Water, Sanitation And Hygiene Practices Research Articles

The Interplay Between Household Risk Perception of Parasitic Infections and Water, Sanitation, and Hygiene (WASH) Practices: Evidence From an Urban Poor Community in the Philippines.

Parasitic diseases pose challenges in impoverished urban settlements with limited access to clean water, proper hygiene, and sanitation (WASH). This study assesses WASH practices and risk perceptions of parasitic infections among households in the Bataan Shipyard and Engineering Corporation (BASECO) Compound in Manila, an urban poor community in the Philippines. A cross-sectional study design was employed to collect data through a self-administered questionnaire. Descriptive statistical analysis was performed to assess the sociodemographic profile, household WASH practices, and respondents' risk perception of parasitic infections. Linear regression analysis was utilized to examine the relationship between these variables. A survey was conducted with 363 households, of which 237 (65.3%) used distilled and purified water from the water refilling stations in the community for drinking. Meanwhile, 120 households (33.10%) consumed tap water. Boiling water was a commonly used method (n=146; 56.60%) for treating drinking water. Most households had flush toilets with septic tanks (n=244; 67.20%), water sources for handwashing (n=307; 84.57%) and soap for handwashing (n=356; 98.10%). On average, they washed their hands 6-10 times daily (n=159; 43.80%). Most households were aware that drinking untreated water (n=318; 87.6%), improper food washing (n=309; 85.1%), using contaminated water sources (n=301; 82.9%), and consuming raw or undercooked meat (n=298; 82.1%) could lead to parasitic infections. 316 respondents (87.1%) identified diarrhea as the most common symptom of parasitic infection. Relationships were found between access to drinking water and the number of household members (B=0.191; p-value=0.001), personal hygiene and the respondents' knowledge of parasitic infections (B=0.112; p-value=0.047), and the overall WASH score with household income (B=0.105; p-value=0.045). The WASH conditions in BASECO, Manila need improvement. Factors associated with their WASH practices include risk perception of parasitic diseases, socioeconomic disparity, and household overcrowding. These factors play a crucial role in identifying areas for improvement and promoting health policies for urban poor communities in the Philippines.

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.

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.

Water sanitation and hygiene practices of the indigenous Tharu community in Chitwan, Nepal

Nepal is a multi-ethnic country with cultural diversity according to ethnicity. Culturally rich, the Tharu ethnicity is the fourth largest ethnic group. Sanitation and hygiene are integral parts of their culture. Water, sanitation, and hygiene (WASH) are fundamental for everyone. This study aims to identify the WASH practices and situation of diarrhoeal diseases among the Tharu ethnic group in the Chitwan district of Nepal. A quantitative cross-sectional survey was used for the study. The study area and ethnic group were selected randomly. Primary data were collected using an interview schedule and observation checklist. Data analysis was carried out using SPSS version 24. The findings confirmed that all households clean their yards, and about 9 in 10 (87.5%) respondents have dustbins in their households. Almost all (98.8%) clean their kitchen utensils twice daily, and 96.8 percent use ash or soap as a cleaning agent. Nearly all (99.7%) households have a toilet (92.8% water seal), whereas 75.3 percent use water, brush, and cleaning agents, and 96.8 percent use separate slippers in the toilet. All the respondents wash their hands with soap before eating food and after defecation. Almost all (95.7%) wash their hands with soap after cleaning yards, 92.5 percent after cleaning the child’s bottom, 91.5 percent after touching cow dung, 89.9 percent after agricultural work, 73.1 percent after feeding the child, and 90.7 percent after cleaning the toilet. The study shows that 46.3 percent of women and girls use commercial sanitary pads during menstruation, and 43.7 percent use pieces of cloth as pads. About half (49.6%) clean their genitals four or more times daily, whereas nine in ten (92.6%) respondents take a bath four or more times during the menstrual period, and 76.8 percent use soap as a cleaning agent. In the previous year, only 26.1 percent of respondents’ families suffered from diarrhea; however, nobody was infected by cholera. The study suggests that socioeconomic status and contextual factors must be improved to strengthen and sustain WASH practices. Including good WASH practices of indigenous Tharu people in the local curriculum could motivate them to empower and develop further good practices, which is possible through the school curriculum, which the local and federal governments mandate.

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.

Usability and Acceptability of a SWASH Mobile Intervention for Behaviour Change in WASH Practices

Adequate access to Water, Sanitation, and Hygiene (WASH) is the principal determinant of human health and well-being. However, many African countries are facing challenges in implementing proper WASH practices. The School WASH (SWASH) Mobile App was developed using the Human Centred Design (HCD) approach, which leverages behavioural theories to track school students' sanitation and hygiene behaviours and encourage positive behaviour change. This study examined the usability and acceptability of the SWASH Mobile App. A qualitative research methodology was employed to assess in depth (i) whether the App achieves its intended objective of influencing WASH behaviour change in schools and (ii) challenges that affect its success. A total of 62 people from 20 schools' students, teachers, and community members in Tanzania participated in the study. The results demonstrated that the SWASH Mobile App was widely accepted and highly usable. The study further revealed that the main challenges were costly and unstable internet, difficulties in fetching pictures, and voting and lack of SWASH Mobile App awareness. The study recommends collaboration between schools and telecommunication companies for cost-effective internet access, the use of image compression techniques for faster access to pictures, and a marketing strategy to increase app awareness

A retrospective study on cholera understanding and WASH (water, sanitation, and hygiene) behavior among adolescents in three regions of La Gonâve, Haiti

BackgroundsThis study assesses the impact of Water, Sanitation, and Hygiene (WASH) interventions on cholera understanding and hygiene practices in La Gonâve Island, Haiti. It examines the changes after implementing interventions in seven villages across the Downtown, Mountain, and Seaside regions. MethodsA retrospective investigation surveyed 210 school students from each region using a validated questionnaire. It assessed knowledge, attitudes, practices (KAP), and environmental aspects related to cholera and hygiene. Data analysis involved descriptive statistics and chi-square tests. ResultsThe study highlights significant disparities in education levels, toilet ownership, and healthcare access. Challenges in finding public toilets (86.67%) and accessing water sources (67.78%) are consistent across regions, with Seaside facing financial constraints (85.00%) and water cost concerns (91.67%). Attitudes toward hygiene vary, with the Mountain region having the highest ‘Never’ responses for handwashing (38.89%), and Downtown leading in water treatment practices (11.67%). There is a strong willingness to share health knowledge, particularly in Downtown (100.00%). Seaside (83.33%) and Downtown (73.33%) revealed a higher cholera awareness, while nearly half of Mountain students lacked knowledge (54.44%). ConclusionsThis study highlights significant disparities in WASH practices among La Gonâve's adolescents in Downtown, Mountain, and Seaside regions. Urgent interventions are crucial for improving sanitation, ensuring clean water access, and implementing targeted hygiene education, especially in the resource-constrained Mountain and Seaside areas. The findings underscore the vital roles of adolescents and schools in disseminating knowledge, with further research needed to explore intervention differences.

Nutritional Knowledge, WASH Practices of Mothers and Their Impact on the Nutritional Status of Children Aged 6–59 Months in Cumilla District, Bangladesh

Introduction: Child malnutrition is a pressing global public health issue, impacting both immediate health and future development. Adequate nutrition is a crucial aspect of public health, with maternal nutritional knowledge playing a vital role in ensuring optimal growth for children. Insufficient awareness about nutrition, even in households with sufficient resources, can result in poor outcomes for children.&#x0D; Aim: This study aimed to explore the contemporary status of maternal nutritional knowledge, water, sanitation, and hygiene (WASH) practices and their effect on the nutritional status of children aged 6–59 months in the Cumilla district of Bangladesh.&#x0D; Methods: A community-based cross-sectional study was carried out on 386 mother-child (6-59 months) pairs from 7 villages of the Cumilla district, Bangladesh. The study was designed to assess nutritional knowledge, WASH practices of mothers and nutritional status of their children using structured questionnaire and anthropometric measures. Chi square test was performed to investigate the association between maternal nutritional knowledge, WASH practices, and the nutritional status of children.&#x0D; Results: The study revealed, the level of nutritional knowledge was average (72.3%) among mothers. The prevalence of stunting, underweight, wasting and overweight were 38.6%, 16.9%, 11.9%, and 7.8% respectively. A strong relationship was found between nutritional knowledge, WASH practices of mothers and child’s stunting (p&lt;0.05) respectively. Maternal nutritional knowledge also had a strong association with underweight where female child was more prone to underweight than its male counterpart (p&lt;0.05). There was no significant association between maternal nutritional knowledge, WASH practices and wasting (p = 0.224, p = 0.328) respectively.&#x0D; Conclusion: The study revealed elevated rates of stunting and overweight in children compared to the national average, while underweight prevalence was lower and wasting prevalence was similar. Therefore, it is crucial to tackle social and cultural issues and implement effective strategies to enhance maternal nutritional knowledge and WASH practices to mitigate malnutrition in the rural areas of Bangladesh.

Relationship of stunting with water, sanitation, and hygiene (WASH) practices among children under the age of five: a cross-sectional study in Southern Punjab, Pakistan

BackgroundReasons for undernutrition are food insufficiency, impaired child care, limited access to healthcare, and maternal lack of health literacy. In addition, there are several environmental factors, such as drinking water quality, poor sanitation, and hygienic practices that can lead to poor nutritional status in children. The present study aimed to compare household-associated risk factors, including water, sanitation, and hygiene (WASH) practices of mothers, with children’s stunting under the age of five.MethodsA face-to-face cross-sectional survey was conducted with mothers of children under the age of five in the Dera Ghazi Khan district in southern Punjab, Pakistan. World Health Organization criteria for stunting were used to identify the participants. A sociodemographic questionnaire was used to collect information from consented parents/guardians on children’s age, feeding, and WASH practices. Pearson’s chi-square, simple regression, and hierarchical regression models were applied for data analysis.ResultsA total of 204 mothers of children of both genders participated in this study. The children’s mean (SD) age was 15.67 (± 10.2) months, their weight was 5.44 (± 1.45) kg, their height was 67.69 (± 10.05), and their mid-upper arm circumference was 9.75 (± 1.30) cm. Children’s stunting was mild (z-score > -2) at 17.6%, moderate (z-score − 2 to -3) at 16.7%, and severe (z-score < -3) at 65.7% of participants. A simple regression model showed a strong association, r2 = 0.062, p = 0.013, with age as the most significant sociodemographic factor. The hierarchical regression model showed a combined value of r2 = 0.0128, p = 0.027, with hand pump and tank water as the significant source of drinking water that was related to stunting among children.ConclusionStunting can be associated with several risk factors, including WASH parameters. This study concluded that children aged under five years are susceptible to stunting in southern Punjab, Pakistan. The contamination of hand pumps and tank water resources was found to be the major contributing factor to stunting.

WASH practices increased the prevalence of malnutrition among under-five children (6–59 months) in an urban slum area in Ibadan, Nigeria

Abstract Access to safe water, proper sanitation, and hygienic practices are fundamental to the growth and survival of children. This study assessed the relationship between water, sanitation, and hygiene (WASH) practices and the nutritional status of children aged 6–59 months in the Beere/Oja-Oba community, Ibadan, Oyo State. This cross-sectional study involved 200 mothers/caregivers with under-five children. WASH practices were assessed using an interviewer-administered questionnaire. Anthropometric measurements were taken and analyzed using WHO Anthro. Data were analyzed using SPSS at p &amp;lt; 0.05. The mean age of the children was 24.91±10.52, and the majority were females (77.5%). Prevalence of stunting (44.0%), wasting (37.5%), and underweight (34.0%) were high among the children. Well (71.5%) and tap/borehole (74.0%) were the major sources of domestic and drinking water respectively, and required 5–15 min (36.9%) to source. The occurrence of diarrhea was high (48.5%) among the children. Time to drinking water source and washing a child's hands before feeding were WASH practices significantly associated with stunting (p = 0.000) and underweight (p = 0.003) among the children from lower socio-economic households (p = 0.045). Access to unsafe water was significantly associated with child malnutrition. There is a need to educate and encourage mothers/caregivers to improve their hygiene practices in the community.

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.

The Internet of Things (IoT) is being used to Control the Implementation of Water, Sanitation, and Hygiene (WaSH) Practices during the COVID-19 Era in Indonesia

This research aims to identify the relationship between duration, content type, perception, and interest in the use of social media platforms Instagram and YouTube by millennials regarding WaSH practices during the COVID-19 pandemic in the Southeast Sulawesi Province, Indonesia. This study adopts a quantitative approach using a cross-sectional research method. The sampling method is probability sampling with a proportional stratified random sampling technique. The population in this study consisted of 936.963 individuals, and a sample size of 384 individuals was taken. The research findings indicate a significant relationship between duration, content type, perception, and interest in the use of social media platforms Instagram and YouTube towards WaSH practices, with respective p-values of 0.000 &lt; 0.05 for each variable. The utilization of Instagram and YouTube by millennials is a compelling effort that can be utilized as an educational means to enhance information regarding WaSH practices. The wise attitude and millennials' awareness of filtering beneficial content from social media and implementing WaSH practices daily are crucial steps in preventing COVID-19.

Knowledge, Attitudes and Practice regarding WASH among Community Dwellers of District Sargodha, Punjab, Pakistan

The sustainable development in communities and improved quality of life is the utmost adjective of various development programs globally. The 21st century challenge for community development is unprecedented and multilayered with diversity of stakeholders. Within the community context, individuals are strongly associated with their knowledge, attitude and practices (KAP) in daily life. Poor knowledge and unsafe practices of water, sanitation and hygiene (WASH) among community dwellers are among the chief vehicles for transforming infections diseases, which are the leading cause of mortality and morbidity, especially among children. To understand the actual condition of KAP regarding WASH a cluster random sampling technique was applied to obtain samples from target communities of district Sargodha. Various univeriate and bivariate analysis applied through SPSS-21 for insight the individual practice. The findings indicated that two third of community dweller had moderate level of Knowledge attitude and practice (KAP) regarding WASH. The findings from T-test show that there is signification variation existed with respect to gender and socio-demographic aspects of community. The community dwellers somehow understand the importance of safe WASH practices, however, there is an intensive need for essential awareness among community dwellers regarding WASH.

Water, sanitation, and hygiene implications of large-scale recycling of treated municipal wastewater in semi-arid regions

Access to water, sanitation, and hygiene (WaSH) is crucial for national development, as it improves human health and fulfills a fundamental need. This study examines the impact of a large-scale groundwater (GW) recharge scheme using secondary treated wastewater (STW) on WaSH characteristics and identifies the major determinants of improved WaSH charecteristics in drought-hit regions of Kolar district, southern India. The study quantifies improved WaSH practices by comparing WaSH characteristics between impacted areas (influenced by STW) and non-impacted areas (not influenced by STW) of Kolar, using household survey data. Pearson's chi-square and student's t-test are used to verify differences between WaSH characteristics. Furthermore, a composite WaSH score is formulated, and a hierarchical stepwise multiple linear regression model is constructed to identify major determinants of improved WaSH scores. The results show that impacted areas have better WaSH characteristics, including daily water supply by gram panchayat, enhanced toilet uses among all family members, bathing patterns, cloth washing practices, toilet cleaning patterns, and water consumption per capita per day. The maximum and minimum WaSH scores of impacted areas were 17.50 and 6.50, respectively, while those of non-impacted areas were 14 and 4.5. This study finds that improved water availability, quality, and security due to daily water supply at the household level are the major determinants of improved WaSH practices. These results can inform policymakers in designing sanitation and hygiene improvement policies that integrate water recycling projects in drought-hit areas.

Environmental, social, and WASH factors affecting the recurrence of cholera outbreaks in displacement camps in Northeast Nigeria: a rapid appraisal

Abstract In 2021, Nigeria witnessed a severe cholera outbreak that affected Borno state, in which more than 1,600,000 internally displaced persons (IDPs) resided at the time. This rapid appraisal explored factors that facilitate the recurrence of cholera outbreaks in sites hosting IDPs in Northeast Nigeria. Semi-structured interviews were conducted with water, sanitation, and hygiene (WASH), management, and healthcare personnel working in ten displacement camps in Borno state. The interviews were complemented by transect walks and field observations, measurements of free residual chlorine levels, and publicly available data published by the International Organization for Migration Displacement Tracking Matrix. The recurrence of cholera outbreaks appears to be facilitated by substantial interactions between IDPs and host communities, and suboptimal WASH services in camps. Of particular concern, IDP camps are exposed to extreme weather-related events that damage facilities and subsequently affect WASH practices. WASH services in camps may likewise be severely hindered by an influx of new arrivals. In conclusion, we emphasize the importance of expanding WASH activities to host communities and developing site-specific WASH interventions and chlorination targets. Practical recommendations are needed for the prevention and control of outbreaks following extreme weather-related events and population influxes.

Basic Water, Sanitation and Hygiene (WASH) practices among school adolescents of rural area, Indore: A comparative study

Background: Young teens are more vulnerable to a variety of infections, particularly teenage girls if they don't take care of their hygiene. The reason of conducting studies in schools is as they spend more than one third of their lifetime in school. School environment, supply of potable water, etc. impact on healthy development. Material and methods: This is a cross-sectional study carried out in the field of RHTC practice at Indore Medical College from February to April 2019. A structured pro- forma that included questions about basic sanitation, water and hygiene practices, is used to gather data from teenagers studying in public and private schools. 200 students from public schools and 200 private schools in Grades 6 to 10 were selected by Quota Sampling to compare WASH practices among themselves. Results: The majority of teenagers in private schools have good levels of personal hygiene 58.3% compared to public schools 41.7%. Standards of personal hygiene increased with age. The majority of 95% of teenagers used drinking water sources in the private sector as opposed to adolescents in public schools. In the study, 73% of private schools had separate washrooms for girls and boys, compared with 89.5% of public schools. Nearly all washrooms in private schools were clean, compared with 40% in public schools. Bins were available in 67% of adolescents in private schools, compared with 34% of adolescents in public schools. Handwashing practices were found to be satisfactory among teens at both schools. Conclusion: Following the launch of the Swatch Bharat Abhiyan, overall WASH practices are enhanced. Practices among teenagers in private schools were found to be satisfactory, but improvements were also observed in public schools. Most of the time, teenagers miss school for lack of core WASH practices.

Drivers of Resistance in Uganda and Malawi (DRUM): a protocol for the evaluation of One-Health drivers of Extended Spectrum Beta Lactamase (ESBL) resistance in Low-Middle Income Countries (LMICs)

In sub-Saharan Africa (sSA), there is high morbidity and mortality from severe bacterial infection and this is compounded by antimicrobial resistance, in particular, resistance to 3rd-generation cephalosporins. This resistance is typically mediated by extended-spectrum beta lactamases (ESBLs). To interrupt ESBL transmission it will be important to investigate how human behaviour, water, sanitation, and hygiene (WASH) practices, environmental contamination, and antibiotic usage in both urban and rural settings interact to contribute to transmission of ESBL E. coli and ESBL K. pneumoniae between humans, animals, and the environment. Here we present the protocol for the Drivers of Resistance in Uganda and Malawi (DRUM) Consortium, in which we will collect demographic, geospatial, clinical, animal husbandry and WASH data from a total of 400 households in Uganda and Malawi. Longitudinal human, animal and environmental sampling at each household will be used to isolate ESBL E. coli and ESBL K. pneumoniae. This will be complimented by a Risks, Attitudes, Norms, Abilities and Self-Regulation (RANAS) survey and structured observations to understand the contextual and psychosocial drivers of regional WASH practices. Bacterial isolates and plate sweeps will be further characterised using a mixture of short-,long-read and metagenomic whole-genome sequencing. These datasets will be integrated into agent-based models to describe the transmission of EBSL resistance in Uganda and Malawi and allow us to inform the design of interventions for interrupting transmission of ESBL-bacteria.

Evaluation of a WASH/MNCH targeted primary health care program in Uganda; a mixed methods study

ABSTRACT Background Evidence on the impact of Maternal Newborn and child health (MNCH) and Water, Sanitation and Hygiene (WASH) interventions on skilled birth attendance (SBA) and neonatal sepsis remains unclear. We conducted this study in Amuru district to generate evidence. Methods A before-and-after study design was conducted. Interventions implemented included; training of HCWs, construction of WASH facilities, and health education of communities. A digitized structured questionnaire was used to obtain data on ANC and SBA, WASH practices and prevalence of pneumonia and diarrhea among 466 expectant mothers and caretakers of under-fives at baseline, midterm and endline. Data on sepsis incidence, ANC, SBA and WASH status was obtained from six healthcare facilities. A total of 12 KIIs and 12 FGDs were conducted. Data were analyzed using STATA 15. Two sample tests of proportions were used to compare findings at baseline and endline. Qualitative data were analyzed using thematic content analysis. Results The number of women delivering at HCFs significantly increased from 41.4% to 63.0% (p < .0001). Incidence of neonatal sepsis reduced from 0.6% to 0.2% (p = .0687), although the difference was not significant. Community-level findings also indicated a decline in cases of water-borne illnesses; cases of dysentery decreased from 10.0% to 0.6%, cases of cholera decreased from 8.9% to 1.9% at endline, cases of typhoid decreased from 26.5% to 12.7% at endline. Conclusion This study revealed that integrated WASH/MNCH interventions can significantly increase ANC and SBA, reduce incidences of neonatal sepsis, diarrhea, pneumonia, and other related diseases and improve WASH practices in communities. Significant improvements in WASH/IPC and the capacity of HCWs to deliver safe MNCH services are realized.

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.

Child Stunting Reduction in Aceh Province: Challenges and a Way Ahead.

Indonesia ranks the fifth highest in child stunting among Asian countries. Aceh, a westernmost province in Indonesia recorded the highest prevalence of stunting in children under two years old in the nation. Our study investigated the current government efforts on child stunting reduction activities since the introduction of Governor Regulation No. 14/2019. The study investigated the current efforts of Aceh governments and relevant actors on child stunting reduction using in-depth interviews, document reviews and focus group discussions. Thirty-five (35) respondents including policy makers were interviewed, four focus group discussions (15 each group) were conducted, and various official documents were reviewed. Various challenges for reducing child stunting in Aceh were identified: inadequate knowledge and skills of Posyandu cadres on child stunting; reluctance to consume iron and folic acid (IFA), and supplementary foods (PMT Bumil) by many pregnant women due to perceived annoying effects and unappetizing taste; work engagement, insufficient breast milk production and inadequate support from husbands failing to achieve exclusive breastfeeding among nursing women; inadequate provision of complementary fortified foods for children 6-23 months; lack of clean water, waste management and WASH practices. The intervention on both nutrition-specific and nutrition-sensitive factors was found to be insufficient in Aceh. Although WASH (water, sanitation and hygiene) practices are the most important contributors to child stunting, only the health agency plays a singular role in reduction efforts by focussing on specific factors. Coordination between relevant agencies to address both factors is required to achieve the effectiveness of child stunting reduction and prevention in Aceh.