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).
Biological Sand Filters: Low-Cost Bioremediation Technique for Production of Clean Drinking Water. Current Protocols in Microbiology, May 2014.
Michael Lea
The burden of microbiologically contaminated water is borne most heavily by the rural (largest, 80%) and peri-urban (fastest-growing) populations without access to safe water in developing countries—all need microbiologically clean water to sustain their lives and secure their livelihoods.
There is conclusive evidence that biological sand (biosand) filters are capable of dramatically improving the microbiological quality of drinking water. Biosand filters are based on a centuries-old bioremediation concept: water percolates slowly through a layer of filter medium (sand), and microorganisms form a bacteriological purification zone atop and within the sand to efficiently filter harmful pathogens from microbiologically contaminated water. Household-scaled biosand filters are a small adaptation of traditional large, slow sand filters such that they can uniquely be operated intermittently.
To use the simple, yet effective, on-demand biofiltration intervention, a person simply pours contaminated water into the household biosand filter and immediately collects treated water.
The purpose of the following comprehensive protocols is to facilitate knowledge transfer with the goal to empower vulnerable, poorest-of-poor populations in rural and peri-urban communities of developing countries, and to also promote using naturally occurring biology and readily available materials that they already possess as a cost-effective practical approach to combat poverty and inequality and achieve the health benefits of safe water by developing their own household water security solutions.
Scaling up integrated prevention campaigns for global health: costs and cost-effectiveness in 70 countries. BMJ Open. 2014 Jun 26;4(6):e003987. doi: 10.1136/bmjopen-2013-003987.
Marseille E. et al.
OBJECTIVE: This study estimated the health impact, cost and cost-effectiveness of an integrated prevention campaign (IPC) focused on diarrhoea, malaria and HIV in 70 countries ranked by per capita disability-adjusted life-year (DALY) burden for the three diseases.
METHODS: We constructed a deterministic cost-effectiveness model portraying an IPC combining counselling and testing, cotrimoxazole prophylaxis, referral to treatment and condom distribution for HIV prevention; bed nets for malaria prevention; and provision of household water filters for diarrhoea prevention. We developed a mix of empirical and modelled cost and health impact estimates applied to all 70 countries. One-way, multiway and scenario sensitivity analyses were conducted to document the strength of our findings. We used a healthcare payer’s perspective, discounted costs and DALYs at 3% per year and denominated cost in 2012 US dollars.
PRIMARY AND SECONDARY OUTCOMES: The primary outcome was cost-effectiveness expressed as net cost per DALY averted. Other outcomes included cost of the IPC; net IPC costs adjusted for averted and additional medical costs and DALYs averted.
RESULTS: Implementation of the IPC in the 10 most cost-effective countries at 15% population coverage would cost US$583 million over 3 years (adjusted costs of US$398 million), averting 8.0 million DALYs. Extending IPC programmes to all 70 of the identified high-burden countries at 15% coverage would cost an adjusted US$51.3 billion and avert 78.7 million DALYs. Incremental cost-effectiveness ranged from US$49 per DALY averted for the 10 countries with the most favourable cost-effectiveness to US$119, US$181, US$335, US$1692 and US$8340 per DALY averted as each successive group of 10 countries is added ordered by decreasing cost-effectiveness.
CONCLUSIONS: IPC appears cost-effective in many settings, and has the potential to substantially reduce the burden of disease in resource-poor countries. This study increases confidence that IPC can be an important new approach for enhancing global health.
Bioremediation of Turbid Surface Water Using Seed Extract from the Moringa oleifera Lam. (Drumstick) Tree. Curr Protoc Microbiol. 2014 May 1;33:1G.2.1-1G.2.8. doi:10.1002/9780471729259.mc01g02s33.
Lea M. Safe Water International, Carpinteria, California.
An indigenous water treatment method uses Moringa oleifera seeds in the form of a crude water-soluble extract in suspension, resulting in an effective natural clarification agent for highly turbid and untreated pathogenic surface water. Efficient reduction (80.0% to 99.5%) of high turbidity produces an aesthetically clear supernatant, concurrently accompanied by 90.00% to 99.99% (1 to 4 log) bacterial reduction. Application of this low-cost Moringa oleifera protocol is recommended for water treatment where rural and peri-urban people living in extreme poverty are presently drinking highly turbid and microbiologically contaminated water.
Periodic Overview of Handwashing Literature: Summary of selected peer-reviewed and grey literature published July – December 2013. The Global Public-Private Partnership for Handwashing (PPPHW)
PPPHW aims to publish overviews of handwashing literature twice a year that provide practical guidance for implementers. We compiled peer-reviewed and grey literature publications (including e-publications and ahead-of-time publications) between July through December 2013.
From these, we selected relevant articles which allowed for practical guidance for implementation. We excluded most publications from high income and/or medical facility based settings. No single study is universally applicable. We strongly recommend considering the context of the study when interpreting results.
