Dimensions of Inequality in Urban and Rural Water, Sanitation and Hygiene Services in Sub-Saharan Africa

Abstract Associations between different forms of malnutrition and environmental conditions, including water, sanitation and hygiene (WASH), may contribute towards persistently poor child health, growth and cognitive development. Experiencing poor nutrition in utero or during early childhood is furthermore associated with chronic diseases later in life. The primary responsibility for provision of water and sanitation, as a basic service and human right, lies with the State; however, a number of stakeholders are involved. The situation is most critical in sub-Saharan Africa (SSA), where, in 2015, 311 million people lacked a safe water source, and >70% of SSA populations were living without adequate sanitation. The aim of this paper was to conduct a systematic review to investigate the state of literature concerned with WASH and its association with nutritional status, and governance in children from birth to 5 years of age in SSA. Articles were sourced from PubMed Central, Science Direct and ProQuest Social Science databases published between 1990 and 2017. The PRISMA Statement was utilised and this systematic review is registered with PROSPERO (CRD42017071700). The search terms returned 15,351 articles for screening, with 46 articles included. This is indicative of a limited body of knowledge; however, the number of publications on this topic has been increasing, suggesting burgeoning field of interest. Targeted research on the governance of WASH through the identification of the various role players and stakeholders at various levels, while understanding the policy environment in relation to particular health-related outcomes is imperative to address the burden of child undernutrition.

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Data-driven analyses of behavioral strategies to eliminate cysticercosis in sub-Saharan Africa

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0009234 ◽

2021 ◽

Vol 15 (3) ◽

pp. e0009234

Author(s):

Laura A. Skrip ◽

Veronique Dermauw ◽

Pierre Dorny ◽

Rasmané Ganaba ◽

Athanase Millogo ◽

...

Keyword(s):

Behavioral Interventions ◽

Human Exposure ◽

Taenia Solium ◽

Public Health Problem ◽

Sub Saharan Africa ◽

P Value ◽

Behavioral Strategies ◽

Sanitation And Hygiene ◽

Neurological Morbidity ◽

Sub Saharan

Background The multi-host taeniosis/cysticercosis disease system is associated with significant neurological morbidity, as well as economic burden, globally. We investigated whether lower cost behavioral interventions are sufficient for local elimination of human cysticercosis in Boulkiemdé, Sanguié, and Nayala provinces of Burkina Faso. Methodology/Principal findings Province-specific data on human behaviors (i.e., latrine use and pork consumption) and serological prevalence of human and pig disease were used to inform a deterministic, compartmental model of the taeniosis/cysticercosis disease system. Parameters estimated via Bayesian melding provided posterior distributions for comparing transmission rates associated with human ingestion of Taenia solium cysticerci due to undercooking and human exposure to T. solium eggs in the environment. Reductions in transmission via these pathways were modeled to determine required effectiveness of a market-focused cooking behavior intervention and a community-led sanitation and hygiene program, independently and in combination, for eliminating human cysticercosis as a public health problem (<1 case per 1000 population). Transmission of cysticerci due to consumption of undercooked pork was found to vary significantly across transmission settings. In Sanguié, the rate of transmission due to undercooking was 6% higher than that in Boulkiemdé (95% CI: 1.03, 1.09; p-value < 0.001) and 35% lower than that in Nayala (95% CI: 0.64, 0.66; p-value < 0.001). We found that 67% and 62% reductions in undercooking of pork consumed in markets were associated with elimination of cysticercosis in Nayala and Sanguié, respectively. Elimination of active cysticercosis in Boulkiemdé required a 73% reduction. Less aggressive reductions of 25% to 30% in human exposure to Taenia solium eggs through sanitation and hygiene programs were associated with elimination in the provinces. Conclusions/Significance Despite heterogeneity in effectiveness due to local transmission dynamics and behaviors, education on the importance of proper cooking, in combination with community-led sanitation and hygiene efforts, has implications for reducing morbidity due to cysticercosis and neurocysticercosis.

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An Overview of Cholera Epidemiology: A Focus on Africa; with a Keen Interest on Nigeria

International Journal of TROPICAL DISEASE & Health ◽

10.9734/ijtdh/2019/v40i330229 ◽

2020 ◽

pp. 1-17

Author(s):

Tarh, Jacqueline Ebob

Keyword(s):

Local Government ◽

Task Force ◽

Case Fatality ◽

Sub Saharan Africa ◽

Polluted Water ◽

The People ◽

Sanitation And Hygiene ◽

The World ◽

Sub Saharan ◽

Sanitary Conditions

Cholera is still a problem in the world today. A huge population of deaths due to cholera disease still occur in Sub-Saharan Africa (Nigeria most especially), Asia, the Americas and other developing countries, where approximately 1.7 billion inhabitants are still served by faecally polluted water sources. Approximately, 2.4 billion inhabitants of these areas of the world lack the majorly required sanitary conditions of living. Legros, asserts that, as of 2019, about forty-seven countries of the globe, are still affected by cholera. Raw or undercooked, contaminated seafood, serves as a vehicle for the transmission (especially to non-endemic areas). A Case Fatality Rate of 4.87% was recorded from 34 Local Government Areas of Bauchi, Borno, Kaduna, Kano and Zamfara state in Nigeria by the 34th week, in 2018, while 298 confirmed cases and 38 deaths (CFR 1.5%) were recorded from three Local Government Areas in two States (Adamawa & Borno) by Epidemiological week 41 in 2019. Cholera in some cases is regarded as a “disease of the poor” because the populations most affected are those that cannot afford to provide the basic health facilities for themselves. For example, waste management systems, and good accommodation with toilet facilities (the living and health conditions of the people) are wanting. In 2017, A Global Roadmap to 2030 was launched by the Global Task Force on Cholera Control (GTFCC Ending Cholera) to decrease the death rate due to cholera by 90%. By so doing, the disease can be eradicated from at least half of the 47 cholera-affected countries. The objectives of this roadmap are: to fortify health systems, water, sanitation and hygiene (WASH), and to coordinate different ways by which cholera can be controlled in these countries by 2030 (ensuring early detection and prompt response to contain outbreaks). This review aimed to understand the epidemiology of cholera in Nigeria, Africa and the world at large, to access the level of spread, management and preventive measures so far implemented in the endemic regions.

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INFLUENCE OF DIETARY INTAKES, ‘WASH’ AND DIARRHEAL MORBIDITY ON STUNTING AMONG CHILDREN BELOW FIVE YEARS IN NAKURU COUNTY: A CASE STUDY OF KAPTEMBWO AND MILIMANI, KENYA

European Journal of Fitness, Nutrition and Sport Medicine Studies ◽

10.46827/ejfnsm.v1i2.82 ◽

2020 ◽

Vol 1 (2) ◽

Author(s):

Daniel Matoke Ayienda ◽

Muthuka J. Kyalo ◽

Job O. Mapesa ◽

Lawrence Mugambi ◽

Eglah J. Kiplagat

Keyword(s):

Descriptive Analysis ◽

Sub Saharan Africa ◽

Eastern Africa ◽

Dietary Intakes ◽

Risk Of Death ◽

Sanitation And Hygiene ◽

Significant Difference ◽

Sub Saharan ◽

Adult Earnings ◽

High Level

Stunting is the most prevalent and pervasive form of under nutrition worldwide. In 2019, an estimate of 144 million (21.3%) of children under the age of 5 years are stunted globally. In sub-Saharan Africa, 34% of children fewer than 5 years are stunted and the burden of stunting is most prevalent in the Eastern Africa region with 37% (FAO, 2017). In Kenya, out of a total of 7 million under 5 years, 1.82 million (26%) children are suffering from stunting; out of which 11.4% are severely stunted. Stunting is associated with greater risk of death from infectious diseases in childhood, poorer cognition, poorer educational outcomes and lower adult earnings. The study population was a total of 314 children aged 0-59 months. Data was collected using survey CTO questionnaire. Use of pesticides, hygiene practices and sanitation (human waste disposal), hand washing practices, water sources and means of water treatment were examined and adequately described in relation to EED and stunting. Survey CTO programme was installed in tablets and or smart phones, in which a questionnaire with closed ended questions was programmed and used to collect a no-paper work data. The Survey CTO programmed questionnaire only allowed the researcher to key in a response for one question before moving to the next question. Data was analyzed using SPSS version 22 software. Descriptive analysis was done using SPSS while regression was done using STATA. There was no significant difference in dietary intakes between children in Kaptembwo and Milimani, and that the dietary intakes in both Milimani and Kaptembwo were adequate and balanced. Out of 202 children sampled in Kaptembwo, 40.59% had experienced diarrhea in the last four weeks to data collection while out of 112 children sampled in Milimani, only 17% had experienced diarrhea in the last four weeks. In spite of the same dietary intakes in Kaptembwo and Milimani, stunting is high in Kaptembwo than in Milimani. Out of a total of 314 children sampled, 25% were stunted in Kaptembwo, while only 3.33% were stunted in Milimani. Diarrhea increases loss of dietary nutrients thereby making the nutrients required for growth inadequate. High level of stunting in Kaptembwo is associated with poor environmental conditions (poor sanitation and hygiene) which contribute to diarrhea. Diarrhea could be key contributor to Environmental Enteric Dysfunction (EED), which is too a contributor to stunting. It is recommended that residents of Kaptembwo and Milimani are educated on the importance of good sanitation and hygiene in order to curb diarrhea, which is a contributor to the development of EED. In the same spirit, understand the importance of proper use of pesticides. Experimental research was done in the same area involving the use of biological markers for EED. Article visualizations:<img src="/-counters-/edu_01/0720/a.php" alt="Hit counter" />

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Transition Management for Improving the Sustainability of WASH Services in Informal Settlements in Sub-Saharan Africa—An Exploration

Sustainability ◽

10.3390/su10114052 ◽

2018 ◽

Vol 10 (11) ◽

pp. 4052 ◽

Cited By ~ 5

Author(s):

Giorgia Silvestri ◽

Julia Wittmayer ◽

Karlijn Schipper ◽

Robinah Kulabako ◽

Sampson Oduro-Kwarteng ◽

...

Keyword(s):

Decision Making ◽

Literature Review ◽

Empirical Work ◽

Informal Settlements ◽

Sub Saharan Africa ◽

Management Process ◽

Transition Management ◽

Management Processes ◽

Sanitation And Hygiene ◽

Sub Saharan

This paper explores how transition management processes can be designed to address the unsustainability of water, sanitation, and hygiene (WASH) services in informal settlements in cities in Sub-Saharan Africa. The unsustainability of services related to WASH in informal settlements in Sub-Saharan Africa is deeply embedded in current societal and governance structures, cultures, and practices; it is context-dependent and involves numerous actors with different interests. Based on a literature review and empirical work in Arusha (Tanzania), Dodowa (Ghana), and Kampala (Uganda), we identify five context dimensions that account for the unsustainability of WASH services: (a) multiplicity of WASH practices, structures, and arrangements; (b) governance capacities for WASH services and maintenance; (c) landownership for sustainable access to WASH; (d) public participation in decision-making related to WASH; and (e) socio-economic inequalities governing access to WASH. These dimensions pose numerous conceptual and application challenges for transition management. Based on these challenges, recommendations are formulated for the design of a contextualized, participatory transition management process that is not only functional, but also emancipatory.

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Why prepaid technologies are not a panacea for inclusive and sustainable rural water services in Tanzania?

Water Policy ◽

10.2166/wp.2020.070 ◽

2020 ◽

Vol 22 (5) ◽

pp. 925-942

Author(s):

Hans C. Komakech ◽

Lukas Kwezi ◽

Mansoor Ali

Keyword(s):

Cost Recovery ◽

Sub Saharan Africa ◽

Water Services ◽

Revenue Collection ◽

Water Users ◽

Operation And Maintenance ◽

The Poor ◽

Rural Water ◽

Sub Saharan ◽

One Year

Abstract Poor sustainability of rural water schemes is a major problem in service delivery in sub-Saharan Africa. About half of the schemes fail one year after commissioning, mostly due to poor operation and maintenance. Many communities fail to collect and manage water revenue. Prepaid technologies are argued to remedy the poor water revenue management. However, it is not clear to what extent prepaid systems can contribute to the sustainability of rural water schemes. This paper assessed the performance of three different cases where prepaid technologies were used in Tanzania. Although the technologies used can simplify water revenue collection, they are not a panacea to deliver sustainable and equitable water services. The capital cost of the prepaid system is often paid for by donors, which is not being recovered, hence the notion of cost recovery is biased here. Also, a strong institutional capacity and knowledge is required alongside the technology. Therefore, the technology which is being promoted as better for improving cost recovery is, instead, causing a burden on water users.

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Internet of Things innovation in rural water supply in sub-Saharan Africa: a critical assessment of emerging ICT

Waterlines ◽

10.3362/1756-3488.18-00028 ◽

2019 ◽

Vol 38 (2) ◽

pp. 71-93 ◽

Cited By ~ 3

Author(s):

Will Ingram ◽

Fayyaz Ali Memon

Keyword(s):

Internet Of Things ◽

Water Supply ◽

Critical Assessment ◽

Sub Saharan Africa ◽

Rural Water Supply ◽

Rural Water ◽

Sub Saharan

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A regional approach to optimizing the location of rural handpumps

Journal of Water Sanitation and Hygiene for Development ◽

10.2166/washdev.2015.128 ◽

2015 ◽

Vol 5 (3) ◽

pp. 493-501 ◽

Cited By ~ 3

Author(s):

Omar S. Hopkins

Keyword(s):

Cost Benefit Analysis ◽

Cost Benefit ◽

Optimal Number ◽

Point Sources ◽

Decision Makers ◽

Sub Saharan Africa ◽

Proposed Model ◽

Rural Water ◽

Time Savings ◽

Sub Saharan

Many rural water supply projects in sub-Saharan Africa are based on the installation of public handpumps. One of the key benefits of these projects is distance and time savings. Surprisingly, references to rural water planning rarely provide systematic approaches to optimizing distance-related benefits. This paper develops a conceptual model to identify the number and location of point sources that maximizes benefits to consumers, thereby serving as an aid to decision makers in identifying good alternatives. The proposed model is based on willingness to pay, a location model to identify optimal locations of sources, and a cost–benefit analysis. The model shows that as the number of sources increases, the distance between households and sources decreases but the user fee must increase to generate the revenue required to maintain them. Higher fees will dissuade households from using the point sources and hence reduce the aggregate distance savings that accrue. This suggests that there is an optimal number and location of point sources.

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