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WaterAid – Assessing the water, sanitation and hygiene needs of people living with HIV and AIDS in Papua New Guinea

Wed, 2014-07-30 16:25

Assessing the water, sanitation and hygiene needs of people living with HIV and AIDS in Papua New Guinea, 2014. WaterAid.

The research revealed that people living with HIV in PNG have increased needs for WASH, and that these needs are not being adequately met. Stigma and discrimination were found to be barriers to access to WASH for respondents and their families. In addition, this study identified priority areas for service providers to direct future activities and best integrate WASH into programming for people living with HIV. Priority areas include hygiene education, safe treatment and storage of water, self-treatment for diarrhoea, latrine construction, and education around the transmission of HIV.

Filed under: East Asia & Pacific, Sanitation and Health Tagged: Papua New Guinea, WASH and HIV/AIDS

UNESCO-IHE – Smart eSOS toilet for emergencies

Tue, 2014-07-29 18:09

UNESCO-IHE – Smart eSOS toilet for emergencies | SOURCE: UNESCO-IHE, July 2014 |

The emergency Sanitation Operation System (eSOS) concept provides a sustainable, holistic and affordable sanitation solution during the aftermath of a disaster. The eSOS reinvents (emergency) toilet and treatment facilities, and uses ICT to bring cost savings to the entire sanitation management chain. The toilet will improve the quality of life of people in need during emergency situations – from natural to anthropological disasters – and minimizes the threat to public health of the most vulnerable members of society.  

The eSOS concept was developed by UNESCO-IHE Institute for Water Education. The experimental prototype of the smart toilet was developed in collaboration with FLEX/The INNOVATIONLAB and SYSTECH and is funded by the Bill and Melinda Gates Foundation-funded project SaniUP – Stimulating local innovation on sanitation for the urban poor in Sub-Saharan Africa and South East Asia.

Smart features
The eSOS emergency toilets are easily deployable in disaster areas because of their robust and light-weight specifications. The smart eSOS toilet includes some unique features in the prototype that will shed new light on how the toilets are used in emergencies. This includes remote-sensing monitoring, an energy supply unit, GSM/GPS sensor/card, occupancy sensors, urine/faeces accumulation sensor, an S.O.S. button, and a communication system that allows for data collection by remote sensing and their transfer to an on or off-site emergency coordination center. The data resulting from the use of the toilets will allow the toilets as well as the entire sanitation management chain to be improved.

Field testing
The eSOS toilet will be tested further in a refugee camp in the Philippines in September with support of the Bill and Melinda Gates Foundation and the Asian Development Bank. UNESCO-IHE PhD fellow Fiona Zakaria from Indonesia will carry out further experimental testing in cooperation with relief agencies on the ground. The eSOS smart toilet design prototype will be manufactured based on the results and feedback obtained from the experimental application.

Filed under: Emergency Sanitation

Compendium of Sanitation Systems and Technologies, 2nd Edition

Mon, 2014-07-28 17:33

Compendium of Sanitation Systems and Technologies 2nd Edition, 2014. IWA; EAWAG.

Authors: E. Tilley, et al.

This second, revised edition of the Compendium presents a huge range of information on sanitation systems and technologies in one volume. By ordering and structuring tried and tested technologies into once concise document, the reader is provided with a useful planning tool for making more informed decisions.

  • Part 1 describes different system configurations for a variety of contexts.
  • Part 2 consists of 57 different technology information sheets, which describe the main advantages, disadvantages, applications and the appropriateness of the technologies required to build a comprehensive sanitation system. Each technology information sheet is complemented by a descriptive illustration.
Download the English 2nd Edition Download the 1st Edition


Filed under: Progress on Sanitation, Publications, Sanitary Facilities, Sanitation and Health

How and Why Countries are Changing to Reach Universal Access in Rural Sanitation by 2030

Fri, 2014-07-25 18:28

How and Why Countries are Changing to Reach Universal Access in Rural Sanitation by 2030 | SOURCE: Eddy Perez, The Water Blog, July 2014.

In this article Eddy Perez discusses how many countries have started working to achieve the goal of universal access to improved sanitation by taking steps to make the transformational changes needed to stop doing “business as usual” in their sanitation programs. 

He provides several examples of what countries are doing to achieve this. One method is that governments are establishing a shared vision and strategy for rural sanitation among key government and development partner stakeholders by building on evidence from at-scale pilots that serve as policy learning laboratories.

Governments are  also partnering with the private sector to increase the availability of sanitation products and services that respond to consumer preferences and their willingness and ability to pay for them and are also working to improve the adequacy of arrangements for financing the programmatic costs.


He then writes about specific sanitation progress in Indonesia, Kenya and Tanzania. In Tanzania, one of the key interventions through which the government of Tanzania is expected to achieve its sanitation vision and targets is the National Sanitation Campaign (NSC).  The Ministry of Health and Social Welfare coordinates the implementation of the National Sanitation Campaign with funding from the Water Sector Development Program.  There have also been efforts to further strengthen and sustain the NSC structure by establishing linkages to other sectors experts and also getting the Ministry of Health to dedicate a budget line for community sanitation. The Water Basket is the main financing mechanism for community sanitation and hygiene in Tanzania. In the Water Basket, there is a clear budget line for sanitation.


Filed under: Africa, East Asia & Pacific, Progress on Sanitation Tagged: Indonesia, Kenya, Tanzania

FSM services in Lusaka: moving up the excreta management ladder

Tue, 2014-07-22 10:29

Despite most residents of African and Asian cities depending on non-sewered sanitation, only a handful of sanitation authorities have addressed the management of faecal sludge from these systems. This Practice Note describes the launch of a faecal sludge management (FSM) service in the peri-urban area of Kanyama, in Zambia.

Click on the image below for a free download.

Filed under: Africa, Progress on Sanitation Tagged: faecal sludge management, FSM, Lusaka, sanitation, Zambia

Water, sanitation, hygiene, and nutrition: successes, challenges, and implications for integration

Fri, 2014-07-18 17:48

Water, sanitation, hygiene, and nutrition: successes, challenges, and implications for integration. Int J Public Health, 2014 Jul 11.

Authors: Teague J, Johnston EA, P Graham J.
Author email:

OBJECTIVES: This study explores the integration of water, sanitation, and hygiene (WASH) and nutrition programming for improved child health outcomes and aims to identify barriers to and necessary steps for successful integration.

METHODS: Sixteen semi-structured in-depth interviews were conducted with key stakeholders from both the WASH and nutrition sectors, exploring barriers to integration and potential steps to more effectively integrate programs.

RESULTS: Key barriers included insufficient and siloed funding, staff capacity and interest, knowledge of the two sectors, coordination, and limited evidence on the impact of integrated programs. To achieve more effective integration, respondents highlighted the need for more holistic strategies that consider both sectors, improved coordination, donor support and funding, a stronger evidence base for integration, and leadership at all levels.

CONCLUSIONS: Organizations desiring to integrate programs can use these results to prepare for challenges and to know what conditions are necessary for successfully integrated programs. Donors should encourage integration and fund operational research to improve the efficiency of integration efforts. Knowledge among sectors should be shared and incentives should be designed to facilitate better coordination, especially where both sectors are working toward common goals.

Filed under: Sanitation and Health Tagged: Nutrition

Multi-level sanitation governance: Understanding and overcoming the challenges in the sanitation sector in Sub-Saharan Africa

Thu, 2014-07-17 13:56

Multi-level sanitation governance: Understanding and overcoming the challenges in the sanitation sector in Sub-Saharan Africa, 2014.

Nelson Ekane, Björn Nykvist, Marianne Kjellén, Stacey Noel and Nina Weitz. Stockholm Environment Institute.

This paper shows how analysis of multi-level governance, path dependency, and institutional inertia can be used to improve understanding of some of the challenges in the sanitation sector in SSA, and discusses approaches that can contribute to improving the sanitation situation in a sustainable way. In addition, the paper asserts that demand-driven strategies and private sector involvement in the sanitation sector is paramount for establishing new sanitation paradigms and socio-technical regimes. We conclude that a good understanding of actors at all levels – that is, their various roles as well as interactions and the way they interpret and respond to policies – is key to accelerating progress in sustainable sanitation coverage in SSA.

Filed under: Uncategorized Tagged: governance

Webinar! The power of creative thinking: working within and around challenging institutional frameworks

Tue, 2014-07-15 14:31

Join WSUP and the WASHplus project for this interactive webinar.

Date: Wednesday, July 23, 2014
Time: 10:00-11:00 EDT (New York) / 15.00–16:00 BST (London)

Reserve your place now at:

Filed under: Africa, Campaigns and Events Tagged: institutional frameworks, Madagascar, sanitation, USAID, WASHplus, water, webinar, WSUP

Poor Sanitation in India May Afflict Well-Fed Children With Malnutrition

Mon, 2014-07-14 13:24

Poor Sanitation in India May Afflict Well-Fed Children With Malnutrition | Source: by Gardiner Harris, New York Times, July 13, 2014.

Excerpts: A long economic boom in India has done little to reduce the vast number of children who are malnourished and stunted, leaving them with mental and physical deficits that will haunt them their entire lives. Now, an emerging body of scientific studies suggest that many of the 162 million children under the age of 5 in the world who are malnourished are suffering less a lack of food than poor sanitation. 

Two years ago, Unicef, the World Health Organization and the World Bank released a major report on child malnutrition that focused entirely on a lack of food. Sanitation was not mentioned. Now, Unicef officials and those from other major charitable organizations said in interviews that they believe that poor sanitation may cause more than half of the world’s stunting problem.

“Our realization about the connection between stunting and sanitation is just emerging,” said Sue Coates, chief of water, sanitation and hygiene at Unicef India. “At this point, it is still just an hypothesis, but it is an incredibly exciting and important one because of its potential impact.”

This research has quietly swept through many of the world’s nutrition and donor organizations in part because it resolves a great mystery: Why are Indian children so much more malnourished than their poorer counterparts in sub-Saharan Africa?

Filed under: Sanitation and Health, South Asia Tagged: India, malnutrition, stunting

You too can become a poo!

Sat, 2014-07-12 06:49

You can dress up as a poo and get flushed down a gigantic toilet in Tokyo’s Miraikan science museum. The toilet is the centre piece of an exhibition on human excrement and the search for the ideal toilet. At the end of the exhibition, visitors are thanked by a choir of toilets.

The exhibition runs from 2 July until 5 October 2014 and costs 1200 yen (around US$ 11 ).

Web site: Miraikan - Special Exhibition “Toilet!? – Human Waste & Earth’s Future” English | Japanese


Filed under: Campaigns and Events, Dignity and Social Development, East Asia & Pacific, Sanitary Facilities Tagged: Miraikan, museums, toilets

AfricaSan 4 dates and venue confirmed!

Fri, 2014-07-11 16:08

The African Ministers’ Council on Water (AMCOW) and the Government of Senegal are pleased to announce the dates and venue of the fourth AfricaSan conference, AfricaSan 4.
Date: 8 – 10 October 2014
Location: Dakar, Senegal (King Fahd Hotel)

Registration website: coming soon, watch this space!

Filed under: Africa, Campaigns and Events, Progress on Sanitation Tagged: AfricaSan 4, AMCOW

WASHplus Weekly: Focus on Fecal Sludge Management

Fri, 2014-07-11 13:21

Issue 153 | July 11, 2014 | Focus on Fecal Sludge Management

This issue focuses on studies, reports, and other materials that have been published so far in 2014 on fecal sludge management (FSM). Included is a just-published and comprehensive guide on planning and organizing the entire fecal sludge management service chain. A WASTE report evaluates FSM methods in emergency situations, and a Water and Sanitation Program  report examines FSM in 12 cities. 


3rd International Faecal Sludge Management Conference, Jan 18-22, 2015, Hanoi, Vietnam(3rd Conference Link) | (2nd Conference Presentations)
Building on the success of the two previous International FSM Conferences in Durban (2011 and 2012), FSM3 will bring together world-class research and science and donors, cities, utilities, investors, consultants, governments, service providers, and industries with the aim of fostering an effective dialogue on solving the problem of dealing with human waste.


Faecal Sludge Management (FSM): Systems Approach for Implementation and Operation, 2014. L Strande, ed., EAWAG. (Link)
This guide compiles the current state of knowledge of this rapidly evolving field and presents an integrated approach that includes technology, management, and planning. It addresses the planning and organization of the entire FSM service chain, from the collection and transport of sludge and treatment options, to the final end use or disposal of treated sludge.

Emergency Sanitation: Faecal Sludge Treatment, 2014. J Spit, WASTE. (Link)
This research aims to expand the knowledge of possible simple fecal sludge treatment technologies that could be rapidly deployed in the event of an emergency and are effective under challenging physical conditions such as unstable soils, high water tables, and flood-prone areas. Three fecal sludge sanitization methods—lactic acid fermentation, urea treatment, and hydrated lime treatment—were investigated by undertaking small scale field trials with pit latrine sludge in Blantyre, Malawi.

Facilitation Manual: Sanitation Entrepreneur Training, 2014. Water and Sanitation Program (WSP). (Link)
A WSP team felt there was a growing need for a standard reference for implementing sanitation entrepreneur training and developed a training program and guide that could be replicated and carried out independently by interested stakeholders.


Webinars with Sanitation Grantees of the Gates Foundation, 2014. (Link)
The videos in this playlist show recordings of webinars hosted by the Stockholm Environment Institute and the Sustainable Sanitation Alliance (SuSanA). The aim is to increase exposure to the Bill & Melinda Gates Foundation research grants on topics such as vapor-permeable membranes, the use of black soldier flies to reduce fecal sludge, and converting feces to biochar, among other ideas.


Report on the Financial Viability of Faecal Sludge End-use in Dakar, Kampala and Accra, 2014. M Bäuerl. (Link)
This report gathers findings from studies conducted in Dakar, Kampala and Accra to examine the technical feasibility of producing dried fecal sludge (FS) with high calorific value and to evaluate demand from end users for alternative sources of energy. Trémolet Consulting contributed to the design of the financial model to assess how much value could be extracted from reselling dried treated FS for industrial use and as an alternative to fertilizers.

Financing Sanitation: Resource Recovery from Faecal Sludge in Kampala, 2014. M Bäuerl. (Link)
The FaME project investigated the financial viability of using dried fecal sludge as an industrial fuel or soil conditioner in agriculture. Objectives included estimating fecal sludge volumes, the market value of fecal sludge treatment products, financial flows in the service chain, and how these need to be distributed to provide financial incentives for stakeholders to improve sanitation services.

The Missing Link in Sanitation Service Delivery: A Review of Fecal Sludge Management in 12 Cities, 2014. WSP. (Link)
A desk study of 12 cities was undertaken as a first step toward analyzing FSM in a variety of cities representing various regions, sizes, types, and levels of service delivery.

Peri-Urban Sanitation and Water Service Provision: Challenges and Opportunities for Developing Countries, 2014. J McConville, SEI. (Link)
There is no standard classification of peri-urban, and the term is applied to a diverse mix of informal and formal settlements, which can contain a wide variety of housing types and range from densely built slums to spacious suburban estates. In general, however, the term refers to the geographical edge of the city, more specifically the urban fringe outside the formal city limits.


Fecal Sludge Management (FSM): Analytical Tools for Assessing FSM in CitiesJnl Wat San Hyg for Dev, May 2014. A Peal. (Abstract)
This paper describes the results of a research study that aims in part to develop a method for rapidly assessing FSM in low- and middle-income cities. The method uses innovative tools to assess both the institutional context and the outcome in terms of the amount of fecal sludge safely managed. This paper considers previous work done on FSM, suggests reasons why it is often neglected in favor of sewerage, and highlights the importance of supporting the increasing focus on solving the FSM challenge.

Shear Rheological Properties of Fresh Human Faeces with Different Moisture ContentWater SA, Apr 2014. S Woolley. (Link)
Dry sanitation requires the handling of feces, which vary in age and degree of transformation. Rheological data are necessary to support the design of equipment to handle faeces. The rheological properties of fresh human feces were measured using a variable-speed rotational rheometer.

Emptying, Transportation and Disposal of Feacal Sludge in Informal Settlements of Kampala Uganda: The Economics of SanitationHabitat Intl, May 2014. C Murung.(Abstract)
Emptying, transportation, and disposal of fecal sludge in informal settlements of Kampala, Uganda, are still a big challenge. With the use of semi-structured interviews, observation, and review of secondary data, this study identifies actors and factors determining emptying costs and the constraints limiting improved service provision.

A Value Proposition: Resource Recovery from Faecal Sludge: Can It Be the Driver for Improved Sanitation? Resources, Conservation and Recycling, July 2014. S Dienera.(Abstract)
Evidence is presented regarding financial incentives for resource recovery from fecal sludge. Possibilities include fuel, protein, building materials, and soil conditioner. Soil amendments potentially do not generate as much revenue as energy production. Local solutions need to be determined, as demand varies significantly among locations.

Measurement of Faecal Sludge In-Situ Shear Strength and DensityWater SA, Jan 2014. J Radford. (Link)
This study developed the portable penetrometer, a device to physically characterize pit latrine sludge through in-situ measurement of its shear strength. The machine produces continuous profiles of shear strength with depth and is capable of testing to approximately 2.5 m below the slab. The portable penetrometer was manufactured and tested in the UK, before profiling approximately 30 pits in Kampala, Uganda.

Potential of Locally Available Products for Use as Binders in Producing Fecal Compost Pellets in GhanaEnvironmental Progress & Sustainable Energy, July 2014. J Nikiema. (Abstract)
Market studies in Ghana have revealed a potential for composted or co-composted fecal matter as nutrient source inputs for agricultural production. To increase the marketability of such products, high nutrient value and easier handling/transport options are considered significant factors that can drive demand. Pelletization is also seen as a potentially interesting option.


WASHplus Weeklies will highlight topics such as Urban WASH, Indoor Air Pollution, Innovation, Household Water Treatment and Storage, Hand Washing, Integration, and more. If you would like to feature your organization’s materials in upcoming issues, please send them to Dan Campbell, WASHplus Knowledge Resources Specialist,

Filed under: Economic Benefits, Progress on Sanitation, Sanitary Facilities, Sanitation and Health Tagged: faecal sludge management

Further co-funding support for the SuSanA Discussion Forum

Fri, 2014-07-11 12:46

July 11, 2014 – Further co-funding support for the SuSanA Discussion Forum aiming to make sanitation solutions sustainable and scalable 

Lack of access to sanitation continues to be a huge global challenge. Therefore, knowledge about what works where and how is crucial to ensure successful sanitation interventions in the longer term. The Bill & Melinda Gates Foundation has provided co-funding for the Sustainable Sanitation Alliance (SuSanA) Discussion Forum for the last 1.5 years by making a grant to Stockholm Environment Institute. This has catalyzed knowledge exchange amongst experts and engaged citizens within the sanitation, water and hygiene sector.

On the 3rd anniversary of the SuSanA Discussion Forum, Stockholm Environment Institute (SEI) is happy to announce that the Bill & Melinda Gates Foundation has given a follow-up grant to SEI for “Extension of the SuSanA Discussion Forum”, thereby supporting online knowledge management, dissemination and peer discussions of the Gates Foundation’s Water, Sanitation and Hygiene projects. The size of the grant is 250,000 USD and it will span a period of 18 months, starting in July 2014.

The project leader for this grant is again Dr. Arno Rosemarin who also led the successful Phase 1 of the same project which ran from November 2012 to April 2014 with a grant size of 233,000 USD. In both phases of this work the focus is to encourage grantees of the Gates Foundation to share and discuss results from their sanitation research grants on the open Discussion Forum of SuSanA – the Sustainable Sanitation Alliance, a network of 231 partner organisations and 3800 individual members. Results from Phase 1, which was carried out together with the Swiss consulting firm seecon international gmbh in close cooperation with the SuSanA secretariat at Deutsche Gesellschaft fuer Internationale Zusammenarbeit (GIZ) GmbH can be accessed via the research page of the SuSanA website. Further outputs from Phase 1 were seven webinars recorded with sanitation grantees and SuSanA members, as well as videos of interviews with grantees at the “Reinvent the Toilet Fair” in Delhi, India in March 2014.

Phase 2 of this project is aimed at increasing the level of awareness, knowledge dissemination and sharing of research and implementation results in the areas of sanitation science and technology, urban sanitation businesses, demand creation, policy and advocacy. It will contribute to the knowledge management and dissemination that the Gates Foundation is carrying out for its many innovative sanitation and hygiene projects.

 The activities of the grant are clustered to support the following three main outputs:

  • Make the SuSanA Discussion Forum a highly accessible, comprehensive and authoritative workplace for the water, sanitation &hygiene community around the world.
  • Ensure that the kernels of knowledge arising from the many innovative projects funded by the Gates Foundation’s Water, Sanitation & Hygiene strategy are put into the hands of the professional community with the aim to disseminate and implement.
  • Catalyze communication among professionals within the community in order to enhance learning and exchange of experience.

We are proud of the fact that all the work that the SuSanA members and the SuSanA secretariat have collectively put into this network since 2007, and into the Discussion Forum since 2011, is being recognised in this way by an important actor and donor in the field of sustainable sanitation worldwide, the Bill & Melinda Gates Foundation.

For further information please consult the SuSanA Discussion Forum over the coming weeks or contact Dr. Arno Rosemarin ( or Dr. Elisabeth von Muench ( who will again support the SEI team for this project and act as community manager. You are also invited to involve yourself personally by expressing your views or sharing your sanitation experiences on the Discussion Forum at any time:

Filed under: Progress on Sanitation Tagged: Sustainable Sanitation Alliance

Umande Trust Sanitation Payment Innovations

Thu, 2014-07-10 16:28

Umande Trust Sanitation Payment Innovations being used at the Bio-Centers within the Urban Informal settlements.

Filed under: Africa, Economic Benefits Tagged: sanitation financing

What we can learn from Brazil’s wastepickers

Tue, 2014-07-08 20:25

What we can learn from Brazil’s wastepickers | by Kyle Wiens

Excerpts: By the time the World Cup ends on July 13, experts estimate that World Cup spectators will generate a staggering 320 tons of trash. Enter the catadores—waste pickers who earn a living by collecting recyclables from the nation’s trash heap, men and women who will dig through the garbage and pick out each aluminum can, plastic bottle, and glass container. And while their jobs may seem humble, their sweat and solidarity are helping to transform Brazil into a true world power in recycling.

Illustrations by Ben Sanders

The movement to organize waste pickers in Brazil began in São Paulo in 1980, when the Catholic Church helped start the Association of Paper Pickers, but it only came into the spotlight nine years later, when association members began protesting on behalf of their right to collect material from public roadways. The association’s work inspired other cities around Brazil to start similar organizations, which (among other things) is helping to end child labor in Brazilian dumps.

A Future in Recycling

In 2009, filmmaker Sean Walsh spent a month following Claudinês Alvarenga, a carroceiro, or cart hauler, for his documentary Hauling. Alvarenga, a father of 27, drove the streets of São Paulo in an old Volkswagen bus, recovering materials from curbsides, businesses, and dumpsters. He fixed what he could, resold what was salvageable, and recycled all the rest.

“Haulers such as Claudinês and his family are the most vital and also the most marginalized group in this immense [recycling] industry,” Walsh says. “They are also the agents of a new environmental world order, which is growing ever more important to our sustainable survival.”

The truth is, catadores and carroceiros are remarkably good at what they do. Necessity has turned them into reuse masters, repair geniuses, and recycling experts. They can sort recyclables more precisely and comprehensively than a machine can, right down to different grades of paper. Because of catadores, Brazil is a world leader in recycling: The country has the highest recycling rates for used aluminum cans—around 98 percent—and is second in world for recycling PET, a plastic used in food packaging.

Filed under: Dignity and Social Development, Economic Benefits, Latin America & Caribbean Tagged: catadores, waste pickers

Estimates on the WASH-related Global Burden of Disease

Mon, 2014-07-07 14:01
Below are abstracts and links to the full-text of articles in the August 2014 issue of  Tropical Medicine and International Health Focus on the Global Burden of Disease from Water While the methods of Global Burden of Disease (GBD) study continue to evolve, recent changes raise questions about the basis of new estimates of the risk associated with water, sanitation and hygiene and warrant consideration of alternative approaches.
  • ​Inadequate water, sanitation and hygiene are estimated to have caused 842,000 deaths from diarrhoea in 2012, i.e., 1.5% of deaths worldwide. These include 361,000 deaths of children under five years.
  • ​A systematic review of the global prevalence of handwashing with soap and its effect on diarrhoeal diseases estimates that only 19% of the world’s population washes hands with soap after contact with excreta and that handwashing reduces the risk of diarrhoeal disease by 23%–40%.
  • ​Based on over 300 studies from a systematic review, an estimated 1.1 billion people are exposed to a drinking water source of moderate to high risk.
  • ​A meta-regression shows that risks of diarrhoea from inadequate drinking water and sanitation could be reduced considerably through targeted interventions. Risk differences depend on type of intervention.
1 – Authors:  Clasen, Thomas, Pruss-Ustun, Annette, Mathers, Colin D., et al. TI  - Estimating the impact of unsafe water, sanitation and hygiene on the global burden of disease: evolving and alternative methods Abstract - AB  - The 2010 global burden of disease (GBD) study represents the latest effort to estimate the global burden of disease and injuries and the associated risk factors. Like previous GBD studies, this latest iteration reflects a continuing evolution in methods, scope and evidence base. Since the first GBD Study in 1990, the burden of diarrhoeal disease and the burden attributable to inadequate water and sanitation have fallen dramatically. While this is consistent with trends in communicable disease and child mortality, the change in attributable risk is also due to new interpretations of the epidemiological evidence from studies of interventions to improve water quality. To provide context for a series of companion papers proposing alternative assumptions and methods concerning the disease burden and risks from inadequate water, sanitation and hygiene, we summarise evolving methods over previous GBD studies. We also describe an alternative approach using population intervention modelling. We conclude by emphasising the important role of GBD studies and the need to ensure that policy on interventions such as water and sanitation be grounded on methods that are transparent, peer-reviewed and widely accepted. ———————————————————————————–

2 – Authors: Prüss-Ustün, Annette, Bartram, Jamie, Clasen, Thomas,  et al.

TI  - Burden of disease from inadequate water, sanitation and hygiene in low- and middle-income settings: a retrospective analysis of data from 145 countries  Full text - Objective - To estimate the burden of diarrhoeal diseases from exposure to inadequate water, sanitation and hand hygiene in low- and middle-income settings and provide an overview of the impact on other diseases.

Methods - For estimating the impact of water, sanitation and hygiene on diarrhoea, we selected exposure levels with both sufficient global exposure data and a matching exposure-risk relationship. Global exposure data were estimated for the year 2012, and risk estimates were taken from the most recent systematic analyses. We estimated attributable deaths and disability-adjusted life years (DALYs) by country, age and sex for inadequate water, sanitation and hand hygiene separately, and as a cluster of risk factors. Uncertainty estimates were computed on the basis of uncertainty surrounding exposure estimates and relative risks. Results - In 2012, 502 000 diarrhoea deaths were estimated to be caused by inadequate drinking water and 280 000 deaths by inadequate sanitation. The most likely estimate of disease burden from inadequate hand hygiene amounts to 297 000 deaths. In total, 842 000 diarrhoea deaths are estimated to be caused by this cluster of risk factors, which amounts to 1.5% of the total disease burden and 58% of diarrhoeal diseases. In children under 5 years old, 361 000 deaths could be prevented, representing 5.5% of deaths in that age group. Conclusions - This estimate confirms the importance of improving water and sanitation in low- and middle-income settings for the prevention of diarrhoeal disease burden. It also underscores the need for better data on exposure and risk reductions that can be achieved with provision of reliable piped water, community sewage with treatment and hand hygiene. ——————————————————————- 3 – Authors: Freeman, Matthew C., Stocks, Meredith E., Cumming, Oliver,  et al. TI  - Systematic review: Hygiene and health: systematic review of handwashing practices worldwide and update of health effects Full text: Objective - To estimate the global prevalence of handwashing with soap and derive a pooled estimate of the effect of hygiene on diarrhoeal diseases, based on a systematic search of the literature. Methods - Studies with data on observed rates of handwashing with soap published between 1990 and August 2013 were identified from a systematic search of PubMed, Embase and ISI Web of Knowledge. A separate search was conducted for studies on the effect of hygiene on diarrhoeal disease that included randomised controlled trials, quasi-randomised trials with control group, observational studies using matching techniques and observational studies with a control group where the intervention was well defined. The search used Cochrane Library, Global Health, BIOSIS, PubMed, and Embase databases supplemented with reference lists from previously published systematic reviews to identify studies published between 1970 and August 2013. Results were combined using multilevel modelling for handwashing prevalence and meta-regression for risk estimates. Results - From the 42 studies reporting handwashing prevalence we estimate that approximately 19% of the world population washes hands with soap after contact with excreta (i.e. use of a sanitation facility or contact with children’s excreta). Meta-regression of risk estimates suggests that handwashing reduces the risk of diarrhoeal disease by 40% (risk ratio 0.60, 95% CI 0.53–0.68); however, when we included an adjustment for unblinded studies, the effect estimate was reduced to 23% (risk ratio 0.77, 95% CI 0.32–1.86). Conclusions- Our results show that handwashing after contact with excreta is poorly practiced globally, despite the likely positive health benefits. ————————————————————————————— 4 – Authors: Bain, Robert, Cronk, Ryan, Hossain, Rifat,  et al. TI  - Global assessment of exposure to faecal contamination through drinking water based on a systematic review Full text: Objectives - To estimate exposure to faecal contamination through drinking water as indicated by levels of Escherichia coli (E. coli) or thermotolerant coliform (TTC) in water sources. Methods - We estimated coverage of different types of drinking water source based on household surveys and censuses using multilevel modelling. Coverage data were combined with water quality studies that assessed E. coli or TTC including those identified by a systematic review (n = 345). Predictive models for the presence and level of contamination of drinking water sources were developed using random effects logistic regression and selected covariates. We assessed sensitivity of estimated exposure to study quality, indicator bacteria and separately considered nationally randomised surveys. Results - We estimate that 1.8 billion people globally use a source of drinking water which suffers from faecal contamination, of these 1.1 billion drink water that is of at least ‘moderate’ risk (>10 E. coli or TTC per 100 ml). Data from nationally randomised studies suggest that 10% of improved sources may be ‘high’ risk, containing at least 100 E. coli or TTC per 100 ml. Drinking water is found to be more often contaminated in rural areas (41%, CI: 31%–51%) than in urban areas (12%, CI: 8–18%), and contamination is most prevalent in Africa (53%, CI: 42%–63%) and South-East Asia (35%, CI: 24%–45%). Estimates were not sensitive to the exclusion of low quality studies or restriction to studies reporting E. coli. Conclusions - Microbial contamination is widespread and affects all water source types, including piped supplies. Global burden of disease estimates may have substantially understated the disease burden associated with inadequate water services. ———————————————————————— 5 – Authors: Wolf, Jennyfer, Prüss-Ustün, Annette, Cumming, Oliver, et al. TI  - Systematic review: Assessing the impact of drinking water and sanitation on diarrhoeal disease in low- and middle-income settings: systematic review and meta-regression Full text: Objective - To assess the impact of inadequate water and sanitation on diarrhoeal disease in low- and middle-income settings. Methods - The search strategy used Cochrane Library, MEDLINE & PubMed, Global Health, Embase and BIOSIS supplemented by screening of reference lists from previously published systematic reviews, to identify studies reporting on interventions examining the effect of drinking water and sanitation improvements in low- and middle-income settings published between 1970 and May 2013. Studies including randomised controlled trials, quasi-randomised trials with control group, observational studies using matching techniques and observational studies with a control group where the intervention was well defined were eligible. Risk of bias was assessed using a modified Ottawa–Newcastle scale. Study results were combined using meta-analysis and meta-regression to derive overall and intervention-specific risk estimates. Results - Of 6819 records identified for drinking water, 61 studies met the inclusion criteria, and of 12 515 records identified for sanitation, 11 studies were included. Overall, improvements in drinking water and sanitation were associated with decreased risks of diarrhoea. Specific improvements, such as the use of water filters, provision of high-quality piped water and sewer connections, were associated with greater reductions in diarrhoea compared with other interventions. Conclusions - The results show that inadequate water and sanitation are associated with considerable risks of diarrhoeal disease and that there are notable differences in illness reduction according to the type of improved water and sanitation implemented.

Filed under: Sanitation and Health Tagged: Global Burden of Disease, handwashing, hygiene

WSUP animation – welcome to the world of urban WASH programming!

Mon, 2014-07-07 09:59

How do you design and implement an effective urban WASH programme? In WSUP’s recent publication “The Urban Programming Guide” we set out the many activities involved, from planning and capacity building to improving services and promoting behaviour change. This short animation brings the publication to life and takes you on a virtual tour of some of these activities in action: enjoy the ride!

You can download the Urban Programming Guide for free from our website.

Filed under: Africa, Education & training, Hygiene Promotion, Resources, Sanitary Facilities, South Asia Tagged: Animation, capacity building, FSM, hygiene, sanaition, urban, utilities, WASH programming, water

Solid Waste Management in the Pacific

Fri, 2014-07-04 12:08

Tibar dumpsite, Timor-Leste. Photo: M. Iyer/ADB

The Asian Development Bank has published a series of snapshots of the solid waste management situation in each of ADB’s 14 Pacific developing member countries. The series assesses solutions and challenges associated with the management of solid waste in the region, with a focus on financing, institutional arrangements and solid waste management technologies.

The series is one of the outputs of a US$ 450,000 ADB techical assistance project 45051-001, which aimed to improve the delivery of solid waste management in the Pacific region.

Overview reports

Solid Waste Management in the Pacific: Appropriate Technologies June 2014 Solid Waste Management in the Pacific: Financial Arrangements June 2014 Solid Waste Management in the Pacific: Institutional Arrangements June 2014

Country snapshots

Solid Waste Management in the Pacific: Cook Islands Country Snapshot June 2014 Solid Waste Management in the Pacific: Fiji Country Snapshot June 2014 Solid Waste Management in the Pacific: Kiribati Country Snapshot June 2014 Solid Waste Management in the Pacific: The Marshall Islands Country Snapshot June 2014 Solid Waste Management in the Pacific: The Federated States of Micronesia Country Snapshot June 2014 Solid Waste Management in the Pacific: Nauru Country Snapshot June 2014 Solid Waste Management in the Pacific: Palau Country Snapshot June 2014 Solid Waste Management in the Pacific: Papua New Guinea Country Snapshot June 2014 Solid Waste Management in the Pacific: Samoa Country Snapshot June 2014 Solid Waste Management in the Pacific: Solomon Islands Country Snapshot June 2014 Solid Waste Management in the Pacific: Timor-Leste Country Snapshot June 2014 Solid Waste Management in the Pacific: Tonga Country Snapshot June 2014 Solid Waste Management in the Pacific: Tuvalu Country Snapshot June 2014 Solid Waste Management in the Pacific: Vanuatu Country Snapshot June 2014
Filed under: East Asia & Pacific, Publications Tagged: Asian Development Bank, Cook Islands, Federated States of Micronesia, Fiji, Kiribati, Marshall Islands, Nauru, Palau, Papua New Guinea, Samoa, solid waste management, Solomon Islands, Timor-Leste, Tonga, Tuvalu, Vanuatu

WEDC – Managing hygiene promotion in WASH programmes

Tue, 2014-07-01 18:50

Managing hygiene promotion in WASH programmes, 2014. WEDC.

Managers of water, sanitation and hygiene (WASH) programmes normally acknowledge that people need to behave in a hygienic manner to protect water supplies and ensure that sanitation facilities are used properly. 

However, promoting hygienic behaviour differs from the construction of infrastructure, with indicators of progress being less concrete. This means campaigns need to be planned and carried out in a suitable manner.

Contents of this guide
What is hygiene?
Principles of hygiene promotion
Planning a hygiene promotion programme
Participatory tools
Analysis of the data
Implementation of the action plan
Methods of hygiene and sanitation promotion
Selecting and training facilitators
Monitoring and evaluation

Filed under: Hygiene Promotion Tagged: WEDC

Focus on Violence and Gender in the WASH and Household Energy Sectors

Fri, 2014-06-27 14:41

WASHplus Weekly | Issue 151 | June 27, 2014 | Focus on Violence and Gender in the WASH and Household Energy Sectors

There have been several new initiatives to deal with the problem of violence and gender. In the WASH sector, several key organizations have worked together to publish a recent toolkit that discusses how to make WASH safer and more effective. In the household energy sector, the SAFE strategy, or the Global Strategy for Safe Access to Fuel and Energy was recently launched by the UN High High Commissioner for Refugees. The SAFE strategy principally addresses technology and program management and provides guidance on a holistic approach to the safety challenge in humanitarian settings. USAID has also published a new toolkit to support the implementation of the U.S. Strategy to Prevent and Respond to Gender-based Violence Globally.



Violence, Gender and WASH: A Practitioner’s Toolkit, 2014. (Link)
The toolkit has been developed by Sarah House, Suzanne Ferron, Marni Sommer and Sue Cavill on behalf of WaterAid with contributions from a wide range of actors. It was funded by the Department for International Development (DFID) of the British Government through the Sanitation and Hygiene Applied Research For Equity (SHARE) Consortium. By recognizing both the risks of violence associated with WASH and the potential benefits of WASH, this toolkit aims to shine a light on this problem and encourage practitioners to recognize their capacity to make WASH safer and more effective.

Toolkit for Monitoring and Evaluating Gender-Based Violence Interventions along the Relief to Development Continuum, 2014. USAID. (Link)
USAID developed this toolkit to support the implementation of the U.S. Strategy to Prevent and Respond to Gender-based Violence Globally. It provides guidance to USAID staff, implementing partners and the larger community of international relief and development practitioners on how to monitor and evaluate gender-based violence interventions along the Relief to Development Continuum (RDC). The RDC is divided broadly into three phases: (1) the pre-crisis phase, (2) the crisis phase, and (3) the post-crisis phase. The toolkit identifies opportunities for doing monitoring and evaluation along the RDC and gives advice on how to address constraints and challenges relating to each phase.


Two Girls Died Looking for a Toilet. This Should Make Us Angry, Not Embarrassed.The Guardian, June 2014. B Frost. (Link)
Attacks on girls and women as they look for somewhere private to defecate are frighteningly common. Improving basic sanitation, as a global goal, would do a lot to make them safer.

Inequity: A Shared Root Cause of Low Access to Sanitation Services and Violence Against WomenIRC Blog, June 2014. D Casella. (Link)
“IRC believes in a world where water, sanitation and hygiene services are fundamental utilities that everyone is able to take for granted, forever. But we are concerned about the pervasive issue of violence against women being subsumed under the urgent need to promote public attention to the global sanitation crisis.”

How a Lack of Toilets Puts India’s Women at Risk of AssaultNPR Radio, June 2014. J McCarthy. (Article/podcast)
India’s former rural development minister, Jairam Ramesh, says increased government assistance for building toilets has spurred construction, as has the issue of women’s privacy. But a social movement to revolutionize attitudes and behaviors toward sanitation in India may be in order. Many Indians look to their new Prime Minister Narendra Modi to make good on his recent election campaign promise: “toilets first, temples later.”

Sanitation Begins with Sanity. Let the Toilets WaitMansampark, June 2014. S Joshi.(Link)
“The argument that better access to toilets would help reduce violence against women is just another mode of denial, as bad as the sexists who want to deny the root of the problem – how families and communities raise men. And when it comes to sanitation, our problems and solutions lie much further away.”

Discussions on the SuSanA Forum about Violence against Women and the Lack of SanitationSuSanA Forum, June 2014. (Link)
There were several posts on the SuSanA Forum about violence against women and the lack of sanitation.

Water, Women and Marital Violence in a Bangladesh Village, 2013. K.M. Rabiul Karim.(Link)
This study explores the consequences of a groundwater project on women’s workload and their experience with marital violence in a Bangladesh village. The project facilitated irrigation water but it also resulted in seasonal domestic water shortages.

Gender Analysis of Water Health and Sanitation Emergency Response in Rakhine State, 2013. UNICEF. (Link)
Gender-based violence (GBV) is under-reported in all emergencies and Rakhine is no exception. Rapid protection assessments indicated that there have been cases of GBV, such as sexual harassment, sexual abuse and domestic violence. It is important to stress that even though there are no reports or evidence on GBV, humanitarian personnel should assume it is happening and take all necessary precautions to prevent and tackle it. On the basis of experience from other emergencies, there is a connection between poorly designed and located WASH facilities (far from shelters, poorly lit, not lockable etc.) and exposure to sexual violence.



Global Strategy for Safe Access to Fuel and Energy (SAFE):  A UNHCR Strategy 2014-2018. UNHCR. (Link)
As a core component of UNHCR’s protection mandate, this strategy aims to safeguard refugees from protection risks such as sexual and gender-based violence (SGBV), which often occurs in the search for firewood and during dark hours. This will be done through the provision of lighting, energy technologies and fuel in camps. It will also help to realize other rights related to health, nutrition, education and livelihoods as well as decrease tensions that may arise between refugees and host communities due to competition over energy resources.

Scaling Adoption of Clean Cooking Solutions through Women’s Empowerment:  A Resource Guide, 2013. C Hart. (Link)
This resource guide builds off of existing resources while compiling and analyzing a wide-variety of case studies, tools, and stories that outline practical, actionable methods and best practices for scaling adoption of clean cooking solutions through women’s empowerment.

Addressing Sexual Violence in and Beyond the Warzone, 2014. Institute of Development Studies. (Link)
A recent meta-analysis of existing studies shows that one in five female refugees or internally displaced persons living in camps or urban areas worldwide has experienced sexual violence while displaced. In 2011, 530 cases of sexual and gender-based violence were reported in Kakuma, a refugee camp in Kenya hosting approximately 100,000 migrants from Somalia, South Sudan, Eritrea and Ethiopia. Women were most frequently exposed to sexual violence when using washing facilities at night and when collecting firewood outside the camp.

Women and Natural Resources: Unlocking the Peacebuilding Potential, 2013. UNEP.(Link)
As the primary providers of water, food and energy at the household and community levels, women in rural settings are often highly dependent on natural resources for their livelihoods, and are therefore particularly susceptible to changes in the availability and quality of these resources during and after conflict. In particular, lack of access to land – which underpins rights to all other natural resources and is a key asset for securing productive inputs – can force them into increasingly vulnerable situations and expose them to higher levels of physical and livelihood risk, with trickle-down impacts on community welfare.

Women as Decision Makers in Community Forest Management: Evidence from Nepal, 2013. M Leone. (Link)
This paper looks at whether and how increased participation of women in the Executive Committee (EC) of Community Forest User Groups (CFUG) in Nepal affects forest protection, specifically the quantity of firewood collected by the households.  The results show that higher female participation in the ECs of CFUGs leads to a significant decrease in firewood extraction. These results suggest that in countries with common property resources, the effectiveness of collective action institutions depends also on their gender composition. The recognition of the essential role that women play in forest management can make a difference in terms of forest conservation.

Collective Violence Caused by Climate Change and How It Threatens Health and Human RightsHealth and Human Rights Journal, June 2014. B Levy. (Link)
Collective violence due to climate change poses serious threats to health and human rights, including by causing morbidity and mortality directly and also indirectly by damage to the health-supporting infrastructure of society, forcing people to migrate from their homes and communities, damaging the environment, and diverting human and financial resources.

A Rights-Based Approach to Indoor Air PollutionHealth and Human Rights, Dec 2013. J Lim. (Link)
Household indoor air pollution from open-fire cookstoves remains a public health and an environmental hazard that impacts negatively on people’s right to health. In poor, rural isolated communities, there is unlikely to be a single behavioral or technological “fix” to this problem. The authors suggest that improved cookstoves are an important health intervention to which people have a right, as they do to family planning, vaccination, and essential primary care medicines. Like these other necessary elements in the fulfillment of the right to health, access to clean indoor air should be incorporated into state health strategies, policies, and plans. State infrastructure and health systems should support public and private sector delivery of improved cookstove services, and ensure that such services reach all communities, even those that are poor, located remotely, and likely not to be served by the market.

Fuel Efficient Stoves and the Reduction of Gender-Based Violence in Darfur IDP CampsPeace and Conflict Monitor, 2014. S Chikhi. (Link)
Gender-based violence against women is a wide-spread phenomenon in Darfur. Victims of the Janjaweed militia, refugee women who leave the camps to collect firewood are further victimized because of social stigma. In order to reduce this type of crimes against humanity the use of fuel efficient stoves is recommended. The success of such an approach to improve the situation for women cannot be achieved without the contribution of non-profit organizations and the international community. A theory of change in that setting will require women’s empowerment and their involvement as leaders within the specificities of the Darfuri traditional context. This paper provides a theoretical framework for the successful use of fuel efficient stoves within the community as well as the needed support for the success of such an endeavor.


The “SAFE” Initiative: Ensuring Safe Access to Appropriate Cooking Fuel in Humanitarian Settings, March 2013. Presentation by Erin Patrick, Women’s Refugee Commission. (Link)

Safe Access to Firewood and Alternative Energy (SAFE): Introduction to Programme Implementation, Clean Cooking Forum, March 2013. Presentation by Megan Gerrard, World Food Programme. (Link)

Innovations in Responding to Domestic Energy Needs of Refugees, IDPs and Vulnerable Populations, Clean Cooking Forum, March 2013. Presentation by Amare Egzhiaber, UNHCR. (Link)

Humanitarian Stove/Fuel Mapping: Key Initial Findings, Clean Cooking Forum, March 2013. Presentation by Women’s Refugee Commission (WRC). (Link)

Ensuring the Supply and Deployment of Cooking Solutions in Emergency Response, March 2013. Presentation by Corinne Hart, Program Manager, Gender and Markets, Global Alliance for Clean Cookstoves. (Link)

Filed under: Dignity and Social Development, Progress on Sanitation, Sanitation and Health Tagged: gender issues, Violence