Category Archives: Sanitation and Health

Water access and sanitation shape birth outcomes and earning potential

Water access and sanitation shape birth outcomes and earning potential. Mongabay, November 8, 2018. mongabay.png

  • Spending more time per day fetching water increased Indian women’s risk of delivering a low birth weight baby, a study has said.
  • Open defecation and using a shared latrine within a woman’s building or compound were also associated with higher odds of low birth weight and pre-term births, respectively, compared to having a private household toilet.
  • The researchers believe that improving water, sanitation and health access and/or reducing gender-based harassment could reduce these adverse birth outcomes.
  • Another study pointed out that enhanced access to a reliable and proximate water supply reduced the time spent by women in collecting water and the proportion of hard labour performed by women. In addition, the thus freed may be spent on other income generating activities.

Read the complete article.

Association of intestinal pathogens with faecal markers of environmental enteric dysfunction among slum‐dwelling children in the first 2 years of life in Bangladesh

Association of intestinal pathogens with faecal markers of environmental enteric dysfunction among slum‐dwelling children in the first 2 years of life in Bangladesh. Tropical Medicine and International Health, August 2018.

Objective – Environmental Enteric Dysfunction (EED) can be assessed by faecal biomarkers such as Myeloperoxidase (MPO), Neopterin (NEO) and Alpha‐1 anti‐trypsin (AAT). We aimed to test the association of intestinal pathogens with faecal markers of EED among slum‐dwelling children in first 2 years of life.

Methods – The MAL‐ED birth cohort data of Bangladesh site were used to conduct this analysis. Multivariable analyses using Generalized Estimating Equations (GEE) were performed to test the association between intestinal pathogens and faecal markers of EED.

Results – Giardiasis, ascariasis and trichuriasis were the most frequent parasitic infections and Campylobacter spp., Enteroaggregative Escherichia coli (EAEC) and Enterotoxigenic Escherichia coli (ETEC) were the common bacterial pathogens observed in stool samples of the children. Giardiasis was found to be significantly associated with MPO and AAT concentrations. A significant association was found between trichuriasis and NEO. Trichuriasis and giardiasis were significantly associated with EED score. Children with EAEC had significantly higher MPO concentrations.

Conclusion – The study results imply the importance of intestinal pathogens in contributing to intestinal inflammation and increased intestinal permeability in young children.

Surprise (or not)! Toy-in-soap intervention increases handwashing among kids in emergency contexts

Surprise (or not)! Toy-in-soap intervention increases handwashing among kids in emergency contexts. FHI360 Research, October 2018.

There is nothing more satisfying in life, for me, than being able to say: I never thought of it that way. The most game-changing innovations can often have seemingly common sense solutions, and we see these solutions popping up everywhere in peer-reviewed literature. soap.png

One of those published solutions jumped out at me this week as I read a Crowd 360 blog post about innovative hand hygiene interventions to celebrate Global Handwashing Day. Researchers from LSHTM, Save the Children and their partners published new evidence showing toys inside soap can increase handwashing among kids in emergency humanitarian contexts.

Studies have examined handwashing with soap in a variety of ways over the years – with adults, with young kids, and with older kids; with health-based messages, with nudges, and with motivational messages; in school-settings, and in stable, non-emergency settings. The new toy-in-soap study, however, is the first evaluation of its kind. Here I summarize why the study is different, what the authors found and why those findings matter.

Read the complete article.

Unsafe Drinking Water Is Associated with Environmental Enteric Dysfunction and Poor Growth Outcomes in Young Children in Rural Southwestern Uganda

Unsafe Drinking Water Is Associated with Environmental Enteric Dysfunction and Poor Growth Outcomes in Young Children in Rural Southwestern Uganda. American Journal of Tropical Medicine and Hygiene, 22 October 2018. ajtmh-logo

Environmental enteric dysfunction (EED), a subclinical disorder of the small intestine, and poor growth are associated with living in poor water, sanitation, and hygiene (WASH) conditions, but specific risk factors remain unclear.

Nested within a birth cohort study, this study investigates relationships among water quality, EED, and growth in 385 children living in southwestern Uganda. Water quality was assessed using a portable water quality test when children were 6 months, and safe water was defined as lacking Escherichia coli contamination.

Overall, our data suggest that programs seeking to improve nutrition should address poor WASH conditions simultaneously, particularly related to household drinking water quality.

Toilets that save lives: a new International Standard to help

Toilets that save lives: a new International Standard to help. ISO, September 2018.

More than 2.3 billion people across the world lack access to basic sanitation services, including 892 million who defecate in the open. Hundreds of thousands of young children die each year from diseases as a result. toilet

New technology is shaping up to provide safe sanitation systems in places that don’t have sewerage treatment plants, offering the potential to save lives and improve the well-being of many. The highly anticipated ISO standard to support this development has just been published.

New international guidelines for such technology will help to catapult the industry to a new level by providing safety and performance requirements that will not only enable their effective manufacture, but the development of the sector as a whole.

ISO 30500Non-sewered sanitation systems – Prefabricated integrated treatment units – General safety and performance requirements for design and testing, is much awaited both by the industry that produces the systems and the countries that need them.

Read the complete article.

 

USAID supported study on unsafe drinking water & environmental enteric dysfunction

Unsafe Drinking Water Is Associated with Environmental Enteric Dysfunction and Poor Growth Outcomes in Young Children in Rural Southwestern Uganda. Source: The American Journal of Tropical Medicine and Hygiene, 22 October 2018.

Environmental enteric dysfunction (EED), a subclinical disorder of the small intestine, and poor growth are associated with living in poor water, sanitation, and hygiene (WASH) conditions, but specific risk factors remain unclear. Nested within a birth cohort study, this study investigates relationships among water quality, EED, and growth in 385 children living in southwestern Uganda.

Water quality was assessed using a portable water quality test when children were 6 months, and safe water was defined as lacking Escherichia coli contamination. Environmental enteric dysfunction was assessed using the lactulose:mannitol (L:M) test at 12-16 months. Anthropometry and covariate data were extracted from the cohort study, and associations were assessed using linear and logistic regression models. Less than half of the households (43.8%) had safe water, and safe versus unsafe water did not correlate with improved versus unimproved water source.

In adjusted linear regression models, children from households with safe water had significantly lower log-transformed (ln) L:M ratios (β: -0.22, 95% CI: -0.44, -0.00) and significantly higher length-for-age (β: 0.29, 95% CI: 0.00, 0.58) and weight-for-age (β: 0.20, 95% CI: 0.05, 0.34) Z-scores at 12-16 months.

Furthermore, in adjusted linear regression models, ln L:M ratios at 12-16 months significantly decreased with increasing length-for-age Z-scores at birth, 6 months, and 9 months (β: -0.05, 95% CI: -0.10, -0.004; β: -0.06, 95% CI: -0.11, -0.006; and β: -0.05, 95% CI: -0.09, -0.005, respectively).

Overall, our data suggest that programs seeking to improve nutrition should address poor WASH conditions simultaneously, particularly related to household drinking water quality.

Acknowledgments: We would like to express special gratitude to the study participants in southwestern Uganda; the Feed the Future Innovation Lab for Nutrition team based at Tufts University in Boston, MA; and the UBCS team based at Makerere University in Kampala, Uganda. We also wish to acknowledge Wafai Fawzi and Nilupa Gunaratna for their contributions to the UBCS design and implementation.

Financial support: Support for this effort was provided by the Feed the Future Innovation Lab for Nutrition at Tufts University, supported by the United States Agency for International Development (award AIDOAA- L-10-00006). C. P. D. was supported in part by National Institutes of Health (NIH) grants K24DK104676 and 2P30 DK040561. Funding sources had no role in the publication process including the analysis of data or the writing of the manuscript.

WHO; IWA – Strengthening operations & maintenance through water safety planning

Strengthening operations & maintenance through water safety planning: A collection of case studies. WHO; IWA, September 2018. who

Strong operations and maintenance (O&M) programmes underpin the effectiveness and sustainability of drinking-water supply systems. Increased attention to and investment in O&M is needed to ensure that water safety and service delivery targets are consistently met and that public health is protected.

Water safety plans (WSPs) are a valuable tool to strengthen O&M programmes, and may contribute to improved O&M by supporting the systematic assessment, prioritization and management of risks from catchment to consumer, including those related to inadequate O&M.

This document presents case studies from lower and higher income settings around the world that highlight O&M benefits resulting from WSP implementation. These case studies contribute to a growing body of information on the outcomes of water safety planning and may be useful in building support for WSPs among water sector senior managers, operational staff and other stakeholders.