Impact of the aquatic pathobiome in low-income and middle-income countries (LMICs) quest for safe water and sanitation practices

The lack of access to safe water and adequate sanitation pose significant health challenges for many individuals and communities in low and middle-income countries. Aside from direct health issues, the lack of access to safe water and adequate sanitation is increasingly associated with psychosocial concerns that affect the wellbeing of individuals and communities. However, the nature of these concerns has received little attention in peer-reviewed literature. This paper draws on environmental stress and ecosocial theories to explore psychosocial concerns related to water and sanitation in Usoma, a lakeshore community in Western Kenya. The study used qualitative key informant interviews (n = 9) and focus group discussions (n = 10). Results reveal deep feelings of anxiety and frustration, embarrassment, negative identity, feelings of marginalization, and lack of self-efficacy. These stressors were a byproduct of daily lived experiences associated with lack of access to safe water and adequate sanitation, as well as the coping strategies people adopted. The paper suggests that benefits of water interventions transcend disease reduction to improved wellbeing through complex social pathways. The findings contribute to knowledge gaps within the water–health nexus and direct policy responses toward largely unexplored psychosocial concerns associated with water and sanitation.

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Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000–17

The Lancet Global Health ◽

10.1016/s2214-109x(20)30278-3 ◽

2020 ◽

Vol 8 (9) ◽

pp. e1162-e1185 ◽

Cited By ~ 3

Author(s):

Aniruddha Deshpande ◽

Molly K Miller-Petrie ◽

Paulina A Lindstedt ◽

Mathew M Baumann ◽

Kimberly B Johnson ◽

...

Keyword(s):

Drinking Water ◽

Low Income ◽

Water And Sanitation ◽

Middle Income ◽

Middle Income Countries ◽

Geographical Inequalities

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

BMJ Open ◽

10.1136/bmjopen-2021-053320 ◽

2021 ◽

Vol 11 (12) ◽

pp. e053320

Author(s):

Sarah Nelson ◽

Dorothy Drabarek ◽

Aaron Jenkins ◽

Joel Negin ◽

Seye Abimbola

Keyword(s):

Community Participation ◽

Low Income ◽

Community Dynamics ◽

Realist Review ◽

Eligibility Criteria ◽

Water And Sanitation ◽

Middle Income ◽

Middle Income Countries ◽

Community Water ◽

Contextual Elements

ObjectiveTo understand how, and under what circumstances community participation in water and sanitation interventions impacts the availability of safe water and sanitation, a change in health status or behaviour and the longevity of water, sanitation and hygiene (WASH) resources and services.DesignRealist review.Data sourcesPubMed, Web of Science and Scopus databases were used to identify papers from low-income and middle-income countries from 2010 to 2020.Eligibility criteria for selecting studiesCriteria were developed for papers to be included. The contribution of each paper was assessed based on its relevance and rigour (eg, can it contribute to context, mechanism or outcome, and is the method used to generate that information credible).AnalysisInductive and deductive coding was used to generate context–mechanism–outcome configurations.Results73 studies conducted in 29 countries were included. We identified five mechanisms that explained the availability, change and longevity outcomes: (1) accountability (policies and procedures to hold communities responsible for their actions and outcomes of an intervention), (2) diffusion (spread of an idea or behaviour by innovators over time through communication among members of a community), (3) market (the interplay between demand and supply of a WASH service or resource), (4) ownership (a sense of possession and control of the WASH service or resource) and (5) shame (a feeling of disgust in one’s behaviour or actions). Contextual elements identified included community leadership and communication, technical skills and knowledge, resource access and dependency, committee activity such as the rules and management plans, location and the level of community participation.ConclusionsThe findings highlight five key mechanisms impacted by 19 contextual factors that explain the outcomes of community water and sanitation interventions. Policymakers, programme implementers and institutions should consider community dynamics, location, resources, committee activity and practices and nature of community participation, before introducing community water and sanitation interventions.

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Review of drivers and barriers of water and sanitation policies for urban informal settlements in low-income and middle-income countries

Utilities Policy ◽

10.1016/j.jup.2019.100957 ◽

2019 ◽

Vol 60 ◽

pp. 100957 ◽

Cited By ~ 13

Author(s):

Sheela S. Sinharoy ◽

Rachel Pittluck ◽

Thomas Clasen

Keyword(s):

Low Income ◽

Informal Settlements ◽

Water And Sanitation ◽

Middle Income ◽

Middle Income Countries ◽

Urban Informal Settlements

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Psychosocial impacts of the lack of access to water and sanitation in low- and middle-income countries: a scoping review

Journal of Water and Health ◽

10.2166/wh.2016.158 ◽

2016 ◽

Vol 15 (1) ◽

pp. 17-30 ◽

Cited By ~ 34

Author(s):

Elijah Bisung ◽

Susan J. Elliott

Keyword(s):

Scoping Review ◽

Well Being ◽

Psychosocial Burden ◽

Social Stressors ◽

Water And Sanitation ◽

Middle Income ◽

Safe Water ◽

Middle Income Countries ◽

Psychosocial Impacts ◽

Low And Middle Income

The lack of access to safe water and adequate sanitation has implications for the psychosocial well-being of individuals and households. To review the literature on psychosocial impacts, we completed a scoping review of the published literature using Medline, Embase, and Scopus. Fifteen studies met the inclusion criteria and were reviewed in detail. Of the included studies, six were conducted in India, one in Nepal, one in Mexico, one in Bolivia, two in Ethiopia, one in Zimbabwe, one in South Africa, and two in Kenya. Four interrelated groups of stressors emerged from the review: physical stressors, financial stressors, social stressors, and stressors related to (perceived) inequities. Further, gender differences were observed, with women carrying a disproportionate psychosocial burden. We argue that failure to incorporate psychosocial stressors when estimating the burden or benefits of safe water and sanitation may mask an important driver of health and well-being for many households in low- and middle-income countries. We propose further research on water-related stressors with particular attention to unique cultural norms around water and sanitation, short and long term psychosocial outcomes, and individual and collective coping strategies. These may help practitioners better understand cumulative impacts and mechanisms for addressing water and sanitation challenges.

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