Author Archives: usaidwaterckm

An update from the Global WASH Cluster Resource Center | Emergency WASH research


The Global WASH Cluster is maintaining a resource center focused on humanitarian WASH with links to relevant journal articles, toolkits, and NGO learnings ( There are over 200 key documents cataloged that cover a variety of WASH themes. A sample of recent documents includes:  


Resiliencelinks – The Center for Resilience is part of USAID’s Bureau for Food Security, soon to be the Bureau for Resilience and Food Security.

University of Colorado, Boulder Drought Resilience Impact Program (DRIP) – The Drought Resilience Impact Platform’s comprehensive systems design integrates early detection and planning with proactive groundwater management to ensure water availability, thus enabling drought-prone communities to become effective managers in the prevention of these humanitarian crises.


5 myths about refugees and WASH. SWA, February 2020. This factsheet identifies and debunks 5 common myths surrounding displaced people, and highlights the implications that WASH practitioners must consider.

Kerlink Gateways powers water-monitoring pilot program for UN refugee agency. Waterworld, Feb 2020. Remote wireless sensing and communication abilities are a possible game-changer for monitoring in refugee situations.


Hygiene programming during outbreaks: a qualitative case study of the humanitarian response during the Ebola outbreak in Liberia. BMC Public Health, January 2020.
The experiences of humanitarians allowed us to identify areas that could be strengthened when designing hygiene programmes in future outbreaks. Specifically, we identified a need for rapid research methods to explore behavioural determinants; increased skills training for frontline staff, and increased operational research to explore behaviour change strategies that are suited to outbreak situations.

USAID WASH updates | Research on WASH and health, water recycling, etc.


USAID Sustainable WASH Systems newsletter on Preventive Maintenance, February 2020. This edition of the Sustainable WASH Systems newsletter focuses on experiences with developing and scaling effective and innovative approaches to maintenance of rural water service delivery. SWS is working with a number of in-country partners to assess promising maintenance models, capture information about their performance, and critically analyze the systems that underpin these models. 

USAID Participation at the 20th AfWA Conference – Kampala, Uganda, February 2020 – The overall theme of AfWA 2020 is “Breaking new grounds to accelerate access to water and sanitation for all in Africa.”

USAID/Uganda Sanitation for Health Activity (USHA) Factsheet – The Uganda Sanitation for Health Activity (USHA) is a five-year project (2018 – 2023) financed by USAID. The project aims to increase the number of people with access to improved and sustainable WASH services, ultimately leading to improved health at household, community, and district levels in three geographic clusters: Central East, Central West and Northern Uganda.


Getting WASH into Health Care Facilities: An Urgent Global Health Need. Think Global Health, February 2020. Will the UN’s prioritization of clean water, sanitation and hand washing in health care facilities finally breed action?

USAID WASH updates | Research on toilet alarms, handwashing, FSM, etc. updates

USAID Sustainable WASH Systems Learning Partnership study – System Approaches to Water, Sanitation, and Hygiene: A Systematic Literature Review. Int. J. Environ. Res. Public Health, Jan 2020. We conducted a wide-ranging systematic literature review of systems approaches for WASH across peer-reviewed, grey, and organizational literature.

Blog post – Breaking Gender Stereotypes, One Toilet at a Time – Merab Namiwanda is an instructor at Ssanje Community Polytechnic Institute and a professional plumber. The mother of four attended a mason training conducted by USAID’s Uganda Sanitation for Health Activity in Kyotera, which demonstrated an improved sanitation product called SATO.

Other USAID updates

Interview with Women in Science: Meet Elizabeth Jordan, USAID WASH Advisor. Feed the Future, Feb 10, 2020. Meet Elizabeth Jordan and learn more about her experience and advice for the next generation of women in science, technology, engineering and mathematics (STEM).

USAID/CENTRAL ASIA ENVIRONMENT AND WATER FACT SHEET, January 2020. USAID’s Smart Waters Project seeks to build a cadre of professionals in Central Asia and Afghanistan who are capable of managing shared water resources to maximize the economic value of water equitably over the long term in the face of climate change and other pressures.


Special Issue “Solutions for Improving Essential Environmental Conditions in Healthcare Facilities in Low- and Middle-Income Countries” A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). Deadline for manuscript submissions: 31 December 2020. In this Special Issue, we are interested in papers that illuminate the scope of the problem, identify potential solutions and effective implementation approaches, and test novel technologies that could help to improve essential environmental conditions (e.g., infrastructure, hygienic items, clean surfaces, behaviors) in HCFs.


Achieving Abundance: Understanding the Cost of a Sustainable Water Future. WRI, January 2020. The paper estimates the costs of delivering sustainable water management for all countries and major basins—estimated globally as US$1.04 trillion (2015$) annually from 2015 to 2030.

“Now we feel like respected adults” – Positive change in gender roles and relations in a Timor-Leste WASH program. WaterAid, Jan 2020. The findings from this research indicate that with just a little conscious effort, WASH programs may achieve not only positive practical outcomes for women, but also small but significant changes for women’s strategic gender interests.

Training manual for fecal sludge-based compost production and application. IWMI, 2020. Based on IWMI’s experience, this training manual has been compiled for plant managers and trainers to help ensure that staff involved in FS treatment and production adopt best practices in all processes involved.

Global Experiences on Waste Processing with Black Soldier Fly (Hermetia illucens): From Technology to Business. IWMI, 2019. The report showcases some of the leading global businesses in Black Soldier Fly production.

Journal Articles

Child handwashing in an internally displaced persons camp in Northern Iraq: A qualitative multi-method exploration of motivational drivers and other handwashing determinants. PLoS One, Feb 2020. Provision of soap and water alone is not sufficient to encourage children to practice handwashing with soap in a humanitarian context. Our findings suggest that equal consideration should be given to the quality and location of handwashing materials and facilities and social norms could be leveraged to promote and enhance child handwashing.

Toilet Alarms: A Novel Application of Latrine Sensors and Machine Learning for Optimizing Sanitation Services in Informal Settlements. Development Engineering, February 2020. This study used cellular-connected motion sensors and machine learning to dynamically predict when daily latrine servicing could be skipped with a low risk of overflow.

A transdisciplinary methodology for introducing SODIS to rural communities in Malawi – formative research findings. IEAM, Feb 2020. Our study used a transdisciplinary methodology to co‐create an innovative SODIS system in rural Malawi.

Designing integrated interventions to improve nutrition and WASH behaviors in Kenya. Pilot and Feasibility Studies, Feb 2020. This study highlights the need to take a multi-sectorial, integrated approach that integrates contextually relevant behavior change theories with the experiential knowledge gleaned from stakeholders into the design of interventions that seek to reduce child stunting.


Q&A: How to plug the WASH financing gaps. Devex, Feb 2020. “Invest in systems of accountability and you’ll see you are planting seeds that will flourish very quickly. You will attract investments and build confidence among donors.”— Catarina de Albuquerque, CEO, Sanitation and Water for All.

Recent research on water ATMs, water tariffs, MHM, sanitation


Pop-up infrastructure: Water ATMs and new delivery networks in India. Water Alternatives, 2020.
The article develops a novel approach to water ATMs as ‘pop-up infrastructure’ in which the movement of matter is operationally independent from, and only contingently reliant on, existing water delivery networks.

Reflecting SDG 6.1 in Rural Water Supply Tariffs: Considering ‘Affordability’ Versus ‘Operations and Maintenance Costs’ in Malawi. Sustainability, January 2020.
Local tariffs in the form of household contributions are the primary financial mechanism to fund the maintenance of rural water supplies in Malawi. An investigation was conducted into the tariffs set by rural service providers to sustain drilled boreholes equipped with Afridev handpumps.

Stool-Based Pathogen Detection Offers Advantages as an Outcome Measure for Water, Sanitation, and Hygiene Trials. The American Journal of Tropical Medicine and Hygiene, 5 Feb 2020.
Stool-based enteric pathogen detection offers several advantages over the conventional WASH trial outcome of caregiver-reported diarrhea.

Menstrual health intervention and school attendance in Uganda (MENISCUS-2): a pilot intervention study. BMJ Open 2020.
The intervention comprised training teachers to improve delivery of government guidelines for puberty education, training in use of a menstrual kit and pain management, a drama skit, provision of analgesics and improvements to school water and sanitation hygiene facilities.

The value of monitoring data in a process evaluation of hygiene behaviour change in Community Health Clubs to explain findings from a cluster-randomised controlled trial in Rwanda. BMC Public Health, January 2020. A cluster-Randomised Controlled Trial evaluation of the impact of the Community Health Clubs (CHCs) in the Community Based Environmental Health Promotion Programme in Rwanda in 2015 appeared to find little uptake of 7 hygiene indicators 1 year after the end of the intervention, and low impact on prevention of diarrhoea and stunting.


Planning and communicating prototype tests for the Nano Membrane Toilet: A critical review and proposed visual tool. Gates Open Research, November 2019. A visual test planning tool is proposed that encompasses the entire product development process and can be used to plan and communicate prototype tests for the Nano Membrane Toilet to ultimately achieve compliance with international standards

Harnessing the power of WASH in the fight against NTDs by Yael Velleman

While in Uganda last week, I had the unique opportunity to sit down with the Ugandan Ministry of Health’s National Program Officer for Trachoma Control, Gilbert Baayenda.

Gilbert Baayenda

Trachoma is a devastating bacterial infection and the world’s leading infectious cause of blindness. It is one of 20 Neglected Tropical Diseases (NTDs) that cause extreme pain, disability and even death. Yet NTDs are preventable. They are diseases of poverty and marginalization that affect over one billion people across 149 countries globally.

Access to safe water, sanitation and hygiene (WASH) is essential for the prevention, treatment and care of NTDs. Recognizing this, the World Health Organization (WHO) and the NTD NGO Network (NNN) developed, “WASH and health working together: A ‘how-to’ guide for Neglected Tropical Disease programmes,” the first step-by-step guide for building successful WASH and NTD partnerships.

Since its launch last year on what is now World NTD Day, the toolkit has been utilized in a number of countries across sub-Saharan Africa and Asia, including Uganda. As the lead on collaboration with the WASH sector on behalf of Uganda’s National NTD Control Program, Gilbert has championed greater coordination between WASH and NTD partners, and is now in the process of adapting the innovative WHO and NNN toolkit to meet national and district-level needs.

What motivates you, as a healthcare professional, to be a WASH champion?

GB: I have lived and worked at the community and sub-national level for about 15 years and have seen what it means to have access to water and sanitation. I’ve worked in nomadic communities where WASH is non-existent – where there is no safe water, no latrine, no hygiene facilities, and water is scarce. Even where we believe that access is relatively good, we hear communities complain that there is only one water source and they must travel far to access it.

What motivates me is the decisions we make and their impact on the community. If even one family that currently has difficulties in access can say that the WASH problem has been resolved, then I would be relieved. If we solve half of the cases of disease within the next couple of years, I would be motivated to scale up to as many homes as we can get to.

What challenges have you faced in addressing WASH and NTDs?

GB: One challenge is that service providers, as well as communities, are not aware of the connection between WASH and NTDs. We must get the message out that without improvement in WASH, we may not be able to sustain the gains we have made in the fight against NTDs.

This is clear when you compare progress on trachoma and schistosomiasis; while we have eliminated trachoma in most endemic districts, we have seen progress on schistosomiasis reversed despite added treatment. The only way we can address this is if we improve WASH.  

In terms of achieving this improvement, we are challenged by natural disasters such as floods, poor soil conditions that make latrine construction difficult, and long distances to water sources. When we conduct health education, we try to emphasise the vital role of WASH.

Getting all the players to sit at the same table and view themselves as part of one WASH community instead of medical, engineering, NGO, social science or hydrology specialists, and initiating collaboration, has been a challenge. Another challenge is that Uganda has a decentralised government system, so whatever we do at the national level has to also reach all 126 districts if we want to make an impact.

Coordination of the collaboration itself is also a challenge as it is important to ensure that one sector does not appear to dominate the others – we’ve therefore tried our best to get everyone together and this is expected to improve as the concept of WASH and NTD collaboration gets more buy in.

How have you begun to overcome these challenges and improve cross-sectoral coordination?

GB: We decided to adopt the WASH and NTDs toolkit [“WASH and health working together”] and customise it to the Ugandan context. We have held meetings at the national level and we would like to hold specific WASH and NTDs meetings with district officials in which we can explain the toolkit and the expected results, to get them to appreciate that collaboration and partnership with WASH stakeholders and relevant ministries is vital. WASH is a very big challenge and we cannot do it alone.

What difference can collaboration make?

GB: Even if we come up with one innovation that can ensure coverage in fishing communities, which are right on the water, yet they have no access to safe water, that will be a huge success. If the communities that are very far from the water source can benefit from innovation to resolve this problem, I would be proud to have been a part of this effort.

For more information:

About the author:
Yael Velleman is the Director of Policy & Communications at SCI Foundation, and co-chairs the NNN WASH Working Group

Can a toolkit make a difference to WASH and NTDs collaboration?

Yael Velleman, WASH Working Group Co-Chair, Neglected Tropical Disease NGO Network, Director of Policy and Communications, SCI Foundation

Leah Wohlgemuth, WASH Working Group Co-Chair, Neglected Tropical Disease NGO Network, Technical Adviser, Sightsavers

One year on from the launch of the first-ever practical guide on WASH and NTDs collaboration, the co-chairs of the NNN WASH Working Group reflect on its impact

A year ago today, Dr. Mwele Malecela, WHO Director for the Department of Control of NTDs, unveiled the first-ever step-by-step guide for building NTD and water, sanitation and hygiene (WASH) partnerships to a crowded auditorium at the London Centre for Neglected Tropical Disease (NTD) Research.

WASH and health working together: A ‘how-to’ guide for Neglected Tropical Disease programmes” is the culmination of more than two years of collaboration between the World Health Organization and the NTD NGO Network (NNN), incorporating real-life program perspectives and tools to improve coordination between the NTD and WASH communities. On this inaugural World NTD Day, the toolkit is celebrating its one-year anniversary and the significant headway made since its launch.

2019 saw a burst of activities to disseminate the toolkit far and wide; it was translated into French and Spanish, transformed into an interactive online version, and featured in two webinars for the NTD and WASH communities. Blogs by WaterAid and the NNN highlighted the mutual benefits of the toolkit to the WASH and NTDs communities, and the toolkit was highlighted in a USAID Water Currents issue on the importance of WASH and NTD integration.

Interviews with The Carter Center’s Kelly Callahan, Director of the Trachoma Control Program, and Dr. Wondu Alemayehu, Technical Advisor at The Fred Hollows Foundation, demonstrated the value of the resource in the eyes of those who have worked towards NTD control and elimination for many years.

The toolkit also made a splash at a number of WASH and global health convenings, with workshops delivered at Stockholm’s World Water Week, UNC’s Water and Health Conference, and the 10th Annual NNN Conference.

More importantly, however, the approach set out in the toolkit was implemented in a number of countries. Inspired by this resource, the Ethiopian Ministry of Health, which was also a major contributor to the toolkit’s content, developed a national framework to guide all government and non-government stakeholders on resourcing, planning and monitoring joint interventions, along with a woreda-level WASH and NTDs coordination toolkit.

Various tools including the situation analysis protocol and planning workshop were also utilized in Benin, Burkina Faso, Cameroon, Côte d’Ivoire, Ghana, Guinea, Kenya, Liberia, Niger, Nigeria, Senegal, Tanzania, Zambia and Zimbabwe.

More recently, the Government of Uganda formally adopted the toolkit as a whole and has begun a process of coordination, and adaptation of the toolkit to the national and local context.

The toolkit has also informed the design of WASH activities with the UK Aid funded Ascend programme in West and Central Africa, including coordination structures and joint planning processes.

As we look ahead to 2020—with the anticipated launch of the 2030 Global NTD Roadmap and complementary Global Strategy on WASH and NTDs, as well as renewed commitments to be made in Kigali this summer—nothing is clearer: cross-sector collaboration is essential to sustainably beating NTDs.

This World NTD Day, we’ll celebrate the progress made in 2019 following the launch of “WASH and health working together”, but know that as a global community, we still have much to do to build successful partnerships.

This will mean taking collaboration to the next level, by convening and supporting capacity building initiatives at the regional and national level, by supporting the development of country and local tools, and by documenting the use of the tools to ensure that the toolkit is continuously enhanced to achieve the ultimate aim: end the scourge of NTDs by 2030.

USAID WASH updates | Literature review on WASH systems

USAID Updates

Journal Articles

System Approaches to Water, Sanitation, and Hygiene: A Systematic Literature Review. Int. J. Environ. Res. Public Health 2020. Authors: by Nicholas Valcourt 1,2,*,Amy Javernick-Will 1,2,Jeffrey Walters 2,3 and Karl Linden 1,2 – 1-Department of Civil, Environmental, and Architectural Engineering, University of Colorado Boulder 2-USAID Sustainable WASH Systems Learning Partnership, United State Agency for International Development | 3-College of Engineering, George Fox University, Newberg, OR 97132, USA

We conducted a wide-ranging systematic literature review of systems approaches for WASH across peer-reviewed, grey, and organizational literature. Our results show a myriad of methods, scopes, and applications within the sector, but an inadequate level of information in the literature to evaluate the utility and efficacy of systems approaches for improving WASH service sustainability. Based on this analysis, we propose four recommendations for improving the evidence base including: diversifying methods that explicitly evaluate interconnections between factors within WASH systems; expanding geopolitical applications; improving reporting on resources required to implement given approaches; and enhancing documentation of effects of systems approaches on WASH services.

Social Network Analysis for Water, Sanitation, and Hygiene (WASH): Application in Governance of Decentralized Wastewater Treatment in India Using a Novel Validation Methodology. Frontiers in Environmental Science, January 2020. Authors: Abishek Sankara Narayan1,2*, Manuel Fischer 1,3 and Christoph Lüthi 1 – 1 Eawag, Swiss Federal Institute of Aquatic Science and Technology, Dubendorf, Switzerland, 2 Institute of Civil, Environmental and Geomatic Engineering, ETH, Swiss Federal Institute of Technology

The use of SNA as an appropriate diagnostic tool for planning Citywide Inclusive Sanitation is explored. Missing data is a major problem for SNA in the studies of governance situations, especially in low- and middle-income countries. Therefore, a novel validation methodology for incomplete SNA data, relying on information from internal and external experts is proposed. SNA and the validation method is then applied to study the governance of decentralized wastewater treatment in four cities of India. The results corroborate key differences between mega and secondary cities in terms of institutions, community engagement and overall sanitation situation including aspects of decentralized wastewater treatment plants, based on the city types.

Menstrual Hygiene Preparedness Among Schools in India: A Systematic Review and Meta-Analysis of System-and Policy-Level Actions. Int J Environ Res Public Health. 2020 Jan 19. Authors: Sharma S1,2, Mehra – 1 Researcher, Department of Clinical Sciences, Lund University, 2 MAMTA Health Institute for Mother and Child.

Less than half of the girls were aware of menstruation before menarche. Teachers were a less common source of information about menstruation to girls. Separate toilets for girls were present in around half of the schools.


Video – Transforming health systems: the vital role of water, sanitation and hygiene. WaterAid, January 2020. 

Dan Campbell