Many thanks to Ian Ross, Ian.Ross@lshtm.ac.uk, for sharing the blog post, Funders shouldn’t misinterpret WASH-B and SHINE results as “WASH doesn’t work”
It is easy to misinterpret the WASH-B and SHINE findings as “WASH doesn’t work”. If funders make this misinterpretation, people will miss out on life-changing WASH services. In this post, I discuss the incremental changes the interventions delivered, how epidemiologists have interpreted the results, and how funders should interpret them.
Thanks also to Val Curtis, Val.Curtis@lshtm.ac.uk, for sharing her article, Explaining the outcomes of the ‘Clean India’ campaign: institutional behavior and sanitation transformation in India. BMJ Global Health, Sept 2019.
The experience of the Clean India program suggests that countries can almost eliminate open defecation. The success of the program was due to the following factors: setting of ambitious targets; use of modern communications strategies and monitoring technology; and provision of visible reward and recognition for employees. What do the new findings imply? Disruptive leadership is needed to create working environments where, sometimes jaded, civil servants are given an opportunity to make a difference. Politicians who embrace the cause of sanitation may find that there are votes in toilets.
Other recently published studies:
Underrepresented groups in WaSH – the overlooked role of chemical toxicants in water and health. Journal of Water, Sanitation and Hygiene for Development, Sept 2019. The review enumerated studies that focused on water quality and treatment from a chemical perspective, highlighting in particular organic contaminants of emerging concern. Organic chemicals were addressed in only 2% of journal articles and fewer than 0.7% of conference presentations.
The Household Water InSecurity Experiences (HWISE) Scale: development and validation of a household water insecurity measure for low-income and middle-income countries. BMJ Global Health, August 2019. The HWISE Scale can be used to monitor and evaluate water insecurity, identify vulnerable subpopulations for maximally effective resource allocation and measure the effectiveness of water-related policies and interventions.
Early life risk factors of motor, cognitive and language development: a pooled analysis of studies from low/middle-income countries. BMJ Open, August 2019. Maternal short stature, anaemia in infancy and lack of access to clean water and sanitation had significant negative associations with cognitive and motor development with effects ranging from −0.18 to −0.10 SDs.
Measuring open defecation in India using survey questions: evidence from a randomised survey experiment. BMJ Open, Sept 2019. We provide the first evidence that individual-level questions find more open defecation than household-level questions.
Testing the socioeconomic and environmental determinants of better child-health outcomes in Africa: a cross-sectional study among nations. BMJ Open, Sept 2019. Across nations, child health was lowest when water quality, improved sanitation, air quality and environmental performance were