Category Archives: Sanitation and Health

Senator Bill Frist – Make water a top global priority. It’s the best, cheapest way to save lives

Make water a top global priority. It’s the best, cheapest way to save lives: Frist. USA Today, August 15, 2018.

The best way to save lives and prevent outbreaks of threats like Ebola is water in health facilities. Congress and the world need to meet this challenge. 

frist

(Photo: Al-hadji Kudra Maliro/AP)

This summer has seen the unprecedented and simultaneous outbreak of six of eight diseases posing the greatest threats to public health, according to the World Health Organization.

You’d think that after the alarmingly fast spread of Ebola in West Africa just a few years ago, we’d have learned our lesson.

Instead, the health intervention that has saved more lives than any other in recorded history remains alarmingly absent in global health care. That poses an immediate and long-term danger to us all.

We call it WASH — water, sanitation and hygiene. It’s the most critical resource in my preparation for every surgical procedure I performed over my lifetime, and it is dismally deficient or nonexistent in hundreds of thousands of health care facilities around the world.

Read the complete article.

Sanitation and health: what do we want to know?

Experts meet to discuss reaching a consensus on what the evidence tells us.

Radu Ban

Radu Ban

Jan Willem Rosenboom

Jan Willem Rosenbom

This is the first of two blogs written about the “Sanitation and health evidence consensus meeting”, convened by the World Health Organization (WHO) in Seattle on May 24 and 25 of 2018. It was written by Jan Willem Rosenboom and Radu Ban, who are both Sr. Program Officers on the Water, Sanitation and Hygiene (WSH) team at the Bill & Melinda Gates Foundation. This first blog will describe the process used to arrive at the consensus, while the second blog will describe the outcome of the consensus and will come out once the results of the consensus meeting have been published. Also, mark your calendars for a session during the 2018 UNC Water and Health conference dedicated to this consensus!

Cambodia - India Two sides of sanitation rubbish and cleanliness. Credit Bill & Melinda Gates Foundation

Two sides of sanitation: rubbish and cleanliness. Credit Bill & Melinda Gates Foundation, Cambodia/India

Introduction: What is this about?

It is hard to imagine that making improvements in sanitation wouldn’t play a role in improving health. After all, we know that shit spreads disease and the F diagram shows us that sanitation is an important tool in blocking the transmission of pathogens from one person to the next, thus lowering exposure. And sure enough: we have strong evidence about the effectiveness of sanitation interventions and improving health and human capital outcomes from rigorous historical studies, from high- as well as low- and middle-income countries.

At the same time, looking at the specific impact of programmatic sanitation interventions, it can be hard to figure out what the evidence is really telling us. On the one hand, a systematic review of the whole body of evidence on sanitation and health (carried out by Freeman et al. in 2017) suggests that sanitation protects against diarrhoea, active trachoma, some soil-transmitted helminth (STH) infections and schistosomiasis. It also improves height-for-age scores of children (i.e. it decreases stunting, which is an important measure of human capacity). On the other hand, several recent sanitation intervention studies have found limited or no impact on different health outcomes. The table below (copied with permission from a presentation by Tom Clasen), provides a summary of key findings from the most recent sanitation studies:

Sanitation blog - Summary of effects from recent sanitation studies

  1. Fewer observed flies and feces; no change in fecal contamination of water
  2. Fewer observed soiled hands and less fecal contamination of water
  3. Except in the study arm considering just water quality improvements

This seeming lack of agreement is confusing, and partly in response to questions from practitioners, on May 24 and 25 of this year WHO convened a meeting of experts to review the existing evidence and reach a consensus about what it is telling us. The group of experts consisted of researchers across multiple disciplines who had written extensively on the topic of sanitation and health. We thought it was necessary to reach consensus among researchers before engaging, in a unified voice, the practitioner community.

At the same time, to make sure that the concerns of practitioners would be considered in the meeting, we published a “request for input” online (through the SuSanA network as well as the Sanitation Updates blog) and we will summarise the responses here. But first…

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The Clean Clinic Approach: Strengthening WASH in Health Care Facilities to Improve Health Outcome for Mothers and Newborns

The Clean Clinic Approach: Strengthening WASH in Health Care Facilities to Improve Health Outcome for Mothers and Newborns

Stephen Sara, the WASH Team Lead on USAID’s Flagship Maternal and Child Survival Program (MCSP) discusses the Clean Clinic Approach, MCSP’s approach for improving WASH in health care facilities. usaid

The approach focuses on facilitating incremental, low-cost WASH improvements to support maternal and newborn health outcomes.

The webinar will review existing standards and tools, discuss the relationship between WASH and infection prevention & control (IPC) and share experiences and lessons learned from implementing the Clean Clinic Approach as part of an integrated health program.

Link to webinar.

Urban sanitation coverage and environmental fecal contamination: Links between the household and public environments of Accra, Ghana

Urban sanitation coverage and environmental fecal contamination: Links between the household and public environments of Accra, Ghana. PLoS One, July 2018.

Exposure to fecal contamination in public areas, especially in dense, urban environments, may significantly contribute to enteric infection risk. This study examined associations between sanitation and fecal contamination in public environments in four low-income neighborhoods in Accra, Ghana.

Soil (n = 72) and open drain (n = 90) samples were tested for Ecoli, adenovirus, and norovirus. Sanitation facilities in surveyed households (n = 793) were categorized by onsite fecal sludge containment (“contained” vs. “uncontained”) using previous Joint Monitoring Program infrastructure guidelines. Most sanitation facilities were shared by multiple households.

Associations between spatial clustering of household sanitation coverage and fecal contamination were examined, controlling for neighborhood and population density (measured as enumeration areas in the 2010 census and spatially matched to sample locations). Ecoli concentrations in drains within 50m of clusters of contained household sanitation were more than 3 log-units lower than those outside of clusters.

Further, although results were not always statistically significant, Ecoli concentrations in drains showed consistent trends with household sanitation coverage clusters: concentrations were lower in or near clusters of high coverage of household sanitation facilities—especially contained facilities—and vice versa.

Virus detection in drains and Ecoli concentrations in soil were not significantly associated with clustering of any type of household sanitation and did not exhibit consistent trends. Population density alone was not significantly associated with any of the fecal contamination outcomes by itself and was a significant, yet inconsistent, effect modifier of the association between sanitation clusters and Ecoli concentrations.

These findings suggest clustering of contained household sanitation, even when shared, may be associated with lower levels of fecal contamination within drains in the immediate public domain. Further research is needed to better quantify these relationships and examine impacts on health.

July 9th webinar – The Clean Clinic Approach: Strengthening WASH in Health Care Facilities to Improve Health Outcome for Mothers and Newborns

The Clean Clinic Approach: Strengthening WASH in Health Care Facilities to Improve Health Outcome for Mothers and Newborns

    • Monday July 09, 2018
    • 8:00 a.m.- 9:30 a.m. EST

Dear Colleagues,

We cordially invite you to join us for a webinar presentation by Stephen Sara, the WASH Team Lead on USAID’s Flagship Maternal and Child Survival Program (MCSP) on implementing the Clean Clinic Approach, MCSP’s approach for improving WASH in health care facilities. usaidmcsp

The approach focuses on facilitating incremental, low-cost WASH improvements to support maternal and newborn health outcomes. The webinar will review existing standards and tools, discuss the relationship between WASH and infection prevention & control (IPC) and share experiences and lessons learned from implementing the Clean Clinic Approach as part of an integrated health program.

Kindly note that we will plan to hold webinar again later in July (in the evening US time) for participants who are not able to attend this session due to being on a different time zone.  The webinar will also be recorded and available for playback as well.

Join Skype Meeting

https://meet.lync.com/savechildrenusa/ssara/MRN9W892

2018 studies, reports and news updates on cholera prevention and control

The latest biweekly update contains journal articles, reports, etc. that have been published so far in 2018. Please let us know if you have additional studies and resources that should be added to this list:

OPEN ACCESS JOURNAL ARTICLES

Setting priorities for humanitarian water, sanitation and hygiene research: a meeting report. Conflict and Health, June 15, 2018.
In June 2017, the Research for Health in Humanitarian Crises (R2HC) programme of Elrha, convened a meeting of representatives from international response agencies, research institutions and donor organisations active in the field of humanitarian WASH to identify research priorities, discuss challenges conducting research and to establish next steps. Topics including cholera transmission, menstrual hygiene management, and acute undernutrition were identified as research priorities.

Cholera epidemic in Yemen, 2016–18: an analysis of surveillance data. The Lancet Global Health, June 2018.
Our analysis suggests that the small first cholera epidemic wave seeded cholera across Yemen during the dry season. When the rains returned in April, 2017, they triggered widespread cholera transmission that led to the large second wave. These results suggest that cholera could resurge during the ongoing 2018 rainy season if transmission remains active.

Editorial: No end to cholera without basic water, sanitation and hygiene. WHO Bulletin, May 2018.
A shared vision and unanimous agreement among Member States, partners and donors to prioritize broader social and environmental determinants of health, including water, sanitation and hygiene, is needed to end cholera.

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SuSanA webinar: The Bill Please: Financing O&M, a Global Perspective on June 7, 2018 (13:00 CEST)

jordan

Sanitation for Millions (S4M) programme funded by German Ministry for Economic Cooperation and Development (BMZ) and Bill and Melinda Gates Foundation (BMGF) aims at improving sustainable access to sanitation and the hygiene situation among impoverished and vulnerable populations on a global level. Currently being implemented in Jordan, Pakistan and Uganda, S4M aims at gathering experience and best practices for upscaling und dissemination.

Ensuring sustainable operation and maintenance (O&M) of sanitary facilities in public institutions is one of the core focuses of the S4M programme and poses a serious /difficult challenge until date. For instance increasing vandalism affects the maintenance of sanitary facilities in schools for boys. Sustainable O&M requires planning and budgeting to carry out the necessary tasks. Decisions on who should fund sanitation O&M for public institutions and how, receives far less attention than design and construction activities.

Join us for a webinar on June 7, 2018 at 13:00 hrs (Central European Summer Time/ Berlin Time) with S4M experts in Uganda, Pakistan and Jordan. They will share their experiences with the challenge of sourcing and allocating financial resources to O&M procedures along the whole sanitation chain.

Presenters:
Christian Rieck, GIZ Uganda
Bjoern Lobo Zimprich, GIZ Jordan
Hashim Khan, GIZ Pakistan

Registrations for this webinar is open now.
www.susana.org/en/susana-webinar-the-bill-please

The webinar will take place on Adobe Connect under the following link: seint.adobeconnect.com/seiwebinar/ 

What kind of O&M challenges do you face? Do share with us below.