The sanitation arc: an alternative examination of WASH behavior change

A primary goal of the WASH sector is to facilitate transitions from open defecation to improved sanitation. Many residents of low-income countries desire improved sanitation but lack the resources to obtain or maintain access to toilets. For such persons, describing the goal as ‘behavior change’ implies a deficiency in mindset, failing to capture contextual factors affecting sanitation access. Furthermore, household circumstances affect movement both up and down the sanitation ladder, a phenomenon that the sector tends to overlook. This study, based on interviews with 308 former subscribers to Haitian container-based-sanitation service EkoLakay, tracks household sanitation access at four points in time: prior to subscribing, during the subscription period, immediately upon unsubscribing, and at the time of interview. We describe this movement through time as the ‘sanitation arc’. Prior to subscribing, households were more likely to practice open defecation or rely on non-household sanitation, and less likely to have private improved sanitation than the average urban Haitian. This distribution is reversed among former subscribers. Nearly half of former subscribers, however, could not afford continuous access to EkoLakay; 80% of involuntary terminations resulted in loss of access to private improved sanitation, and over one-third of these households reverted to open defecation.

PROSPECTS FOR THE DEVELOPMENT OF FEED PRODUCTION FOR FUR ANIMALS

The article considers the species of fur animals bred in Ukraine. The volumes of fur production and the number of animal farms in the world and Ukraine are analyzed, of which Denmark, China and Poland are in the top three. The share in the total volume of fur production in Ukraine is only 1%. Domestic enterprises for breeding fur animals, which keep about 700 thousand minks in industrial conditions, are considered.The structure of the gastrointestinal tract of carnivorous and herbivorous fur animals, their consumption of nutrients and biologically active substances in feed were analyzed. Features of feeding fur animals are determined by the seasonality of vital functions, which determines changes in metabolism and nutritional value of feed. The importance of access to fresh drinking water in the diets of carnivorous fur animals is considered.The necessity of production of compound feeds for fur animals, which meet the norms of feeding and restrictions on the introduction of components, is substantiated.The need of fur-bearing animals in nutrients and biologically active substances for the production of high-quality nutritious compound feeds, for obtaining high-quality shine and density of fur, better digestibility by the body is shown. The ratios of digestible nutrients in the diets of minks of domestic and Scandinavian breeds are given, the percentage of metabolic energy in different feeding periods is given. The low percentage of compound feed production for fur farming is substantiated.Types of compound feeds and their advantages are presented. Technological methods of production of compound feeds for fur animals such as extrusion, expansion and granulation with the introduction of fat into the press granulator are analyzed. Finished feed should be solid and have a granule size of 4.5… 5 mm for grinding cutters, with high nutritional properties and biological value, and improved sanitation. Thanks to modern technologies, harmful microflora is disinfected and shelf life is increased.The state of domestic feed mills for the production of quality feed for fur animals is analyzed. Thanks to the emergence of new recipes and compliance with feeding standards, the technology of compound feed production for fur farming is being improved.

Are maternal and child health initiatives helping to reduce under-five mortality in Ghana? Results of a quasi-experimental study using coarsened exact matching

Background Despite a 53 % decline in under-five mortality (U5M) worldwide during the period of the Millennium Development Goals (MDGs), U5M remains a challenge. Under-five mortality decline in Ghana is slow and not parallel with the level of coverage of child health interventions. The interventions promoted to improve child survival include early initiation of breastfeeding, clean postnatal care, and skilled delivery. This study sought to assess the effectiveness of these interventions on U5M in Ghana. Methods A quasi-experimental study was conducted using secondary data of the 2008 and 2014 Ghana Demographic and Health Surveys. Coarsened Exact Matching and logistic regression were done. The interventions assessed were iron intake, early initiation of breastfeeding, clean postnatal care, hygienic disposal of stool, antenatal care visits, skilled delivery, intermittent preventive treatment of malaria in pregnancy, and tetanus toxoid vaccine. Results There were 2,045 children under-five years and 40 (1.9 %) deaths in 2008. In 2014, the total number of children under-five years was 4,053, while deaths were 53(1.2 %). In 2014, children less than one month old formed 1.6 % of all children under-five years, but 47.8 % of those who died. Mothers who attended four or more antenatal care visits were 78.2 % in 2008 and 87.0 % in 2014. Coverage levels of improved sanitation and water connection in the home were among the lowest, with 11.6 % for improved sanitation and 7.3 % for water connection in the home in 2014. Fifty-eight (58), 1.4 %, of children received all the eight (8) interventions in 2014, and none of those who received all these interventions died. After controlling for potential confounders, clean postnatal care was associated with a 66% reduction in the average odds of death (aOR = 0.34, 95 %CI:0.14–0.82), while early initiation of breastfeeding was associated with a 62 % reduction in the average odds of death (aOR = 0.38, 95 % CI: 0.21–0.69). Conclusions Two (clean postnatal care and early initiation of breastfeeding) out of eight interventions were associated with a reduction in the average odds of death. Thus, a further decline in under-five mortality in Ghana will require an increase in the coverage levels of these two high-impact interventions.

An Investigation Profile in Pediatric Patients Suspected of Acute Hepatitis A

Hepatitis A virus (HAV) infection is one of the important causes of hepatitis in developing countries. It is transmitted through feco-oral route. This poses major health problems in children. Serum samples of the patients from pediatrics department suspected of acute viral hepatitis presenting with clinical features like fever, nausea, vomiting, and jaundice were collected and analyzed by using commercially available mini VIDAS 307 (Biomeriux) to detect anti HAV IgM antibodies. A nine months prospective study was conducted in the Department of Microbiology and immunology of Shri Guru Ram Rai Institute of Medical and health science Dehradun, India. Of the 47 serum samples received during the study period, 23 (48.93%) were found to be positive for anti-HAV IgM (VIDAS 307 Biomeriux). The prevalence was found to be more in male patients than in female patients, that is,14 (60.8%) and 9 (39.13%) respectively, and was predominantly seen in the 5–10 years of the age group (60%). Peak cases were found in the month of October and November. The study showed a high positivity (48.93%) of HAV in this sub-Himalayan region indicating the role of preventive measures including safe drinking water, improved sanitation and vaccination in preventing infection. Thus, detection of anti-HAV IgM becomes the cornerstone entity for diagnosis.

Socio-Economic Condition and Constraints faced by Tea Garden Women Workers in Chhattisgarh

The present study was conducted in Jashpur district of Chhattisgarh to find out the socio-economic condition of women tea growers, to find out the constraints faced by them and seek suggestions to improve better working conditions. A total of 120 respondents were selected randomly for the present study. The data was collected through a pre-structured interview schedule and later appropriate statistical analysis was done to find out meaningful result. The result showed that the women tea growers found that there was improper sanitation facility inside the tea garden. They suggested that improved sanitation facility and social mobility could help them to improve better working environment.

The Availability of Improved Sanitation Facilities and Its Associated Factors in the 12th District of Kandahar City, Afghanistan

Background. The majority of people practicing open defecation and utilizing unhealthy sanitation facilities are in the developing world. The utilization of unimproved sanitation facilities remains the primary risk factor for many diseases, including nutritional diseases, diarrheal diseases, typhoid, cholera, and dysentery, particularly among children. Objectives. This study was carried out to assess the availability of improved sanitation facilities and factors associated with it in the 12th district of Kandahar city, Kandahar Province, Afghanistan. Methods. The study is a cross-sectional survey, conducted between September and October 2019. A structured questionnaire was used to gather self-reported information of the respondents, including sociodemographic information, household characteristics, and behavioral and environmental characteristics of the available sanitation facilities. Factors associated with the availability of the improved sanitation facility were determined using a multivariable logistic regression model. Results. In this study, the availability of improved sanitation facilities was 85.7% (95% confidence interval (CI) = 77.6%–92.1%). It was significantly influenced by living in a private house (adjusted odds ratio (AOR) = 2.99 (95% CI; 1.43–6.26)); inside location of latrine (AOR = 14.31 (95% CI; 3.59–56.99)); individual household latrine (AOR = 2.03 (1.04–3.95)); and the number of latrines in the household (AOR = 5.04 (2.45–10.35)). Conclusion. The availability of improved sanitation facilities was higher compared to the national level in the study area. This study provides significant evidence on approaches in line with the World Health Organization’s (WHO) Joint Monitoring Program and Sustainable Developmental Goals (SDGs) for enhancing the availability of improved sanitation facilities in Kandahar city.

The Economic and Health Impacts of Inadequate Sanitation

Nearly half of the world’s population, 4.2 billion people, lack access to a hygienic sanitation facility. About 673 million people regularly defecate outdoors, in the open. Many of those who still lack access to sanitation services are among the most challenging populations to reach: the poorest, the most remote, and the most marginalized. Inadequate sanitation is also a major cause of death and disease in countries around the world, causing 432,000 diarrheal deaths annually and contributing to several neglected tropical diseases, including intestinal worm infections, schistosomiasis, and trachoma. It also contributes to malnutrition, adversely affecting early childhood development and thus affecting long-term outcomes, such as educational attainment and earnings in later life. The disease burden of inadequate sanitation overwhelmingly falls on the poor. Sanitation infrastructure access can result in direct benefits that households receive when they have access to sanitation services and an external benefit or externality produced by a community’s access to clean sanitation infrastructure. Thus, for the full benefits of sanitation infrastructure to be realized, efforts should focus on improving community-wide coverage of improved sanitation and eliminating open defecation. This expands the menu of policy options available for targeting conditions like anemia and undernutrition and would require a significant shift in thinking for many researchers and policymakers, who tend to overlook the important role of disease in determining “nutritional” outcomes. Beyond their intrinsic value to human health and well-being, improved sanitation services would play a contributory and catalytic role in furthering progress toward other development goals, particularly those relating to education, and sustainable economic growth. Thus, furthering people’s access to adequate sanitation services is a necessary milestone in the global stride toward a sustainable, high quality of life for all.

Rural–Urban Disparities in Access to Improved Sanitation in Indonesia: A Decomposition Approach

One of the targets in the Sustainable Development Goals (SDGs), which is Target 6.2, aims to achieve access to adequate and equitable sanitation. The Government of Indonesia targets universal access to improved sanitation in 2019. However, almost two out of five households in Indonesia are without access to improved sanitation. Moreover, access to improved sanitation is lower in rural areas than that in urban areas. Studies examining the drivers of the disparity in Indonesia are also limited. Therefore, this study was aimed at assessing the characteristics associated with the rural–urban disparity in access to improved sanitation facilities among households in Indonesia. We employed data from the 2016 Indonesian National Socio-Economic Survey (SUSENAS) comprising 290,848 households. The analysis was twofold. First, we fitted multivariate probit regression models using average marginal effects as the measure of association. We then conducted a detailed non-linear decomposition of the rural–urban disparity attributable to all the explanatory variables. The multivariate regression analysis suggested that households living in rural areas were 11.35% (95% confidence interval = [10.97, 11.72]) less likely to have access to improved sanitation facilities than those residing in urban areas. The decomposition analysis suggested that 48.78% are attributable to spatial, demographic, housing, and socio-economic factors, which meant that almost half of the inequalities could be reduced by equalizing these factors. The results provide a decomposition of factors amenable to curtail urban–rural inequalities. Hence, equity-oriented approaches to increasing access to improved sanitation should be prioritized to achieve universal access in 2030 in line with SDG Target 6.2.

Theirs is the kingdom of heaven

For many centuries, one in three newborns did not survive up to their first birthday, and details and causes of their death were unknown. Pioneers of vital statistics were Graunt and Petty in Britain, Süßmilch in Prussia, Berg in Sweden, Quetelet in Belgium, Villermé in France, Bodio in Italy, and Woodbury in the US. Since 1860, halfway reliable records were available, and infant mortality, at that time ranging from 100 to 300 per 1000 live births, was perceived as a humanitarian and political problem. Variables identified as associated with infant mortality included artificial feeding, poor sanitation, parental social and marital status, male sex, ethnicity, prematurity, and others, although their precise mechanisms often remained unclear. Since 1860, a dramatic and sustained decline in infant mortality caused a demographic revolution. Recent infant mortality rates ranged from 2 to 12 per 1000 live births in developed countries. Most of this reduction was achieved through public health measures and improved sanitation. Only since prematurity became the major cause of mortality could medicine claim to have enabled most of this progress.

Geographic and occupational mobility of small-scale fishers of Lake Malawi: an exploratory study of water, sanitation, and hygiene access, Malawi

The livelihood of small-scale fishers on the world's freshwater lakes cuts across the Sustainable Development Goal (SDG) 6, which covers water and sanitation, and SDG 8 on economic growth. The aim of this study was to examine the nature and extent of fishers' mobility patterns and access to improved sanitation facilities, safe drinking water, and handwashing practices while at work and home for two fishing camps in Malawi. The study used key informant interviews, questionnaires, water quality testing, and an observational checklist, followed by interviews on fishers' occupational migration. Many fishers (85%; 51/60) live and work in fishing camps with their families. Most fishers only went on day trips, but 8% of their working days were away from the fishing camps. Only eight fishers had safe (0 cfu/100 ml) drinking water at home. Most fishers reported drinking from and going to the toilet in the lake during fishing. Historical trends in cholera cases did not correlate with higher periods of migratory behavior of fishers observed in this study. Improving the livelihoods of small-scale fishers requires attention to their culture, the economics of the industry, and geographic criteria while at work and within fishing communities along the shores of Lake Malawi.