency results in inadequate provision of WASH facilities, ineffective hygiene education, and a lack of clear learning objectives for students. The absence of WASH-related guidance in key school management tools and policy documents further exacerbates the challenges. The study highlighted the need for a comprehensive School WASH policy to oversee, regulate, and provide guidance for the implementation of WASH standards in educational institutions. Recommendations included developing and implementing a comprehensive School WASH policy, enhancing the curriculum framework to ensure the coverage of WASH topics, providing clear guidelines and resources, incorporating WASH into policy documents, conducting capacity-building and awareness programmes, and establishing a robust monitoring and evaluation system.

Biologic quality of households' drinking-water in an urban local government area of Oyo State, Southwest, Nigeria

Background: Inadequate access to Water, Sanitation, and Hygiene (WASH) facilities is a global public health issue with several associated illnesses, particularly in developing countries like Nigeria. It is imperative to understand the availabilities of these facilities, to provide baseline data for policy design and implementation. This study assessed access to WASH facilities. It also examined the factors associated with drinking-water contamination by coliform organisms in households within Ogbomoso North Local Government Area, Oyo-State, Nigeria.&#x0D; Methods: Cross-sectional design was employed and a two-stage cluster-sampling method was used to recruit eligible respondents from 100 households. Interviewer-administer, semi-structured questionnaire was used to collect data. Chi-square test and binary logistic regression were used for inferential statistics.&#x0D; Results: Mean age of respondents was 40.5±16.7years, 81.0% of the households practiced open defecation, and 78.9% of those with toilet facilities used pit latrines. The most common water source was borehole (71.6%); available within 5 minutes walking distance to residence of 68.0% of study participants. Sixty-three percent of the households had high drinking water coliform counts. High drinking-water coliform counts were influenced by the presence or absence of toilets facilities (OR=4.61, CI=1.22-1.68), types of toilets (OR=2.63, CI=3.22-5.34), and water sources (OR=0.12, CI=0.47-0.68).&#x0D; Conclusion: Access to good quality water and basic sanitation facilities is sub-optimal in the study setting despite being an urban community. Authors advocate for more vibrant and intentional government efforts at ensuring equitable access to WASH facilities in the Nigerian communities. This is to fast-track the nation's journey towards the actualization of the sustainable development goal (SDG)-6.

WASH and drinking water quality considerations in schools in reflection of the sustainable development goals – a review

Abstract Poor drinking water quality has been linked to negative health outcomes across the world. Drinking water quality is an essential part of safe water, sanitation, and hygiene (WASH). Safe WASH in schools is linked with the achievement of sustainable development goals (SGDs), specifically, SDG 6. It is unclear whether water quality is always assessed as part of WASH in schools. This study focused on determining the consideration of water quality aspects during WASH assessment in schools by examining published studies. A systematic online review of the literature was conducted to identify studies that reported on the assessment of WASH facilities in schools. Titles, abstracts, and full text of retrieved articles were screened. Seventy-five studies were identified. Thirty-two studies considered drinking water quality analysis as part of WASH in schools. Chemical (66%), microbial (59%), and physical (38%) parameters were included in drinking water quality analysis, with lead (Pb), and Escherichia coli being mostly included. This study reveals that some studies did not include an evaluation of drinking water quality, though it reflects an important exposure pathway between WASH services and health outcomes. It is, therefore, recommended that routine water quality monitoring be included in school WASH to ensure learner's health is protected.

Assessing sustainability of WASH projects in public and private schools of Jalalabad City, Nangarhar, Afghanistan

This study examined the sustainability of water, sanitation, and hygiene (WASH) projects in six schools in Jalalabad City, Afghanistan, using interviews, surveys, and observations. The study applied a recently developed framework called the “sustainability assessment framework and indicators in water sanitation and hygiene system.” The study found that community engagement, availability of facilities, appropriate technology and infrastructure, behavior changes, financial sustainability, and monitoring and evaluation were critical factors in promoting the sustainability of WASH projects in schools. One school had a 70.12% total score of sustainability and had good and sustainable water supply facilities, while five schools had partially sustainable and acceptable conditions, which had 68.79%, 63.24%, 61.25%, 59.33%, and 57.81% total scores of sustainability. In assessing the sustainability of sanitation facilities, two schools had 62.03% and 57.16% sustainability scores and were in good and partially sustainable condition, three schools had 48.92%, 48.64%, and 48.42% sustainability scores and were in partially sustainable and acceptable conditions that needed improvement, and one school had 39.88% sustainability score and was in bad and unsustainable condition. The study recommends increasing investment in WASH facilities, implementing sustainable maintenance practices, increasing community engagement, developing targeted interventions, and regular monitoring and evaluation to ensure the long-term viability and sustainability of WASH facilities in schools.

Coverage of safely managed water, sanitation and hygiene: An application of small area estimation

Disaggregated information on welfare indicators is useful for targeted policies. This study constructs geographic maps of water, sanitation, and hygiene (WASH) for provinces and districts in Vietnam (which has 63 provinces and 712 districts). The study finds that poorer provinces and districts tend to have remarkably lower access to safely managed sanitation and water. Provinces in the Northern Midlands and Mountain Areas, and Central Highlands have the lowest level of access to safely managed sanitation and drinking water. There is a great variation in the availability of WASH facilities between districts within the same provinces. Additionally, the study highlights that districts with a higher population of ethnic minorities tend to experience lower rates of access to safely managed sanitation and drinking water. Even within the same district, moreover, ethnic minorities face greater challenges in accessing safely managed sanitation and drinking water compared to the majority Kinh population.