Tag Archives: Research

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…

Continue reading

Empirical Study of Urban WASH Impacts: Research on the Relationship of Population Density and Neighborhood-Level Sanitation…

Empirical Study of Urban WASH Impacts: Research on the Relationship of Population Density and Neighborhood-Level Sanitation Access to Fecal-Associated Health Impacts

RFA#:WASH2013-001 traction

  • Status:Posted:March 18, 2013
  • Questions Due:Monday, April 1, 2013, 5:00pm (EST)
  • Applications Due: Monday, April 29, 2013, 5:00pm (EST)

The purpose of this Request for Applications (RFA) is to fund research that will more fully characterize the relative health impact (i.e., diarrheal diseases, STH infections, and anthropometric measures in children) of sanitation coverage in areas marked by high population densities compared to those with lower population densities.

The TRAction Project anticipates making one award not to exceed 2,000,000 USD to achieve the purpose of this RFA.

Results of this research will be shared with national decision-makers, program implementers, researchers, and other stakeholders to promote learning and inform the targeting of sanitation interventions.

Attachment Size
Appendix E_TEMPLATE SubAgreement Template.pdf 139.19 KB
WASH RFA– Empirical Study of Urban WASH Impacts.pdf 364.74 KB
budget template.xls 153 KB

Desk Review Study of Urban WASH Impacts: Research on the Relationship of Population Density…

Desk Review Study of Urban WASH Impacts: Research on the Relationship of Population Density and Neighborhood-Level Sanitation Access to Fecal-Associated Health Impacts

RFA#:WASH2013-002 traction

  • Status:Current
  • Posted:March 18, 2013
  • Questions Due:Monday, April 1, 2013, 5:00pm (EST)
  • Applications Due:Monday, April 29, 2013, 5:00pm (EST)

The purpose of this Request for Applications (RFA) is to fund research involving the secondary analysis of data that will more fully characterize the relative health impact (i.e., diarrheal diseases, STH infections, and anthropometric measures in children) of sanitation coverage in areas marked by high population densities compared to those with lower population densities.

The TRAction Project anticipates making one or more awards of approximately 50,000-100,000 USD each to achieve the purpose of this RFA.

Results of this research will be shared with national decision-makers, program implementers, researchers, and other stakeholders to promote learning and inform the targeting of sanitation interventions.

Attachment Size
WASH RFA– Desk Review Study of Urban WASH Impacts.pdf 376.06 KB
Appendix E_TEMPLATE SubAgreement Template.pdf 139.19 KB
budget template.xls 153 KB

Ethiopia: Researchers to Tighten Gap in Water, Sanitation Policies

Adama — Researches and intensive discussions help to tighten the gap between policy issues of the Water and Sanitation Sector (WSS), said the Research, Development and Coordination Department of the Ministry of Water Resource.

At the consultative forum held on Friday under the theme of “Financing WASH” in Adama, Abity Getaneh, Department’s Irrigation and Drainage Research Coordinator in the Ministry, said Ethiopia has a huge benefit to earn from both researchers and practitioners of the WSS. “A host of institutions across the country are now deeply involved in providing teaching, research, and practical inputs to learning process in the sector” he said.

Abity on the one day consultative meeting added that a number of active networks and forum are improving sector coordination and enhancing the overall understanding of the challenges in the implementation of sustainable water and sanitation services.

The purpose of the Forum for Learning on Water and Sanitation (FLoWS) is providing an umbrella under which learning across networks forum can be shared more effectively and specifically as well as fostering sector understanding of the multi-stakeholder forum point. This will strengthen the capacity for the Ethiopian WSS sector to link learning and research to key policy processes across the year and support delivery of Multi-Stake holders Forum (MSF) undertakings.

Read More – Daily Monitor