Water, Sanitation and Hygiene Conditions in Kenyan Rural Schools: Are Schools Meeting the Needs of Menstruating Girls? Water 2014, 6(5).

Kelly T. Alexander, et al. Email: kel4@cdc.gov

Water, sanitation and hygiene (WASH) programs in African schools have received increased attention, particularly around the potential impact of poor menstrual hygiene management (MHM) on equity for girls’ education. This study was conducted prior to a menstrual feasibility study in rural Kenya, to examine current WASH in primary schools and the resources available for menstruating schoolgirls. Cross-sectional surveys were performed in 62 primary schools during unannounced visits. Of these, 60% had handwashing water, 13% had washing water in latrines for menstruating girls, and 2% had soap. Latrines were structurally sound and 16% were clean. Most schools (84%) had separate latrines for girls, but the majority (77%) had no lock. Non-governmental organizations (NGOs) supported WASH in 76% of schools. Schools receiving WASH interventions were more likely to have: cleaner latrines (Risk Ratio (RR) 1.5; 95% Confidence Intervals [CI] 1.0, 2.1), handwashing facilities (RR 1.6, CI 1.1, 2.5), handwashing water (RR 2.7; CI 1.4, 5.2), and water in girls’ latrines (RR 4.0; CI 1.4, 11.6). Schools continue to lack essential WASH facilities for menstruating girls. While external support for school WASH interventions improved MHM quality, the impact of these contributions remains insufficient. Further support is required to meet international recommendations for healthy, gender-equitable schools.

Improving performance of WASH actors: Capacity Self-Assessments of SHAW partner NGOs, 2014. IRC.

Implementing large-scale water, sanitation and hygiene programmes requires expert technical and management skills to ensure that programme goals and targets are realised. Capacity self-assessments help organisations deepen their understanding of their existing capacities and future capacity needs and enable them to formulate capacity development action plans. These plans guide them in the continuous strengthening of their capacities. This paper describes IRC’s experience and lessons learned in conducting Capacity Self-Assessment workshops as part of the SHAW programme.

CSAs can be a powerful tool to help organisations take responsibility for improving individual skills as well as organisational capabilities. A well-designed, flexible and guided workshop enables participants to embrace change towards their own capacity development. Impact of the CSA is heavily dependent on quality facilitation and follow up support after the initial assessment workshop.

Designing Programme Implementation Strategies to Increase the Adoption and Use of Biosand Water Filters in Rural India. Water Alternatives, 7(2) 2014.

Authors: Tommy K.K. Ngai. Centre for Affordable Water and Sanitation Technology (CAWST), Calgary, Alberta, Canada; tngai@cawst.org

Richard A. Fenner. Centre for Sustainable Development, Department of Engineering, University of Cambridge, Cambridge, England; raf37@cam.ac.uk

Abstract: Low-cost household water treatment systems are innovations designed to improve the quality of drinking water at the point of use. This study investigates how an NGO can design appropriate programme strategies in order to increase the adoption and sustained use of household sand filters in rural India. A system dynamics computer model was developed and used to assess 18 potential programme strategies for their effectiveness in increasing filter use at two and ten years into the future, under seven scenarios of how the external context may plausibly evolve. The results showed that the optimal choice of strategy is influenced by the macroeconomic situation, donor funding, presence of alternative options, and the evaluation time frame.

The analysis also revealed some key programme management challenges, including the trade-off between optimising short- or long-term gains, and counter-intuitive results, such as higher subsidy fund allocation leading to fewer filter distribution, and technology advances leading to fewer sales. This study outlines how an NGO can choose effective strategies in consideration of complex system interactions. This study demonstrated that small NGOs can dramatically increase their programme outcomes without necessarily increasing operational budget.

Chapter 42: Global review of the adoption, use, and performance of the biosand filter
Chapter 43: Recent advances in household biosand filter design

Authors: Tommy Ngai and Derek Baker, CAWST.

Impact studies: The importance of safe drinking water at the point of consumption; Impact on diarrhoeal diseases for children under 5 and school absence rates for children between 6 to 12, 2014. 1001Fontaines.

1001fontaines, a non-profit organisation created in 2004, contributes to the global effort of international solidarity improving access to safe drinking water in small rural communities. It aims to improve the health of these populations by enabling them to meet their needs for safe drinking water in a sustainable manner and without any specific infrastructure or expertise.The major objective of these studies was to measure to what extent the health of the beneficiaries of the 1001fontaines services were improved by such services.

More specifically, two populations were observed:- Children between 6 and 12, where attendance at school (School study) was measured;- Children under 5, within their families (Cohort study), for whom episodes of diarrhoeal diseases were reported and correlated to the water source used by the family.

For the School study, attendance rates were extracted from the attendance reports of each school.These groups were observed during a 6 month period, during which each family of the Cohort study was visited twice a month in order to record potential diarrhoeal diseases.

Mobile phones, rent-to-own payments & water filters Evidence from Kenya, 2014.

Authors: Jill E. Luoto and David I. Levine. RAND Labor & Population.

Uptake of safe water products remains low, in spite of modest cost. We experimented with a sales offer that combined a free trial and rent-to-own payments for durable filters. Purchase rates doubled under this sales offer to 31% compared to a traditional lump-sum sales contract. To lower transaction costs we collected payments using Kenya’s vast mobile banking network, MPESA. Mobile repayment rates were low; many filters were paid only when a vendor came in-person to request payment, which adds social pressure. While the rent-to-own offer is attractive, more work is needed to reduce transaction costs in rural and peri-urban Kenya.

Heterogeneous Effects of Information on Household Behaviors to Improve Water Quality. Working Paper EE 14-July 2014.

Authors: Joe Brown*Amar Hamoudi‡ Marc Jeuland§ Gina Turrini†

*Faculty of Infectious Disease & Tropical Medicine, London School of Hygiene & Tropical Medicine; joe.brown@lshtm.ac.uk‡Sanford School of Public Policy & Department of Economics, Duke University; amar.hamoudi@duke.edu§Sanford School of Public Policy & Department of Economics, Duke University; marc.jeuland@duke.edu†Department of Economics, Duke University; gina.turrini@duke.edu

Providing information about health risks only sometimes induces protective action. This raises questions about whether and how risk information is understood and acted upon, and how responses vary across contexts. We stratified a randomized experiment across two periurban areas in Cambodia, which differed in terms of socioeconomic status and infrastructure. In one area, showing households specific evidence of water contamination altered their beliefs about health risk and increased their demand for a treatment product; in the other area, it had no effect on these outcomes. These findings highlight the importance of identifying specific drivers of responses to health risk information.



USAID Ethiopia Water Activities, July 2014.

Water considerations cut across nearly every aspect of USAID programming. In addition to the need for drinking, for hygiene, and to deliver health care, water is needed to irrigate crops, feed livestock and develop industrial production. A dwindling supply of water is often a potential source of conflict. USAID incorporates water activities within its health, education, agriculture, governance, resilience and emergency assistance programs.

USAID also contributes to national capacity to plan and manage water resources through the Addis Ababa University program with the University of Connecticut.

Increase Prevalence of Key Hygiene Behaviors
USAID Ethiopia promotes three hygiene practices with the greatest demonstrated impact on health: (1) hand washing with soap at critical times, (2) safe disposal and management of excreta, and (3) improving household water storage, handling and treatment. In addition, community based approaches to behavior change, e.g., through health and agriculture extension services, support communities transitioning from open defecation. This includes working with a broad range of providers of hygiene products and services to provide household water treatment and storage technologies and other products to facilitate optimal hygiene behaviors

Increase Access to Sustainable Water Supply Services

  • To accelerate access to water, USAID Ethiopia is helping to strengthen the ability of local governments to engage communities, mobilize financing for both system expansion and operations and maintenance, and oversee service providers. Support to water and sanitation entrepreneurs can increase coverage and generate income, particularly for those who have no alternatives.By focusing on capacity building and leveraging local partners, activities can minimize overreliance on donors and bolster lasting sustainability.

Water Filter Provision and Home-Based Filter Reinforcement Reduce Diarrhea in Kenyan HIV-Infected Adults and Their Household Members. Am J Trop Med Hyg, 2014 vol. 91 no. 2 273-280, May 2014.

Patricia B. Pavlinac, et al.
E-mail: ppav@uw.edu

Among human immunodeficiency virus (HIV) -infected adults and children in Africa, diarrheal disease remains a major cause of morbidity and mortality. We evaluated the effectiveness of provision and home-based reinforcement of a point-of-use water filtration device to reduce diarrhea among 361 HIV-infected adults in western Kenya by comparing prevalence of self-reported diarrhea before and after these interventions. After provision of the filter, 8.7% of participants reported diarrhea compared with 17.2% in the 3 months before filter provision (odds ratio [OR] = 0.39, 95% confidence interval [95% CI] = 0.23–0.66, P < 0.001). The association was similar among 231 participants who were already taking daily cotrimoxazole prophylaxis before being given a filter (OR = 0.47, 95% CI = 0.25–0.88, P = 0.019). Educational reinforcement was also associated with a modest reduction in self-reported diarrhea (OR = 0.50, 95% CI = 0.20–0.99, P = 0.047). Provision and reinforcement of water filters may confer significant benefit in reducing diarrhea among HIV-infected persons, even when cotrimoxazole prophylaxis is already being used.

A Solar Disinfection Water Treatment System for Remote Communities. Procedia Engineering, 2014.

Peter Kalt, et al.

Worldwide, approximately 780 million people do not have access to safe and clean water for drinking, cooking or washing.
Consumption of untreated water exposes humans to a range of contaminants including faecal-borne pathogens and chemical pollutants. As a consequence, it is estimated that 1.5 million people die each year as a result of the consumption of untreated or contaminated water. These deaths are preventable with access to clean and safe water, but capital costs and maintenance requirements for large-scale treatment systems are prohibitive and challenging to implement in remote or distributed communities. Such remote communities typically suffer from faecal contamination of transient water sources, rather than chemical or radiological contaminants. To address this problem a low-cost continuous-feed water treatment facility has been designed and developed. The facility utilises solar (UVA) radiation to treat pathogens. Additionally, the facility is designed such that it can be manufactured in-situ from limited or improvised resources at low capital and maintenance costs. The system is modular so that multiple systems can be used to increase water treatment capacity as required. Testing indicates that 3 modules of the design can treat 34L of water in 4 hours producing a 4-log reduction in E. Coli (from 8 × 105 CFU/ml) with a residence time of less than 30 minutes. This is based on an average solar-based UVA flux of ranging from 24 to 36 W/m2 (time average of 28 W/m2).