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PubMed2003

Water, sanitation and hygiene for the health of developing nations.

The water and sanitation needs of the poor in developing countries are huge. To meet the target of water and sanitation for all by the end of 2025, some 2.9 billion people will have to receive improved water supplies, and 4.2 billion improved sanitation. The technologies used must be appropriate and, in particular, simple, affordable and sustainable.

Developing Countries↗
PubMed2003

Sanitation and hygiene in urban and rural households in East Africa.

Latrine possession, disposal of children's faeces and waste-water in 1015 households in 33 sites in Kenya, Tanzania and Uganda were studied in 1997. Assistants conducted interviews and observed the state and use of latrines, disposal of children's faeces, wastewater, and household socio-demographic characteristics. Latrine possession was 92.4% in Uganda, 95% in Kenya and 99.5% in Tanzania. In unpiped sites, 73.5% of Ugandan, 90.5% of Tanzanian and 95% of Kenyan households had latrines. Over 30% of latrines in rural Uganda were contaminated with faeces, compared with 10% in Tanzania. More latrines in urban Kenya and Uganda had contaminated surroundings than in the rural areas. The mean number of people using a toilet in the urban areas (10) was significantly higher than in rural areas (7), (F = 45.5; P < 0.001). Toilets in Kenya and Uganda were more likely to be fouled than in Tanzania. Households where the head was an educated professional or business person, or the toilet had a door, lid or concrete wall or floor or waste water was disposed of in the latrine, were less likely to have fouled toilets. Most households disposed of the faeces safely with a few placing them in the garden or elsewhere. The study emphasises the need to promote appropriate sanitation and hygiene.

Adult↗
PubMed2005

Creating demand for sanitation and hygiene through Community Health Clubs: a cost-effective intervention in two districts in Zimbabwe.

Unless strategies are found to galvanise rural communities and create a demand for sanitation, we cannot achieve the United Nations Millennium Development Goal of halving the 2.4 billion people without sanitation by the year 2015. This study describes an innovative methodology used in Zimbabwe--Community Health Clubs--which significantly changed hygiene behaviour and built rural demand for sanitation. In 1 year in Makoni District, 1244 health promotion sessions were held by 14 trainers, costing an average of US dollars 0.21 per beneficiary and involving 11,450 club members (68,700 beneficiaries). In Tsholotsho District, 2105 members participated in 182 sessions held by three trainers which cost US dollars 0.55 for each of the 12,630 beneficiaries. Within 2 years, 2400 latrines had been built in Makoni, and in Tsholotsho latrine coverage rose to 43% contrasted to 2% in the control area, with 1200 latrines being built in 18 months. Although Zimbabwe has historically relied on subsidies to stimulate sanitation, this intervention shows how total sanitation could be achievable. The remaining 57% of club members without latrines in Tsholotsho all practised faecal burial, a method previously unknown to them. Club members' hygiene was significantly different (p<0.0001) from a control group across 17 key hygiene practices including hand washing, showing that if a strong community structure is developed and the norms of a community are altered, sanitation and hygiene behaviour are likely to improve. This methodology could be scaled up to contribute to ambitious global targets.

Community Health Planning↗
PubMed1990

The anthropometric status of children in Kurunegala district in Sri Lanka: its relation to water supply, sanitation and hygiene practice.

Anthropometric data for 1295 children were collected during cross-sectional surveys conducted in Kurunegala District, Sri Lanka between March 1987 and March 1988. The relationship between anthropometric status and a range of water, sanitation and hygiene-related exposures was examined. After taking account of socioeconomic and other potential confounding factors, some evidence was found that boiling of water was associated with improved height-for-age. It seems unlikely that boiling of water alone could be responsible for the observed increase in height-for-age. Boiling of water may be acting as a "marker" for a range of hygiene and child-care behaviours. No convincing evidence of any other association was found. In particular, water source was not associated with anthropometric status. A concurrent study conducted in the same population found evidence of a substantial reduction in diarrhoea morbidity associated with the use of improved sources. These findings, taken together, lend support to the hypothesis that interventions for the control of diarrhoea may have no detectable impact on anthropometric status.

Anthropometry↗