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International Journal of Environmental... Aug 2014International monitoring of drinking water and sanitation shapes awareness of countries' needs and informs policy, implementation and research efforts to extend and... (Review)
Review
International monitoring of drinking water and sanitation shapes awareness of countries' needs and informs policy, implementation and research efforts to extend and improve services. The Millennium Development Goals established global targets for drinking water and sanitation access; progress towards these targets, facilitated by international monitoring, has contributed to reducing the global disease burden and increasing quality of life. The experiences of the MDG period generated important lessons about the strengths and limitations of current approaches to defining and monitoring access to drinking water and sanitation. The methods by which the Joint Monitoring Programme (JMP) of WHO and UNICEF tracks access and progress are based on analysis of data from household surveys and linear regression modelling of these results over time. These methods provide nationally representative and internationally comparable insights into the drinking water and sanitation facilities used by populations worldwide, but also have substantial limitations: current methods do not address water quality, equity of access, or extra-household services. Improved statistical methods are needed to better model temporal trends. This article describes and critically reviews JMP methods in detail for the first time. It also explores the impact of, and future directions for, international monitoring of drinking water and sanitation.
Topics: Environmental Monitoring; History, 20th Century; History, 21st Century; International Cooperation; Sanitation; United Nations; Water Supply; World Health Organization
PubMed: 25116635
DOI: 10.3390/ijerph110808137 -
American Journal of Public Health Feb 2012
Topics: Female; Humans; Hygiene; Sanitation
PubMed: 22390432
DOI: 10.2105/AJPH.2011.300419 -
International Journal of Environmental... Dec 2019Three of four recent major sanitation intervention trials found no effect on diarrhea. These results conflicted with longstanding beliefs from decades of literature. To... (Meta-Analysis)
Meta-Analysis Review
Three of four recent major sanitation intervention trials found no effect on diarrhea. These results conflicted with longstanding beliefs from decades of literature. To understand this discordance, we placed recent trials into the historical context that preceded them in two ways. First, we evaluated the history of published literature reviews on sanitation and diarrhea. Second, we conducted meta-analyses on studies from the most recent systematic review to uncover features that predict effectiveness. We found that 13 literature reviews dating to 1983 consistently estimated a significant protective effect of sanitation against diarrhea. However, these were marred by flawed studies and inappropriately averaged effects across widely heterogeneous interventions and contexts. Our meta-analyses highlight that the overall effect of sanitation on diarrhea was largely driven by sewerage and interventions that improved more than sanitation alone. There is no true overall effect of sanitation because variability between intervention types and implementation contexts is too complex to average. Ultimately, the null effects of recent latrine interventions are not surprising. Instead, the one trial that found a strong relative reduction in diarrhea is the historical outlier. The development of transformative sanitation interventions requires a better understanding of the social and environmental contexts that determine intervention effectiveness.
Topics: Diarrhea; Humans; Research Design; Review Literature as Topic; Sanitation; Sewage; Toilet Facilities; Water Supply
PubMed: 31905628
DOI: 10.3390/ijerph17010230 -
Maternal & Child Nutrition Oct 2019Poultry production in low income countries provides households with nutrient-rich meat and egg products, as well as cash income. However, traditional production systems...
Poultry production in low income countries provides households with nutrient-rich meat and egg products, as well as cash income. However, traditional production systems present potential health and nutrition risks because poultry scavenging around household compounds may increase children's exposure to livestock-related pathogens. Data from a cross-sectional survey were analysed to examine associations between poultry, water, sanitation, and hygiene practices, and anthropometric indicators in children (6-59 months; n = 3,230) in Burkina Faso. Multilevel regression was used to account for the hierarchical nature of the data. The prevalence of stunting and wasting in children 6-24 months was 19% and 17%, respectively, compared with a prevalence of 26% and 6%, respectively, in children 25-60 months. Over 90% of households owned poultry, and chicken faeces were visible in 70% of compounds. Caregivers reported that 3% of children consumed eggs during a 24-hr recall. The presence of poultry faeces was associated with poultry flock size, poultry-husbandry and household hygiene practices. Having an improved water source and a child visibly clean was associated with higher height-for-age z scores (HAZ). The presence of chicken faeces was associated with lower weight-for-height z scores, and no associations were found with HAZ. Low levels of poultry flock size and poultry consumption in Burkina Faso suggest there is scope to expand production and improve diets in children, including increasing chicken and egg consumption. However, to minimize potential child health risks associated with expanding informal poultry production, research is required to understand the mechanisms through which cohabitation with poultry adversely affects child health and design interventions to minimize these risks.
Topics: Animal Husbandry; Animals; Anthropometry; Burkina Faso; Child, Preschool; Diet; Female; Growth Disorders; Humans; Hygiene; Infant; Male; Nutritional Status; Poultry; Rural Population; Sanitation; Water Supply
PubMed: 30912287
DOI: 10.1111/mcn.12818 -
Journal of Environmental and Public... 2015Inadequate urban sanitation disproportionately impacts the social determinants of women's health in informal settlements or slums. The impacts on women's health include... (Review)
Review
Inadequate urban sanitation disproportionately impacts the social determinants of women's health in informal settlements or slums. The impacts on women's health include infectious and chronic illnesses, violence, food contamination and malnutrition, economic and educational attainment, and indignity. We used household survey data to report on self-rated health and sociodemographic, housing, and infrastructure conditions in the Mathare informal settlement in Nairobi, Kenya. We combined quantitative survey and mapping data with qualitative focus group information to better understand the relationships between environmental sanitation and the social determinants of women and girls' health in the Mathare slum. We find that an average of eighty-five households in Mathare share one toilet, only 15% of households have access to a private toilet, and the average distance to a public toilet is over 52 meters. Eighty-three percent of households without a private toilet report poor health. Mathare women report violence (68%), respiratory illness/cough (46%), diabetes (33%), and diarrhea (30%) as the most frequent physical burdens. Inadequate, unsafe, and unhygienic sanitation results in multiple and overlapping health, economic, and social impacts that disproportionately impact women and girls living in urban informal settlements.
Topics: Cities; Kenya; Poverty Areas; Sanitation; Socioeconomic Factors; Urban Population; Women's Health
PubMed: 26060499
DOI: 10.1155/2015/209505 -
Bulletin of the World Health... Jun 2018
Topics: Cholera; Cholera Vaccines; Developing Countries; Humans; Hygiene; Sanitation; Water Purification; Water Supply
PubMed: 29904216
DOI: 10.2471/BLT.18.213678 -
International Journal of Environmental... Jun 2019Water-, sanitation-, and hygiene-related diseases are killing many people each year in developing countries, including Rwanda, and children under the age of five are the...
Water-, sanitation-, and hygiene-related diseases are killing many people each year in developing countries, including Rwanda, and children under the age of five are the most vulnerable. This research assessed human waste disposal practices, knowledge on diseases caused by contact with human faeces, and knowledge on causes and prevention of selected WASH-related diseases. One thousand one hundred and seventy-three students were interviewed out of 2900 students. The results showed, regarding students' waste disposal practices, that 96.3% use latrines, 20.5% practice open defecation in bushes, and 3.2% defecate in water bodies. Regarding knowledge on diseases caused by contact with human faeces, 56.9% responded that they were aware of cholera, 26.5% of diarrhoea, 2.2% of dysentery, 0.3% of malaria, 0.1% of shigellosis, and 3.8% of typhoid. The majority of the respondents, between 50-99%, could not identify the main causes of the WASH-related diseases. This paper also showed that students lack health knowledge in regard to WASH-related diseases' causes and prevention. Therefore, the provision of water and sanitation infrastructures should go with the provision of health education on how to avoid these diseases and possible ways to improve the well-being of the students both at home and in their various schools.
Topics: Child; Defecation; Developing Countries; Diarrhea; Feces; Female; Health Education; Health Knowledge, Attitudes, Practice; Humans; Hygiene; Male; Refuse Disposal; Rwanda; Sanitation; Schools; Students; Toilet Facilities
PubMed: 31185642
DOI: 10.3390/ijerph16112052 -
BMJ Open Jul 2022Equitable and affordable access to improved sanitation facilities is linked to health and is among the priority areas of development programmes in a country like India....
OBJECTIVE
Equitable and affordable access to improved sanitation facilities is linked to health and is among the priority areas of development programmes in a country like India. This study assesses the level of different sanitation facilities accessed by households and attempts to understand the socioeconomic characteristics of the households that received financial benefits from the (), a Government of India flagship programme.
DESIGN
Cross-sectional study.
SETTING AND PARTICIPANTS
The study extracted data from the 76th round (2018) of the National Sample Survey, consisting of 106 837 households in India.
OUTCOME MEASURES
Sanitation services and benefits received from the Swachh Bharat Mission in the last 3 years preceding the survey were the two outcome variables of this study. Bivariate and multinomial logistic regression analysis were performed to identify factors associated with the outcome variables.
RESULTS
Findings show the existence of state and regional disparities, along with rural-urban gaps, in the accessibility of sanitation facilities. Half of the households (52%, n=55 555) had access to safely managed sanitation facilities, followed by basic services (14.8%, n=15 812), limited services (11.4%, n=12 179) and unimproved services/open defecation (21.8%, n=23 290). Limited and unimproved facilities decreased significantly (p<0.001) with increase in economic status, although poor and less educated households received the maximum benefit from the Swachh Bharat Mission.
CONCLUSION
The mission has been successful in increasing access overall; however, many people continue to lack access to improved sanitation and there remains a need to follow up poor and rural households to determine their usage of and the current state of their sanitation facilities.
Topics: Cross-Sectional Studies; Family Characteristics; Humans; India; Rural Population; Sanitation; Socioeconomic Factors; Toilet Facilities
PubMed: 35906052
DOI: 10.1136/bmjopen-2021-060118 -
International Journal of Environmental... Jan 2019Public health has always been, and remains, an interdisciplinary field, and engineering was closely aligned with public health for many years. Indeed, the branch of... (Review)
Review
Public health has always been, and remains, an interdisciplinary field, and engineering was closely aligned with public health for many years. Indeed, the branch of engineering that has been known at various times as sanitary engineering, public health engineering, or environmental engineering was integral to the emergence of public health as a distinct discipline. However, in the United States (U.S.) during the 20th century, the academic preparation and practice of this branch of engineering became largely separated from public health. Various factors contributed to this separation, including an evolution in leadership roles within public health; increasing specialization within public health; and the emerging environmental movement, which led to the creation of the U.S. Environmental Protection Agency (EPA), with its emphasis on the natural environment. In this paper, we consider these factors in turn. We also present a case study example of public health engineering in current practice in the U.S. that has had large-scale positive health impacts through improving water and sanitation services in Native American and Alaska Native communities. We also consider briefly how to educate engineers to work in public health in the modern world, and the benefits and challenges associated with that process. We close by discussing the global implications of public health engineering and the need to re-integrate engineering into public health practice and strengthen the connection between the two fields.
Topics: Alaska Natives; Engineering; History, 20th Century; Humans; Indians, North American; Public Health; Sanitary Engineering; Sanitation; United States; Water Supply
PubMed: 30700061
DOI: 10.3390/ijerph16030387 -
PLoS Neglected Tropical Diseases Jun 2017A lack of access to sanitation is an important risk factor child health, facilitating fecal-oral transmission of pathogens including soil-transmitted helminthes and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
A lack of access to sanitation is an important risk factor child health, facilitating fecal-oral transmission of pathogens including soil-transmitted helminthes and various causes of diarrheal disease. We conducted a meta-analysis of cross-sectional surveys to determine the impact that community-level sanitation access has on child health for children with and without household sanitation access.
METHODOLOGY/PRINCIPAL FINDINGS
Using 301 two-stage demographic health surveys and multiple indicator cluster surveys conducted between 1990 and 2015 we calculated the sanitation access in the community as the proportion of households in the sampled cluster that had household access to any type of sanitation facility. We then conducted exact matching of children based on various predictors of living in a community with high access to sanitation. Using logistic regression with the matched group as a random intercept we examined the association between the child health outcomes of stunted growth, any anemia, moderate or severe anemia, and diarrhea in the previous two weeks and the exposure of living in a community with varying degrees of community-level sanitation access. For children with household-level sanitation access, living in a community with 100% sanitation access was associated with lowered odds of stunting (adjusted odds ratio [AOR] = 0.97, 95%; confidence interval (CI) = 0.94-1.00; n = 14,153 matched groups, 1,175,167 children), any anemia (AOR = 0.73; 95% CI = 0.67-0.78; n = 5,319 matched groups, 299,033 children), moderate or severe anemia (AOR = 0.72, 95% CI = 0.68-0.77; n = 5,319 matched groups, 299,033 children) and diarrhea (AOR = 0.94; 95% CI = 0.91-0.97); n = 16,379 matched groups, 1,603,731 children) compared to living in a community with < 30% sanitation access. For children without household-level sanitation access, living in communities with 0% sanitation access was associated with higher odds of stunting (AOR = 1.04, 95% CI = 1.02-1.06; n = 14,153 matched groups, 1,175,167 children), any anemia (AOR = 1.05, 95% CI = 1.00-1.09; n = 5,319 matched groups, 299,033 children), moderate or severe anemia (AOR = 1.04, 95% CI = 1.00-1.09; n = 5,319 matched groups, 299,033 children) but not diarrhea (AOR = 1.00, 95% CI = 0.98-1.02; n = 16,379 matched groups, 1,603,731 children) compared to children without household-level sanitation access living in communities with 1-30% sanitation access.
CONCLUSIONS/SIGNIFICANCE
Community-level sanitation access is associated with improved child health outcomes independent of household-level sanitation access. The proportion of children living in communities with 100% sanitation access throughout the world is appallingly low. Ensuring sanitation access to all by 2030 will greatly improve child health.
Topics: Anemia; Child, Preschool; Cross-Sectional Studies; Diarrhea; Family Characteristics; Female; Growth Disorders; Health Surveys; Humans; Infant; Logistic Models; Male; Multicenter Studies as Topic; Odds Ratio; Risk Factors; Sanitation
PubMed: 28594828
DOI: 10.1371/journal.pntd.0005591