Dissertations / Theses: 'Water sanitation and hygiene (WaSH)'

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Mpofu, Claudius. "Adopting a resilience lens in managing decentralized water, sanitation and hygiene (WASH) systems." Thesis, KTH, Hållbar utveckling, miljövetenskap och teknik, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-236974.

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Climate change and increased pressure on water resources through urban and peri-urban population growth present some major uncertainties to the sustainable provision of good quality water, sanitation and hygiene (WASH) services, particularly to small-scale decentralized systems which are considered more vulnerable compared to centralized systems. The concept of “resilience” could be useful when dealing with such uncertainties. It deals with planning for shocks and stressors which could help address long-term water security and sanitation challenges. The aim of this research is to explore the relevance of the concept of resilience in dealing with uncertainties for decentralized WASH systems. Through literature review, interviews (n=22) and group discussions (n=18), the relevance of the 7 resilience principles, developed by SRC, to WASH planning for decentralized systems was explored. WHO community water and sanitation planning guidelines were reviewed to determine how resilience could add useful aspects to management of decentralised WASH systems. Results showed that the resilience concept is important in planning and management of decentralized WASH systems, since, with the resilience principles as a basis, there is potential to involve different stakeholders to share knowledge, skills and resources across multiple scales. The three resilience principles considered most important from the 7 SRC resilience principles for decentralized WASH were identified as: 1) Broadening participation, 2) Maintenance of diversity and redundancy, and 3) Management of slow changing variables and feedbacks. Other important WASH aspects missing from the resilience principles were: 1) Contextuality, 2) Accountability, 3) Equity and human rights, 4) Monitoring and maintenance, 5) Resource capacity. Two case studies served as examples of how decentralized WASH systems are managed in a high-income country (Värmdö, Sweden) and a low/middle income country (MSETO, Kenya). In both cases, applied resilience principles were identified together with areas of improvement. With reference to resilience, Värmdö municipality showed strength in the flow of information (connectivity) between actors but lacked integrated WASH planning guidelines and diversity of water supplies. The MSETO project exhibited strength in overlapping responsibilities (polycentric governance) but lacked management of slow changing variables and feedbacks, linked to the lack of adequate re-sources. The analysis of WHO Water Safety Plans and sanitation safety planning guidelines through the resilience framework revealed that the WHO guidelines have a heavy focus on technical aspects and lack an integrated approach involving polycentric governance and complex adaptive system thinking. There is need for the revision of the guide-lines to incorporate community social aspects, strategies of improving water availability and consideration of complex adaptive systems thinking. Municipalities and practitioners are recommended to consider resilience principles as well as the identified missing aspects in WASH planning and interventions. Further research is needed investigating necessary conditions for the application of resilience principles and important trade-offs.

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Nahalamba, Sarah Birungi. "Socioeconomic Status, Water, Sanitation, Hygiene, and Economic Cost of Childhood Diarrheal Diseases in Uganda." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7317.

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Worldwide, diarrhea is the second leading cause of death in children aged under 5, yet it is both preventable and treatable. Several studies have established the effects of exposure to inadequate water, sanitation, and hygiene (WASH) on diarrhea prevalence, but little was known on how the interactions of socioeconomic status and WASH influence the economic cost of treatment of diarrhea. This retrospective cross-sectional survey study was focused on assessing the correlation between socioeconomic status, WASH, and household cost of treatment of diarrhea among children aged under 5 in Uganda using the multiple exposure-multiple effect model. Secondary data from the 2015/16 Uganda National Panel Survey were used. At bivariate level of analysis, 5 of 6 independent variables (education level of mother, household expenditure, residence type, source of drinking water, and type of toilet facility) had statistically significant associations with household cost of treatment of diarrhea (p value < .05). The multivariate-hierarchical multiple linear regression indicated that only 3 of the 6 variables significantly predicated household cost of treatment of diarrhea. These were highest education level of mother (p = 0.001), source of drinking water (p = 0.022), and type of toilet facility (p = 0.012). At p value < .05, about 67% of the variation in the cost of treatment was explained by the independent variables. Households with a higher socioeconomic status incurred higher costs of treatment, although those with a lower status experienced the highest prevalence rates. Therefore, policy makers and practitioners could use these findings to employ multiple interventions to address the disease burden and cause behavior change.

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Schiedek, Leonie. "Water Governance in the SDG Era - An Analysis of National Commitments to Water, Sanitation, and Hygiene." Thesis, Uppsala universitet, Institutionen för geovetenskaper, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-412137.

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The 21st century is marked by the forecast of a frightful set of crises caused by anthropogenic activities. Among them, an emerging water crisis threatens the existence of life on the planet. It is mainly triggered by a lack of good water governance. The concept of water governance refers to a range of different societal systems that are involved in the management of water resources, and the delivery of water services. However, these systems are threatened by several problems causing a mismanagement of water resources, involving corruption, deficits of democratization, or inequalities. This study examines commitments to improved water, sanitation, and hygiene provided by the Sanitation and Water for All partnership through a qualitative content analysis in order to allow an insight in current goal-setting for improved water governance. In this study, we show that even though stakeholders across geographical regions and constituencies aim at efficient governance measures, they neglect the importance of the procedural factors of good governance, for instance participation or adaptiveness. Instead they mostly focus on the outcome. Further, the study reveals that the commitments lack timely and measurable components and often do not include allocation of budgets. Although stakeholders show their intention to commit to action and work collaboratively, they often lack long-term thinking. Against the background of emerging global challenges in the water sector, most stakeholders are not yet prepared to work efficiently with new forms of governance in order to establish sustainable and resilient systems. Nevertheless, multi-stakeholder partnerships provide a basis to start a learning journey and can help to facilitate capacity development and future literacy. This thesis reveals starting points for improvement, gives practical recommendations for action and further research directions, that are necessary to explore the differences between regions and constituencies further and improve the goal-setting process in the following years.

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Hanyinda, Kelvin. "The availability and adequacy of water, sanitation and hygiene (wash) infrastructure in 13 mission hospitals in rural Zambia." University of the Western Cape, 2019. http://hdl.handle.net/11394/6939.

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Magister Public Health - MPH
Background and Rationale The World Health Organization (WHO) has shown that the provision of Water Sanitation and Hygiene (WASH) in Health Care Facilities (HCFs) of many low and middle-income countries is poor. This is compounded by the lack of national plans and consolidated data on WASH in HCFs. This study assessed the availability and adequacy of Water Sanitation and Hygiene (WASH) infrastructure in 13 mission hospitals spanning 13 districts in Zambia. The objectives of this study were to identify the different kinds of WASH infrastructure available, and their adequacy, and factors influencing the status of WASH infrastructure and services in the selected hospitals. Methodology This study had a mixed methods design with semi-quantitative, descriptive and qualitative components. Assessments were conducted of the WASH infrastructure on the hospital property, and specifically in the male medical wards and outpatient facilities as two tracer areas, using a WHO checklist adapted and administered by the researcher. Checklist items were assigned scores (0=absent/bad to 2=on target/good) and total WASH scores for each facility compiled. For the qualitative component, individual semi-structured interviews using an interview guide were conducted, also by the researcher, with the facility managers and the head staff of the male medical wards. Results Overall coverage with an improved water source was reasonably good with 11 of the 13 hospitals reporting availability of improved water sources within the facilities. Hand washing basin coverage was similarly good. In contrast, coverage by well-functioning toilets was not as high, with 5 hospitals reporting toilets that were either broken, blocked, or having no running water and no toilet paper. Facility WASH scores varied from 22 (38%) to 57 (97%) out of a possible total of 58 points. Most of the Facility Managers indicated that the hospital WASH infrastructure was old, and with frequent breakdowns. This was worsened by lack of readily available spares and materials for repairing once there was a fault. Conclusion This study reveals an uneven coverage of WASH across facilities and elements, with poor sanitation a challenge across facilities. This is compounded by ongoing challenges in WASH infrastructure maintenance. Moving forward, there is need for government to develop a clear policy on WASH in HCFs. A national plan with resources and a monitoring framework need to be in place for streamlined support and tracking of progress by all stakeholders.

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Gleaton, Arlyn Nathalia. "Perceptions of Water, Sanitation and Hygiene Interventions in Select Communities in Central America. Recommendations to Explore the Issue of Sustainability." Digital Archive @ GSU, 2012. http://digitalarchive.gsu.edu/iph_theses/243.

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Background: Estimations from the Joint Monitoring program for Water Supply and Sanitation (JMP, 2012) reveal that “less than five percent of water and sanitation interventions are revisited once they have been completed and less than one percent are monitored over the long term”. Since 2000, the Centers for Disease Control and Prevention(CDC) has been working with the American Red Cross (ARC) to evaluate the long-term sustainability of post-disaster water, sanitation and hygiene interventions (WASH) provided in Guatemala, Honduras, Nicaragua and El Salvador. Sustainability assessments were conducted in 2006, 2009 and most recently in 2012. In the 2012 evaluation, a qualitative approached was included to extent the results obtained from quantitative surveys through an exploration of individual perceptions and current practices. Methodology: Key-informant interviews were conducted with the heads of household in 15 communities purposively selected. All interviews were recorded, transcribed, coded and analyzed using the computer assisted qualitative data analysis software MAXQDA10 Results: Interviewees discussed issues related to the quality, safety and adequacy of the water and sanitation infrastructure and hygiene education sessions received. Issues of corruption in the water committees and delayed repair of damaged infrastructure resulting in erratic service were frequently reported. In addition, lack of financial support, community engagement, and equity were identified by heads of household as major limitations to sustain and improve WASH interventions. Conclusions: This exploration provides valuable information to further examine the factors driving people’s adoption of hygienic practices and maintenance of water and sanitation facilities in the Central American region.

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Abad, Tent Pau. "The use of video to communicate water, sanitation and hygiene in Haiti: A comparison between SAWBO, GHMP and UNESCO’s cholera prevention initiatives." Thesis, Malmö universitet, Fakulteten för kultur och samhälle (KS), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-23457.

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Health communication campaigns in developing countries can take many different forms and make use of a wide range of communication tools. One of these tools are multimedia resources such as videos. Initiatives like the Scientific Animations Without Borders (SAWBO) or the Global Health Media Project (GHMP) have been created for the only purpose of developing videos adapted to different cultures and languages in order to tackle a variety of health issues relevant to developing countries. The present study pretends to focus on the use of such videos for water, sanitation, and hygiene (WASH) behavior in the context of cholera epidemic which hit Haiti in late 2010. By using comparative research procedures, three videos have been selected for content analysis from three different institutions: SAWBO, GHMP, and UNESCO Haiti. The results from this analysis served as guidelines for further survey analysis carried out through field questionnaires to a sample of the video’s target audience, that is, Haitian children aged from about 10 to 13 years old. The purpose of the study was to understand and compare the impact and effectiveness of these resources in transmitting disease prevention practices to the target audience. The results indicate that the videos usually coincided in the issues to inform about cholera, but differed in most of the features portrayed within the issues. Moreover, responses to the questionnaires reflected that the messages portrayed were only retained by an average half of the participants, with more or less success depending on the topic.

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Lombard-Latune, Rémi. "Innover pour les services d’assainissement en zone tropicale : approche technique par filtres plantés de végétaux et accompagnement par modélisation participative." Thesis, Lyon, 2019. http://www.theses.fr/2019LYSE1035/document.

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Les Objectifs de Développement Durable visent d'ici 2030 un « accès pour tous à des services d'assainissement et d'hygiène adéquats, en mettant fin à la défécation à l'air libre ». Un service d'assainissement peut-être défini par ses composantes techniques et sociales, et leurs interactions. Dans l'optique de proposer des pistes d'améliorations des services d'assainissement en zone tropicale, les travaux de cette thèse ont porté à la fois sur des infrastructures de traitement et sur l'implication de l'ensemble des acteurs dans la définition du service. L'analyse croisée des contextes des départements d'outre-mer (DOM) français et du Sénégal a permis d'identifier des contraintes qui pèsent sur le secteur de l'assainissement en zone tropicale. Du point de vue des infrastructures de traitement, ces contraintes nous ont amenées à proposer des procédés issus de la famille des Filtres Plantés de Végétaux (FPV) comme solutions à priori pertinentes. Cette thèse présente leurs adaptations à la zone tropicale, en détaillant les choix retenus pour le dimensionnement, la conception des filtres et le choix des végétaux. Une centaine de campagnes de suivi ont été réalisées sur 7 stations pilotes en tailles réelles, à travers les 5 DOM. Les résultats montrent que malgré une plus grande compacité, le dimensionnement proposé permet de conserver des niveaux de traitement au moins comparables à ceux observés en climat tempéré. Compte tenu des contraintes climatiques et organisationnelles en milieu tropical, une analyse de leur résilience à des perturbations et de leur fiabilité de traitement a été réalisée par une étude statistique sur les données produites par l'autosurveillance réglementaire. Elle montre que les FPV sont également plus fiables que les procédés de traitement conventionnel les plus répandus pour les petites collectivités. Ce qui s'explique à la fois par la barrière physique que représente ces procédés de cultures fixées sur support fin ainsi que par des besoins en entretien plus réduits. Le deuxième axe de recherche part du constat d'un manque de concertation entre acteurs au moment de la planification de l'assainissement, étape qui préside à la construction du système d'assainissement. En particulier, les utilisateurs, leurs besoins et leurs contraintes sont très peu et mal pris en compte. La modélisation d'accompagnement pourrait permettre de créer à la fois un support (le modèle) permettant de discuter des choix techniques et de leurs conséquences, ainsi que le cadre dans lequel les différents acteurs pourraient échanger leurs points de vue et trouver un consensus soutenable. Un processus de modélisation d'accompagnement a été conçu et mis en place sur la planification de l'assainissement dans 2 zones (urbaine et rurale) du Sénégal. Il nécessitait, pour proposer des scénarios viables, d'intégrer une part non négligeable de connaissances expertes. Centré sur les populations, ce processus a permis la création d'un premier modèle générique sur l'accès à l'assainissement qui prend la forme d'un jeu de rôle. La pertinence de tels outils dans la caractérisation des besoins des usagers a été évaluée. Par ailleurs, l'attention a été portée sur l'acceptation par les usagers du service proposé et sa traduction en volonté de contribution
Sustainable Develoment Goals aim by 2030, to « achieve access to adequate and equitable sanitation and hygiene for all and end open defecation », by « using safely managed sanitation services ». Sanitation service can be defined by its technical and social components, and their interactions. This thesis focuses on both treatment infrastructures and involvement of all the stakeholders into service definition. Cross analysis of French Overseas Territories (FOT) and Senegal contexts, has identified common constraints that weigh on sanitation sector in tropical areas. From treatment infrastructure point of view, these constraints lead to suggest treatment wetlands systems and particularly French vertical-flow treatment wetland (FS-VFTW) to easier sludge managment, as a relevant solution. Their adaptation for tropical climate is the subjet of the first axis of our work. It aimed at defining their adaptation in terms of design, plant choices and defining the treatment wetlands type to implement according to outlet requirements. A hundred of 24h sampling campains were performed on 7 full scale demonstration plants, accross the 5 FOTs. Results show that despite more compacity, the proposed design allows maintaining performances at least similar to those observed in temperate climate. Due to climatic and organizational constraints inn tropical climate, a statistical analysis has been done to point out the resilience and reliability of the systems based on regulatory selfmonitoring data. It highlights the fact that FS-VFTWs are more reliable than most of the conventional treatment processes when applied for small size communities. Their physical barrier (filter) and their lower maintenance requirement explain this observation. The second axis of our research is based on an observed lack of consultation between stakeholders during the sanitation planning phase, which is responsible for the construction of the sanitation system. In particular, the users, their needs and their constraints are poorly and badly taken into account. Companion modeling approach could create both a support (the model) for discussing technical choices, as well as the framework within which the stakeholders could exchange points of view and find a sustainable consensus. Such a process has been developed and implemented for sanitation planning in 2 areas (urban and rural) of Senegal. Focused on household population, this process has led to create a generic model for sanitation access, embodied as a role playing game, which include a significant part of expert knowledge. The relevance of such tools in the characterization of user needs has been evaluated. In addition, attention was paid to users' acceptance of the proposed service and its translation into a willingness to contribute

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Mikaelsdotter, Carolina. "Barriers affecting women’s decision to seek care during pregnancy, childbirth and postnatal period in rural Kenya." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-387655.

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Background: Antenatal care (ANC), facility delivery and postnatal care (PNC), are proven to reduce maternal and child mortality and morbidity in high burden settings. However, few rural pregnant women use these services sufficiently and it is essential to identify the barriers. Aim: The aim of this study was to examine barriers, with a focus on water, sanitation and hygiene (WASH), affecting women’s decision to seek care during pregnancy, childbirth and postnatal period in rural Kenya, and to examine if the Afya intervention helped overcome barriers. Methods: A qualitative study was conducted in the Siaya County, Kenya. 25 mothers were selected by using purposive sampling for in-depth interviews and focus group discussions. Assessment of WASH facilities was conducted at 5 healthcare facilities. Data were analysed by content analysis method. The “three delay model” informed the analytic process and discussion. Results: Women delayed seeking or did not attend ANC and PNC or gave birth at home, due to lack of knowledge of benefits of maternal health services and on complications; traditional and religious beliefs; embarrassed over pregnancy; busy with other life activities or of fear of HIV status and hospitals. Gender norms, distance and transport costs were the contributing factor for delaying in reaching the hospital. Unprofessional and inadequate number of staff, lack of equipment and supplies, and the water, sanitation and hygiene quality were factors delaying receiving quality care. The assessment showed on inadequate WASH facilities. Conclusion: Use of antenatal care, delivery and postnatal care in rural western Kenya is influenced by several barriers. The findings suggest a need to increase the knowledge about ANC and PNC, and to lower barriers preventing women from reaching the healthcare facility. There is also a need to improve the WASH facilities and the healthcare personnel’s treatment.

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Ritter, Rebecca Lyn. "Novel scale development to assess the role of sanitation access and use on household fecal contamination in Accra, Ghana." Thesis, University of Iowa, 2015. https://ir.uiowa.edu/etd/3174.

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Diarrheal disease is one of the leading causes of mortality of children under 5 years of age. Despite this, diarrheal disease is easily preventable through adequate water, sanitation and hygiene. Sanitation access is currently classified as “improved” or “unimproved” based on level of latrine access. This does not account for differences in human behaviors, or differences in exposure risk. A sanitation score was built using behavioral and access data in order to better classify the sanitation environment of a household. Due to low levels of sanitation access and practice of open defecation in Ghana, households in four neighborhoods in Accra, Ghana were selected to participate in the data collection. Data was collected through a survey, environmental sanitary inspections and collection of hand rinse and environmental swab samples. These samples were then tested for fecal indicators, by measuring presence and concentration of E. coli and human Adenovirus. A novel sanitation score based on latrine access and use for each household was created. Hierarchical linear and logistic regression was used to compare the sanitation score to the environmental contamination as indicated by the E. coli and Adenovirus. Higher sanitation scores were significantly associated with increases in Adenovirus concentration (PR=1.6, 95%CI=1.1, 2.2). The sanitation score was not significantly associated with E. coli or presence of Adenovirus. Further development of a sanitation score variable could help to better understand sanitation environments.

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Njingana, Sikhanyisele. "Role of water as a resource in hygiene and sanitation." University of the Western Cape, 2019. http://hdl.handle.net/11394/6810.

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Magister Philosophiae (Land and Agrarian Studies) - MPhil(LAS)
Water supply and sanitation remain a huge problem in townships and rural areas of South Africa, in effect affecting the water supply, hygiene and health of marginalized communities. Following democracy in 1994, South Africa’s new government embarked on a program of eradicating backlogs in water supply and sanitation that had become endemic under apartheid in townships and rural areas. In addition, South Africa’s constitution categorically states that every citizen has a right to a minimum of basic water supply and sanitation. Internationally, access to basic water supply and sanitation are fundamental human rights. Thus the South African government aims is to ensure that all South Africans have access to basic water and sanitation services. This study investigated the quantity and quality of water and how these effect sanitation and hygiene of communities using Walmer Township in the Nelson Mandela Bay Municipality as a case study. The study used a multi-pronged methodological approach including structured interviews with a sample of households, key informant interviews, focus group discussions, observations and secondary information. Although the Walmer Community felt that they had access to sufficient quantity of water for their daily use and that the quality of the water was fine, the reality was that most households use less than the daily minimum amount of water per person as required in the constitution because of the distance where they have to fetch the water, which is too far to collect more water than they absolutely need. There is need for municipality to provide more stand pipes in order to reduce the distance that most households have to walk to fetch water. 80% of Walmer residents still use the bucket system, which is the issue that the community is more aggrieved about. One of the reasons the bucket system persists is the unplanned development of the Township and the type of dwellings (mostly shacks) that people still use. Also, the Township has grown and mushroomed organically as a result of the constant influx of people looking for better economic opportunities from rural areas or other urban areas. This makes it very difficult for the municipality to plan for and provide services and infrastructure as the Municipality is always playing catch-up. Worse still, the average number of people that use each bucket toilet (over 80) makes it extremely difficult to maintain the toilets clean and in functional and usable state at all times. Another problem is that the buckets, in particular those managed by the municipality, are not collected as scheduled resulting in spill-over of the toilets. Most of all, there are currently no clear arrangements around management and maintenance of the bucket toilets. Therefore the impact that the bucket system has on the residents’ health and hygiene, and the general Township environment is dire. The uncontrolled and continuing influx of people into Walmer Township has led to very high population density, with the average number of people per household up to ten. Most people of working age in these households are unemployed, which means that most households in the Township depend on social grants for survival. The high unemployment rate and dependency on social grants by most households in Walmer Township means that the community cannot afford to pay for services and therefore depend on amenities provided by the Municipality. The majority of the population of Walmer Township depends on basic services provided by the Municipality. These are provided as public amenities available to all Walmer residents, which makes them largely ‘open access’. This has resulted in poor management and poor maintenance of these amenities. The unhygienic state of most of the bucket toilets and the poor state of water stand taps is as a result of this current management arrangement. It would improve management of these public amenities if a system of locating stand taps and bucket toilets to specific households that could limit access and use to these defined groups of households was introduced. These households would then be responsible for maintaining and managing use of the specific and allocated amenities. The current management arrangements for these public amenities point to the fact that there is currently lack of participatory planning and management between the Municipality and the community. The Municipality takes top-down decisions resulting in disjuncture between the Municipality and the Community in terms of real community needs, provision of these needs, and how they should be serviced and managed.

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Okyere, Charles Yaw [Verfasser]. "Water Quality in Multipurpose Water Systems, Sanitation, Hygiene and Health Outcomes in Ghana / Charles Yaw Okyere." Bonn : Universitäts- und Landesbibliothek Bonn, 2018. http://d-nb.info/1161527087/34.

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Yaw, Okyere Charles [Verfasser]. "Water Quality in Multipurpose Water Systems, Sanitation, Hygiene and Health Outcomes in Ghana / Charles Yaw Okyere." Bonn : Universitäts- und Landesbibliothek Bonn, 2018. http://nbn-resolving.de/urn:nbn:de:hbz:5n-48542.

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Cohen, Byron. "Water and Sanitation Policy in Selected Case Studies: Equatorial Guinea, Malawi, and Mauritania." Scholarship @ Claremont, 2016. http://scholarship.claremont.edu/cmc_theses/1412.

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What are the policy-relevant factors that condition WASH sector performance in Sub-Saharan Africa? Close examination of three case study countries, Equatorial Guinea, Malawi, and Mauritania, reveals interesting insights. Delivery of WASH services is shaped to a large extent by the overall quality and structure of a country’s government. More specifically, having an excessive profusion of policy-making and policy-implementing actors can hinder WASH sector performance. Furthermore, governments may face strong incentives to invest more heavily in providing WASH services to urban areas over rural areas, and to invest more heavily in the water sub-sector than in the sanitation sub-sector. Adequate financing of WASH investment appears to be a necessary but not sufficient condition for performance in both the water and sanitation subsectors. Additionally, monitoring and evaluation appears to be a crucial factor in formulating and implementing effective policies. In the rural water subsector, a country’s institutional setup and technology choice can have a major impact on water source maintenance and operability.

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Webster, James. "Culture's influence: towards understanding stakeholder interactions in rural water, sanitation and hygiene promotion projects." Thesis, Cranfield University, Cranfield University at Silsoe, 2006. http://hdl.handle.net/1826/1369.

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Variations frequently occur between the intended and actual outcomes of rural water, sanitation and hygiene promotion projects, even projects that exhibit best practice. As a result, the intended impact of poverty reduction through sustained health improvements is diminished. This thesis establishes that inadequate consideration of culture in interactions between and within project stakeholders is a major reason for these unintended project outcomes. Aspects of individual and group behaviour that are influenced by culture are examined, and an initial conceptual framework of established cultural dimensions developed. This framework is then applied to a broad variety of stakeholder groups: seven end user groups and two implementing agencies in Ethiopia and Uganda; national Governments and international donor organisations. As a result, two new cultural dimensions are proposed. Firstly, concern for public selfimage, defined as ‘the degree to which an individual expresses interest in how others perceive him/herself, and the manner in which the individual seeks to influence that perception’. Secondly, spirituality, defined as ‘the nature and degree of people’s beliefs and practices concerning the existence, nature, and worship of, and connectedness to God, a god, gods, or a greater spiritual whole, and involvement of the divine or greater spirit in the universe and human life’. Aspects of these dimensions that need to be measured are identified. Hierarchies of cultural dimensions are identified where a certain combination of individual or group orientations causes the suppression or even reversal of behaviour in a dimension. Modifications to established cultural dimensions are recommended, especially long-term orientation which the author proposes renaming to ‘resistance to change’. A multidisciplinary approach that reflects the complexities of group behaviour and converges research findings is recommended, including utilising software that simulates complex systems. Recommendations are made for development practitioners, especially to enhance participation, promote femininity and achieve lasting change through training.

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Webster, James. "Culture's influence : towards understanding stakeholder interactions in rural water, sanitation and hygiene promotion projects." Thesis, Cranfield University, 2007. http://dspace.lib.cranfield.ac.uk/handle/1826/1369.

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Variations frequently occur between the intended and actual outcomes of rural water, sanitation and hygiene promotion projects, even projects that exhibit best practice. As a result, the intended impact of poverty reduction through sustained health improvements is diminished. This thesis establishes that inadequate consideration of culture in interactions between and within project stakeholders is a major reason for these unintended project outcomes. Aspects of individual and group behaviour that are influenced by culture are examined, and an initial conceptual framework of established cultural dimensions developed. This framework is then applied to a broad variety of stakeholder groups: seven end user groups and two implementing agencies in Ethiopia and Uganda; national Governments and international donor organisations. As a result, two new cultural dimensions are proposed. Firstly, concern for public selfimage, defined as ‘the degree to which an individual expresses interest in how others perceive him/herself, and the manner in which the individual seeks to influence that perception’. Secondly, spirituality, defined as ‘the nature and degree of people’s beliefs and practices concerning the existence, nature, and worship of, and connectedness to God, a god, gods, or a greater spiritual whole, and involvement of the divine or greater spirit in the universe and human life’. Aspects of these dimensions that need to be measured are identified. Hierarchies of cultural dimensions are identified where a certain combination of individual or group orientations causes the suppression or even reversal of behaviour in a dimension. Modifications to established cultural dimensions are recommended, especially long-term orientation which the author proposes renaming to ‘resistance to change’. A multidisciplinary approach that reflects the complexities of group behaviour and converges research findings is recommended, including utilising software that simulates complex systems. Recommendations are made for development practitioners, especially to enhance participation, promote femininity and achieve lasting change through training.

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Bostoen, Kristof. "Measuring access and practice : designing a survey methodology for the hygiene, sanitation and water sector." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2007. http://researchonline.lshtm.ac.uk/682235/.

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Access to safe water and sanitary means of excreta disposal are essential elements of human development and poverty alleviation. It is estimated that one in four people in the developing world lacks access to water while over half the population has no access to sanitation. From the Alma-Ata declaration in 1978 to the recent Millennium Development Goals, efforts to improve this situation have been hampered by the lack of meaningful indicators to measure hygiene, sanitation and water coverage and establish progress towards the goals and targets set out by the international community. This thesis aims to determine if measuring prevalence of access to water~ sanitation and the practice of hygienic behaviour in hous~hold surveys can be.improved. With no indicators available in current international' laws and targets, various aspects of access and practice were examined to design indicators for field-testing. By using - existing data sets, the research established that there is a high geographic clustering of the measures of interest, which results in large design effects (deff) and rates of homogeneity (roh) in cluster surveys. Based on the calculated roh optimum numbers ofcluster and sample size were calculated for the field trials. This requires introducing survey costs in the sample size calculations. The high clustering of water and sanitation indicator require large sample sizes, resulting in large amounts of data which organisations in the four field trials in Kosovo, South Africa, Kenya and Laos found difficult to handle. Practical problems in the implementation of the survey method resulted in non-sampling errors and could cause reluctance in adoption the methodology. The research improved water and sanitation indicators but found that for individual behaviour such as hygiene the household is not a suitable sampling unit. It also showed that observation among interviewers have to be better standardised to reduce the inter-surveyor.variation. Representative sampling is the current bottleneck in the development of such a survey method. Current method requires a good understanding of sampling theory as well as reliable sample frames, which are rarely available to implementing organisations. Alternative sampling methods are suggested, and recommendations are made for the further development ofthe survey method designed in this research, which to date may be too complex for widespread use.

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Greene, Nicola. "Intra-annual variability in standards of water and sanitation in Upper Humla, Nepal : an investigation into the causes, importance and impact." Thesis, Loughborough University, 2014. https://dspace.lboro.ac.uk/2134/16183.

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This study investigates the impact of seasonality on standards of water and sanitation in the mountainous district of Humla, Nepal. The research considers impact on two levels: community level access and service delivery. First of all, it examines annual variation in village level access to water and sanitation. Secondly, it looks at the wider picture of service delivery and considers how seasonal variations present opportunities and challenges for improvement in standards for water and sanitation. Three case studies from Humla are presented which illustrate village level access to water and sanitation over a calendar year. These case studies summarise the content of 45 semi-structured interviews, 9 focus group discussions and 9 months of observational work in the district. Variations in weather, village population, infrastructure functionality, and environmental conditions are found to influence the experienced levels of access to water and sanitation at any given time. The impact of seasonality on service delivery was investigated via 39 key informant interviews. Both climatic (e.g. weather) and non-climatic (e.g. budget timings) sources of seasonality are found to impact programme implementation. The mismatch of local seasonal calendars and those imposed by central hubs is found to cause particular difficultly in effective delivery of water and sanitation services. The findings of this research have theoretical, methodological and practical implications. Theoretically, it is suggested that a mountain community s level of access to water and sanitation varies considerably over the course of a calendar year to the point where it needs to be considered if on the ground standards are to be improved. Methodological guidance is provided detailing means of investigating seasonality and its impact on standards of water and sanitation in other scenarios. Practical suggestions focus on incorporating seasonality into assessments of access to water and sanitation and programme delivery in mountain communities.

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Kanyerere, Joyce Robertson Ng'oma. "Exploring factors that influence learners' use of sanitation facilities and personal hygiene practices in a girls' boarding school, Zomba District, Malawi." University of the Western Cape, 2016. http://hdl.handle.net/11394/5591.

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Magister Public Health - MPH
Background: Millennium Development Goal 7 was to ensure environmental sustainability by aiming to halve the proportion of people without sustainable access to basic sanitation and safe drinking water by the year 2015. The 2015-MDG Report estimated that the use of improved sanitation rose from 54% to 68% globally, but the target of 77% was not met, and that implies slowing the progress in the health and education sectors. Although Malawi has made significant progress in increasing access to safe water and improved sanitation in comparison to other Sub-Saharan African countries, disparities in improved water supply and sanitation within Malawi remains a challenge. In Malawi, only about a quarter of all schools have improved latrines with a ratio of one latrine for every sixty learners. While the water and sanitation situation in primary schools of Malawi is reported to be making progress, such progress remains unreported in secondary schools. Aim: The purpose of this qualitative study was to provide insight on the water and sanitation situation in secondary schools by understanding factors that influence learners' use of the water and sanitation facilities and personal hygiene practices in a girls' boarding secondary school in Zomba District, Malawi. Methodology: This study employed a descriptive qualitative study design using individual interviews, focus group discussions (FGDs) and observations. A purposive sample consisting of 12 learners participated in two FGDs, while individual interviews were conducted with 6 prefects, 2 teachers responsible for sanitation at the school and 1 matron. The FGDs and individual interviews were targeted at exploring these participants' perceptions, experiences, challenges faced in the use of water and santation facilities and perceptions of appropriate interventions to improve hygiene practices and utilization of sanitation services. Thematic analysis was used to analyze the data. Findings: The findings indicate that there were several factors that influenced learners' use of water and sanitation and their hygiene practices at the school. One of the main challenges was the irregular supply of safe water by the Southern Region Water Board which meant that alternate sources of water, which was not always potable, had to be used instead. Poor water and sanitation infrastructure and facilities including lack of privacy in shower cubicles and the poor condition of the incinerator that is meant for disposal of sanitary pads were other challenges facing the learners. There were also insufficient toilets and shower cubicles for the number of learners at the school. A good number of learners knew the importance of hand washing for their personal health at school, but limited accessibility to running water compromised their hand washing practices and personal hygiene including menstrual hygiene. Conclusion: It can be concluded that the challenging factors occur at the macro, meso and micro levels but more importantly that these levels are interrelated and impact on one another, emphasising the complexity of the water and sanitation situation in the study school, but could most likely also be the situation at other schools in Malawi. Therefore multi-level interventions will have to be put in place to address these challenges. Recommendations: The present study recommends that at macro level the Department of Education should provide an enabling environment and political will to facilitate development of a multi-sectoral approach that would complement the school operation rules to improve the adequacy of the water and sanitation facilities and hygiene practices. In addition, the Southern Region Water Board should ensure a reliable supply of safe water to the school and provide better infrastructure of piped water. At meso level (school organisational level), the school management should take more responsibility for maintaining the infratstructure. In addition, the school-board, the school management and parents'-teachers' association and learners should form a committee to discuss and implement strategies that would enhance the learner's use of water and sanitation facilities at the school and ensure their privacy and dignity. At micro level, the school, the communities including families and religious leaders should encourage personal hygiene practices repeatedly amongst everybody.

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Cantrell, Brittany L. "An Evaluation of a Water, Sanitation, and Hygeine Program in Rural Communities Outside Port-Au-Prince, Haiti." Digital Archive @ GSU, 2013. http://digitalarchive.gsu.edu/iph_theses/260.

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Background: In 2010, a massive earthquake left the capitol Port-au-Prince in ruins and destroyed infrastructure providing electricity, piped clean water, and waste removal to the region. Water, sanitation, and hygiene intervention programs attempt to reduce the burden of water-related disease in earthquake-affected regions. However, there are few evaluations of these programs, especially following natural disasters. Methods: Data provided by Samaritan’s Purse Canada’s WASH program were examined. The data set included a household (N=1198) and a latrine (N=167) survey that recorded household use of laundry pads, bath houses, hand-pumped drilled wells, health and hygiene education sessions, and latrines as well as demographic data. Data analysis was conducted in IBM SPSS Version 20.0. Descriptive statistics were computed, and statistical relationships were analyzed for 1.) Health and hygiene education session attendance and program outcomes and 2.) Household diarrheal disease and program interventions Results:This study found that households attending any of four health and hygiene sessions were significantly more likely to use program-provided bath houses and hand-pumped wells (p Discussion: This study concluded that health and hygiene session attendance is positively associated with the utilization of program interventions. However, further improvements in data collection methodology are needed to fully understand the effects of this multi-intervention WASH program on target communities.

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Cantrell, Brittany L. "An Evaluation of a Water, Sanitation, and Hygiene Program in Rural Communities Outside of Port-au-Prince, Haiti." Digital Archive @ GSU, 2013. http://digitalarchive.gsu.edu/iph_theses/286.

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Background: In 2010, a massive earthquake left the capitol Port-au-Prince in ruins and destroyed infrastructure providing electricity, piped clean water, and waste removal to the region. Water, sanitation, and hygiene intervention programs attempt to reduce the burden of water-related disease in earthquake-affected regions. However, there are few evaluations of these programs, especially following natural disasters. Methods: Data provided by Samaritan’s Purse Canada’s WASH program were examined. The data set included a household (N=1198) and a latrine (N=167) survey that recorded household use of laundry pads, bath houses, hand-pumped drilled wells, health and hygiene education sessions, and latrines as well as demographic data. Data analysis was conducted in IBM SPSS Version 20.0. Descriptive statistics were computed, and statistical relationships were analyzed for 1.) Health and hygiene education session attendance and program outcomes and 2.) Household diarrheal disease and program interventions Results: This study found that households attending any of four health and hygiene sessions were significantly more likely to use program-provided bath houses and hand-pumped wells (p<0.05). Attendance was also significantly associated with increased knowledge of diarrheal disease prevention and hand washing technique. Households using the program-provided hand pump reported lower rates of diarrhea in children under five years old. Discussion: This study concluded that health and hygiene session attendance is positively associated with the utilization of program interventions. However, further improvements in data collection methodology are needed to fully understand the effects of this multi-intervention WASH program on target communities.

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Mulondo, Michael. "Participatory action research approach to address the poor water, sanitation and hygiene conditions in an informal urban settlement in Windhoek, Namibia." University of Western Cape, 2020. http://hdl.handle.net/11394/7684.

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Philosophiae Doctor - PhD
Water, sanitation and hygiene (WASH) are fundamental to health and are regarded as a fundamental human right for survival, dignity, productivity, reproductive health and happiness. In low socio-economic communities and settings, especially those who are residing in informal urban settlements, where appropriate WASH interventions are not in place, the risks of mortality and morbidity from especially infectious disease are high. A participatory action research (PAR) study was conducted to address the poor WASH conditions in the Havana informal urban settlement in Windhoek, Namibia. The study comprises of four phases.

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Grimes, Jack Edwin Thomas. "An investigation into the roles of water, sanitation, and hygiene in the control of schistosomes and other helminths." Thesis, Imperial College London, 2015. http://hdl.handle.net/10044/1/44497.

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Schistosomes (primarily Schistosoma mansoni, S. haematobium, and S. japonicum) and soil-transmitted helminths (STHs: Ascaris lumbricoides, Trichuris trichiura, and hookworms) are prevalent parasites in many tropical countries. Their life cycles suggest that water, sanitation, and hygiene (WASH) might reduce their transmission. However, this field has suffered from a lack of rigorous studies with sufficient statistical power. A systematic review and meta-analysis determined that people with access to safe water and adequate sanitation have significantly lower odds of schistosome infection, although there was a risk of socioeconomic confounding (that is, people of higher socioeconomic status having better WASH and being protected from infection for other reasons). A more qualitative review identified many sources of complexity and non-linearity between WASH exposures and schistosome infection outcomes. Next, in a survey in and around 30 schools in southern Ethiopia, children were tested for the parasites, and school-, household-, and child-level WASH facilities and practices were assessed. Child- and household-level sanitation risk factors were compared with hookworm infection (the other helminths being very rare), but no significant associations were found. Finally, a school-level WASH survey was integrated into an Ethiopian national mapping programme for schistosomes and STHs, and data were collected from 1,645 schools. School-level scores were constructed, reflecting exposure to potentially schistosome-infested water during the collection of water for school, and the adequacy of school sanitation and hygiene facilities. These were compared with school-level arithmetic mean infection intensities for S. mansoni and the STHs, using Kendall's τb. Statistically significant associations were found for water and S. mansoni, sanitation and A. lumbricoides, and hygiene and hookworm, suggesting that these are the WASH elements best suited to the control of the respective parasites.

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Rosenberg, Anna Charlotta. "Overlooking Girls’ Wellbeing : The opportunity cost of education encountered by menstruating schoolgirls in Sub Saharan Africa." Thesis, Södertörns högskola, Institutionen för naturvetenskap, miljö och teknik, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:sh:diva-32254.

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Educating girls is advantageous for future livelihood security and socio economic development. Menstruating schoolgirls especially need to experience improved menstrual hygiene management (MHM) within schools in order to obtain quality education towards securing future as well as present wellbeing. This paper explores how menstruating schoolgirls’ opportunities are affected by insufficient water, sanitation and hygiene (WASH) facilities in schools within Sub-Saharan Africa. The required information has been gathered through a qualitative research method using scientifically based material on the situation of MHM in Sub-Saharan African schools as well as semi-structured questionnaires alongside my personal recollection of MHM. Focus has been given to the capabilities of menstruating schoolgirls under existing WASH facilities in schools analysed through the Capability Approach. Effects of poor MHM in schools are known to cause discomfort and poor constructive participation during lessons as well as decreased school attendance. A gender-based approach has also been examined which presents most schools as non-conducive towards girl’s education promotion.
Utbildning är gynnsam för deras framtida försörjningsmöjligheter samt för socioekonomisk utveckling. Menstruerande skolflickor är mest utsatta under de otillräckliga sanitetsförhållanden som råder i flera skolor söder om Sahara. Den här rapporten utforskar skolflickors förmåga att sköta deras menshygien under skolvistelsen samt hur bristande sanitetsresurser påverkar flickornas framtida utsikter och akademiska kapacitet. Undersökningen är baserad på en kombination av kvalitativa metoder och material som vetenskapliga studier, en semistrukturerade enkätundersökning samt min egen erfarenhet av menshygien i skolor söder om Sahara. Fokus har tillägnats menstruerande skolflickors möjligheter att hantera deras mens i ohygieniska förhållanden genom att koppla detta till ”The Capability Approach”. Avsaknaden av fungerande sanitetsstrukturer försämrar skolflickors välmående vilket leder till nedsatt deltagande under lektioner samt minskad skolgång vid mens. En könsbaserad utgångspunkt har det också påvisat att skolorna är mindre anpassande för flickor.

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Hasan, Mohammad Monirul [Verfasser]. "Investment in health within the agriculture, water, sanitation and hygiene nexus for rural households in Bangladesh / Mohammad Monirul Hasan." Bonn : Universitäts- und Landesbibliothek Bonn, 2018. http://d-nb.info/1160033870/34.

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Freeman, Matthew Charles. "The impact of a school-based water, sanitation and hygiene program on health and absenteeism of primary school children." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2011. http://researchonline.lshtm.ac.uk/682433/.

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This thesis describes research designed to quantify and describe the impact of improved access to school water, sanitation, and hygiene (WASH) access on pupils' helminth infection and diarrhoeal disease and absence from school. The research was undertaken as part of a five-year cluster-randomized trial in 185 public primary schools in Nyanza Province, Kenya that addressed school WASH impacts, knowledge diffusion, sustainability, and advocacy. One hundred eighty-five schools were randomly selected and assigned to five study arms to receive various water treatment, hygiene promotion, sanitation, and water supply improvements. All pupils at enrolled schools were dewormed at baseline and at two follow-up time pOints. A total of 11,458 pupils were interviewed over two years to compare rates of school absence, rates and intensity of reinfection with soil transmitted helminths, and risk of diarrhoeal disease. We found no overall impact of our school-based WASH intervention on pupil absence. However, a domain analysis revealed a substantial and significant reduction in absence for girls attending schools that received WASH improvements. Schools that received a hygiene promotion and water treatment (HP&WT) intervention showed statistically similar reductions to those that received HP&WT in addition to sanitation improvements. Gender-specific effects were also found for reduced reinfection of soiltransmitted helminth infection. Girls showed a significant decline in prevalence and intensity of infection with Ascaris lumbricoides, while boys showed reduced reinfection for Hookworm. Household WASH characteristics significantly modified the effect of the school-based intervention, revealing potential questions about exposure to fecal pathogens at home and at school. Schools that received HP&WT and those that received HP&WT plus sanitation improvements showed no reduction in diarrhoeal disease prevalence. However, schools allocated to the water "scarce" research group, which received water supply improvements in addition to HP&WT and sanitation, did show significant and substantial reductions in both prevalence and duration of diarrhoeal illness. While household-level WASH has been investigated extensively, this is the first comprehensive study to investigate the impact of improved WASH at schools. Overall, our results reveal the important role that school WASH can play in mitigating disease burden and lowering pupil absence. Additional research is necessary to fully explore these issues.

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Giné, Garriga Ricard. "Monitoring water, sanitation and hygiene services : developing tools and methods to measure sustainable acces and practice at the local level." Doctoral thesis, Universitat Politècnica de Catalunya, 2015. http://hdl.handle.net/10803/334692.

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Water and sanitation improvements together with good hygiene (WaSH) have well-known positive impacts on human development and poverty alleviation. However, universal access to safe drinking water and basic sanitation remains a huge challenge in many low income countries, where vast numbers of people lack these basic services. To help end this appalling state of affairs, the Millennium Development Goals and other international initiatives have been launched to reduce the proportion of underserved people. These efforts, however, have been hampered by the lack of meaningful indicators to measure coverage and to establish progress towards the goals and targets set out by the international community. From an institutional viewpoint, the competences for many sector-related responsibilities have been delegated to lower administrative levels of government. It has come to be widely accepted that such decentralization process can help to reduce poverty because local governments are assumed to be more knowledgeable about and responsive to the needs of the poor. The sector also calls for greater transparency and accountability. In all, local decision-makers are being increasingly challenged by the need to take informed decisions and give an objective account of their actions, which rely crucially on adequate monitoring and reporting systems. Amongst others, available data may be employed to i) measure progress and performance; ii) improve transparency in budgetary procedures; and iii) allocate resources to deliver services where they are most needed. Today, reliable information on key WaSH-related variables at the local level is often missing, but even when it is available, the uptake and usage of such data by policymakers is, at best, challenging. Limited capacity of recipient governmental bodies, an inadequate monitoring and reporting framework, and lack of data updating mechanisms are common reasons that hamper an adequate appropriation and continued use of the data for planning and monitoring purposes. In an effort to address the shortcomings cited above, this thesis discusses methodologies for routine data collection and develops tools and processes to support local planning. In doing so, it covers the monitoring cycle of data collection, data analysis and data dissemination. In Chapter 1, an improved approach for data collection is presented. It combines two different information sources: the water point and the household, and thus provides a more complete picture of the context in which the services are delivered. Chapter 2 reviews four different approaches that are commonly adopted for monitoring purposes: i) health impact indicators; ii) the Joint Monitoring Programme; iii) one multidimensional, water-focused composite indicator; and iv) easy-to-use planning indices designed locally on an ad hoc basis. From a policy-making perspective the usefulness of outcomes produced by each approach is discussed. Chapter 3 introduces a variety of policy tools that may be used to promote decision-making: i) composite indices; ii) a small set of simple thematic indicators; and iii) object oriented Bayesian networks (ooBn). Chapter 4 presents different alternatives to enhance data interpretation and disemination, which is crucial to promote evidence-based and equity-oriented planning. Overall, results indicate that accurate and comprehensive data, if adequately collected, exploited and visualized through simple instruments, can serve as the basis for effective targeting and prioritization, both central to sector planning. The actual application and implementation of the proposed monitoring and reporting tools and processes in the real world, however, is to a certain extent elusive; and this has been pointed out as a major weakness of this research. Two specific challenges that remain unaddressed, namely the upgrading of decision support systems, and the design of data updating mechanisms, suggest the way forward.
Assegurar l'accés a l'aigua, promoure la higiene i facilitar l'accés al sanejament ajuda a prevenir la transmissió de malalties relacionades amb una deficient provisió d’aquests serveis i reduir el risc d'epidèmies. No obstant, l'accés universal a l'aigua potable i als serveis bàsics de sanejament segueix sent un enorme desafiament en molts països en vies de desenvolupament, on un gran nombre de persones continuen sense tenir cobertes unes necessitats bàsiques. En aquest context, el sector ha vist com es posaven en marxa vàries iniciatives, com els Objectius de Desenvolupament del Mil·lenni, per tal de reduir la proporció de persones desateses. Aquests esforços, però, s'han vist obstaculitzats per la falta d'indicadors fiables alhora d’avaluar el nivell de cobertura i de mesurar els avenços envers les metes i els objectius establerts per la comunitat internacional. En els darrers anys, les competències sectorials s'han delegat a les administracions locals, sota el supòsit de que els processos de descentralització ajudarien a reduir la pobresa en base a un millor coneixement, per part de les autoritats locals, sobre les necessitats reals de la població. Així mateix, també ha anat creixent la demanda de més transparència i una millor rendició de comptes. Per tots aquests motius, cada vegada s’ha anat qüestionant més el fet de que els processos de presa de decisió no es fonamentin en informació actualitzada i basada en evidències, i no depenguin per tant d’un marc adequat que permeti el correcte seguiment, avaluació i la presentació periòdica d'informes. Entre altres coses, la informació disponible s’hauria de poder utilitzar per i) mesurar els avenços i el progrés assolit; ii) millorar la transparència i el control pressupostari; i iii) assignar els recursos disponibles de manera equitativa. Dissortadament, la informació sobre el sector és generalment escassa, però fins i tot quan és accessible, el seu ús per part dels governants és limitat. Amb la voluntat d’abordar aquest accés i ús deficient de la informació, aquesta tesi desenvolupa eines i processos per donar suport a la planificació local dels servies d’aigua i sanejament. En síntesi, es pretén cobrir tot el cicle de la informació, que integra la recollida, l’anàlisi i la seva posterior difusió. En el capítol 1 es presenta una metodologia millorada per a la recopilació de dades. Aquesta combina dues fonts d'informació: el punt d'aigua i la llar; i en conseqüència proporciona una visió més completa del context en què es proveeixen els serveis. El Capítol 2 presenta quatre enfocaments diferents a l’hora d’avaluar el nivell de servei: i) indicadors d'impacte sobre la salut; ii) el Programa Conjunt de Seguiment de la OMS i UNICEF; iii) un indicador agregat multidimensional; i iv) una bateria d’índexs de planificació dissenyats ad hoc per respondre a les necessitats locals. Es discuteix la utilitat de cada alternativa i la seva pertinença des d’una òptica de política pública. El Capítol 3 introdueix varis instruments dissenyats per a promoure la presa de decisions: i) índexs agregats; ii) indicadors temàtics senzills; i iii) les xarxes bayesianes. El Capítol 4 presenta diferents alternatives per millorar la interpretació i disseminació de la informació, que esdevenen activitats necessàries per a promoure una planificació basada en l'evidència i orientada a l'equitat. Per concloure, els resultats indiquen que l’accés a la informació, si aquesta es compila correctament, s’explota i es visualitza a través d’instruments i processos senzills, pot revertir en una correcta priorització d’accions i de grups beneficiaris i, per tant, millorar la planificació sectorial. És cert, però, que l'aplicació real i la posada en pràctica d’aquestes eines i processos no és en cap cas trivial. Es plantegen, en aquest sentit, dos reptes que suggereixen el camí a seguir: la millora dels sistemes de suport a les decisions i el disseny de mecanismes adequats per a l'actualització de dades.

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Sours, Patrick J. "Maji Marwa: Rainwater Harvesting Initiative." The Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu1563367729255742.

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Manona, Wellman Wela. "Impact of health, water and sanitation services on improving the quality of life of poor communities." Thesis, Stellenbosch : Stellenbosch University, 2004. http://hdl.handle.net/10019.1/49987.

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Thesis (PhD)--Stellenbosch University, 2004.
ENGLISH ABSTRACT: Good health is a major imperative for social, economic and personal development, thus an important dimension of quality of life. Quality of life, in turn, is significantly influenced by access to the goods and services provided by the State. Access to infrastructure and services such as water and sanitation, has direct effects on health. Thus, the delivery of health, water and sanitation services should ensure improved access to basic needs, enhance the health profile of poor communities and their access to employment opportunities. Safe clean water supplies and adequate sanitation services therefore are among the major determinants of health. Health-related services such as water and sanitation should ensure a certain average life expectancy and eliminate mass disease and ill health. Mindful of the fact that there are many factors that determine the quality of life, the aim of the study was to investigate the impact of health, water and sanitation services in improving the quality of life among poor communities. To do this, this study adopted a comparative qualitative analysis approach between poorly serviced and adequately serviced areas. Subsequent to the findings, this study espouses constructive suggestions and recommendations that could act as guidance to community development agencies' strategies in amelioration of the quality of life among poverty-stricken communities. The research was based on a narrow model of services (health, water and sanitation services) that have impact on improving the quality of life among poor communities. The empirical findings of this study indicate these services to be insufficient to draw conclusive findings in other aspects of the survey. The research was conducted in a sample of 573 households in 6 communities in the Eastern Cape and Western Cape Provinces in South Africa. The sample comprised 3 communities in the category classified as poorly serviced with health, water and sanitation services, and 3 communities that were regarded as adequately provided with these services. The data was gathered by means of structured questionnaires, administered by the researcher with the assistance of a trained field worker. Additional, the data was gathered by means of a semi-structured, open-ended interview with a Sister-in-Charge of a clinic in the rural villages. The interaction between variables on the improvement of the quality of life were explored by means of basic statistics, which made it possible to assess the effects of independent and dependent variables. The results of data analysis provided support for the proposition contained in the premise of the study that although the provision of health, safe clean water and adequate sanitation services lead to improvement in the standard of living, their impact alone does not incorporate all the attributes that enhance quality of life as suggested by mainstream schools of thought in the health sector. Poverty-related factors also have to be taken into account. As such, the findings of this study have shown that poverty, combined with poor public health conditions, inadequate nutrition, overcrowded poor quality housing, lack of accessible drinking water and sanitation, renders communities vulnerable to ill health. Given the poor socio-economic conditions prevalent in the communities under investigation, it was not surprising that tuberculosis was most prevalent in all areas. In line with the premise of this study, there were instances that povertyrelated factors such as income, housing and nutrition had significant influences with regard to improvement in the quality of life. It became evident therefore that in certain instances, health, water, and sanitation services alone are not sufficient to make conclusive findings. Thus, the impact of povertyrelated factors such as income, housing and nutrition necessitate expansion of factors that impact on the quality of life to include their influence.
AFRIKAANSE OPSOMMING: Goeie gesondheid is 'n belangrike vereiste vir sosiale, ekonomiese en persoonlike ontwikkeling, en dus ook 'n wesenlike aspek van 'n goeie lewensgehalte. Toegang tot goedere en dienste wat deur die staat voorsien word, het ook 'n beduidende invloed op lewensgehalte. Boonop het die toegang tot infrastruktuur en dienste soos water en sanitasie 'n direkte invloed op gesondheid. Die lewering van gesondheids, water- en sanitasiedienste verseker dus die bevrediging van basiese behoeftes, onderwyl arm gemeenskappe se gesondheidsprofiel en daarmee saam hul toegang tot werksgeleenthede verbeter word. Toegang tot veilige en skoon waterbronne en voldoende sanitasiedienste is gevolglik van die belangrikste gesondheidsbepalers. Gesondheidsverwante dienste soos water en sanitasie verseker 'n sekere gemiddelde lewensverwagting, en verminder die moontlikheid van wydverspreide siektetoestande. Met inagneming van die feit dat lewensgehalte deur talle faktore beïnvloed kan word, was die doel van hierdie studie om ondersoek in te stel na die invloed van gesondheids, water- en sanitasiedienste op die verbetering van lewensgehalte in arm gemeenskappe. Gevolglik is 'n vergelykende analise tussen areas met swak dienslewering en areas met bevredigende dienslewering uitgevoer. Op grond van die bevindinge word sekere voorstelle en aanbevelings gemaak wat kan dien as riglyne vir ontwikkelingsagentskappe ter bevordering van die lewensgehalte in arm gemeenskappe. Die navorsing was gegrond op 'n beperkte model van dienste (gesondheids, water- en sanitasiedienste) wat die verbetering van lewensgehalte in arm gemeenskappe beïnvloed. Die empiriese bevindinge van die studie toon aan dat hierdie dienste onvoldoende is om as basis te dien vir beslissende uitsprake oor ander aspekte van die opname. Die studie het 'n steekproef van 573 huishoudings in 6 gemeenskappe in die provinsies van die Oos-Kaap en Wes-Kaap in Suid-Afrika ingesluit. Die steekproef het bestaan uit 3 gemeenskappe met swak gesondheids, water en sanitasiedienste, en 3 gemeenskappe waar sulke dienste op 'n bevredigende vlak voorsien word. 'n Gestruktureerde vraelys is gebruik om die navorsingsinligting in te samel, wat deur die navorser en 'n opgeleide veldwerker toegedien is. Bykomende inligting is bekom deur 'n semigestruktureerde onderhoud met die verpleeghoof van 'n kliniek in 'n landelike gemeenskap. Die invloed van die verskillende veranderlikes op lewensgehalte is deur middel van basiese statistiese analise geëvalueer. Die resultate van die data-analise verleen 'n mate van steun vir die premis van die studie dat hoewel die voorsiening van gesondheid, veilige, skoon water en voldoende sanitasie tot 'n beter lewenstandaard kan lei, die uitwerking daarvan as sodanig nie alle vereistes insluit vir 'n beter lewenstaard nie, soos voorgestaan deur hoofstroom denkskole in die gesondheidsektor. Faktore wat met armoede verband hou moet ook in ag geneem word. Die studie se bevindinge dui dus daarop dat armoede, tesame met swak openbare gesondheidstoestande, onvoldoende voeding, gebrekkige behuising en swak water- en sanitasiegeriewe gemeenskappe meer kwesbaar maak. Weens die swak sosio-ekonomiese toestande in die gemeenskappe in die steekproef, is gevind dat tuberkulose wydverspreid voorkom. Alhoewel die studie se hipotese met betrekking tot verskeie aspekte bevestig is, was daar ook gevalle waar armoede-verwante faktore soos inkomste, behuising en voeding 'n beduidende rol gespeel het. Dit het dus geblyk dat gesondheids, water- en sanitasiedienste nie in alle gevalle voldoende is om swak lewensgehalte te verklaar nie. Dus sal die faktore wat op lewens kwaliteit 'n impak maak, uitgebrei moet word om vir die invloed van armoede-verwante faktore soos inkomste, behuising en voeding voorsiening te maak.

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Gore, Fiona. "Assessing the evidence for applying burden of disease methods, with a specific focus on unsafe water, sanitation and hygiene in developing countries." Thesis, University of Surrey, 2015. http://epubs.surrey.ac.uk/807440/.

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INTRODUCTION Health data in low- and middle-income countries are often inconsistent and of poor quality, or simply non-existent. This impedes the ability of countries themselves and the international community to arrive at a precise understanding of national burden of disease patterns. The sophisticated statistical modeling and projection methods used internationally to compensate for missing country data cannot provide more than ‘best estimates,’ with no possibility of verifying their outputs. The result is continuing unnecessary morbidity and mortality, often in children under five years of age, as data deficiency translates into insufficient information to guide policy and technical interventions, and to enable prioritization in resource dissemination. This research therefore aims to assess the quality and quantity of data available at country level for the purpose of estimating the burden of disease. It highlights the frequently weak and fragmented nature of what data is present, together with capacity deficiencies at both institutional and individual level to gather, analyse and interpret health and related data. A particular focus is placed on assessing the burden of disease attributable to environmental risk factors, specifically for unsafe water, sanitation and hygiene, together with those elements of malnutrition deriving directly from these factors. Combining these two sets of risk factors to derive estimates of their burden of disease at country level is a new approach and not yet undertaken by countries. METHODS Case-study is the central method used. Two country cases (Uganda and Mozambique) were selected by convenience sampling as WHO missions on related topics were taking place at this time. Detailed information on institutional and individual data understanding and capacity was obtained through semi-structured interviews. Extensive evaluation or assessment of existing data and internationally applied methodologies has also been carried out to demonstrate the extent and impact of the present data weakness and paucity that form the rationale for carrying out this work. Other cases have been used to demonstrate the synthesis of water, sanitation and hygiene statistics and methods with those of malnutrition. RESULTS Enabling a move from globally generated estimates based on limited national data in which country users have little confidence, to better quality and reliable statistics based on stronger national data is the root of this study. Having clarified the health impacts of data deficiency, its principal contribution is the development and testing of a tool to overcome these deficiencies, offering country users a way to radically improve their national data systems. A prototype National Burden of Disease (NBD) Toolkit had earlier been developed by WHO but had operational weaknesses and hence poor uptake by countries. Moving from problem analysis to problem solving, this study has devised a method of linking the various spreadsheets comprising the NBD, creating a logical, simplified, and systematic interface between its elements and thereby making it easier and more appealing to the user. The tool, with its user-friendly interface, can thus now become a suitable support to national-level burden of disease estimation work, and contribute to creating further awareness of the value of timely data and their role in health development. DISCUSSION The present scope of work with the tool and interface fills a pressing gap, yet is limited. Further testing in a wider range of countries in different geographic regions is needed. Nonetheless, the initial results and growing uptake give confidence that this and similar future approaches will fall on fertile ground. As country-level institutions become more accustomed to using tools of this kind to fill long-standing data gaps and quality issues, it can be anticipated that they will feel greater confidence in their own data, reduced reliance on internationally-generated estimates and projections that are frequently not well understood, and an increased sense of ownership over the national process. CONCLUSION Greater capacity and confidence in the domain of data management will feed directly into health research and improvements in health planning and interventions. Key among these are improvements in access to safe water, sanitation and hygiene – an area in which data are notoriously elusive. As the world now moves towards a revised global framework for development goals and targets after 2015, a stronger and more effective evidence base is more critical than ever.

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Travers, Anyess R. "A Systematic Review Examining the Added Value of Water, Sanitation, and Hygiene Interventions for Preventive Chemotherapy Programs on Reducing the Prevalence of Trachoma." Digital Archive @ GSU, 2010. http://digitalarchive.gsu.edu/iph_theses/156.

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BACKGROUND: Trachoma is a leading cause of avoidable blindness. Currently, trachoma is endemic in 57 countries, infects approximately 84 million people globally, and continues to threaten over 10 % of the world’s population with the risk of blindness. Caused by the bacteria Chlamydia trachomatis, blindness due to trachoma is caused by repeated eye infection resulting in the inflammation of the upper eyelid eventually leading the upper lid to pull inward scratching and tearing the cornea causing it to become opaque resulting in loss of vision. The World Health Organization recommends eliminating trachoma as a public health problem using the SAFE strategy: Surgery, Antibiotic, Face washing and Environmental control. OBJECTIVES: This review examined the benefits of the added value of water, sanitation, and hygiene education interventions on preventive mass drug administration for trachoma. METHODS: Trials were identified from MEDLINE, PubMed, and LISTA EBSCO databases using a series of search terms. No restrictions were put on study date, location, design, or language of publication. The abstracts were examined from each of the searches, and any abstract describing risk factors, survey results of mass drug administration (MDA), or providing a general overview of trachoma were automatically discarded. Full text of papers including the combined use of key words including SAFE, WASH, intervention, impact, added value, MDA, azithromycin/ Zithromax® were obtained for review. Twelve full texts articles were retrieved all relevant information were placed in a standardized data extraction form. MAIN RESULTS: Three studies met the complete criteria for inclusion. All studies found a significant change in reduction of active trachoma prevalence. One study focused on the added benefit of antibiotic and environmental components on hygiene education delivered by radio. Another trial compared two villages; the control community performed MDA and the surgery while the intervention village added the F and E components. The final study as well focused the added benefit of ‘F’ and ‘E’ on ‘A’. Two of the three studies found this reduction was from the added benefit of face washing ‘F’ and environmental control ‘E’ to antibiotic use. CONCLUSIONS: In order to eliminate blinding trachoma as a public health problem, recurrence of the active form of the disease must be interrupted before repeated scarring leads to trichiasis. The antibiotic component of the SAFE strategy is a quick fix to the immediate problem. The ‘F’ and ‘E’ components are the more sustainable interventions, yet little research has been done on the actual amount of added value the individual ‘A’‘F’&’E’ components have to one another. After thorough review of the articles, articles were found which documented the ‘F’ and ‘E’ components provide significant value to the overall decrease of prevalence of active. However, the limited results of the search suggest more research can better elucidate the ability of the ‘F’ and ‘E’ components to reduce trachoma prevalence and ultimately impact blinding.

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Kappner, Kalle. "Water and the Micro-Geography of the Urban Mortality Transition: Essays on 19th Century Berlin." Doctoral thesis, Humboldt-Universität zu Berlin, 2021. http://dx.doi.org/10.18452/23257.

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Kap. 1 schätzt den Effekt sozial gemischten Wohnens auf Resilienz gegenüber epidemischen Schocks. Anhand von Gesundheitsberichten und Berufsdaten aus Stadtverzeichnissen assoziiere ich die Verbreitung der Cholera während der 1866er Epidemie mit einem Maß für soziale Diversität für ca. 12200 Häuser Berlins. Diversere Häuser erleben mit höherer Wahrscheinlichkeit mindestens einen Fall, sind aber auch erfolgreicher bei der Eindämmung weiterer Fälle. Zur kausalem Interpretation nutze ich exogene Variation, die sich aus den geometrischen Eigenschaften der Gebäude ergibt. Ich zeige, dass Exposition gegenüber Außenkontakten und gemeinsamer Zugang zu Leitungswasser in gemischten Mietergemeinschaften die Inzidenzeffekte teilweise erklären. Kap. 2 evaluiert, ob die Cholera als Katalysator für städtische Was¬ser-infrastrukturreformen fungierte. In einer Fallstudie Berlins im 19. Jahrhundert zeige ich, dass die Interpretation der Cholera durch Miasma- und proto-epidemiologische Theorien der prä-bakteriologischen Ära ineffiziente, kontraproduktive Wasserwirtschaftsreformen inspirierten, was die Sterblichkeit für einige Zeit erhöhte. Das gängige Narrativ eines durch epidemische Schocks „erzwungenen“ sanitären Aufbruchs vermittelt ein irreführendes Bild der westlichen Volksgesundheitsgeschichte. Kap. 3 zeigt, dass Leitungswassernetze ohne Kanalisation geringen gesundheitlichen Nutzen stiften. Mittels Wasserspülung schwemmen Individuen Krankheitserreger in Rinnsteine, Grundwasserleiter, Straßen und offene Gewässer. Entlang dieser Abwasserströme lebende Nachbarn werden zusätzlichen Gesundheitsrisiken ausgesetzt, die durch den Anschluss der Abfallverursacher an eine Kanalisation neutralisiert werden. Mittels eines Flussrichtungsmodells schätze ich die Abwasser-Exposition für alle Gebäude Berlins in 1875/1880. In einer Differenz-in-Differenzen-Regression zeige ich, dass die negativen externen Effekte der Leitungswassernutzung dessen direkte Vorteile im Aggregat teilweise aufheben.
Chapter 1 estimates the causal effect of mixed-income housing on resilience to epidemic shocks. Using detailed health reports and occupational data from town directories, I relate cholera incidence to a social diversity measure at the level of Berlin’s roughly 12,200 buildings during the 1866 pandemic. Mixed tenant communities are more likely to experience an initial case, but also more successful in containing further in-house spread. To establish causality, I exploit exogenous variation from building lots’ geometric properties in an instrumental variable approach. I find that increased exposure to outside contacts and shared tap water access partly explain the effects. Chapter 2 evaluates whether cholera functioned as catalysts for the efficient reform of urban water infrastructure. Studying 19th century Berlin, I find that cholera’s conception through miasmatist frameworks and the proto-epidemiological tools of the pre-bacteriological era inspired inefficient and counterproductive approaches to water management and potentially deepened the mortality penalty for a certain time. This suggests that the popular interpretation of a sanitary awakening enforced by epidemic shocks paints a misleading picture of Western public health history. Chapter 3 tests a mechanism explaining why cities yield little health benefits from tap water if they do not simultaneously construct sewers. Individuals use the pressurized water supply to flush pathogens from their local environment, thus feeding additional waste to gutters, groundwater acquirers, streets and open water bodies. Neighbors living along the resulting waste flows bear indirect costs, only neutralized once waste emitters connect to sewers. Using a flow direction model based on Berlin’s elevation profile, I estimate waste flow trajectories and exposure for all buildings in Berlin in 1875/1880. In a difference-in- differences approach, I find that tap water’s negative external effects partly offset its direct benefits.

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O'Connell, Bethesda. "Biosand Water Filter Evaluation: Meta-Evaluation and Pilot Study of Field Use Indicators." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etd/3059.

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Diarrheal diseases are a global public health burden, killing 1.8 million people annually. Diarrhea disproportionately affects children and those in poverty. Most diarrheal cases can be prevented through safe drinking water, basic hygiene and/or sanitation measures, with drinking water interventions having the most impact on reducing diarrheal disease. A meta-evaluation was completed of studies evaluating a specific household water treatment method, the biosand water filter. Results from the meta-evaluation illustrate that biosand water filters improve drinking water quality and reduce diarrheal disease. However, there is no generally agreed upon field method for determining biosand water filter effectiveness that is useable in low-resource communities. A pilot study was conducted of potential field use indicators, including the Colilert coliform Presence/ Absence test, hydrogen sulfide, alkalinity, hardness, pH, and fluorescently-labeled latex microspheres. The study included both laboratory and field testing. The Colilert Presence/ Absence test had the highest correlation to the United States Environmental Protection Agency standard method (IDEXX Quantitrays), but more data is needed before making a recommendation. This study adds to understanding about evaluation of biosand water filters and provides preliminary data to address the need for a field use indicator for biosand water filters.

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Tayea, Alia A. "An integrated approach to assessing the public health impacts of NGO water, sanitation and hygiene programmes in rural communities : a case study from southern Malawi." Thesis, University of Strathclyde, 2010. http://oleg.lib.strath.ac.uk:80/R/?func=dbin-jump-full&object_id=13255.

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Gouws, Claudia. "Water en sanitasie in die landelike Hoëveldse woning 1840 -1910: n kultuurhistoriese studie / deur Claudia Gouws." Thesis, North-West University, 2007. http://hdl.handle.net/10394/2291.

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The location of the site where the pioneers settled permanently was determined by the availability of water in the immediate environment. The Highveld contains fertile soils, a fine climate, and an abundance of water. The area has always been extensively used for crop and stock farming, but in general, mixed farming was practiced. The farmers depended on the availability of water, therefore their experiences, observations, weather forecasts, and conclusions, developed into a popular folk meteorology. Furthermore, environmental factors such as local topography, micro climate, hydrography, ground fertility, and the appearance of natural vegetation determined whether or not an area was suitable for permanent residence. The farmstead may be divided into three functional zones (the core-, extended-, and outer farmyard) that are joined by a canal network, used for irrigation and drinking water. The farmhouse and buildings, erected a stones throw away from the water source, served as a focal point for the activities of the farmer. The manipulation of the water source by obstruction of streams and the construction of water canals, weirs and water furrows, assisted the farmer in planning his activities and in using the water to his advantage. The settlement and development of the residence on the rural parts of the Highveld may be divided into three distinct phases. Firstly, the temporary trekboer phase, secondly the pioneer phase and thirdly the permanent settlement phase. The permanence of residence had a direct influence in the layout of the house, the method of construction, and the use of the available water supply. At first, the trekkers were content to reside in roof dwellings (their wagons and tents and a grass screen as their kitchen and a hut near a spring). The first houses were hartbieshuise and kapsteilhuise. The more permanent homesteads of the earlier settlers were a simple rectangular structure (pioneer house) with a saddle grass roof. With the introduction of galvanised iron sheeting, the house was expanded and developed into the veranda-, stoeproom- and a flat roofed rectangular house. This development resulted into a typical rural Highveld homestead. After the discovery of gold in the vicinity of the Witwatersrand, the first gold rush took place resulting in the proclamation of Johannesburg in 1886. Prospectors, mostly foreigners, descended upon the Witwatersrand. Housing took on a more planned structure resembling the late Victorian period of housing in England. The water supply and drainage systems were planned and improved, making it possible to provide running water to kitchens and bathrooms. This impacted firstly on the upper riches of society in the cities, later on the lower middle classes and lastly on the rural areas. European technology regarding the supply of hot pipe water and drainage systems changed the layout of the house. The cooking activity moved from outside behind a screen to a seperate room inside the house. Inevitable changes regarding collecting, storage, purpose, saving and drainage of household water took place. Between 1840 and 1910, evolutionary changes took place regarding sanitation, water supply and personal hygiene. Being part of a particular social class made certain facilities available to certain individuals. A rural Highveld dwelling rarely included sanitary facilities, instead dwellers had a more primitive wash basin in each room in which they washed daily. On a Saturday, a weekly bath was taken in a bathtub in the kitchen or bedroom. Trekkers simply relieved themselves outside. A revolution in sanitary habits and facilities became inevitable. The Victorian dwelling on the Highveld was built according to a standard plan, including a flush water system already in place. This was the ultimate manifestation of sophistication and civilization. The aim of this investigation is to identify the similarities and differences between the use of water by the pioneer, the poor people and the wealthy in their rural dwellings. Furthermore, information has been obtained regarding water usage and sanitation in the bathroom and kitchen in the rural dwelling to be useful in the area of historic architecture and the heritage of our water history.
Thesis (M.A. (History))--North-West University, Vaal Triangle Campus, 2008.

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Habulembe, Raider. "Evaluation of the effect of poor water, sanitation and hygiene practices on growth and the incidence of infectious diseases in infants and young children aged 6-23 months in a selected rural district, Zambia." University of the Western Cape, 2018. http://hdl.handle.net/11394/6430.

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Philosophiae Doctor - PhD (School of Public Health)
Poor water, sanitation and hygiene (WASH) services and practices in communities are known to be responsible for most of the infections occurring among infants and young children in developing countries. A combined effect of disease, poor diet, care practices and other factors among infants/children are known to lead to undernutrition reported in most developing countries. Apart from the reduced growth and productivity potential that malnutrition exhibits on the affected population, it is also an underlying cause to 50% of child mortality in poor communities. In light of this, the primary objective of the study was to evaluate the effect of poor WASH practices on growth and infectious disease incidence in infants and young children aged 6-23 months in the rural district of Monze in Zambia.

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Blodgett, Richard R. "Waterborne Disease Reduction Using Evidence-based Microbiology Verification in Lower Nyakach, Kenya." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5608.

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Waterborne diseases continue to plague the poorest people in low-income countries and are estimated to cause 4,600,000 acute incidents of diarrhea resulting in over 2,000 deaths daily. A major challenge is performing microbiology tests to monitor drinking water quality. Friends of the Old (FOTO) implemented a novel strategy using evidence-based microbiology to educate communities about the relationship between contaminated water and disease. Two commercially available tests for E.coli, adapted for fieldwork, provided easily interpreted results of contamination that correlate with WHO's disease risk categories. Simple and effective household water treatment options 'solar pasteurization and/or chlorination' were provided to all 14,400 families and 42 schools in Lower Nyakach, Kenya. From February to May, 2015, adjacent districts had serious cholera outbreaks, but in Lower Nyakach, where education and the use of chlorine were nearly universal, there were no cases of cholera and steadily decreasing rates of diarrhea. A cross-sectional study was conducted to verify self-reported water treatment practices with evidence-based microbiological testing. A random sample of 377 households revealed that 95% treat their water each and every time they collect. Microbiological verification found 96% of household safe water storage vessels were low risk compared to their very high risk source water. A strong association (p < 0.001) existed between the observed decrease in diarrhea trends from health facilities in Lower Nyakach and exposure to the novel training. The strategy used by FOTO could be replicated to empower communities worldwide to identify contaminated drinking water sources and to reduce the incidence of waterborne disease.

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Vaca, Sánchez Nayeli. "Gestión comunitaria del agua y saneamiento en Mozambique: un enfoque desde su interior." Doctoral thesis, Universitat de Lleida, 2017. http://hdl.handle.net/10803/457517.

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En aquesta investigació es mostra la importància que té l'aigua i sanejament com a eix fonamental per al desenvolupament humà i garant de la salut, s'aborda la problemàtica des de l'àmbit global fins a un enfocament local situant un cas d'estudi a la comunitat de Mabandlane a la província de Gaza a Moçambic. Es mostra que l'acostament basat des de la perspectiva de les comunitats rurals a diferència de l'enfocament basat només en la infraestructura dels projectes de desenvolupament comunitari, aconsegueix un empoderament sostenible en l'àmbit rural. Les troballes en el treball de camp mostren la importància de l'enfocament comunitari en totes les estratègies de desenvolupament rural. Donar poder a les persones a través d'una millor comprensió del seu context cultural i pensament tradicional genera participació, presa de decisions i construcció de mecanismes de sostenibilitat en el desenvolupament integral de les comunitats rurals.
En esta investigación se muestra la importancia que tiene el agua y saneamiento como eje fundamental para el desarrollo humano y garante de la salud, se aborda la problemática desde el ámbito global hasta un enfoque local situando un caso de estudio en la comunidad de Mabandlane en la provincia de Gaza en Mozambique. Se muestra que el acercamiento basado desde la perspectiva de las comunidades rurales a diferencia del enfoque basado solo en la infraestructura de los proyectos de desarrollo comunitario, logra un empoderamiento sostenible en el ámbito rural. Los hallazgos en el trabajo de campo muestran la importancia del enfoque comunitario en todas las estrategias de desarrollo rural. Empoderar a las personas a través de una mejor comprensión de su contexto cultural y pensamiento tradicional genera participación, toma de decisiones y construcción de mecanismos de sostenibilidad en el desarrollo integral de las comunidades rurales.
This research shows the importance of water and sanitation as a fundamental axis for human development and health guarantor, addressing the problem from a global perspective to a local approach by placing a case study in the community of Mabandlane in the Province of Gaza in Mozambique. It is shown that the approach based on the perspective of rural communities as opposed to the approach based only on the infrastructure of community development projects, achieves sustainable empowerment in rural areas. The findings in the field work show the importance of the community approach in all rural development strategies. Empowering people through a better understanding of their cultural context and traditional thinking generates participation, decision making and construction of sustainability mechanisms in the integral development of rural

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Claire, Travers. "NO ONE CARES WE’RE BLEEDING : THE PLACE OF MENSTRUAL MANAGEMENT IN HUMANITARAIN RESPONSE." Thesis, Uppsala universitet, Teologiska institutionen, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-298878.

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Menstrual management is a pervasive issue for women globally, and it becomes critical in times of crisis. During these times of crisis and disaster, humanitarian response seeks to provide relief of suffering by meeting essential needs, in a comprehensive and predictable manner. Yet the provision of menstrual management remains largely ad hoc. Through a comprehensive literature review of documents pertaining to menstrual management in emergencies, this paper offers a qualitative analysis of modern humanitarian strategic approaches, to explore the place of menstrual management in emergencies. The core findings are that menstrual management is not fodder for strategy in humanitarian aid, and therefore lacks a ‘home’ in any of the humanitarian approaches to response. It is not fully integrated into either technical strategic implementation, typified by the cluster approach, nor through cultural implementation approaches, typified by gender mainstreaming. This paper also offers some explanations of why such an omnipresent need has, as yet, remained un-championed. This discussion is based on a theoretical framework offered by feminist theory. Supplemented by an understanding of organisations as gendered structures (Acker, 1990), this thesis posits that these cavities in modern humanitarian response are due to the inherent inability and reluctance of the humanitarian system to concern itself with a bodily, female issue such as menstrual management.

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Van, Es Katherine. "Improving sanitation and hygiene: effects on childhood growth in rural Zambia." Thesis, 2017. https://hdl.handle.net/2144/26945.

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The relationships between water, sanitation, and hygiene (WASH) interventions and malnutrition markers such as stunting, wasting, and underweight have been poorly characterized until recently. There is a need to identify interventions that may play a role in these relationships to improve nutritional status of children under 5 years old. In 2013, Zambia was not on track to meet MDG 7c, to halve the proportion of the population without sustainable access to safe drinking water and basic sanitation. To address this goal, the Zambian government implemented the Zambia Sanitation and Hygiene Program (ZSHP). The goal of the program was to reduce WASH-related diseases in rural areas by promoting community wide sanitation using community-led total sanitation (CLTS), legal enforcement, and hygiene promotion. An important component of the ZSHP is CLTS, which has been implemented in a majority of districts. The overall study aims to explore the effectiveness of a CLTS intervention on coverage and quality of household sanitation facilities, defecation behavior, and child health in a rural setting in Zambia. A secondary outcome that was measured in the analysis of the overall study was the effect of CLTS on stunting, wasting, and underweight in children under the age of 5. These three outcomes are the focus of this thesis. It was hypothesized that these three outcomes would decrease in prevalence with an increase in sanitation coverage resulting from the CLTS program. Cross-sectional anthropometric and household data for Zambian children under 5 and their households from baseline and end line surveys were analyzed to determine any association between multiple WASH indicators and nutritional status. The baseline survey was conducted in 2013 and the end line in 2016. Only households with at least one child under the age of 5 were surveyed at both baseline and end line. Primary caretakers were interviewed during home visits to assess sanitation resources, child-feeding practices, and the health status of their children under the age of 5. In addition, anthropometric data of children under the age of 5 was taken to assess their nutritional status of their children. The prevalence of underweight, stunting, and wasting at end line was 12.9%, 40.9%, and 7.4% respectively, all of which showed statistically significant decreases from baseline measurements (p=≤0.001, 0.03, and ≤0.001 respectively). Predictors of undernutrition were analyzed using logistic regression controlling for age and sex. Nutritional status of children under 5 years of age was found to be associated with several WASH indicators. Children who were taken to a clinic during an episode of diarrhea and children who lived in households with an improved water source had 46% and 26%, respectively, decreased odds of being stunted. Children who lived in households that were close (<4 min walk) to a water source had a 73% decrease in odds of being wasted. Finally, children who had diarrhea in the two weeks before the survey had 63% and 42% increased odds of being underweight or wasted respectively. Focus areas of the program have increased coverage of key indicators of sanitation and hygiene but a relatively high prevalence of sanitation- and hygiene-related diseases remain. These rural areas have high rates of reported diarrhea, acute respiratory illness, and stunting among young children even though most have had exposure to the ZSHP activities. With increased focus, not only on better human sanitation, but also on household environment sanitation, the prevalence of disease and malnutrition will start to decrease and we will begin to see healthier communities in Zambia.

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(7847804), Grace L. Baldwin. "DEVELOPMENT OF DESIGN CRITERIA AND OPTIONS FOR PROMOTING LAKE RESTORATION OF LAKE BOSOMTWE AND IMPROVED LIVELIHOODS FOR SMALLER-HOLDER FARMERS NEAR LAKE BOSOMTWE - GHANA, WEST AFRICA." Thesis, 2019.

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The Lake Bosomtwe impact crater is located in the Ashanti region of Ghana, West Africa. The impact crater diameter from rim to rim is approximately 10.5 km wide with a lake located at the center. Three different districts touch the lake containing 155,000 hectacres of land. There are approximately 7,500 people from 24 villages, and 12 of those villages reside within walking distance of the lake shore. Within the last ten years, the lake has been subjected to overfishing and environmental degradation. The health of the lake has declined due to overfishing and algae blooms caused by improper fertilization rates. Because of these factors, residents of the area have been forced to transition to subsidence farming as their main vocation. According to the Ghana Statistical Service group, 97.6% of the population participates in some form of rural crop farming (Ghana Statistical Service, 2010). Experience with common practices such as crop rotation, fertilizer use, and erosion control is extremely limited. The lake has not been recommended for recreational use due to the excess runoff in the form of agrochemicals, liquid, and organic waste. Caged aquaculture and traditional fishing within Lake Bosomtwe is currently illegal.

A comprehensive Institutional Review Board (IRB) survey was developed for the six primary research questions to be examined. From these six research questions, 147 specific questions were developed. Three of the 147 questions were to obtain Global Positioning System (GPS) data for community households, pit latrines, and water wells or boreholes. This study sought to interview 10-15 farmers per village, for each of the 12 villages located along the shore of Lake Bosomtwe of their perspective on land use change/cover in the Lake Bosomtwe area, current farming practices, current water sanitation and hygiene practices, and current fishing practices. These surveys were collected in the form of oral responses, for which 118 small-holder farmers were interviewed. Of the participants surveyed, 66% were qualified to answer all questions, and 100% of participants completed the survey.

Some specific statistical tests were conducted based of market assessment survey. It was determined that no association between gender and level of education existed. Meaning, that female participants interviewed have just as many opportunities as male participants to pursue education beyond Junior High School (JHS). Yield averages between the villages on the north side of the lake with road access and villages on the southern portion of the lake with limited to no road access were determined to be significantly different. It was determined that road access does affect village yield. When comparing average usable yields between villages located on the northern side of the lake with road access or between villages on the southern side of the lake with limited to no road access, these results were not statistically significant. No significant difference in the scores for villages with road access on the northern side of the lake and villages with limited to no road access on the southern side of the lake existed. Therefore, road access does not affect village usable yield. Through statistical analysis an association was determined between people who practice bathing and washing in the lake and those who practice fishing as a form of livelihood.

Four decision matrices were created to prioritize the following items: Farm Components, technologies to showcase at an appropriate technology center, improved farming practices to showcase through Demonstration Plots, and extension outreach topics. The top three results for the Farm Components were: Appropriate Technology Center (ATC), Demonstration Plots, and a Micro-Credit Union. The top three technologies to showcase as part of the ATC are: PICS Bags, Moisture Meters, and Above-Ground Aquaculture. The three demonstration plots recommended terracing/erosion control, crop rotation, and cover crops. The highest priority extension outreach topics were: basic home/farm finance, improving health through washing stations, and post-harvest loss prevention. The top three priorities of each decision matrix will be the focus of further study, so that these topics can be developed and programs focusing on these needs can be implemented in collaboration with the community partners.

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Lutchminarayan, Renuka Devi. "Sanitation, water, and hygiene in Ethekwini Municipality, Durban, South Africa : a baseline cross-sectional study." Thesis, 2007. http://hdl.handle.net/10413/2390.

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Introduction: Inadequate water supply and sanitation adversely affects the health and socio-economic development of communities. Since 2003, more than 40 000 households in peri-urban and rural areas within eThekwini Municipality, South Africa, have been provided with urine diversion toilets, safe water and hygiene education. eThekwini Municipality have requested that these interventions be evaluated to monitor their effect on health outcomes. Aim: The aim of the study is to describe the baseline situation in respect of sanitation, safe water and hygiene behaviour in Intervention Areas in eThekwini Municipality and compare these to Control Areas. Methods: An observational analytic cross sectional study design was undertaken. A multi-stage sampling procedure was followed and six study areas were randomly selected. Three Intervention Areas (urine diversion toilets) were matched with three Control Areas (no urine diversion toilets). A total of 1337 households, comprising of 7219 individuals, were included in the study. A Household Questionnaire a and an Observational Protocolb was administered by fieldworkers. Data was entered onto a custom designed EpiData database, processed and analysed using SPSS version 13. Results: The baseline characteristics revealed that Intervention and Control areas were very similar other than the provision of urine diversion toilets, safe water and hygiene education in the Intervention area. The Intervention area scored higher than the Control area (2.31 vs. 1.64) with regard to having a cleaner toilet, with no flies, no smells, having hand-washing facilities and soap provided close to the toilet. Some of the collected data from questionnaire responses were not consistent with the fieldworkers observations. It was reported that 642 households in the Control and 621 in the Intervention areas washed their hands with soap, whilst only 396 households in the Control and 309 in the Intervention areas were observed to have washed their hands with soap. Conclusion: Households in the Control area are at a greater risk of developing diarrhoeal and other related diseases. The provision of safe water, urine diversion toilets and hygiene education in the Intervention area has proved to be successful. Recommendations: eThekwini municipality must expand the package of services c to the Control areas. Sustainable hygiene education programmes must continue to be implemented and be evaluated over time. Plate 1: Inside view of the UD Toilet Plate 2: Ground tank providing 200 litres free water Plate 3: Hygiene education material Plate 4: External rear view of the UD toilet
Thesis (MMed.)-University of KwaZulu-Natal, Durban, 2007.

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Padayachee, Silverani. "Experiences of Laotian teachers of the Human Values Water, Sanitation and Hygiene Education training programme." Diss., 2012. http://hdl.handle.net/10500/8763.

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Access to safe water and improved sanitation remains threatened by the ever increasing demand in urbanised cities of the world. Adequate management of this problem could not be achieved through technical and regulatory methods alone. A human values-based education approach, namely the Human Values Water, Sanitation and Hygiene Education (HVWSHE) programme, was considered a suitable intervention strategy to bring about the desired changes in attitude and behaviour by the water users. This research involves an empirical case study approach that explores the experiences of Laotian teachers as adult learners of the HVWSHE intervention as well as a literature study on adult education, adult learning facilitation, human values-based education and teacher beliefs. Focus group meetings, lesson observations, participant observation, field notes and a researcher journal was used to collect data. This study revealed that the HVWSHE training programme had a positive effect on the adult learners’ attitude and behaviour towards a better water-use and sanitation-friendly ethic.
Educational Studies
M. Ed. (Adult Education)

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Mohammed, Abdulwahid Idris. "Assessing environmental sanitation in Urban setting of Duken Town, Ethiopia." Diss., 2011. http://hdl.handle.net/10500/6296.

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The aim of this study was to assess the environmental sanitation conditions with regard to water, sanitation, waste management and personal hygiene of households of Dukem town in Ethiopia. A cross-sectional study design was used to conduct the research. A total of 391 households had participated in the study. Majority of households had access to improved source of drinking water. The mean per capita per day water consumption of the households was low. Two-thirds of households had improved toilet facilities. Availability of improved waste management was grossly inadequate. Two-thirds of households had washed hands after visiting toilet. Generally households had good domestic environmental sanitation conditions but it also emerged that the households were deprived from full range of access to the most essential environmental sanitation services. Therefore, the inadequate level of service to the study area could be seen as opportunity for further focused improvements towards universal access to improved environmental sanitation.
Health Studies
M.A. (Public Health)

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Mohammed, Ahmed Yasin. "Investigation of drinking water quality, sanitation-hygiene practices and the potential of indigenous plant seed for water purification in Southeast Ethiopia." Thesis, 2017. http://hdl.handle.net/10500/24083.

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Background: Access to safe water and sanitation are universal need and basic human right, but the provision of quality water and improved sanitation remains a challenge in many African countries including Ethiopia. Objectives: The study investigated drinking water quality, sanitation-hygiene practices and the potential of Moringa stenopetala seed powder for the purification of water in Bale Zone, Southeast Ethiopia. Methodology: A community-based cross-sectional study was conducted among 422 randomly selected households in Robe and Ginnir Towns. Data were collected by interviewer-administered structured questionnaires from June 2012 to August 2013. An observation checklist was used to observe the sanitary condition of water sources. A total of 71 water samples were collected using sterile glass bottles in accordance with the standard method of American Public Health Association APHA. The physicochemical and bacteriological water quality analyses were done in Addis Ababa Environmental protection and Oromia water and Energy laboratories. The efficiency of Moringa stenopetala seed powder for removal of turbidity, hardness, and nitrate was evaluated. Data were analyzed SPSS Version 21.0 for the window. Descriptive analysis was done for appropriate variables. Logistic regression was used to identify the factors associated with under-five diarrhea. The results were presented using adjusted odds ratio and P-value of < 0.05 was used to declare significance association. Results: From the total sample, 401 respondents participated making a response rate of 95%. More than one third (37.9%) of the respondents were found to use pipe water. Two hundred and eighty (69.8%) of households wash storage containers before refilling and 325 (81%) of households were using separate containers for water storage. Two hundred seventy (67.3%) of the households had pit latrine. Prevalence of childhood diarrhea was found to be 50.1%. From the logistic regression model, those households having access to clean water source are 68% less likely to have under-five diarrhea, the households having clean storage of drinking water are 45% less likely to have under-five diarrhea in their home, and those households having poor latrine sanitation are 68% more likely to have under-five diarrhea in their home. Seed powder of 200mg/l Moringa stenopetala reduced the Nitrate concentration doses from 5.49mg/l to 8.18mg/l, a 75mg/l was reduced the turbidity from 4.49NTU to 1.07 NTU. A total hardness of 427 was reduced by 7.8% after treatment with powder seed of Moringa stenopetala. Conclusion: Prevalence of childhood diarrhea was high and it is associated with lack of access to a clean water source, poor sanitation of drinking water storage and latrine. Prevalence of open field defecation was remarkably high. The iron content of drinking water was above the range of World Health Organization standards. Moringa stenopetala seed powder has efficiency in the reduction of total and faecal coliform, turbidity, hardness and nitrate level in drinking water Recommendation: Health education on water handling, sanitation and low-cost effective water treatment methods like Using Moringa stenopetala seed should be practiced at the household level.
Environmental Sciences
Ph. D. (Environmental Science)

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Makali, Miriam. "Examining The Influence Of HIV Status Upon The Access To Improved Water And Sanitation In Households In Kenya." 2016. http://scholarworks.gsu.edu/iph_theses/458.

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Introduction: Access to water, sanitation and hygiene (WASH) is a basic human right, yet globally748 million people lack access to improved drinking water, 2.5 billion lack access to improved sanitation and 946 million still practice open defecation. Sub-Saharan Africa accounts for 66% of the global new HIV infections. Access to improved WASH is an important issue, especially for people living with HIV/AIDS. They are more prone to opportunistic infections like diarrhea arising from the lack of proper sanitation and access to clean water. In Kenya, there is a dearth of literature examining the association between HIV status and the access to improved water and sanitation. This study sought to address this topic. Aim: We set out to determine the association between HIV status and the access to improved water and sanitation in Kenya using the 2008 -2009 Kenya Demographic and Health Survey (KDHS). Methods: The study analyzed 3753 HIV negative households and 422 HIV positive households. For descriptive statistics, a weighted sample was used to obtain the frequencies and percentages. Weighted bivariate and multivariable logistic regression was used to establish the association between HIV status and the independent variables of interest. Results: There were no statistically significant associations in access to improved water or improved sanitation comparing HIV status and covariates measuring the access to improved water and sanitation. We did find, however, a statistically significant higher odds of HIV positive households reporting treating their drinking water compared to HIV negative households (adjusted odds ratio = 1.4; 95% confidence interval 1.11, 1.84). Discussion: HIV positive patients are more vulnerable to opportunistic infections than the rest of the population.It is imperative for the Kenyan gorvenment to tailor specific interventions that are targeted to this particular group,through scaling up the access to basic sanitation and piped water as well as emphasizing appropriate water treatment methods at the point of use.

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Weidner, Annett. "Effects of community - based water, sanitation and hygiene activities on hygiene behaviour in different ethnic groups from north-west Lao PDR -measured before and after an intervention project." Doctoral thesis, 2015. https://repositorium.ub.uni-osnabrueck.de/handle/urn:nbn:de:gbv:700-2015070313302.

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Worldwide, around 780 million people lack access to improved drinking water sources and 2.5 billion lack improved sanitation (WHO, 2013c). The United Nations (UN) declared access to drinking water and sanitation a fundamental human right in July 2010 (UN, 2010). Each year there are approximately 1.7 billion cases of diarrhoea worldwide. It kills around 2.2 million people globally each year (4.0% of all death), of which 760,000 are children under five years old, mostly in developing countries. Diarrhoeal disease is the second leading cause of death in children under five years old (WHO, 2013c). The lack of drinking water, sanitation facilities and good hygiene practises are considered the main causes for diarrhoea (WHO, 2013d). For this dissertation, a specific health intervention (CBHFA - Community based Health and First Aid) was evaluated which had taken place during three years in 20 target communities in Bokeo Province in Lao PDR. The activities were in the field of water supply, sanitation facilities and hygiene education against diarrhoea. Objective: The objective of this survey study is to show that hygiene behaviour changes in a certain target population through the implementation of CBHFA, if a) individuals have access to improved drinking water sources; b) have access to a HH latrine and c) receive hygiene information. An improvement by 50.0% for each of the hygiene indicator: water use and treatment, hand washing, sanitation, food handling, waste disposal and cleanliness was considered a behavioural change and thus an illustration of the effectiveness of CBHFA. Methods: Hygiene behaviour was measured before and after the CBHFA intervention through above mentioned hygiene indicators. Quantitative figures were collected at two different points in time, in a pre- and post-survey, then analysed and evaluated. Interviews and observations were done through community assessment/evaluation with 20 focus groups in all target communities. 488/487 (pre-survey/post-survey) households (HHs) were interviewed and observed. Knowledge about diarrhoea (definition/signs, prevention, danger, treatment and modes of transmission) was tested. The change in hygiene behaviour as well as the water and sanitation situation was measured through a comparison of the pre- with the post-results. The Relative Risk (RR) and Odds Ratio (OR) were calculated for different variables, such as ethnicity, gender, education, age and income and their changes before and after the implementation of the health intervention project. Results: Water use and sanitation This research clearly shows that the availability of a public water system (gravity fed water system) in the target communities has increased (from 45.0% to 85.0%) as well as the availability and use of hand flush pit latrines (from 20.2% to 63.7%). 95.2% of HHs that owned a latrine used them. The water treatment through “boiling” (from 70.1% to 75.0%) in HHs has improved, but not significantly. Open defecation (OD) decreased from 78.9% to 34.7% (by 56.0%). However it is still practised by more than a third of HHs. OD is one of the highest transmission risks of diarrhoea and can only be eliminated by 100.0% sanitation within the community (WHO, 2008). Hand washing There has been a significant increase of interviewees washing their hands with water and soap (from 8.0% to 38.0%). This result was confirmed by observing the existence of soap in kitchens with 33.0% and in latrines with 20.3% of HHs. The ORs calculated for hand washing “with water and soap” and compared for each stratum of the variables gender, formal education and age group show no statistical difference, but there is a statistical difference regarding income and washing hands “with water and soap”. Relevant occasions for hand washing, such as “after defecation” and “before food preparing”, that could reduce the risk of the transmission of diarrhoeal diseases have not achieved a meaningful improvement. Waste disposal Waste disposal, such as collecting and burning has increased from 23.4% to 42.5% (by 81.6%) according to the HH responses. A matter of concern is the increased HHs (from 26.8% to 29.0%) that disposed their waste by “throwing the waste outside the village”. This waste disposal method is statistically different regarding formal education. The number of HHs with non-educated interviewees where this method was practised has increased over the intervention time in contrast to the number of HHs with educated interviewees. Knowledge about diarrhoea Knowledge was tested. The definition/signs of diarrhoea, its prevention, danger, treatment and modes of transmission were not known by more than 50.0% of the interviewees. It seems that hygiene indicators can improve without this awareness, if improved water and sanitation facilities are provided. However, further investigations are required. The results show that knowledge about diarrhoea is not statistically different regarding formal education and age, but regarding gender. Giving at least one right answer was higher in women than in men. Results and income The results of the pre-survey show that income is significantly associated with owning a latrine and using water vessels, such as pots and jars for drinking, but not associated with using soap for hand washing. However after the implementation of the health interventions, the comparison of the ORs of the HHs with low income per capita (≤200,000 LAK, exchange rate: 1 EUR=10,000 LAK) versus the HHs with high income per capita (>200,000 LAK) shows a statistical difference regarding hand washing “with water and soap”. The OR of the high income per capita group is stronger than the OR of the low income per capita group. Owning a latrine does not show a statistical difference regarding income due to the provision of subsidized latrines by the health intervention project. Occurrence of diarrhoeal diseases The pre-survey results clearly show that diarrhoeal diseases ranked at the top of all recorded cases of diseases. The post-survey results show fewer villages with diarrhoeal outbreak and reduced numbers of reported cases. Summary: An improvement by 50.0% has been reached in hand washing with water and soap, reduction of OD, safe food (by covering), waste disposal (by collecting and burning) and cleanliness but no improvement has been reached in the hygiene indicators “water use and treatment” and in crucial “occasions for hand washing (after defecation, before food preparing)”. Therefore the CBHFA intervention is considered only partially effective in the field of hygiene behaviour change.

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Cassivi, Alexandra. "Access to drinking water in low-and middle-income countries: monitoring and assessment." Thesis, 2020. http://hdl.handle.net/1828/12102.

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Lack of access to drinking water remains widespread as 2.1 billion people live without safely managed service that includes improved water sources located on premises, available when needed, and free from contamination. Monitoring global access to drinking water is complex, yet essential, particularly in settings where households need to fetch water to meet their basic needs, as multiple factors that relate to accessibility, quantity and quality ought to be considered. The overall objective of this observational study is to increase knowledge surrounding monitoring and assessment of access to drinking water supply in low-and middle-income countries. The dissertation was comprised of five manuscripts which address the objective using various approaches including systematic review (manuscript 1), secondary data analysis (manuscript 2), and primary data analysis (manuscripts 3-5) to gather evidence towards improving access to drinking water. Primary data were collected through a seasonal cohort study conducted in Southern Malawi that included 375 households randomly selected in three different urban and rural sites. Methods used included structured questionnaires, observations, GPS-based measurements, and water quality testing. Findings from this study highlight the importance of conducting appropriate assessment of household behaviours in accessing drinking water in view of improving reliability of the indicators and methods used to monitor access to water. Seasonal variations that may affect water sources' reliability and household’s needs should be put forward to improve benefits of improving access to water and sustainable health outcomes. Further to target reliable and continuous availability from an improved water source at proximity to the household, interventions should aim to ensure safe quality of water at the point of use for mitigating the effect of post-collection contamination, and ensure sufficient quantities of water to allocate for personal and domestic hygiene. Focusing on the benefits of improving access to water at the point of consumption is essential to generate more realistic estimations, suitable interventions and appropriate responses to need.
Graduate

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Singh, Urisha. "The health-related microbial quality of drinking water from ground tanks, standpipes and community tankers at source and point-of-use in eThekwini Municipality : implications of storage containers, household demographics, socio-economic issues, hygiene and sanitation practices on drinking water quality and health." Thesis, 2009. http://hdl.handle.net/10413/8362.

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The aim of this study was to investigate the microbiological quality of drinking water at the source (taps at eThekwini laboratories, standpipes and mobile community tankers) and corresponding point-of-use (storage containers and ground tanks) supplied to peri-urban areas in Durban by eThekwini Municipality. It also aimed to identify factors associated with deterioration in water quality such as storage of water, household demographics, hygiene and sanitation practices. In order to determine the microbial quality of drinking water, the pour plate method (for enumeration of heterotrophic organisms) and the membrane filtration technique (for total coliforms and E. coli enumeration) were used. Conductivity, turbidity, pH and total and residual chlorine levels of drinking water were measured. Microbial and physico-chemical data was collated and statistically analysed with epidemiological data from an associated study to determine the link between microbial quality of drinking water, household demographics, health outcomes, socio-economic status, hygiene and sanitation practices. Findings showed that all point-of-use water was unsafe for human consumption as a result of either poor source water quality, in the case of standpipes, and microbial contamination at the point-of-use, in the case of ground tanks and community tankers. The latter could be attributed to unsanitary environments, poor hygiene practices or poor wateruse behaviour. Households which included children aged 0-5 years and in which open-top containers were used for water storage had the highest rates of diarrhoea and vomiting. Water from ground tanks had the best microbial quality but people in households using this water presented with the highest rate of diarrhoea. Therefore provision of microbially safe drinking water will not reduce the rate of health outcomes if addressed in isolation. In order to reduce water-associated illness, provision of safe and adequate amounts of water, hygiene and sanitation education and education on water-use behaviour should be provided as a package. The provision of improved water delivery systems does not ensure that drinking water is safe for human consumption. Measures, such as point-of-use water treatment should be considered to ensure that drinking water provided at the source and point-of-use is microbially safe for human consumption.
Thesis (M.Sc.)-University of KwaZulu-Natal, 2009.

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Murivhame, Lavhelesani Given. "Faecal contamination pathways and prevalence of diarrheal pathogens in rural households with and without improved sanitation facilities." Diss., 2017. http://hdl.handle.net/11602/990.

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Rieckmann, Johannes P. "Battle and Beating, Water and Waste: Micro-Level Impact Evaluation in Developing and Emerging Economies." Doctoral thesis, 2014. http://hdl.handle.net/11858/00-1735-0000-0022-5E96-E.

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Die Dissertation mit dem Titel “Battle and Beating, Water and Waste: Micro-Level Impact Evaluation in Developing and Emerging Economies” beinhaltet die Ergebnisse ökonometrischer Wirkungsevaluierungen, die innerhalb zwei verschiedener Themengebieten des täglichen Lebens in Entwicklungs- und Schwellenländern durchgeführt wurden: Gewalt und Wasser. Im ersten dieser Themengebiete konzentriert sich die Analyse auf die Verhaltens-Reaktionen der Bevölkerung, die in räumlicher Nähe zu gewaltsamem Konflikt lebt. Detailliert die Wirkung solcher Exponierung auf das Auftreten häuslicher Gewalt untersuchend, trägt das erste Kapitel – gemeinsam verfasst mit Dominik Noe – dazu bei, die gesellschaftlichen Kosten kriegsähnlicher Auseinandersetzungen abzuschätzen. Insbesondere die Nachwirkungen auf zwischenmenschliche Beziehungen und soziales Verhalten gegenüber Familie und Freunden werden betrachtet. Wir formulieren die Theorie, dass das Leben in Haushalten in der Nähe zu Orten von extrem gewaltsamen Zwischenfällen die Wahrscheinlichkeit von Frauen in diesen Haushalten erhöht, Opfer häuslicher Gewalt zu werden. Diese Theorie überprüfen wir dann anhand von Daten aus Kolumbien; einem Land, in dem sowohl reichhaltige Daten zu Gefechten als auch zu häuslicher Gewalt vorliegen. Die Kernerkenntnis lautet, dass eine höhere Intensität der gewaltsamen Konflikte mutmaßlich die Wahrscheinlichkeit der Frauen, Opfer häuslicher Gewalt zu werden, deutlich erhöht. Das zweite und dritte Kapitel dieser Dissertation sind dem zweiten Themengebiet gewidmet, und hier insbesondere Aspekten des Anschlusses von Haushalten an Leitungswasser und moderne Abwasser-Entsorgung. Das zweite Kapitel – gemeinsam verfasst mit Stephan Klasen, Tobias Lechtenfeld und Kristina Meier – untersucht die Wirkung des Anschlusses von Haushalten an Leitungswasser und Abwasser-entsorgung auf Gesundheit sowie Schul- und Arbeitsplatz-Anwesenheit. Es trägt zu der derzeit noch überschaubaren Anzahl von Wirkungsevaluierungen im Wasser- und Abwasserbereich bei, und ist nach Kenntnis der Autoren die erste rigorose Wirkungsevaluierung im städtischen Umfeld. Quasi-experimentelle Methoden und Wasserqualitäts-Tests unter Berücksichtigung von ungleichmäßiger Infrastruktur-Ausbreitung erlauben es, die Wirkungen separat einerseits für Anschluss lediglich an Leitungswasser, als auch andererseits für zusätzlichen Anschluss an Abwasserentsorgung, zu schätzen. Die Kernerkenntnis lautet, dass Anschluss an Leitungswasser in jemenitischen Städten schädlich sein kann, wenn die Wasserversorgung unregelmäßig ist; und die Wirkung bei regelmäßiger Versorgung im Vergleich zu traditionellen und alternativen Wasserquellen sehr gering ist. Anschluss an Abwasserentsorgung scheint dagegen bei regelmäßiger Wasserversorgung zu gesundheitlichem Nutzen zu führen. Es ist regelmäßig zu beobachten, dass in Aufbereitungsanlagen entkeimtes Leitungswasser innerhalb des Haushaltes rekontaminiert wird. Wasserqualitäts-Tests an Testpunkten entlang der Versorgungskette innerhalb des Haushaltes erlaubt Rückschlüsse auf Ort und Quelle der Kontaminierung. Der Löwenanteil dieser Verschlechterung der Wasserqualität ist auf Verhalten im Zusammenhang mit Wasser-Handhabung und Hygiene zurückzuführen. Das in Alleinautorschaft verfasste dritte Kapitel baut auf dem zweiten auf und untersucht, welche treibenden Faktoren hinter Verhaltensaspekten stehen, die Rekontaminierung verhindern würden. Spezifisch die Determinanten von Wasserbehandlung und Hygiene werden untersucht, und vor dem Hintergrund der Erkenntnisse aus dem zweiten Kapitel interpretiert. Die Kernerkenntnis lautet, dass Hygiene-Training, Zugang zu Informations- und Kommunikations-Technologie sowie Schulbildung mutmaßlich zu den relevanten, beeinflussbaren Determinanten zählen. Anschluss an Leitungswasser und Abwasserentsorgung – welche üblicherweise bestenfalls mittelfristig ausgebaut werden können – haben scheinbar ebenfalls wünschenswerte Effekte, allerdings in geringerem Maße, und in höherem Maße bei Leitungswasser als bei zusätzlicher Abwasserentsorgung.

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Dissertations / Theses on the topic 'Water sanitation and hygiene (WaSH)'

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