Please see the note below from Tom Corellis and be sure to check out the website he refers to. We have been asked to compile biweekly updates on specific Emergency WASH topics and issues so starting with this update, the first biweekly update each month will be a webliography of the most recent Emergency WASH studies, reports, resources, etc. The second monthly biweekly update will focus on a specific Emergency WASH topic. We have listed some possible topics below and welcome your suggestions.
Tom Corellis, firstname.lastname@example.org – Colleagues, Shelter Centre, which I direct, is a long-standing global partner of the WASH Cluster and developed with OFDA support www.humanitarianlibrary.org. To our knowledge, this contains one of the largest collections on WASH. It is crowd-sourced and community moderated, meaning your members can share knowledge onto it and collate that knowledge into collections useful to their work. We have WASH interns working around the world adding to their Collections.
Recent Journal Articles
The link between mental health and safe drinking water behaviors in a vulnerable population in rural Malawi. BMC Psychology, July 8. This research is especially relevant in emergency contexts, as it indicates that mental health measures before any WASH interventions will make them more effective.
Cholera prevention and control in refugee settings: Successes and continued challenges. PLoS Negl Trop Dis. 2019 Jun. Cholera continues to be a significant problem in humanitarian settings, with recent outbreaks in displaced populations in South Sudan, Yemen, Cameroon, Nigeria, Tanzania, Uganda, Haiti, and Iraq. The success of cholera prevention and control in refugee camps over the past 2 decades highlights the possibility of managing this deadly disease, even in complicated humanitarian crises.
Residual Maintenance Using Sodium Hypochlorite, Sodium Dichloroisocyanurate, and Chlorine Dioxide in Laboratory Waters of Varying Turbidity. Special Issue – Water, Sanitation, and Hygiene in Humanitarian Contexts, June 2019. Sodium hypochlorite (NaOCl) and sodium dichloroisocyanurate (NaDCC) are commonly used for household water treatment (HWT); chlorine dioxide (ClO2) is a potential new HWT option.
Ready for the Dry Years: Building resilience to drought in South-East Asia. UN ESCAP, June 2019. The study identifies actions that states can individually and collectively undertake to mitigate the impacts of drought and proposes three priority areas of intervention.
Climate change adaptation and resilience and water, sanitation and hygiene: links between SDG 13 and SDG 6. WaterAid, July 2019. Climate change is water change. Climate change is often discussed in terms of carbon emissions, but people feel the impacts largely through water.
Policy Brief on Climate Change and Water launched during High-level Political Forum on Sustainable Development. UN Water, July 12. In the side-event titled Deep dive: Climate change and water, UN-Water launched an update of its Policy Brief on Climate Change and Water.
Impacts of increasing community resilience through humanitarian aid in Pakistan. International Initiative for Impact Evaluation (3ie), June 2019. This impact evaluation sheds light on whether and how vulnerabilities to negative shocks can be reduced.
Epidemiological data analysis for the early warning alert and response network (EWARN) in humanitarian emergencies: a quick reference handbook. WHO, 2019. This handbook is intended for country-level epidemiologists and surveillance officers who work in data analysis and the production of epidemiological reports for dissemination to stakeholders to inform the need for public health interventions, or the effect of ongoing interventions.
Three things we’ve learned about measuring quality in humanitarian WASH responses. Oxfam Blog, July 10, 2019. Back in January, we introduced the Quality Assurance and Accountability Project (QAAP) – a Global WASH Cluster initiative led by Oxfam, in partnership with Solidarités International, Tufts University, and UNICEF. The project supports humanitarian WASH coordinators to go beyond simple headline indicators to understand – and ultimately improve – the quality of our work.
Bill Frist: Lessons not learned in Congo’s Ebola outbreak. Fox News, July 6. Getting WASH into health care facilities is a solvable problem. When I served as U.S. Senate majority leader, I drafted legislation to formalize U.S. policy addressing the overall lack of safe water and sanitation in developing nations.
24TH Global Wash Cluster Meeting: Successful step to save the right of access to water and sanitation. ReliefWeb, June 2019. 180 representatives from all humanitarian water and sanitation sectors had agreed, during the first two days of the symposium, to identify five priority recommendations to be presented to the Emergency Directors on Thursday, June 20, 2019.
Global WASH Cluster YouTube Channel – The channel appears to be new and has 3 videos so far as well as several useful playlists.
Emergency WASH Biweekly Updates, August – December 2019, draft editorial calendar
The first biweekly update each month will be a webliography of the most recent Emergency WASH studies, reports, resources, etc. The second monthly biweekly update will focus on a specific Emergency WASH topic. Below are some topic ideas and we welcome your suggestions:
The five myths are published in a new report, Running Dry: Tackling the myths about urban water and sanitation.
As urbanisation continues to gather pace, it is vital that these myths are debunked:
“Authorities in sub-Saharan Africa and south Asia are extending utility services as fast as they can, but because of the rate of urbanisation, we are barely making progress towards universal water and sanitation access,” said Neil Jeffery, CEO, Water & Sanitation for the Urban Poor.
“Overcoming the five myths identified by WSUP in Running Dry will help cities to deliver better services to marginalised urban citizens, so that more people can participate in the economic advantages of urbanisation.”
“It is not a lost cause – but we need to act now to develop services that are citywide, affordable, and meet the needs of all residents.”
The issue of clean water and safe sanitation in urban areas is integral to the Sustainable Development Goals, especially Goal 6 – “ensure availability and sustainable management of water and sanitation for all”, and Goal 11 – “make cities and human settlements inclusive, safe, resilient and sustainable.” At present, the world is not on track to meet these goals.
But it is not a lost cause. More can be done to recognise approaches that are working, and to focus efforts on responses that can be scaled up right across urban areas. By overcoming the five myths identified in this policy brief, clean, readily available and affordable water and safe, dignified sanitation can be extended to all citizens living in urban areas.
For more information contact:
About Water & Sanitation for the Urban Poor
Water & Sanitation for the Urban Poor (WSUP) is a not-for-profit company that helps transform cities to benefit the millions who lack access to water and sanitation. We were created in 2005 as a response to the unprecedented urban explosion that has left cities unable to provide basic services, such as access to a toilet or drinking water, to low-income communities. We work in seven countries in sub-Saharan Africa and Asia, supported by an office in the UK. Since inception we have helped nearly 20 million people access better water, sanitation and hygiene services.
In addition to the reports and studies listed below, be sure to check out the latest updates to Globalwaters.org: Meet the Plumber Breaking Gender Norms in Côte D’Ivoire, Webinar Discusses the Use of Monitoring Data in WASH Sector Decision-Making and articles from Niger, Egypt, the African Water Association and Urban Links in USAID in the News.
PRO-WASH Human Centered Design Workshop Tools. PRO-WASH, June 2019.
Implementing the source-to-sea approach: A guide for practitioners. SIWI, July 2019.
Vietnam: Toward a Safe, Clean, and Resilient Water System. World Bank. 2019.
The link between mental health and safe drinking water behaviors in a vulnerable population in rural Malawi. BMC Psychology, July 2019.
WASH practices and its association with nutritional status of adolescent girls in poverty pockets of eastern India. BMC Women’s Health, BMC Women’s Health, July 2019.
What motivates open defecation? A qualitative study from a rural setting in Nepal. PLoS One, July 2019.
Effects of single and combined water, sanitation and hygiene (WASH) interventions on nutritional status of children: a systematic review and meta-analysis. Italian Journal of Pediatrics, July 2019.
3D-printed clay-based ceramic water filters for point-of-use water treatment applications. Progress in Additive Manufacturing, July 2019.
Period Poverty Occurs in the United States, Too. Engineering for Change, July 2019.
Bill Frist: Lessons not learned in Congo’s Ebola outbreak. Fox News, July 2019
Le présent rapport s’inscrit dans le cadre de l’élaboration d’un diagnostic organisationnel du service en charge de l’eau, de l’hygiène et de l’assainissement de la Commune de Banfora, au Burkina Faso. La structuration et l’organisation de l’institution municipale comprend une Direction des Services Techniques Municipaux (DSTM) au sein de laquelle évolue un Service en charge de l’Eau, l’Hygiène et l’Assainissement (SEHA). Le diagnostic mené dans le cadre de l’élaboration du Plan Stratégique Communal (PSC 2018-2030) de Banfora a révélé que la commune dans sa structuration actuelle est en mesure d’assurer pleinement les mandats assignés à la commune, mais cette aptitude est grandement handicapée par la faiblesse des moyens humains et financiers mis à disposition.
C’est donc pour mieux organiser le travail et offrir des services de qualité à la population que la commune de Banfora en collaboration avec IRC Burkina, a commandité un diagnostic organisationnel du service technique en charge de l’eau, de l’hygiène et de l’assainissement logé au sein de la DSTM. L’objectif ultime étant de proposer une nouvelle organisation dudit service et de proposer un plan d'action triennal pour la mise en place de la nouvelle organisation et le renforcement des capacités opérationnelles de ce service. La structuration et l’organisation de l’institution municipale comprend une Direction des Services Techniques Municipaux (DSTM) au sein de laquelle évolue un Service en charge de l’Eau, l’Hygiène et l’Assainissement (SEHA). Le diagnostic mené dans le cadre de l’élaboration du Plan Stratégique Communal (PSC 2018-2030) de Banfora a révélé que la commune dans sa structuration actuelle est en mesure d’assurer pleinement les mandats assignés à la commune, mais cette aptitude est grandement handicapée par la faiblesse des moyens humains et financiers mis à disposition.
C’est donc pour mieux organiser le travail et offrir des services de qualité à la population que la commune de Banfora en collaboration avec IRC Burkina, a commandité un diagnostic organisationnel du service technique en charge de l’eau, de l’hygiène et de l’assainissement logé au sein de la DSTM. L’objectif ultime étant de proposer une nouvelle organisation dudit service et de proposer un plan d’action triennal pour la mise en place de la nouvelle organisation et le renforcement des capacités opérationnelles de ce service.
The WASH Benefits and SHINE trials: interpretation of WASH intervention effects on linear growth and diarrhea. Lancet Global Health, August 2019.
Summary: Child stunting is a global problem and is only modestly responsive to dietary interventions. Numerous observational studies have shown that water quality, sanitation, and handwashing (WASH) in a household are strongly associated with linear growth of children living in the same household.
We have completed three randomised efficacy trials testing improved household-level WASH with and without improved infant and young child feeding (IYCF) on stunting and diarrhoea in Bangladesh, Kenya, and Zimbabwe. In all trials, improved IYCF had a statistically significant benefit, but WASH had no effect on linear growth.
In observational analyses of data from the control groups of the three trials, baseline sanitation was a strong risk factor for stunting in the study populations, suggesting this frequently reported association might be confounded by unmeasured factors of household wellbeing. WASH interventions reduced diarrhoea in Bangladesh, but not in Kenya or Zimbabwe.
Intervention promoters visited participants six times per month in Bangladesh compared with monthly in Kenya and Zimbabwe; a review of the literature shows that virtually all published studies that have reported an effect on diarrhoea through home-based water treatment and handwashing promotion achieved high adherence by visiting participants at daily to fortnightly intervals.
Despite achieving substantial behavioural change and significant reduction in infection prevalence for some enteric pathogens, detection of enteropathogens among children in the WASH groups of the trials was typically at ten times higher prevalence compared with high-income countries.
Considering these results, we recommend that future research in the WASH sector focus on developing and evaluating interventions that are radically more effective in reducing faecal contamination in the domestic environment than the interventions implemented in these trials.
The index includes 36 peer-reviewed studies from 2019 that explore handwashing in connection with diverse programmatic areas. It also includes several studies from 2018 that were not included in the 2018 Index due to publication timelines.
This issue of Water Currents features selected studies from the index, as well as links to handwashing-related websites.
Progress on Household Drinking Water, Sanitation and Hygiene 2000–2017: Special Focus on Inequalities. WHO; UNICEF, June 2019. In 2017, 22 percent of the global population (1.6 billion people) had handwashing facilities that lacked water or soap, and 18 percent (1.4 billion people) had no handwashing facility at all.
Handwashing with Soap after Potential Faecal Contact: Global, Regional and Country Estimates for Handwashing with Soap after Potential Faecal Contact. International Journal of Epidemiology, December 2018. Researchers found that many people lack a designated handwashing facility, but even among those with access, handwashing with soap is poorly practiced. People with access to designated handwashing facilities are about twice as likely to wash their hands with soap after potential fecal contact as people who lack a facility.
Child Defecation and Feces Disposal Practices and Determinants among Households after a Combined Household-Level Piped Water and Sanitation Intervention in Rural Odisha, India. American Journal of Tropical Medicine and Hygiene, April 2019. A study in rural India found that disposal of child feces into a latrine was uncommon, even among households with access to an improved pour-flush latrine that was used by adults in the household.
Read the complete article.
Authors: Liesbet Olaerts, Jeffrey P. Walters, Karl G. Linden, Amy Javernick-Will and Adam Harvey
This study analyzed combinations of conditions that influence regular payments for water service in resource-limited communities. To do so, the study investigated 16 communities participating in a new preventive maintenance program in the Kamuli District of Uganda under a public–private partnership framework.
Overall, the findings from this study reveal distinct pathways of conditions that impact payment compliance and reflect the multifaceted nature of water point sustainability. Practically, the findings identify the processes needed for successful payment compliance, which include a strong WUC with proper support and training, user perceptions that the water quality is high and available in adequate quantities, ongoing support, and a lack of nearby water sources.
A comprehensive understanding of the combined factors that lead to payment compliance can improve future preventative maintenance programs, guide the design of water service arrangements, and ultimately increase water service sustainability.
Authors: David M. Berendes, Juan S. Leon, Amy E. Kirby, Julie A. Clennon, Suraja J. Raj, Habib Yakubu, Katharine A. Robb, Arun Kartikeyan, Priya Hemavathy, Annai Gunasekaran, Sheela Roy, Ben Chirag Ghale, J. Senthil Kumar, Venkata Raghava Mohan, Gagandeep Kang and Christine L. Moe
Open drains are common methods of transporting solid waste and excreta in low-income urban neighborhoods. Open drains can overflow due to blockages with solid waste and during rainfall, posing exposure risks. The goal of this study was to evaluate whether pediatric enteric infection was associated with open drains and flooding in a dense, low-income, urban neighborhood.
Children in areas susceptible to open drain flooding had increased odds of enteric infection as rainfall increased. Results suggested that infection increased with rainfall due to neighborhood infrastructure (including poor fecal sludge management) and not frequency of contact. Thus, these exposures may not be mitigated by changes in personal behaviors alone. These results underscore the importance of improving the neighborhood environment to improve children’s health in low-income, urban settings.
The devastating impacts of Cyclone Idai in early March were widespread across five of Mozambique’s eleven provinces, affecting 1.5 million people. The city of Beira was hardest hit, and thousands of families are still struggling to get their lives back together.
After a major relief operation which saw families housed in temporary camps, residents are now moving back to what is left of their houses, starting work on fixing roofs and rebuilding their lives, doing the best that they can with scarce resources.
In particular, poor water, sanitation and hygiene presents a major obstacle for communities.
The water network is now back up and running, but with reduced supply – except for the limited number of people who have household connections, most residents are reliant on accessing shared taps in their communities, travelling further afield to buy water or obtain water from unimproved often polluted sources. The main water treatment plant for the city is damaged and will need to be repaired by FIPAG, the water utility.
Sanitation facilities are extremely limited: the sewer network covers only about 10% of the city, with the rest of the city dependent on pit latrines, toilets with septic tanks or having no access to a sanitation facility.
In the wake of the cyclone, the damage to sanitation facilities, combined with the lack of safe drinking water, caused fears that cholera could spread rapidly. Cholera is an infectious disease transmitted when people drink water contaminated by faecal matter.
Although major outbreak of cholera was contained by the relief operation, an estimated 4,000 cases were diagnosed up to mid-April in the main cities and their peri urban areas.
But the challenge now is: how can sanitation systems be rebuilt and improved in Beira city, given the high water table which presents a real problem for constructing sanitation facilities and managing sanitation waste?
With the relief operation now reducing in scope, WSUP is planning how it can support the long-term recovery of the city. Even before the cyclone, poverty levels were extremely high in Beira, particularly in the peri-urban communities: now, we hope to use the post-cyclone recovery efforts to make a long-term, sustainable difference to the city’s residents.
WSUP has worked in Beira since 2015, with the water utility FIPAG as well as with community-based organisations whose operations were significantly set back by the cyclone. Our operations were put temporarily on hold in the wake of Cyclone Idai but we are now building up our presence again.
Our goals include:
Six months ago, we started a process for water, sanitation and hygiene (WASH) practitioners and coordination platforms to measure the quality of our responses across different contexts. James Brown reflects on what we have learned so far.
Back in January, we introduced the Quality Assurance and Accountability Project (QAAP) – a Global WASH Cluster initiative led by Oxfam, in partnership with Solidarités International, Tufts University, and UNICEF. The project supports humanitarian WASH coordinators to go beyond simple headline indicators to understand – and ultimately improve – the quality of our work.
Since October, our team has visited Bangladesh, Myanmar, South Sudan and Colombia. We’ve met with coordinators; programme teams; experts in WASH, protection, monitoring, and inclusion; as well as people directly affected by crisis.
The purpose of each visit is to understand specific needs and challenges, and the approaches that have already been tried. We then work with the response team over several months to develop and test a quality assurance system that includes practical measurement tools.
A massive and rapid influx of Rohingya refugees from Myanmar has created the largest refugee camp in the world. With the anticipated camp lifespan running into the long-term, it is essential to make good decisions about how to invest limited resources early on.
Across the border, the work of WASH teams is constrained by ongoing restrictions on INGOs delivering services in confined camps. Longer-term planning to support internally displaced people (IDPs), sequestered to these camps since 2012, remains difficult given the absence of a clear government strategy for durable solutions to their displacement.
Decades of conflict have displaced a third of the population. Over two million people have been forced to flee the country completely. Any optimism based on the recent peace deal is tempered by the threat of Ebola from neighbouring countries. The WASH cluster is coordinating a response in both formal and open sites across the country; constantly responding to new needs.
Despite the unique challenges of each context, we found consistency in the following themes:
WASH partners and third parties conduct sophisticated monitoring that includes surveys, interviews, focus groups, user feedback systems and community engagement. In recent years, smartphone or tablet based digital surveys, GPS mapping and aerial imagery from satellites and drones have enabled us to collect huge amounts of data. And specialist assessment organisations such as REACH can support organisations through large scale, multi-sector data collection and analysis.
All this data can support responses to make evidence-based decisions, and to monitor the effectiveness of our interventions. However, the right data needs to be collected, shared and analysed in the right way. We found that this is not always consistent between partners, which means joint analysis at the response level is limited.
Too often, data can’t tell us whether services really are equitable, sustainable, dignified or safe.Additionally, the data being collected often does not measure the objectives of the WASH response, or the risks faced by people it aims to serve. Strategic response objectives often include phrases like ‘equitable and sustainable access’ or ‘safe and dignified facilities’.
Yet too often, data used to measure these indicators can’t tell us whether the services really are equitable, sustainable, dignified or safe. Community engagement and consultation is rarely even factored into the planning of water and sanitation facilities. We measure and report from our humanitarian response point of view, rather than from the experience of people using them.
We saw many examples of WASH teams carrying out good quality programmes, designing approaches that are both effective and appropriate. The potential for other organisations in the response to learn from them, and to scale up to improve quality is great.
However, service levels and approaches are often not consistent across organisations. And, while knowledge of key standards frameworks, such as Sphere and the Core Humanitarian Standard (CHS) is widespread, these standards are not routinely applied to programme design, or the development of monitoring frameworks.
WASH coordination platforms exist to promote joined up approaches across organisations, but in a complex response this can be extremely difficult. Teams are concerned about the growing number of WASH actors working without engaging with UN-led coordination mechanisms. We heard calls for the National Humanitarian WASH Coordination Platform (NHWCP) to be strengthened, and to ensure compliance with agreed ways of working.
The Quality Assurance and Accountability Project will continue to work with coordination platforms to tackle these issues. Together with country partners, we will define clear expectations and standards for each response, and design how best to monitor key performance indicators.
By ensuring information is collected, analysed and shared in the right way, we can highlight where the quality issues arise. Ultimately, our aim is to put quality at the top of the agenda. When partners have the right information at the right time, we will all be able to deliver continually improving, and more effective WASH services.
James joined Oxfam’s Global Humanitarian Team as a Public Health Engineer in 2012. In 2016, he was seconded to the Field Support Team of the Global WASH Cluster (GWC), taking on national coordination roles in both Iraq and Ukraine, working on capacity building initiatives and leading the GWC’s Technical Working Group on Cash and Markets. Before joining Oxfam, he founded a social enterprise developing household water treatment products for the development sector. His background combines humanitarian WASH programming with human-centred design and engineering.
USAID/MEDRC Humanitarian Desalination Challenge: Call for Proposals – In partnership with USAID, MEDRC Water Research is launching an international research call for proposals to boost innovation in small scale desalination technologies. The Humanitarian Desalination Challenge Research Call will support pathway research, aimed at the delivery of an innovative family sized desalination unit.
WASH BENEFITS STUDIES
Achieving optimal technology and behavioral uptake of single and combined interventions of water, sanitation hygiene and nutrition, in an efficacy trial (WASH benefits) in rural Bangladesh. Trials, July 6. Rigorous implementation of interventions deployed at large scale in the context of an efficacy trial achieved high levels of technology and behavioral uptake in individual and combined WASH and nutrition intervention households. Further work should assess how to achieve similar uptake levels under programmatic conditions.
WASH Benefits Bangladesh trial: system for monitoring coverage and quality in an efficacy trial. Trials, July 6. Behavioral objectives were drinking treated, safely stored water, safe feces disposal, handwashing with soap at key times, and age-appropriate nutrition behaviors. We administered monthly surveys and spot-checks to households from randomly selected clusters for 6 months early in the trial. If any fidelity measures fell below set benchmarks, a rapid response mechanism was triggered.
WASH practices and its association with nutritional status of adolescent girls in poverty pockets of eastern India. BMC Women’s Health, July 5. Poor WASH practices like water facility outside the household premise, unimproved sanitation facility, non use of soap after defecation had significant association with poor nutritional status of adolescent girls.
Economic cost analysis of low-cost sanitation technology options in informal settlement areas (case study: Soweto, Johannesburg). International Journal of Hygiene and Environmental Health, 3 July 2019. The study revealed that simplified sewerage is the cheapest option for Soweto informal settlement, even when the costs of pumping and treatment are included. Gravity simplified sewerage with treatment is cheaper than the UDDT system and VIP latrine at all population densities above 158 and 172 persons/ha, respectively. The total annual cost per household of simplified sewerage and treatment was US$142 compared to US$156 and US$144 for UDDT and VIP latrine respectively.
Microbial Source Tracking Using 16S rRNA Amplicon Sequencing Identifies Evidence of Widespread Contamination from Young Children’s Feces in an Urban Slum of Nairobi, Kenya. Environ. Sci. Technol., June 21, 2019. Among environmental samples, young children’s feces were almost always identified as the dominant source of human fecal contamination inside households (hands, surfaces) whereas older children/adult feces were often identified as the dominant source outside households (standing water, streams, soil). Markers for young children’s feces were also detected in standing water and streams, and markers for both fecal sources were equally likely to be dominant in open ditches. These results establish motivation for sanitation interventions that directly address child feces management.
BLOG POSTS/NEWS ARTICLES
Will Sarni: “Cyber security is critical for water utilities.” Smart Water Magazine, July 2019. Digital technologies are providing vastly improved connectivity from source to use.
Gender and water collection responsibilities – A snapshot of Latin America. Water Blog, June 26. In those households where water needs to be collected, 57 % of those collecting water in El Salvador, 55.6 % of those fetching water in Panama, and 57.9 % of those fetching water in Paraguay are women. In Mexico, the burden of fetching water seems more evenly divided: with 50.8 % of women burdened with water-collection responsibilities.
As a major Indian city runs out of water, 9 million people pray for rain. Washington Post, June 28. A severe water shortage is stalking Chennai, whose metropolitan area is home to 9 million people. The city’s reservoirs and lakes are parched and its wells have run dry after two years of scanty rains here.
The post UN-Water vacancy as International Cooperation Adviser appeared first on UN-Water.
This lack of adequate services is an opportunity for those who can deliver safely managed sanitation services to customers, including those in low-income settlements. In collaboration with the Aquaya Institute, WSUP is investigating opportunities to incentivise the private sector to provide safe emptying services to low-income residents of Kisumu.
The first phase, recently completed, assessed the market for faecal sludge emptying services in Kisumu – who is emptying these pits, how much are they charging, and what are they providing for that price? This kind of real-time information from the operators themselves is crucial if we are to know what kind of incentives are the most appropriate to test.
Through a literature review, stakeholder interviews, mapping and transect walks, pit emptying observations, focus group discussions and business model analyses, researchers found that:
So what’s next?
Price is what is preventing uptake of safe services in low-income areas – so any successful intervention or incentive needs to tackle that. A Sanitation Working Committee (which includes representatives from national, County and City Public Health Departments, the Kisumu utility and the Greater Lakes University of Kisumu) is exploring different models to subsidise and manage safe emptying in target areas.
We hope that these trials will lead to a policy that is designed to alleviate the major burdens that are preventing safe service providers from working in neighbourhoods where they are needed most – we will be sharing results within the next few months.