A community demand-driven approach toward sustainable water and sanitation infrastructure development

Hubbard, Brian; Sarisky, John; Gelting, Richard J.; Baffigo, Virginia; Seminario, Raul; Centurion, Carlos

doi:10.1016/j.ijheh.2011.05.005

Cited by 22 publications

(22 citation statements)

References 12 publications

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“…26,[53][54][55] Although children can be effective promotors of health messages received at school to their family members, 53,56 our findings are in line with previous studies showing that uptake and translation of health messages to effective behavior changes at their homes may be difficult to achieve (as changing practices takes time; e.g., to safely store and treat drinking water, but also due to key constraints such as water scarcity). [53][54][55] A closer involvement of communities and households in school-based programs with a stronger household and community component might be necessary to achieve sustained and meaningful long-term effects for children's health and well-being. 7,13 Additionally, more comprehensive nutritional and agricultural interventions may be needed given the high rates of undernutrition found in our study regions.…”

Section: Discussionsupporting

confidence: 88%

School Children’s Intestinal Parasite and Nutritional Status One Year after Complementary School Garden, Nutrition, Water, Sanitation, and Hygiene Interventions in Burkina Faso

Erismann

Diagbouga

Schindler

et al. 2017

The American Journal of Tropical Medicine and Hygiene

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The potential health benefits of combined agricultural, nutrition, water, sanitation, and hygiene (WASH) interventions are poorly understood. We aimed to determine whether complementary school garden, nutrition, and WASH interventions reduce intestinal parasites and improve school children's nutritional status in two regions of Burkina Faso. A cluster-randomized controlled trial was conducted in the Plateau Central and Center-Ouest regions of Burkina Faso. A total of 360 randomly selected children, aged 8-15 years, had complete baseline and end-line survey data. Mixed regression models were used to assess the impact of the interventions, controlling for baseline characteristics. The prevalence of intestinal parasitic infections decreased both in intervention and control schools, but the decrease was significantly higher in the intervention schools related to the control schools (odds ratio [OR] of the intervention effect = 0.2, 95% confidence interval [CI] = 0.1-0.5). Indices of undernutrition did not decrease at end-line in intervention schools. Safe handwashing practices before eating and the use of latrines at schools were significantly higher in the intervention schools than in the control schools at end-line (OR = 6.9, 95% CI = 1.4-34.4, and OR = 14.9, 95% CI = 1.4-153.9, respectively). Parameters of water quality remained unchanged. A combination of agricultural, nutritional, and WASH-related interventions embedded in the social-ecological systems and delivered through the school platform improved several child health outcomes, including intestinal parasitic infections and some WASH-related behaviors. Sustained interventions with stronger household and community-based components are, however, needed to improve school children's health in the long-term.

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Section: Discussionsupporting

confidence: 88%

School Children’s Intestinal Parasite and Nutritional Status One Year after Complementary School Garden, Nutrition, Water, Sanitation, and Hygiene Interventions in Burkina Faso

Erismann

Diagbouga

Schindler

et al. 2017

The American Journal of Tropical Medicine and Hygiene

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“…Conversely, households that used UD toilets and kept them clean were associated with decreased microbial contamination of drinking water and decreased rates of health outcomes. There is ample evidence that defecation practices (open defecation vs. UD toilets or pit latrines) contributes to poor microbial quality of drinking water and increase in health outcomes such as diarrhoea (VanDerslice and Briscoe, 1995;Root, 2001;Trevett et al, 2005;Trevett and Carter, 2008;Hubbard et al, 2011). It has also been shown that when open defecation is practised, people are less likely to wash their hands (Trevett et al, 2004;Isunju et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

“…However, the link between human health and microbial drinking water quality in isolation has been contested. Whilst some studies have shown that good microbial quality of drinking water is related to a reduction in health outcomes (Payment et al, 1991(Payment et al, , 1993, other studies suggest that a reduction in health outcomes is more likely to be achieved through the provision of good quality and quantity of water in conjunction with proper hygiene practices and good sanitation (Esrey et al, 1991;Payment et al, 1993;Peter, 2010;Hubbard et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Microbial quality of drinking water from groundtanks and tankers at source and point-of-use in eThekwini Municipality, South Africa, and its relationship to health outcomes

Singh¹,

Lutchmanariyan²,

Wright³

et al. 2013

WSA

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Drinking water quality was investigated at source and corresponding point-of-use in 2 peri-urban areas receiving drinking water either by communal water tanker or by delivery directly from the distribution system to household-based groundtanks with taps. Water quality variables measured were heterotrophic bacteria, total coliforms, E. coli, conductivity, turbidity, pH, and total and residual chlorine. Water quality data were analysed together with an existing epidemiological database to investigate links between microbial quality of drinking water, household demographics, health outcomes, socio-economic status, hygiene and sanitation practices. Groundtank households had better quality drinking water than households using storage containers filled from communal tankers. Uncovered storage containers had the poorest microbial water quality among all storage containers. All stored water did not meet drinking water standards, although mains water did. Households with children under 5 years and using open-topped containers had the poorest water quality overall. Households with groundtanks had the best water quality at point-of-use, but did not have the lowest occurrence of health effects. Although groundtanks were supplied together with urine diversion (UD) toilets and hygiene education, groundtank households showed overall poorer hygiene practices than tanker-supplied households, and some groundtank households with UD toilets preferred to continue using open defecation. Households that practised open defecation had higher levels of E. coli in their drinking water and higher rates of adverse health outcomes. Poorer socio-economic standing and lower educational standard were associated with poorer water quality, poorer hygiene practices and higher rates of diarrhoea and vomiting.

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“…High levels of social cohesion and connectedness is an enabler of efforts to access external funds or mobilise community resources (21,46,50,70). Involvement of a broad range of community members in water and sanitation initiatives can promote a collective sense of ownership, which, in turn, can facilitate social cohesion and connectedness by providing opportunities for a community to share a common goal (8,71,72). By promoting community ownership of a resource, involving community members in capacity building (e.g.…”

Section: Accessmentioning

confidence: 99%

How community engagement in water and sanitation interventions impacts human health, infrastructure and service longevity in low- and middle-income countries: a realist review

Nelson

Drabarek

Jenkins

et al. 2020

Preprint

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Background Access to safe water and sanitation is considered a basic human right and a focus of the Sustainable Development Goals. However, many water and sanitation interventions do not have long lasting impacts in communities and are generally associated with high levels of failure. Limited information is available to understand what types of interventions work for whom and under what circumstances. Methods A realist review to understand how, and under what circumstances community engagement in water and sanitation interventions impacts access (to safe water and sanitation), change (in health status or behaviour), and sustainability (of resources and services). We systematically searched PubMed, Web of Science and Scopus databases to identify studies from low- and middle-income countries.Results We reviewed 56 studies conducted in 25 countries. We identified five mechanisms that explain access, change and sustainability outcomes: 1) accountability (policies and procedures to hold communities and committees responsible for their actions and outcomes of an initiative), 2) diffusion (spread of an idea or behaviour by innovators over time through communication amongst members of a community), 3) market (the interplay between demand and supply of a service or resource), 4) ownership (sense of possession and control of the service or resource), and 5) shame (a feeling of disgust in one’s behaviour or actions). Contextual elements identified include: community location, communities with similar characteristics, communication, leadership, fines/penalties, seasonality, resource dependency, access to resources and funding, community financial and technical skills and knowledge, leadership, ongoing support and acknowledgement of change, community connectedness and social cohesion, community willingness to pay, committees that followed and understood responsibilities, rules and management plans, active committees with women and community/committee involvement in the design, planning or implementation of the intervention. Conclusion The findings highlight five key mechanisms, impacted by 19 contextual factors that explain outcomes of community-based water and sanitation interventions. Policy makers, program implementers and institutions need to consider community dynamics, location, resources, committees and level of community involvement, prior to the introduction of community-based water and sanitation interventions.

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A community demand-driven approach toward sustainable water and sanitation infrastructure development

Cited by 22 publications

References 12 publications

School Children’s Intestinal Parasite and Nutritional Status One Year after Complementary School Garden, Nutrition, Water, Sanitation, and Hygiene Interventions in Burkina Faso

School Children’s Intestinal Parasite and Nutritional Status One Year after Complementary School Garden, Nutrition, Water, Sanitation, and Hygiene Interventions in Burkina Faso

Microbial quality of drinking water from groundtanks and tankers at source and point-of-use in eThekwini Municipality, South Africa, and its relationship to health outcomes

How community engagement in water and sanitation interventions impacts human health, infrastructure and service longevity in low- and middle-income countries: a realist review

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