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Special Issue of Water Currents on WASH and COVID-19 - March 26, 2020

Special Issue of Water Currents on WASH and COVID-19 - March 26, 2020 This special issue contains links to key websites as well as studies and reports that discuss the WASH-related aspects of COVID-19.
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March 26, 2020 – WASH and COVID-19

Handwashing is one of the best ways to protect yourself from COVID-19. Photo credit: FHI 360/USAID SPLASH Project

This special issue contains links to key websites as well as studies and reports that discuss the water, sanitation, and hygiene (WASH)–related aspects of COVID-19. With the release of additional funding, to date USAID has committed up to $100 million in financing from the Emergency Reserve Fund for Contagious Infectious-Disease Outbreaks for 25 countries affected by novel coronavirus (COVID-19) or at high risk of its spread.

The COVID-19 virus is transmitted through two main routes: respiratory and contact. No evidence to date suggests that the virus is present in surface or groundwater sources or transmitted through contaminated drinking water. And no evidence to date suggests that the COVID-19 virus has been transmitted via sewerage systems, either with or without treatment.

The provision of safe WASH conditions is essential to protecting human health during all infectious disease outbreaks, including the COVID-19 outbreak. Below are some WASH–related infectious disease prevention and control measures. 
  • Ensuring good and consistently applied WASH and waste management practices in communities, homes, schools, marketplaces, and health care facilities will further help to prevent human-to-human transmission of the COVID-19 virus.
  • Frequent and proper handwashing with soap is one of the most important measures that can be used to prevent infection with the COVID-19 virus. WASH activities aiming to respond to COVID-19 should work to enable handwashing by improving services and facilities and using proven behavior change techniques. 
  • Reliable water services in health facilities and households are critical to ensuring both sufficient quantities of safe drinking water and the ability to maintain hygiene (including hand hygiene, laundering, cleaning, and disinfection). 

Overviews
Q&A: The Novel Coronavirus Outbreak Causing COVID-19. BMC Medicine, February 2020. This article discusses the clinical presentation of COVID-19, how people are being treated, and what measures are likely to be successful in curbing its further spread.

Q&A on Coronaviruses (COVID-19). World Health Organization (WHO), March 2020. This Q&A provides information on the spread of COVID-19, symptoms, treatment, and more.

Key Considerations: Quarantine in the Context of COVID-19. Social Science in Humanitarian Action, March 2020. This brief sets out practical considerations relating to the design and impact of measures that restrict human movement patterns in the context of COVID-19.

Preparedness and Response Planning Toolkit. USAID, January 2019. A toolkit designed to help national-level public health decision-makers develop a plan for effective preparedness and response to public health emergencies and ensure a robust multisectoral and One Health approach.

WASH/Hygiene Aspects
Water, Sanitation, Hygiene and Waste Management for COVID-19 Technical Brief. WHO; UNICEF, March 2020. This brief summarizes the latest evidence on persistence of the COVID-19 virus in drinking water, sewage, and surfaces and highlights key elements of existing WHO guidance on water, sanitation, and health care waste, which is relevant for viruses (including coronaviruses). It focuses largely on health care and community settings.

Handwashing with Soap—Our Best Defence Against Coronavirus. Wash’em, March 2020. The act of handwashing with soap remains the best defense against coronavirus. This guide gives practical tips on how to encourage community-level handwashing behavior with the aim of controlling and preventing the spread of the coronavirus.

Handwashing and Coronavirus Fact Sheet. Global Handwashing Partnership (GHP), March 2020. For novel viruses with no vaccine, it is especially important to practice preventative measures, such as handwashing, cleaning and disinfecting surfaces, and social distancing to slow the outbreak.

Persistence of Coronaviruses on Inanimate Surfaces and their Inactivation with Biocidal Agents. Journal of Hospital Infection, March 2020. Human coronaviruses can remain infectious on inanimate surfaces for up to nine days. Surface disinfection with 0.1 percent sodium hypochlorite or 62 percent–71 percent ethanol significantly reduces coronavirus infectivity on surfaces within one minute of exposure time.

The Water Professional’s Guide to COVID-19. Water Environment Federation, February 2020. Because this disease already has begun to spread worldwide, it is important that water sector professionals keep informed on the attributions of this virus and any measures needed to protect both workers and public health. The information posted here is a summary of current knowledge about this emerging viral pathogen.

The Sphere Standards and the Coronavirus Response. Sphere, 2020. The document outlines the underlying principles and the importance of community engagement, as well as a detailed review of the relevant technical guidance in the WASH and Health chapters of the Sphere Handbook.

Coronavirus Outbreak Updates. GHP Soapbox, February 2020.  In this newsletter, GHP provides an update on the coronavirus outbreak, its impacts, and measures that can be taken to protect households and communities.

Coronavirus Disease (COVID-19) Technical Guidance: Infection Prevention and Control/WASH. WHO, February 2020. This article contains links to WHO tools and guidelines on topics such as protective equipment, home care for patients, waste management, and handrub formulations.

To Fight the Coronavirus, Wash Your Hands and Support Clean Water Access Around the World. USA Today, March 2020. In this op-ed, Susan Barnett of Global Water 2020 discusses the importance of handwashing and how the lack of safe health care (from insurance to soap and water) around the world is jeopardizing everyone’s health.

Why COVID-19 Can’t Beat a Good Hand-Washing. Popular Science, March 2020. Matthew Freeman, a professor of epidemiology and global health at Emory University, discusses the science behind how handwashing works to fight germs.

COVID-19–Why the Gaps in Available Data are Far More Terrifying. IRCWASH Blog, March 2020. The WASH community must support health authorities in tackling the outbreak by: amplifying the emphasis on hygiene and handwashing by any means; making available its expertise, from technical solutions to campaigning and improving water security; and prioritizing its work with health care facilities to prevent them from becoming sources of viral transmission.

Websites
Coronavirus Disease (COVID-19) Pandemic. WHO – This website includes information and guidance regarding the current outbreak of COVID-19 that was first reported in Wuhan, China, in December. Please visit this page for daily updates. The website has information on Situation Reports, Travel Advice, Technical Guidance, and additional information.

Global WASH Cluster (GWC) COVID-19 Resource Menu – The Resource Menu is a mapping of current WASH specific resources relating to the COVID-19 global response and GWC will keep updating it as the situation develops.

Coronavirus Disease 2019 (COVID-19). Centers for Disease Control and Prevention (CDC) – The CDC website features information on prevention, symptoms, the U.S. caseload, and information targeted to specific audiences, including health care professionals and communities. It also has a Frequently Asked Questions section.

Coronavirus Resources. GHP – This webpage links to fact sheets, technical briefs, and a growing list of other resources.

COVID-19 and WASH. Sanitation and WASH for All – This page contains different resources and tools such as documents, videos, social media materials with messaging on public health, webinar recordings, etc.

Coronavirus COVID-19 Global Cases Dashboard. Johns Hopkins Center for Systems Science and Engineering – This dashboard provides statistics on the number of cases, deaths, and recoveries by country.

Social Media Accounts

Journal/Research Collections
Major publishers have created coronavirus information centers where relevant and current research is open access. These include: Additional issues of Water Currents are available here.

Disclaimer: The contents of this issue are the responsibility of the USAID Water Communications and Knowledge Management Project and do not necessarily reflect the views of USAID or the United States Government.

Prepared by Dan Campbell, Knowledge Creation/WASH Specialist, USAID Water Communications and Knowledge Management Project, dcampbell@waterckm.com
If you would like to feature your organization's materials or suggest other content for upcoming issues of Water Currents, please send them to Dan Campbell, Knowledge Creation/WASH Specialist, at dcampbell@waterckm.com.

For past issues of Water Currents, visit Globalwaters.org.
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Water Currents: World Water Day 2020

Water Currents: World Water Day 2020 World Water Day is held annually on March 22 to focus attention on the vital importance of water 
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March 10, 2020 – World Water Day 2020

USAID supported climate-resilient repairs to two schools in Tacloban City, Philippines, including erecting a steel water tank that can withstand high winds, installing a cistern, and burying exposed water lines and encasing them in concrete where needed. Photo credit: USAID/Philippines

World Water Day is held annually on March 22 to focus attention on the vital importance of water to safeguarding human security and maintaining the health of the planet's ecosystems. This year's theme, "Water and Climate Change," highlights the urgent importance of strengthening water security and establishing access to a sustainable water supply in the face of extreme weather events worldwide.

Under USAID’s Water and Development Plan (part of the U.S. Government Global Water Strategy), improving management of water resources is a key objective. This development result seeks to help partner countries better cope with the rising pressures on freshwater resources, including drinking water supplies, through investments that sustainably manage and equitably allocate water supplies, expand watershed protection and restoration, and increase communities’ resilience in face of water-related shocks and stresses. Making sure that water points and water systems are maintained, reliable, and able to operate without fail during times of drought or flood is a critical way that USAID is helping increase resilience in the face of drought and other climate change stressors.

We would like to thank staff from USAID’s Sustainable Water Partnership (SWP), Global Water 2020, and the Institute for Ecological Civilization (EcoCiv) for their contributions to this issue, which covers upcoming events related to World Water Day and recent studies and research that delve into the impacts of growing water insecurity on health, water quality, and vulnerable communities as well as “Day Zero” scenarios.

Events
World Water Day 2020: Water and Climate Change – The theme of World Water Day 2020 focuses on Water and Climate Change. Extreme weather events are making water more scarce, more unpredictable, more polluted, or all three and yet humans and all the systems they rely upon require water to survive. Resources on the website include Case Studies, Social Media and Communications, and an Events page.

Inaugural W12 Congress, May 18–20, 2020, Cape Town, South Africa – Water experts and policymakers from around the world will gather to promote solutions for water security at the city level. Participants will share challenges and successes and develop new strategies, with a particular focus on innovative approaches to funding water projects where they are needed most. The result will be the “W12 Protocol,” a set of best practices and accompanying resources for cities facing water scarcity. Work on the W12 Protocol is underway, with input from key strategic partner UNESCO and leading experts.

World Water Day 2020: Water and Climate Change. Globalwaters.org, February 2020. This event page highlights the theme of this year’s World Water Day and describes USAID’s investment approach to improve drinking water access in rural and urban communities, protect freshwater resources, and increase communities’ resilience in a water-stressed world. It also includes links to USAID stories, podcasts, and blogs related to the topic.

Water and Peace Conference, April 1, 2020, Philadelphia  – The Global Water Alliance will host a special conference in partnership with Drexel University’s Department of Peace Engineering and the Water Center at the University of Pennsylvania. This year’s conference, an official preparatory event for the 2021 World Water Forum in Senegal, will focus on developing systems of water governance and management to promote peace and mitigate watershed conflicts through cross-boundary collaboration.

Overviews
UN-Water Policy Brief on Climate Change and Water. UN-Water, October 2019. This policy brief explains how the global climate crisis is inextricably linked to water. An increased variability in the water cycle is inducing extreme weather events; reducing the predictability of water availability; decreasing water quality; and threatening sustainable development, biodiversity, and enjoyment of the human rights to safe drinking water and sanitation worldwide.

Water Security in an Uncertain Future: Enhancing Water Resources Management and Planning by Reducing Climate- and Weather- Related Risks. Climatelinks, May 2019. USAID’s SWP and Southern Africa’s Resilient Waters Program both work in basins that cover multiple countries and ecosystems. These programs are addressing vulnerabilities by engaging stakeholders to create decision-making frameworks and water allocation plans that consider impacts to livelihoods, risks to ecosystems, and the effects of changing climate and weather patterns.

Climate Change Adaptation and Resilience and Water, Sanitation and Hygiene: Links Between SDG 13 and SDG 6. WaterAid, July 2019. This brief describes the link between SDG 6 (clean water and sanitation) and SDG 13 (climate change) and highlights how water—too much or too little—is often the way developing countries are experiencing the effects of climate change. The paper includes case studies from Bangladesh and the Sahel.

Review of Water and Climate Change Policies in South Asia. International Water Management Institute, May 2019. This report assesses the suitability of the water and climate-related policy environment (existing policy, legislation, strategy, and planning instruments) for adapting to the impacts of climate change in the water sector in South Asia.

A Road Map to Greater Water Security. USAID SWP, 2019. This article describes how SWP is facilitating a water allocation plan in Tanzania.

Women Leading the Fight for Water Security. USAID SWP, 2019. For SWP, engaging women and other marginalized groups is an important element of the Water Security Improvement process.

Gordon Mumbo on Water and Livelihoods in the Mara River Basin. Environmental Change and Security Program, 2019. Mumbo and his colleagues are working across Kenya and Tanzania on a water location plan that considers how much water is needed to sustain the environment, the people, and the wildlife.

The Untold Story of Water in Climate Adaptation Part II: 15 Countries Speak. Global Water Partnership, December 2019. This synthesis reviews how water resources management currently contributes to climate resilience and sustainable development in 15 countries.

Day Zero/Drought
Towards a Water Secure Future: Reflections on Cape Town’s Day Zero Crisis. Urban Water Journal, October 2019. The article recommends that government, the private sector, and consumers need to work together to develop and implement a water sensitive approach that will transform water planning, supply, and demand at scale.

No Drips, No Drops: A City Of 10 Million Is Running Out of Water. Goats and Soda, June 2019. In India's sixth-largest city, lines for water snake around city blocks and Chennai, with a population of almost 10 million, is nearly out of water.

Beyond ‘Day Zero’: Insights and Lessons from Cape Town. Hydrogeology Journal, June 2019. The article discusses a range of factors that contributed to Cape Town nearing “Day Zero” and the difficulty of putting restrictions on water allocation. The article ends by suggesting that Cape Town diversifies its water sources, particularly by investing in groundwater management. Currently, Cape Town relies heavily on rainwater as the city’s source of freshwater.

Water Resilience Lessons from Cape Town’s Water Crisis. WIREs Water, July 2019. The situation that played out in Cape Town in 2018 provides insightful lessons for what water resilience should look like. The article argues that anticipatory strategies should be a key component. The article also addresses how cooperation and trust between government and citizenry affect water resilience in times of crisis.

How to Communicate Drought: A Guide by the Integrated Drought Management Programme in Central and Eastern Europe. Global Water Partnership, 2019. This guide is geared toward water professionals and journalists. For journalists, the guide sets out what people really need to know about drought, and for water professionals, the guide offers experiences of working with the media to communicate drought in ways that increase public interest and engagement.

Financing/Cost Issues
Climate Change Is Hurting Africa’s Water Sector, but Investing in Water Can Pay Off. World Resources Institute, October 2019. This blog describes how investments in three key areas of the water sector will improve people’s climate resilience across Africa.

Short-Changed on Climate Change: Money, Water and the People on the Frontline. WaterAid, March 2020. The low level of climate finance spent on WASH services reflects the poor recognition of how these services can build resilience to climate change.

Achieving Abundance: Understanding the Cost of a Sustainable Water Future. World Resources Institute, January 2020. This working paper proposes a method for decision-makers to calculate the cost required to deliver sustainable water management to any geography.

Vulnerable Communities
Discussion Paper: Climate, Sanitation and Health. World Health Organization, July 2019. This paper provides an overview of the impacts of climate variability and change on sanitation and the implications for health. It outlines potential adaptation options for strengthening sanitation governance, policies, systems and services, and highlights further research needs and imperatives for policy and programming.

Child Health, Household Environment, Temperature and Rainfall Anomalies in Honduras: A Socio-Climate Data Linked Analysis. Environmental Health, January 2020. The authors conclude that in light of shifts in global temperature and precipitation, tackling in advance those household environmental factors responsible for poor child health outcomes (better sanitation and clean cooking fuel) can prevent a further deterioration of children’s health in Honduras.

Water, Sanitation and Hygiene Risk Factors for the Transmission of Cholera in a Changing Climate: Using a Systematic Review to Develop a Causal Process Diagram. Journal of Water and Health, January 2020. Through a systematic review and meta-analysis, this study examines the main WASH factors associated with cholera transmission, focusing on cases in community settings. The authors developed a health impact pathway and causal process diagram indicating how climate change may influence WASH and thus cholera transmission, which  will help policymakers focus on cholera risk mitigation, now and in the future.

Water as a Tool for Resilience in Times of Crisis. Wilson Center; USAID SWP, May 2019. At this event, experts discussed what practitioners and policymakers can do to bolster effective water management for the world’s most vulnerable communities. This is one in a series of events and reports on Water Security for a Resilient World.

Global Report on Water and Disasters. Secretariat of High-level Experts and Leaders Panel on Water and Disasters, July 2019. In terms of economic loss, 2018 was recorded as one of the worst economic-loss years mainly due to disasters related to water and climate.

Water Treatment/Water Quality
WELLSPRING: Source Water Resilience and Climate Adaptation. The Nature Conservancy, August 2019. Source water protection has always been fundamental to water resources management. Freshwater ecosystems can be a key component in providing resilience to communities, but they also need to be resilient themselves. This report describes how to manage source waters for resilience at the same time as managing source waters resiliently.

Complex Interactions Between Climate Change, Sanitation, and Groundwater Quality: A Case Study from Ramotswa, Botswana. Hydrogeology Journal, May 2019. This study investigated the coupled human and natural systems linking climate, sanitation, and groundwater quality in Ramotswa, a rapidly growing peri-urban area in semi-arid southeastern Botswana, which relies on the transboundary Ramotswa aquifer for water supply.

Unaffordable and Undrinkable: Rethinking Urban Water Access in the Global South. World Resources Institute, August 2019. The paper explores what cities can do to ensure more equitable access to safe, reliable, and affordable water, while facing down major trends affecting water access, including population growth, degraded and depleted water sources, and climate.

Strategic Recommendations for Climate Smart Water Utilities Using the Flood and Drought Portal in Planning. IWA, May 2019. This document focuses on strategic recommendations for water utilities on why and how to integrate climate change impacts into planning and management of water resources, specifically through water safety plans.

Climate Change Will Affect Access to Fresh Water. How Will We Cope? Chemical and Engineering News, February 2020. Water purification can be costly, so chemists and engineers are working to make less-expensive, more energy-efficient technologies that will be more widely accessible.

Water, Sanitation and Hygiene: Three Essential Ingredients to Resilient Agricultural Supply ChainsWaterAid, November 2019. Providing WASH resources can make companies more resilient and productive. This booklet provides information for sectors that are reliant upon the agricultural supply chain to protect and improve WASH resources for the people and business in the regions in which they operate.

If you would like to feature your organization's materials or suggest other content for upcoming issues of Water Currents, please send them to Dan Campbell, Knowledge Creation/WASH Specialist, at dcampbell@waterckm.com.

For past issues of Water Currents, visit Globalwaters.org.
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Water Currents: Sanitation Topics - February 20, 2020

Water Currents: Sanitation Topics - February 20, 2020 USAID is doing its part to fill evidence gaps related to sanitation and behavior change 
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February 20, 2020 – Sanitation Topics

Staff from Malaysia’s Indah Water Konsortium taught over 50 water practitioners from six countries about improved sanitation. Photo credit: Jay Tecson

Because sanitation uptake continues to lag behind drinking water in terms of access gains, development practitioners are taking a closer look at what has and hasn’t worked in the past, modifying approaches that delivered early wins but not sustainable gains in coverage, and making sanitation financing a priority.
 
USAID is doing its part to fill evidence gaps related to sanitation and behavior change and support the reduction of open defecation and movement of communities up the sanitation ladder by identifying, researching, and sharing best practices for the delivery of water, sanitation, and hygiene (WASH) services and sustained behavior change. The Agency has also made it a priority to close financing gaps to help countries achieve universal access to WASH services through sustainable and creditworthy business models, increased public funding, and expanded market finance for infrastructure investment.
 
This issue contains recent studies and resources on a variety of sanitation-related topics such as market-based sanitation, community-led total sanitation, fecal sludge management, sanitation financing, and others.

Market-Based Sanitation
Gaming for Profit: Using a Game to Learn about Market-Based Sanitation. USAID, November 2019. USAID’s Market-Based Sanitation game teaches the fundamentals of a sanitation market system and how an enterprise’s choices affect their viability as a business. Links to the game materials are on the USAID WASHPaLS (Water, Sanitation, and Hygiene Partnerships and Learning for Sustainability) website.

Developing Consumer Markets within Rural WASH Systems. All Systems Go! WASH Systems Symposium, March 2019. This paper takes a look at how consumer WASH markets are being developed and the role of different types of actors in the system.

Webinar: Designing Effective Sanitation Enterprises. USAID WASHPaLS, September 2018. WASHPaLS presents a detailed discussion of the elements of a sanitation enterprise, including mechanisms and practices, design approaches, and key considerations based upon the findings of a WASHPaLS desk review.

Triggers for Growing a Sanitation Business Aimed at Low-Income Customers: Experience from Five Cities. Water and Sanitation for the Urban Poor (WSUP), May 2019. This Topic Brief presents WSUP’s experience supporting sanitation businesses oriented toward low-income customers in five cities. Each case study highlights changes to the business model or enabling environment with the potential to trigger business growth.

Ensuring the Quality of Sanitation Products During Project Scale-Up. PSI, June 2019. The USAID–funded Sanitation Service Delivery Project uses a market-based approach to increase access to sanitation.This includes identifying and supporting private sector actors to produce prefabricated latrine materials and install household latrines.

Community-Led Total Sanitation
Policy Diffusion in the Rural Sanitation Sector: Lessons from Community-Led Total Sanitation (CLTS). World Development, December 2019. This paper analyzes the reasons that drove the wide diffusion of CLTS. The approach was perceived as a fast and effective solution to the problem of open defecation and spread under the leadership of influential donors, NGOs, persuasive practitioners, and academics.

A Market-Based, Pro-Poor Approach to Rural Sanitation. Global Communities, October 2019. This report discusses a major paradigm shift for CLTS approaches and related government programs and policies in Ghana.

How Does Community-Led Total Sanitation (CLTS) Promote Latrine Construction, and Can It Be Improved? A Cluster-Randomized Controlled Trial in Ghana. Social Science & Medicine, January 2020. This study examines what psychosocial determinants enhance the effectiveness of CLTS in increasing latrine coverage and whether CLTS would be improved with the addition of the risks, attitudes, norms, abilities, and self regulation approach, known as RANAS.

An Examination of CLTS's Contributions Toward Universal Sanitation. USAID WASHPaLS, August 2018. The review offers a description of the CLTS intervention, tracing its evolution in theory and practice, and analyzes its strengths and weaknesses. Read the report or view the webinar that presents the findings.

Sustainable Total Sanitation in Nigeria: Final Research Report. Institute for Fiscal Studies, 2019. This evaluation examines the large-scale rollout of two different WaterAid sanitation interventions in Nigeria, one taking a CLTS approach and the other focused on sanitation marketing, their impacts on toilet ownership, and the possible interactions between the two approaches.

Role of Implementation Factors for the Success of Community-Led Total Sanitation on Latrine Coverage. A Case Study from Rural Ghana. Environmental Science and Technology, April 2019. This study of 94 communities in rural Ghana determined that the success of CLTS interventions can be improved by investing in follow-up visits, the support of local leaders, and the careful application of incentives.

The Role of Social Identification for Achieving an Open-Defecation Free Environment: A Cluster-Randomized, Controlled Trial of Community-Led Total Sanitation in Ghana. Journal of Environmental Psychology, December 2019. Researchers studied the effectiveness of CLTS in more than 100 communities in Ghana to determine whether social identification affected open defecation rates. The results highlight the need to consider the social context when planning and implementing sanitation campaigns.

CLTS Knowledge Hub – Community-Led Total Sanitation. The CLTS website aims to be a global hub for CLTS, connecting the network of practitioners, communities, NGOs, agencies, researchers, governments, donors, and others involved or interested in CLTS. The knowledge hub publishes Frontiers of CLTS: Innovations and Insights and each issue focuses on a specific CLTS topic.

Fecal Sludge Management (FSM)
Faecal Sludge Management Landscape in South Asia: Synthesis of a Multi-Country Study. WaterAid, September 2019. The objective of this study is to understand the key elements of the macro-level enabling framework for FSM and on-the-ground interventions in Bangladesh, India, Nepal, and Pakistan.

Safely Managed Sanitation in High-Density Rural Areas: Turning Fecal Sludge into a Resource through Innovative Waste Management. World Bank, September 2019. This report explores the challenges of fecal sludge management in densely populated rural areas and it presents some typical current practices, examples of financially sustainable FSM services, and global innovations in waste management with potential replicability for FSM.

Sanitation Financing and Cost-Benefit Analyses
Facilitating Relationships Between Private Sanitation Service Providers and Commercial Banks in Senegal. USAID WASH-FIN, April 2019. USAID WASH-FIN (Finance) technical support is helping foster links between private sanitation service providers and commercial banks in Senegal as well as encouraging these banks to explore additional opportunities in markets previously unknown to them. Additional financing studies and resources are available on the WASH-FIN website.

India: Can Microloans Increase Toilet Ownership and Use? World Bank, August 2019. This evaluation found that sanitation loans increased toilet ownership and reduced open defecation.

Doing More with Less: Smarter Subsidies for Water Supply and Sanitation. World Bank, August 2019. This report explores how public resources can be used most effectively to achieve universal delivery of water supply and sanitation services and guide policymakers on improving subsidy design and implementation.

Who Gives a Sludge about Toilets? Building Markets for Safe and Sustainable Sanitation. Social Finance, November 2019. Social Finance partnered with USAID, the Stone Family Foundation, and iDE to design the world’s first development impact bond for sanitation. This $10 million bond is a groundbreaking initiative that brings safe sanitation to some of the poorest and most vulnerable households in Cambodia.

Benefit‐Cost Analysis of Community‐Led Total Sanitation: Incorporating Results from Recent Evaluations. Bill and Melinda Gates Foundation, January 2019. The authors state that CLTS interventions would pass a benefit-cost test in many situations, but that benefit-cost metrics are not as favorable as many previous studies suggest.

Health Costs and Benefits from a Pilot Rural Sanitation Intervention in India. Journal of Water, Sanitation and Hygiene for Development, September 2019. This study examined the costs and health benefits of sanitation interventions undertaken over a three-year period by the National Rural Drinking Water Security Pilot Project in India. Researchers quantified the health-related net benefits and the software and infrastructure costs associated with latrine construction and found positive economic returns.

Evidence-Based Policy Analysis? The Strange Case of the Randomized Controlled Trials of Community-Led Total Sanitation. Oxford Review of Economic Policy, Spring 2020. Researchers state that cost–benefit analysis could still “save” CLTS because small treatment effects may still yield net positive economic benefits if the costs of implementing CLTS programs are modest.

Other Sanitation Studies and Resources
Systems Reboot: Sanitation Sector Change in Maputo and Lusaka. WSUP, November 2019. This Discussion Paper provides examples of how a systems approach can be applied at a city level by looking at two cities—Lusaka, Zambia, and Maputo, Mozambique—that have experienced positive change in their onsite sanitation sector over the last decade.

UNC Water Institute—Testing CLTS Approaches for Scalability. This website contains reports and resources from Plan International’s Testing CLTS Approaches for Scalability project, which aimed to advance rural sanitation efforts in Kenya, Ethiopia, and Ghana by improving the cost-effectiveness and scalability of CLTS.

If you would like to feature your organization's materials or suggest other content for upcoming issues of Water Currents, please send them to Dan Campbell, Knowledge Creation/WASH Specialist, at dcampbell@waterckm.com.

For past issues of Water Currents, visit Globalwaters.org.
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Water Currents: WASH and Neglected Tropical Diseases - January 28, 2020

Water Currents: WASH and Neglected Tropical Diseases - January 28, 2020
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January 28, 2020 – Neglected Tropical Diseases

Checking for Trachoma in Vietnam: A woman is seen washing up during a trachoma impact survey in Na Ri District, Bac Kan Province, Vietnam. Facial cleanliness is essential for elimination of the disease. Photo credit: RTI International/ Nguyen Minh Duc.

The provision of safe water, sanitation, and hygiene (WASH) is recognized as both a key intervention and a necessary component for the prevention and provision of care for all neglected tropical diseases. USAID’s Neglected Tropical Diseases (NTD) Program in the Bureau for Global Health contributed content and suggested this topic as a way to highlight the first-ever World NTD Day on January 30, 2020. World awareness days, such as this one, offer an opportunity to mobilize greater attention and action on priority issues, particularly in the countries and communities most directly affected.
 
Since 2006, USAID NTD support has expanded from five countries to 32 and resulted in the treatment of 1.3 billion people. USAID identifies which communities are at risk and targets its interventions, supports and facilitates mass drug administration, and monitors its results.
 
This issue of Water Currents updates the May 2019 NTD issue with USAID NTD resources and just-published studies on dengue, schistosomiasis, soil-transmitted helminth infections, and trachoma.

Events
World Neglected Tropical Diseases Day, January 30, 2020 – World NTD Day will bring together civil society advocates, community leaders, global health experts, and policymakers working across the diverse NTD landscape. More than 180 partners from around the globe and across sectors have committed to celebrate the first-ever World NTD Day to ultimately help #BeatNTDs.

Overviews
WASH and Health Working Together: A ‘How-To’ Guide for Neglected Tropical Disease Programmes. World Health Organization (WHO), 2019. This toolkit provides step-by-step guidance to NTD program managers and partners on how to engage and work collaboratively with the WASH community to improve delivery of water, sanitation, and hygiene services to underserved populations affected by NTDs.

Safer Water, Better Health. 2019 Update. WHO, 2019.This report presents recent evidence on the links among inadequate WASH and disease, adverse health outcomes, and injuries. The WASH–attributable burden of 12 major diseases is analyzed and information is provided on effective and cost-effective interventions.

Burden of Disease from Inadequate Water, Sanitation and Hygiene for Selected Adverse Health Outcomes: An Updated Analysis with a Focus on Low- and Middle-Income Countries. International Journal of Hygiene and Environmental Health, June 2019. Inadequate WASH remains an important determinant of global disease burden. This study updates estimates of the the WASH–attributable burden of diarrheal disease, respiratory infections, malnutrition, and NTDs with a focus on low- and middle-income countries.

The U.S. Government and Global Neglected Tropical Disease Efforts. Kaiser Family Foundation, July 2019. Over the past 10 years, the United States has become more involved in global NTDs, launching its first NTD program in 2006 through USAID with a focus on seven NTDs that can be controlled and even eliminated with low-cost and effective interventions.

NTD Toolbox. This toolbox, supported by USAID, contains guidance, tools, and resources for NTD program managers.

Dengue
Dengue and Severe Dengue Fact Sheet. WHO, April 2019. Dengue prevention and control depends on effective vector control measures. Sustained community involvement can improve vector control efforts substantially. The main mosquito vectors of dengue breed in and around human habitation and their eggs can remain dry for months and hatch when in contact with water.

The Current and Future Global Distribution and Population at Risk of Dengue. Nature Microbiology, June 2019. The geographical range of dengue is expected to expand in the coming years. This study provides projections of future changes in virus suitability and human population at risk for the years 2020, 2050, and 2080.

Implementation of Guppy Fish (Poecilia reticulata), and a Novel Larvicide (Pyriproxyfen) Product (Sumilarv 2MR) for Dengue Control in Cambodia. PLoS Neglected Tropical Diseases, November 2019. This study was designed to better understand the community acceptance and perceptions of two biological controls that would overcome insecticide resistance for consideration in dengue control strategies for the future. The author recommends that both mosquito control interventions be considered in future projects in Cambodia, which has one of the highest per-capita incidence rates of the disease.
 
Schistosomiasis
The Prevalence of Schistosomiasis in Uganda: A Nationally Representative Population Estimate to Inform Control Programs and Water and Sanitation Interventions. PLoS Neglected Tropical Diseases, August 2019. This study found the national prevalence of schistosomiasis was 25.6 percent among children ages 2 to 4 and that defecation behaviors of individuals were more strongly associated with infection status than household water and sanitation infrastructure.

Environmental Determinants of Distribution of Freshwater Snails and Trematode Infection in the Omo Gibe River Basin, Southwest Ethiopia. Infectious Diseases of Poverty, November 2019. Human activities, such as open field defecation and urination; livestock grazing; farming; and swimming serve as important predictors of the abundance of trematode infection.

Unavoidable Risks: Local Perspectives on Water Contact Behavior and Implications for Schistosomiasis Control in an Agricultural Region of Northern Senegal. American Journal of Tropical Medicine and Hygiene, October 2019. The findings highlight the capacity of local populations to participate actively in schistosomiasis control programs and the limitations of widespread drug treatment campaigns. Interventions that target the environmental reservoir of disease may provide opportunities to reduce exposure while maintaining resource-dependent livelihoods.

No More Neglect: Female Genital Schistosomiasis (FGS) and HIV. UNAIDS, December 2019. FGS results from untreated infection with Schistosoma haematobium that affects mostly women and girls who come in contact with contaminated freshwater bodies during their daily chores and livelihoods. This condition is under-reported and under-diagnosed and can leave those affected more vulnerable to HIV, however, it is treatable.

Soil-Transmitted Helminth (STH) Infections
Impact of the “BALatrine” Intervention on Soil-Transmitted Helminth Infections in Central Java, Indonesia: A Pilot Study. Tropical Medicine and Infectious Disease, December 2019. Researchers tested a low-cost, locally designed and constructed all-weather latrine (the “BALatrine”), along with a community education program promoting appropriate hygiene-related behavior. This integrated intervention was associated with a reduced incidence of STH infection.

Soil-Transmitted Helminth Infections Factsheet. WHO, March 2019. Control is based on periodical deworming to eliminate infecting worms, health education to prevent re-infection, and improved sanitation to reduce soil contamination with infectious eggs.

Effects of Single and Integrated Water, Sanitation, Handwashing, and Nutrition Interventions on Child Soil-Transmitted Helminth and Giardia Infections: A Cluster-Randomized Controlled Trial in Rural Kenya. PLoS Medicine, June 2019. The research found that integrating water, sanitation, and handwashing concurrently in the household can protect children from roundworm infection and also that water treatment alone may provide protection, suggesting that combining WASH interventions does not yield greater health benefits than implementing single interventions.

Domains of Transmission and Association of Community, School, and Household Sanitation with Soil-Transmitted Helminth Infections (STH) Among Children in Coastal Kenya. PLoS Neglected Tropical Diseases, November 2019. Findings from this study highlight the need for continued efforts, alongside deworming, to extend access to good sanitation facilities at homes, schools, and across communities.

Trachoma
Trachoma Fact Sheet. WHO, June 2019. Trachoma is a public health problem in 44 countries and is responsible for the blindness or visual impairment of about 1.9 million people. This sheet provides key facts and information on economic impact, prevention and control, and the WHO response.

Integrating Face Washing into a School-Based, Handwashing Behavior Change Program to Prevent Trachoma in Turkana, Kenya. American Journal of Tropical Medicine and Hygiene, October 2019. The integration of trachoma prevention messages into ongoing, widespread hygiene promotion programs in schools may result in the long-term practice of face washing, which could be effective when used at scale to contribute to the elimination of trachoma.

Unimproved Water Sources and Open Defecation are Associated with Active Trachoma in Children in Internally Displaced Persons Camps in the Darfur States of Sudan. Transactions of the Royal Society of Tropical Medicine and Hygiene, October 2019. Disease elimination in conflict-related settings presents a unique challenge for the trachoma community, and may require an innovative approach.

Associations Between Water, Sanitation and Hygiene (WASH) and Trachoma Clustering at Aggregate Spatial Scales, Amhara, Ethiopia. Parasites & Vectors, November 2019. Water access and facial cleanliness are important factors in the clustering of trachoma within this region. Intensified promotion of structural and behavioral interventions to increase WASH coverage may be necessary to eliminate trachoma as a public health problem in Amhara and perhaps other hyper-endemic settings.

WHO Reports 91% Reduction in Trachoma Prevalence in Weekly Epidemiological Record. International Coalition for Trachoma Control, July 2019. The number of people at risk from trachoma, the world's leading infectious cause of blindness, has been reduced by 91 percent from 1.5 billion in 2002 to 142.2 million in March 2019.

Prevalence and Associated Factors of Active Trachoma Among Children in Ethiopia: A Systematic Review and Meta-Analysis. BMC Infectious Diseases, December 2019. This study determined the prevalence of active trachoma in different districts of Ethiopia. Absence of a latrine, unclean faces of children, and no reported use of soap for washing are the important factors associated with active trachoma among children.

USAID NTD Resources
USAID Neglected Tropical Diseases Program – Over the past 14 years, USAID has supported 31 countries in Africa, Asia, and Latin America to fight NTDs. USAID’s support has enabled the delivery of medicines to one out of seven people globally, made possible by a $22 billion drug donation.

USAID Act to End NTDs East Program – This program, led by RTI International, is working in 13 countries located throughout the globe in Southeast Asia, East Africa, and elsewhere to support national governments to reach NTD control and elimination goals by implementing proven, cost-effective public health interventions.

USAID Act to End NTDs West Program – This program, led by FHI 360, is working primarily in 11 West and Central African countries to eliminate seven of the most common NTDs. Act West is strengthening the capacity of national NTD programs and helping them better integrate across health systems.

USAID ENVISION Project – The ENVISION project supported disease-endemic countries to scale-up integrated NTD control and elimination activities and to strengthen national health systems to control and eliminate those diseases. See the project’s final report.

USAID Neglected Tropical Diseases Factsheet. USAID, August 2019. The USAID Neglected Tropical Diseases Program targets the most prevalent neglected tropical diseases that have proven, cost-effective health interventions. These diseases include lymphatic filariasis, trachoma, onchocerciasis, schistosomiasis, and soil-transmitted helminths.

If you would like to feature your organization's materials or suggest other content for upcoming issues of Water Currents, please send them to Dan Campbell, Knowledge Creation/WASH Specialist, at dcampbell@waterckm.com.

For past issues of Water Currents, visit Globalwaters.org.
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Water Currents: Water Harvesting Methods - December 12, 2019

Water Currents: Water Harvesting Methods - December 12, 2019 Water conservation of both surface and groundwater is a key component to increase access to, quantity, and quality of water supplies...
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December 12, 2019 – Water Harvesting Methods

In anticipation of a normal rainy season after the 2016 drought in Yap, Federated States of Micronesia (FSM), USAID and the College of Micronesia-FSM installed portable rainwater harvest bags in the water-challenged atoll communities to help migrants start up resilient home gardens. Photo credit: Dorelyn Jose/Partners for Global Research and Development

Water conservation of both surface and groundwater is a key component to increase access to, quantity, and quality of water supplies to meet basic human needs, support economic growth, enhance food security, and maintain ecosystems.

Within USAID water conservation is viewed as a multisectoral challenge that is addressed through water resources management, food security, biodiversity conservation, resilience, climate change, and natural resources management programming. Common methods to conserve water include implementing modern irrigation methods, increasing forest cover, and reusing water/wastewater. This issue focuses on two relatively low-tech, cost-effective water conservation techniques, rainwater and fog harvesting.

Rainwater harvesting methods can improve access to drinking and irrigation water, increase groundwater recharge and reduce stormwater discharges, mitigate urban flooding and the overloading of sewage treatment plants. Fog harvesting is an ancient practice in which water is collected from fog using large pieces of vertical canvas.

RAINWATER HARVESTING 

Country Reports
Lessons from the Field: Rainwater Harvesting in India. National Geographic, May 2019. This article gives an overview of Hiware Bazaar village in India and how the village has successfully used rainwater harvesting to secure water supplies.

Rain Water Harvesting Brings Relief to Four Drought and Flood Prone Districts in Sri Lanka. Daily FT, July 2019. The USAID–funded water harvesting project of the Lanka Rain Water Harvesting Forum is nearing completion. Its has installed rainwater harvesting (RWH) units that benefit more than 17,000 people, 48 schools, and 10 medical clinics.

Why Doesn’t Every Family Practice Rainwater Harvesting? Factors that Affect the Decision to Adopt Rainwater Harvesting as a Household Water Security Strategy in Central Uganda. Water International, November 2018. This article investigates the reasons householders do, and don’t, adopt domestic rainwater harvesting. Factors that emerged as important are the work of intermediary organizations, finance mechanisms, life course dynamics, and land tenure.

A Review of Rainwater Harvesting in Malaysia: Prospects and Challenges. Water, April 2018. Although Malaysia issued rainwater harvesting guidelines in 1999, this study found that its implementation as an alternative water resource is still limited due to its long return on investment and poor public acceptance.

Assessing the Potential for Rooftop Rainwater Harvesting from Large Public Institutions. International Journal of  Environmental Research and Public Health, February 2018. RWH from large institutions in Ethiopia would enable a significant volume of potable water to be transferred to localities critically suffering from water shortage. However, the present study assumed that financial constraints to install large-sized storage tanks pose a possible challenge.

Rainwater Harvesting in Buildings in Brazil: A Literature Review. Water, April 2018. Topics covered in this review include economic, environmental, and social impacts related to RWH. It also assesses legislation enacted to promote the practice.

Potential of Rainwater Harvesting in Rwanda: A Deep-Dive into Best Management Practices of Rainwater Harvesting Systems in Kigali. Centre for Science and Environment, April 2019. This report focuses on urban RWH systems and includes case studies from schools, hotels, and industries in Kigali.

Health/Water Quality Issues
A Global Review of the Microbiological Quality and Potential Health Risks Associated with Roof-Harvested Rainwater Tanks. Nature, March 2019. To provide a summary of microbial contaminants in rainwater tanks and contextual factors, researchers conducted a comprehensive review to analyze the uses of rainwater, factors affecting water quality, concentrations of fecal indicators and pathogens, the attribution of pathogens to host sources using microbial source tracking, and microbial ecology. The study also determined human health risks using epidemiological approaches and quantitative microbial risk assessments and treatment approaches for mitigating risks.

Improving Water Access and Health Through Rainwater Harvesting: Perceptions of an Indigenous Community in Jalisco, Mexico. Sustainability, September 2019. A survey revealed that the use of RWH systems in this community has increased and that the incidence of diarrheal diseases has decreased significantly.

Arsenic Detected in Rainwater Harvesting Tanks in Bolivia. Rural Water Supply Network, August 2019. This finding alerted organizations to the risk of rainwater contamination in the region. Tests identified roof dust that flushes into the tanks from the roof catchment as the principal source of arsenic in the rainwater. No arsenic was detected in raw rainwater before it interacted with the roof or tank. The source of the arsenic in the dust is unknown, but widespread mining contamination in the area is likely a contributor.

Antibiotic-Resistant Pathogenic Escherichia Coli Isolated from Rooftop Rainwater-Harvesting Tanks in the Eastern Cape, South Africa. International Journal of  Environmental Research and Public Health, May 2018. The results of this study concluded that the use of untreated harvested rainwater for potable purposes may pose a risk of transmission of pathogenic and antimicrobial-resistant E. coli.

Rainwater Harvesting for Smart Health Care Facilities. Pan American Health Organization, May 2019. This technical brief discusses the components of a rainwater harvesting system for health care facilities.

Nonpotable Uses of Rainwater
Rainwater Harvesting for Agricultural Irrigation: An Analysis of Global Research. Water, June 2019. It is necessary to increase the number of studies on the capacity of RWH systems to cover irrigation needs in different farming contexts, the factors that determine their adoption by farmers, the economic and financial feasibility of their implementation, and their contribution to mitigating global climate change.

An Analysis of the Effectiveness of Two Rainwater Harvesting Systems Located in Central Eastern Europe. Water, March 2019. Researchers analyzed the effectiveness of RWH systems for toilet flushing in academic facilities located in Poland and Slovakia. The study concluded that the use of rainwater for toilet flushing would achieve water savings of 29 percent and 18 percent, respectively, for facilities located in Slovakia and Poland.

Practices and Hydrological Effects of Road Water Harvesting in Northern Ethiopia: Towards Design of Multi-Functional Infrastructures. Momona Ethiopian Journal of Science, October 2019. Results of the study revealed that harvesting water from road catchments is found to have several benefits: increase in shallow groundwater recharge, improvement in soil moisture (up to 90 percent increase), and increase in the availability of surface water in ponds and reservoirs.

Technologies
Infiltration Ponds: Restoring Groundwater Resources. USAID Indonesia Urban Water, Sanitation and Hygiene (IUWASH PLUS) Project, April 2019. An innovative intervention developed under the predecessor project IUWASH constructed and installed infiltration ponds to collect rainwater, an effective method to improve groundwater sources.

Smart Phone App to Improve Rainwater Harvesting in Africa. UN Environment Program (UNEP), April 2019. A smart phone app developed by UNEP and the UN Educational, Scientific and Cultural Organization calculates the amount of rainwater that can be harvested from the roof of houses. The app is based on actual meteorological data collected from weather stations across Africa.

Smart Rainwater Management: New Technologies and Innovation. IntechOpen, October 2019. This chapter discusses water quality issues in cities and the research advances in handling those issues. Among them it investigates RWH technologies and some of their practical applications.

Implementation of Rainwater Harvesting Systems with a Geomembrane Bag in Honduras and El Salvador. Global Water Partnership, February 2019. RWH systems using a geomembrane bag to store rainwater have proven to be a successful technology because of its technical simplicity and wide availability of components, and can be an effective alternative in places where conventional systems are not considered.

FOG HARVESTING 

How Scientists Are Harvesting Fog to Secure the World’s Water Supply. PBS News Hour, July 2019. This news segment highlights how scientists around the world are leveraging familiar scientific principles with modern technology to capture water from the moisture in fog. John Yang reports on these innovative efforts to address the worsening water crisis.

Gender and Community Mainstreaming in Fog Water Collection Systems. Water, October 2018. This paper concludes that fog water collection projects have shown positive outcomes for women and girls through the freeing of time for domestic and educational pursuits, improved health outcomes, and improved perceptions of self and others’ perceptions of women.

Drops of Diplomacy: Questioning the Scale of Hydro-Diplomacy through Fog-Harvesting. Journal of Hydrology, July 2018. This paper argues that, by using fog to facilitate collaborative exchange, a nonprofit organization in Morocco is engaging in a form of hydro-diplomacy to lay the groundwork for durable peace, intercultural understanding, and symbiotic growth.

Fog Water Collection: Challenges Beyond Technology. Water, March 2018. Among the unconventional water resources, the potential to collect water from the air, such as fog harvesting, is by far the most under-explored. Fog water collection is a passive, low maintenance, and sustainable option that can supply fresh drinking water to communities where fog events are common. Because of the relatively simple design of fog collection systems, their operation and maintenance are minimal and the associated cost likewise; although, in certain cases, some financially constrained communities would need initial subsidies.

Fog and Dew as Potable Water Resources: Maximizing Harvesting Potential and Water Quality Concerns. GeoHealth, October 2018. The few studies that report trace metal or biological measurements suggest elevated trace metal concentrations or biological contamination that could be of concern to public health. This article discusses the potential for fog and dew harvesting technologies and the need for trace metal and biological analyses of these waters before use.

Online One Day Masterclass: Fog Collection for Water Management and Sustainable Forestry. Water Harvesting Lab, February 2019. Research has shown fog collection, and fog-forest interaction management, is a viable way to fight drought, combat land degradation, and overcome climate change in arid areas. This online course explains the strategies and practicalities of fog collection.

If you would like to feature your organization's materials or suggest other content for upcoming issues of Water Currents, please send them to Dan Campbell, Knowledge Creation/WASH Specialist, at dcampbell@waterckm.com.

For past issues of Water Currents, visit Globalwaters.org.
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Water Currents: World Toilet Day 2019

Water Currents: World Toilet Day 2019 Toilets are more than a household necessity—they save lives, protect dignity, and create economic opportunity. 
Bringing you the latest water sector research, resources, and news.
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November 14, 2019 – World Toilet Day 2019

Students in Ghana pose in front of their new school latrine built under the USAID WASH for Health program. Photo credit: Global Communities

Toilets are more than a household necessity—they save lives, protect dignity, and create economic opportunity. This November 19, join the annual celebration of World Toilet Day to raise awareness of the importance of sanitation to lift people out of poverty. This year’s theme “Leaving No One Behind” emphasizes the importance of expanding sanitation access to the more than 4.2 billion people living without safely managed sanitation options.
 
USAID goes beyond toilet construction to address weak demand and low capacity for sanitation improvements. The Agency’s comprehensive approach includes engaging the private sector to develop aspirational and affordable products, unlocking financing, and strengthening sanitation governance, coupled with behavior change to encourage use and maintenance. To learn more about USAID’s sanitation activities, follow us @USAIDWater or visit Globalwaters.org

This Water Currents contains recent studies and resources related to the sanitation issues facing marginalized or special populations, such as people with disabilities, refugees, sanitation workers, and the urban poor.

Events 
World Toilet Day 2019: Leaving No One Behind – This year’s World Toilet Day (WTD) theme emphasizes that a toilet is not just a toilet. When a person does not own or have access to a toilet, he or she is vulnerable and can be “left behind” in terms of health, dignity, and opportunity. The official advocacy day website provides resources, including factsheets in multiple languages, posters, and social media messages.

World Toilet Summit 2019 – The World Toilet Summit takes place each November to coincide with World Toilet Day celebrations. This year’s summit will be held in Sao Paulo, Brazil, November 18–19, 2019.

Overviews 
Sanitation Factsheet. World Health Organization, June 2019. Inadequate sanitation is estimated to cause 432,000 diarrheal deaths annually and is a major factor contributing to several neglected tropical diseases, including intestinal worms, schistosomiasis, and trachoma. Poor sanitation also contributes to malnutrition.

Scaling Market-Based Sanitation: Desk Review on Market-Based Rural Sanitation Development Programs. USAID Water, Sanitation, and Hygiene Partnerships and Learning for Sustainability (WASHPaLS) Project, 2018. This desk review investigates the current state of knowledge in market-based sanitation (MBS) and establishes a framework to analyze, design, and improve MBS interventions. A webinar summarizes the report findings.

Policy Diffusion in the Rural Sanitation Sector: Lessons from Community-Led Total Sanitation (CLTS). World Development, December 2019. This paper, produced with support from the USAID WASHPaLS Project, uses a qualitative approach to analyze the reasons and processes that drove the wide diffusion of CLTS, showing that CLTS was embraced because it was perceived as a fast and effective solution to the problem of open defecation.

Toward a Hygienic Environment for Infants and Young Children: A Review of the Literature. USAID WASHPaLS Project, 2018. This literature review examines the health risks to infants and young children from fecal exposure in their home environments. A webinar and blog summarize the report’s findings.

Safely Managed Sanitation in High-Density Rural Areas: Turning Fecal Sludge into a Resource Through Innovative Waste Management. World Bank, September 2019. This report explores the challenges of fecal sludge management (FSM) in densely populated rural areas and it presents some typical current practices, examples of financially sustainable FSM services, and global innovations in waste management with potential replicability for FSM.

Guidance on Programming for Rural Sanitation. WaterAid, February 2019. Guidance is provided on the design of large-scale sanitation programs in rural communities, with a focus on the achievement of sustained household and collective sanitation and hygiene outcomes.

Smart Sanitation City: The Sanitation Economy at City Scale. Toilet Board Coalition, 2018. Smart Sanitation Cities present a significant opportunity to design future sanitation systems leveraging smart city growth trends to address the global sanitation crisis.

People with Disabilities 
Systematic Review of Menstrual Hygiene Management Requirements, Its Barriers and Strategies for Disabled People. PLoS One, February 2019. This review assessed the menstrual hygiene requirements of disabled people—a population often discriminated against and facing its own taboos—identified the barriers they face, and cataloged interventions to help them manage their menstruation hygienically and with dignity.

Support Mechanisms to Strengthen Equality and Non-Discrimination (EQND) in Rural Sanitation (Part 2 of 2). CLTS Knowledge Hub, July 2019. This issue of Frontiers of CLTS examines the potential of support mechanisms designed to help disadvantaged groups access and use hygienic toilets in driving more equitable rural sanitation outcomes. It covers the latest thinking on the opportunities and challenges of support mechanisms and explores what work remains to be done.

Equality and Non-Discrimination (EQND) in Sanitation Programmes at Scale (Part 1). CLTS Knowledge Hub, September 2017. This issue looks at who should be considered potentially disadvantaged, how they can effectively participate, and what should be done to address diverse needs to make processes and outcomes sustainable and inclusive.

Are Current Approaches for Measuring Access to Clean Water and Sanitation Inclusive of People with Disabilities? Comparison of Individual- and Household-Level Access Between People with and without Disabilities in the Tanahun District of Nepal. PLoS One, October 2019. People with disabilities face substantial challenges to meeting their water, sanitation, and hygiene (WASH) needs, particularly in using services autonomously, consistently, hygienically, with dignity and privacy, and without pain or fear of abuse. These challenges are not captured through household-level data, and so individual-level WASH access data are needed to monitor progress toward universal WASH access.

Gender 
A Mixed-Methods Study of Women’s Sanitation Utilization in Informal Settlements in Kenya. PLoS One, March 2019. Women living in informal settlements, in particular, are disproportionately affected by lack of access to sanitation. A majority of women in this study used an unsafe method of disposal at least once in a 24-hour period that increased their risk of direct exposure to waste and harmful pathogens.

Not Just Any Toilet: Women’s Solutions to Sanitation in Informal Settlements in Nairobi. Journal of Development Practice, September 2018. The purpose of this study was to provide women with an opportunity to share their perspectives and solutions to sanitation in informal settlements. The most common solution was to build more toilets, but women had a variety of suggestions—including gender-specific solutions.

Water, Sanitation and Hygiene: Measuring Gender Equality and Empowerment. Bulletin of the World Health Organization, June 2019. Inequalities in access to WASH services have been measured between rural and urban areas and across country wealth quintiles, as well as by sex. However, past studies have not adequately measured the burdens placed on women and girls, the opportunity costs of these burdens, and female empowerment related to WASH decision-making and autonomy.

Female-Friendly Public and Community Toilets: A Guide for Planners and Decision Makers. WaterAid; Water and Sanitation for the Urban Poor (WSUP); UNICEF, October 2018. The guide explains why toilets must be female-friendly before detailing the essential and desirable features needed to make them so. It also suggests ways to increase gender sensitivity in town planning on sanitation.

Engaging Men and Boys in Sanitation and Hygiene Programmes. CLTS Knowledge Hub, August 2018. This review focuses on men and boys: how to engage them (or not), how to mobilize them as allies in the transformation of sanitation and hygiene outcomes, and the problems they contribute to and experience.

Humanitarian WASH 
Rapid Review of Disability and Older Age Inclusion in Humanitarian WASH Interventions. Elrha, May 2019. People with disabilities and older people make up significant population groups, however, they are disproportionately affected by and among the most marginalized in humanitarian response.

Sani Tweaks: Guide to Best Practices in Humanitarian Response Sanitation. Oxfam, February 2018. Research has shown that humanitarian agencies are failing to properly consult the users of the latrines they build, leading many people—especially women and girls—to stop using those latrines as they find them inaccessible, unsuitable, and/or unsafe. To address this, the Oxfam WASH team has developed a series of communications tools that seek to promote best practices in sanitation.

Tiger Worm Toilet Manual: Globally Relevant Learnings from Myanmar. Elrha, March 2019. Tiger Worm Toilets contain composting worms inside the pit that digest feces in-situ, replacing the build up of raw sludge with vermicompost. This removes the need for traditional desludging. To date, more than 900 Tiger Worm Toilets have been built and trialed across four countries by Oxfam in a range of settings, including urban, peri-urban, and camps. They have been shown to work in both household and shared communal camp settings.

Urban Poor 
The Use of Research in Participatory Planning of Sanitation and Hygiene: Lessons from Babati, Tanzania. WaterAid, October 2019. This policy brief captures learnings from research in Babati Town in Tanzania to inform the development of a sanitation and hygiene plan and pro-poor town-wide planning.

Review of Drivers and Barriers of Water and Sanitation Policies for Urban Informal Settlements in Low-Income and Middle-Income Countries. Utilities Policy, October 2019. This study identifies donor prioritization and collective action as key drivers of water and sanitation policy, and social exclusion, lack of land or dwelling tenure status, the political economy of decision-making, and insufficient data as key barriers.

Anchoring Innovations in Oscillating Domestic Spaces: Why Sanitation Service Offerings Fail in Informal Settlements. Research Policy, February 2020. Newly provided and improved basic services are not maintained by users despite seemingly superior functionality and user convenience. One major reason for this is an insufficient understanding of the context in which users have to manage their daily lives.

Assessing the Market for Safe Faecal Waste Emptying Services in Low-Income Areas of Kisumu, Kenya. WSUP, June 2019. Results from this study indicate that future interventions need to address the price barrier between formal (safe) and informal (unsafe) fecal sludge emptying.

Evaluating the Potential of Container-Based Sanitation. World Bank, February 2019. Container-based sanitation consists of an end-to-end service—that is, one provided along the whole sanitation service chain—that collects excreta hygienically from toilets designed with sealable, removable containers and strives to ensure that the excreta is safely treated, disposed of, and reused.

Experiences of Shared Sanitation–Towards a Better Understanding of Access, Exclusion and ‘Toilet Mobility’ in Low-Income Urban Areas. Journal of Water, Sanitation and Hygiene for Development, May 2019. This study examines shared sanitation access and use by using innovative mapping methods in compound house units in Fante New Town, Kumasi, Ghana.

Challenges of Governing Off-Grid 'Productive' Sanitation in Peri-Urban Areas: Comparison of Case Studies in Bolivia and South Africa. Sustainability, June 2019. A comparison of two initiatives in Bolivia and South Africa offers valuable insights for introducing functional off-grid “productive” sanitation systems relying on urine-diverting dry toilets in peri-urban settlements. Findings suggest that household acceptance of these toilets largely depends on consistent awareness raising and capacity building, in addition to adapting to local needs and creating a sense of ownership over the toilet system.

Sanitation Workers 
Guaranteeing the Rights of Sanitation Workers: Links between SDG 8 and SDG 6. WaterAid, June 2019. Despite their vital role in urban sanitation service provision and the occupational risks that accompany their profession, sanitation workers are often overlooked in health protection and sanitation program design, and are typically employed informally.

The Health, Safety and Dignity of Sanitation Workers: A Blind Spot in Safely Managed Sanitation. Water Blog, May 2019. Sanitation workers often suffer terrible working conditions and are generally taken for granted in sanitation programs. Yet, without them, the sanitation service chain can’t function.

Websites 
USAID Water, Sanitation and Hygiene Partnerships and Learning for Sustainability Project – WASHPaLS is working to improve water supply, sanitation, and hygiene programming by identifying, researching, and sharing best practices for the delivery of WASH services and sustained behavior change.

Toilet Board Coalition – The coalition has the ambition to address the global sanitation crisis by accelerating the sanitation economy. To do so it enables private sector engagement; connects large and small companies; and ensures close collaboration among private, public, and nonprofit sectors with the purpose of achieving Sustainable Development Goal 6—universal access to sanitation.

Sanitation Updates – USAID’s WaterCKM project and IRC maintain this news and opinion blog on sanitation. Sanitation Updates was originally set up to promote the 2008 International Year of Sanitation and continues to provide news, information, and resources in support of achieving the goal of sanitation for all.

If you would like to feature your organization's materials or suggest other content for upcoming issues of Water Currents, please send them to Dan Campbell, Knowledge Creation/WASH Specialist, at dcampbell@waterckm.com.

For past issues of Water Currents, visit Globalwaters.org.
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Water Currents: WASH & Mobile Technologies - October 29, 2019

Water Currents: WASH & Mobile Technologies - October 29, 2019 Mobile devices, technologies, and services have the potential to improve service delivery to remote populations.
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October 29, 2019 – WASH & Mobile Technologies

Water and sanitation customers are increasingly being offered digitized options for payment. Photo credit: GSMA

Mobile devices, technologies, and services have the potential to improve service delivery to remote populations and the bottom line for water and sanitation service providers. In addition to monitoring how water, sanitation, and hygiene (WASH) systems function, mobile technologies can be used to deliver financing and payment solutions, to collect reliable data on usage and operations, and to identify gaps and inform policy decisions.

USAID works on building the capacity of local governments and utilities to apply these new technologies to enhance data collection for decision-making, monitor the quality and quantity of water resources, improve forecasting, and support overall monitoring and evaluation efforts. This issue contains recent studies on how mobile applications are being applied to financing, water utilities, humanitarian WASH situations, and other areas.

We would like to thank staff from the GSMA Mobile for Development Utilities Initiative for contributing content to this issue.

Overviews 
Draft USAID Digital Strategy. USAID, October 2019. USAID’s first ever Digital Strategy charts an Agency-wide vision for development and humanitarian assistance in the world’s rapidly evolving digital landscape. The strategy is open for comment through November 3, 2019.

How Can Online Data Platforms Improve Management of Water, Sanitation and Hygiene Services? WaterAid's Experience Using mWater. WaterAid, February 2019. Increased access to mobile phones has allowed for a shift in how information is gathered, shared, and used. WaterAid staff discuss how this access can benefit the water, sanitation, and hygiene sector, and explore the benefits of the online data tool mWater in monitoring the quality of WASH services.

The Future of Water: A Collection of Essays on 'Disruptive' Technologies that May Transform the Water Sector in the Next 10 Years. IDB, April 2019. Experts identify what they believe to be the key technological changes that will transform the sector and whether they have the potential to become “disruptive.” The authors also discuss which enabling conditions would be necessary to encourage the adoption and mainstreaming of each technology.

Mobile for Development Utilities Perspective – Our Quarterly Insights – Issue 1. GSMA, August 2019. In this first issue, GSMA explores the digitization of water utilities in Africa and Asia. Water utilities in countries with poor access to clean water are stuck in a cycle of huge operational losses, making it impossible to invest in infrastructure that would serve more people and leaving many to rely on unsafe alternative sources of water. Can digitization help solve the problem?

Access to Water and Sanitation in Emerging Markets: The Impact of Mobile Technology. GSMA, November 2018. In this video, grantees of the Mobile for Development Utilities Innovation Fund—CityTaps, Loowatt, and Wonderkid—discuss what they are doing to solve the access gap and what the future of these sectors looks like.

Key Trends in Mobile-Enabled Water Services: What’s Working and What’s Next. GSMA, August 2018. This report discusses three key trends in mobile-enabled water delivery that have been tested and explores these in light of broader industry trends.

Financial Technology 
Testing the Waters: Digital Payments for Water and Sanitation. CGAP; GSMA, March 2019. Research found that digitizing payments in the water sector can have a positive impact on the financial sustainability of water service delivery models for low-income populations. Specifically, digital payments reduce operational expenses and enable more efficient service delivery.

Digitizing Payments for Household Water Connections in Ghana. Safe Water Network, August 2018. Prepaid, mobile, money-enabled meters for household connections improve water service provider financial viability and consumer satisfaction. However, robust consumer training is needed to realize full financial, operational, and consumer benefits.

The Potential of PAYGo for Achieving Water and Sanitation for All (SDG 6). BFA, March 2019. This report explores how digital tools (e.g., smart meters and mobile payments) developed as part of PAYGo solar in East Africa can be combined with new business models to scale in-home water connections in pursuit of clean water for all.

Fintech for the Water Sector: Advancing Financial Inclusion for More Equitable Access to Water. World Bank, January 2019. The emerging field of financial technology (fintech) can help address barriers to financial inclusion in the water sector while potentially reducing or eliminating the need for subsidy. This paper explores how fintech can support expansion of market-based solutions for water, sanitation, and irrigation, identifying several case studies where fintech is already being used to address financial inclusion and access to water.

Performance-Based Funding for Reliable Rural Water Services in Africa. Uptime; University of Oxford, May 2019. A graveyard of failed water supply infrastructure across Africa points to the legacy of well-meaning but poorly executed investments. The enduring problem is that providing maintenance services to rural and remote populations is not financially viable in many contexts. Without credible data on observed delivery costs, government, donors, private finance, or other investors cannot allocate current funding efficiently.

Humanitarian/Health Applications 
Mapping and Analysis of the Disaster Risk of Water Supply Schemes by Using Mobile Application41st WEDC International Conference, 2018. As part of a risk mapping study to determine the functionality and status of water supply schemes following the Nepal 2015 earthquake, researchers used a mobile-based tool, KOBO, to collect the data and information. The findings were linked with Google Earth.

Formative Research for the Design of a Scalable Water, Sanitation, and Hygiene Mobile Health Program: CHoBI7 Mobile Health Program. BMC Public Health, August 2019. The pilot findings indicate that the CHoBI7 mHealth program has high user acceptability and is feasible to deliver to diarrhea patients that present at health facilities for treatment in Bangladesh. Both text and voice messages were recommended for program delivery.

The Digital Lives of Refugees: How Displaced Populations Use Mobile Phones and What Gets in the Way. GSMA, July 2019. Humanitarian services are increasingly digitizing, and mobile phone penetration and use among refugees is growing. The transition to mobile-based services can offer significant protection dividends and other wide-ranging benefits for refugees who are digitally literate and can access and engage with mobile services effectively.

Disruptive Technologies and their Use in Disaster Risk Reduction and Management. ITU, March 2019. Technological advancement and innovation have created new opportunities for enhancing disaster resiliency and risk reduction. Innovations in such areas as robotics and drone technology are transforming many fields, including disaster risk reduction and management.

Global Report on Water and Disasters. High-Level Experts and Leaders Panel on Water and Disasters (HELP), July 2019. Water-related disasters in 2018 resulted in a death toll of 6,500, more than 57 million people affected, and economic losses of $140 billion worldwide.

Monitoring Applications 
The Digital Dividend: Information Technology Improves the Delivery of Water and Sanitation Services. UNICEF, January 2019. This article discusses a registered key informant for the Mahole water point in Insiza South District, southeast of Bulawayo, Zimbabwe. Her duties include ensuring that information on water infrastructure (including the pump functionality of boreholes, water yields, and water quality) reaches the area enumerator in real time.

Leveraging Satellites and the Internet of Things, SweetSense Facilitates Water Service Access in Kenya and Water Resource Management in California. Agrilinks, May 2019. SweetSense is a social enterprise that integrates and leverages cutting-edge technologies to improve the quality and value of water services. This article discusses SweetSense’s partnership with USAID in Kenya and with the Freshwater Trust in California.

Mobile Crowd Participation to Root Small-Scale Piped Water Supply Systems in India and Bangladesh. Journal of Water, Sanitation and Hygiene for Development, January 2019. To identify the relevance and acceptability of piped water supply and smartphone monitoring, this study conducted four surveys with potential end users. Based on these surveys, the authors concluded that there is a desire for piped water systems, that households already own smartphones with Internet access, and that there is an interest in smartphone monitoring.

Mobile Communities in Ethiopia Seek Fixed Solutions to their Water and Sanitation Challenges. USAID Global Waters, July 2018. Working with USAID’s Lowland WASH Activity, SweetSense, a private-sector partner, has installed 107 sensors to conduct real-time data monitoring of each water scheme’s operations. These sensors rely on the same technology that enables many people in the United States to program their thermostats remotely from an app on their phones.

Handpump Data Improves Water Access. Thematic Research Network on Data and Statistics, November 2018. The Smart Handpump Project illustrates how new information flows from innovative sensor data can improve key services. Such low-cost and scalable data interventions strengthen the governance and management of resources critical to sustainable development.

A Review of In-Situ and Remote Sensing Technologies to Monitor Water and Sanitation Interventions. Water, June 2018. It is hoped that improved monitoring of water and sanitation interventions will reveal more cost-effective and efficient ways of meeting the Sustainable Development Goals (SDGs). In this paper, the authors review the landscape of approaches that can be used to support and improve on the water and sanitation targets of SDG 6.1 and SDG 6.2.

Sanitation Services 
Integrating Mobile Tech into Sanitation Services. Water and Sanitation for the Urban Poor, June 2019. This Topic Brief is a useful guide for those in the WASH sector with an interest in integrating mobile phone technology into sanitation service provision in sub-Saharan Africa.

Supporting Waterless Flush Sanitation Through Mobile Technology–Loowatt. GSMA, April 2019. This video showcases how Loowatt  is leveraging mobile technology and mobile payments to more efficiently deliver container-based sanitation services in Madagascar.

Water Utilities
Seeking Sustainability in Water Service Delivery in Haiti. USAID Global Waters, October 2019. This blog discusses the use of the mWater platform by the USAID’s Water and Sanitation (WatSan) Project in Haiti. mWater is an open-source platform that helps water utilities to better map and manage water systems.

Digital Water Industry Leaders Chart the Transformation Journey. International Water Association, June 2019. This paper—largely based on interviews, surveys, and inputs from nearly 50 utility executives and more than 20 subject matter experts—examines how digitalization is transforming the water sector through the experiences of water and wastewater utilities. The aim of this report is to provide an overview of the current state of digital in the water sector, the potential value for digital solutions, and the lessons learned from those on the digital journey.

Mobile for Development Utilities Annual Report: Intelligent Utilities for All. GSMA, March 2019. The Mobile for Development Utilities program improves access to basic energy, water, and sanitation services in underserved communities using mobile technology and infrastructure. Its work encompasses any energy, water, and sanitation service provided to a community that includes a mobile component.

Delivering Water to Urban Homes Through Smart Metering and Mobile PaymentsCityTaps. GSMA, February 2019. This video showcases how GSMA Mobile for Development Utilities Innovation Fund grantee CityTaps’ prepaid smart meter solution is enabling the urban poor in Niamey, Niger, to access affordable and safe running water at home. Their prepaid smart meter incorporates machine-to-machine technology, which allows households to make micro-prepayments for their water at any time using mobile money.

Websites
Digital Innovations for WASH in Urban Settings – UNICEF, Arm, the African Academy of Sciences with the Swedish International Development Cooperation Agency, and the Bill & Melinda Gates Foundation launched a Global Grand Challenge Exploration—Digital Innovations for WASH in Urban Settings—with the aim of improving access to safe, clean, and affordable water in urban areas. The website contains descriptions of the grantees from Kenya, Uganda, Vietnam, and other countries.

GSMA Mobile for Development – This program stimulates digital innovation to deliver both sustainable business and large-scale socio-economic impact for the underserved.

GSMA Mobile for Development Utilities Programme – The goal for this GSMA program is to unlock commercially sustainable business models that leverage mobile to deliver affordable and improved energy, water, and sanitation services in emerging markets.

If you would like to feature your organization's materials or suggest other content for upcoming issues of Water Currents, please send them to Dan Campbell, Knowledge Creation/WASH Specialist, at dcampbell@waterckm.com.

For past issues of Water Currents, visit Globalwaters.org.
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Water Currents: Celebrate Global Handwashing Day 2019

Water Currents: Celebrate Global Handwashing Day 2019
Celebrate Global Handwashing Day on October 15, 2019
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October 15, 2019 – Global Handwashing Day

Children in Kuach, South Sudan, learn how to wash their hands properly. USAID and its partners help communities learn about essential hygiene and health behavior to prevent diseases like cholera and diarrhea. Photo credit: UNICEF/Kate Holt.
Children in Kuach, South Sudan, learn how to wash their hands properly. USAID and its partners help communities learn about essential hygiene and health behavior to prevent diseases like cholera and diarrhea. Photo credit: UNICEF/Kate Holt.

October 15, 2019, is Global Handwashing Day (GH Day), an annual advocacy day dedicated to increasing awareness and understanding about the importance of handwashing with soap. This year’s theme is “Clean Hands for All,” which gives much needed attention to the marginalized groups that lack access to handwashing facilities or face discrimination in the provision of handwashing and other water, sanitation, and hygiene (WASH) services.

The theme aligns with USAID’s Water and Development Plan under the 2017 U.S. Government Global Water Strategy, which has the stated result of increasing the practice of key hygiene behaviors including handwashing with soap among the underserved and most vulnerable populations.

This issue contains recent research and studies about handwashing programs and services for people with disabilities, refugees, patients in health care facilities, schoolchildren, and the urban poor.

Events
Global Handwashing Day, October 15, 2019 – Inequalities in handwashing facilities and lack of effective handwashing promotion programs can put individuals at higher risk for diseases that impact their health, education, and economic outcomes. GH Day 2019—with its theme of social inclusion—follows the global push to leave no one behind in the Sustainable Development Agenda. The Global Handwashing Partnership (GHP) organizes this annual event.

Overviews
Handwashing with Soap after Potential Faecal Contact: Global, Regional and Country Estimates. International Journal of Epidemiology, December 2018. 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. Still, even among those with access, handwashing with soap is poorly practiced.

People with Disabilities
Mainstreaming Disability and Making WASH Programmes Inclusive. Institute of Development Studies, October 2018. Designing inclusive WASH facilities from the start is the most cost-effective approach. Nonetheless, the cost of retrofitting existing facilities is less than some might expect.

Disability and Development Report: Realizing the Sustainable Development Goals by, for and with Persons with Disabilities. United Nations, 2019. Households, as well as governments, can implement low-cost, inclusive adaptations and universal design solutions to facilities, including toilets, water points, water carriers, bathing places, and handwashing facilities.

Patients in Health Care Facilities
Interventions to Improve Water Supply and Quality, Sanitation and Handwashing Facilities in Healthcare Facilities, and Their Effect on Healthcare-Associated Infections in Low-Income and Middle-Income CountriesBMJ Global Health, July 2019. The authors of this review concluded that there is a dearth of evidence for the effect of WASH in healthcare facilities and that additional and higher quality research is needed to understand the impact of different WASH interventions on infections associated with these facilities. Filling this gap can help prioritize the most effective approaches in these often resource-poor settings.

Safe Water and Hygiene Integration with Human Immunodeficiency Virus and Antenatal Services: Leveraging Opportunities for Public Health Interventions and Improved Service Uptake. American Society of Tropical Medicine and Hygiene, March 2018. This evaluation suggests that provision of hygiene kits, refills of supplies on subsequent visits, and HIV testing during antenatal clinic visits is feasible and may help improve household hygiene and increase the use of health services.

Barriers and Opportunities Experienced by Staff when Implementing Infection Prevention and Control Guidelines During Labour and Delivery in Healthcare Facilities in Nigeria. Journal of Hospital Infection, August 2019. Safe childbirth and postnatal care require comprehensive adherence to hand hygiene protocols and the use of disposable personal protective equipment.

Diffusion of Handwashing Knowledge and Water Treatment Practices from Mothers in an Antenatal Hygiene Promotion Program to Nonpregnant Friends and Relatives, Machinga District, Malawi. International Quarterly of Community Health Education, September 2018. Qualitative data from in-depth interviews suggest that program participants helped motivate adoption of water treatment and hygiene behaviors among friends and relatives.

Preventing Neonatal Sepsis in Rural Uganda: A Cross-Over Study Comparing the Tolerance and Acceptability of Three Alcohol-Based Hand Rub Formulations. BMC Public Health, November 2018. Mothers of newborn children in eastern Uganda participated in a test of three alcohol-based hand rub (ABHR) formulations for preventing neonatal infection. All three had high overall satisfaction scores, but participants scored the ABHR with added perfume the highest and used it much more often than plain ABHR.

Low-Income Urban Populations
Effects of Complexity of Handwashing Instructions on Handwashing Procedure Replication in Low-Income Urban Slums in Bangladesh: A Randomized Non-Inferiority Field Trial. Journal of Water, Sanitation and Hygiene for Development, June 2019. Handwashing instructions vary in complexity, with some recommending multiple steps. Simple handwashing steps are easier to remember in the long term compared to complex steps.

Acceptability and Feasibility of Sharing a Soapy Water System for Handwashing in a Low-Income Urban Community in Dhaka, Bangladesh: A Qualitative Study. American Society of Tropical Medicine and Hygiene, August 2018. The soapy water system evaluated in this study was simple in design, cost-effective, replicable, popular with intervention recipients and neighboring nonrecipients, and commonly shared among nonrelated households, suggesting a potential for scalability.

Refugees/Humanitarian Situations
Rapid Review of Disability and Older Age Inclusion in Humanitarian WASH Interventions. Humanitarian Innovation Fund, May 2019. People with disabilities and the elderly are disproportionately affected by and at greater risk because of their lack of access to water and sanitation during humanitarian response situations.

Could the Supertowel Be Used as an Alternative Hand Cleaning Product for Emergencies? An Acceptability and Feasibility Study in a Refugee Camp in Ethiopia. PLoS One, May 2019. Researchers found the Supertowel to be an acceptable and useful hand-cleaning product that could complement soap use in crisis contexts.

Child's Play: Harnessing Play and Curiosity Motives to Improve Child Handwashing in a Humanitarian Setting. International Journal of Hygiene and Environmental Health, September 2018. Distributing soaps with toys embedded inside, in a rapidly deployable intervention, can improve child handwashing behavior during humanitarian emergencies.

Assessing Emotional Motivators for Handwashing with Soap in Emergencies: Results from Three Asian Countries. Waterlines, January 2019. This paper examines how emotional motivators can help promote handwashing with soap among mothers affected by an emergency.

Schoolchildren
A Disruptive Cue Improves Handwashing in School Children in Zambia. Health Promotion International, October 2018. The intervention tested in this study saw a greater increase in the likelihood of soap use in intervention schools than in control schools, though both intervention and control schools saw an increase in handwashing without soap. This low-cost intervention could be scaled throughout Zambia and may work well in other countries of similar circumstances.

Effect of a School-Based Hygiene Behavior Change Campaign on Handwashing with Soap in Bihar, India: Cluster-Randomized Trial. American Journal of Tropical Medicine and Hygiene, August 2018. The authors found no evidence for a health-relevant effect of the “School of 5” intervention on handwashing with soap in schoolchildren and their mothers, possibly due to low campaign intensity, ineffective delivery, and a model not well tailored to these challenging physical and social environments.

Handwashing Research
January to June 2019 Handwashing Research Index. GHP, June 2019. Between January and June 2019, GHP found 36 studies that explore handwashing in connection with diverse programmatic areas in global health and development.

2018 Handwashing Research Index. GHP, March 2019. In 2018, GHP found 155 studies that explore handwashing in connection with a range of areas in global health and development, varying from urban design to maternal and child health.

The State of Handwashing in 2017: Annual Research Summary. GHP, May 2018. In this summary, GHP outlines key themes and findings from 117 handwashing-related research papers published in 2017.

Other Studies
Toward Complementary Food Hygiene Practices among Child Caregivers in Rural Malawi. American Journal of Tropical Medicine and Hygiene, June 2019. This study found that presence of a handwashing facility and locally made dish rack and psychosocial factors (attitude, norms, ability, self-regulation) were strong predictors of success of interventions emphasizing key behaviors to improve food hygiene.

Toolkit: Understanding and Addressing Equality, Non-Discrimination and Inclusion in Water, Sanitation and Hygiene (WASH) Work. WaterAid, 2018. This resource provides practical guidance and support on reducing inequalities commonly found in WASH programs and advocacy work.

Websites
Global Handwashing Partnership – GHP is a coalition of international stakeholders working to promote handwashing with soap and recognize hygiene as a pillar of international development and public health.

If you would like to feature your organization's materials or suggest other content for upcoming issues of Water Currents, please send them to Dan Campbell, Knowledge Creation/WASH Specialist, at dcampbell@waterckm.com.

For past issues of Water Currents, visit Globalwaters.org.
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Water Currents: WASH and Antimicrobial Resistance - October 1, 2019

Water Currents: WASH and Antimicrobial Resistance - October 1, 2019
This issue of Water Currents focuses on the connection between WASH and antimicrobial resistance. 
Bringing you the latest water sector research, resources, and news.
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October 1, 2019 – WASH & Antimicrobial Resistance

Antimicrobial-resistant bacteria and their antimicrobial resistance genes are common and widespread contaminants in wastewater and water. Photo credit: Melody McNeil, USAID/West Africa

Antimicrobial resistance (AMR) occurs when microorganisms such as bacteria or virus change to resist the action of antimicrobials (e.g., antibiotics). Currently, it is estimated that at least 700,000 people die each year due to drug-resistant diseases. Each year, more and more common diseases are becoming untreatable and lifesaving medical procedures are becoming much riskier due to AMR. A recent UN report on AMR (“No Time to Wait,” listed below) states that drug-resistant diseases could cause 10 million deaths each year by 2050, and that by 2030, AMR could force up to 24 million people into extreme poverty.

This issue of Water Currents contains recent studies on the connection between AMR and water and sanitation, the One Health approach to tackling AMR, country situation reports, and other AMR–related topics.

USAID’s priorities under the U.S. Government Global Water Strategy—improving good governance, water access, and sanitation and hygiene—are considered essential to prevent and counteract the spread of global microbial resistance. In addition, USAID’s Bureau for Global Health works with international organizations and local governments, academia, and private sector partners across Asia and Africa to promote prudent use of antimicrobials in the livestock, aquaculture, and crop production sectors to minimize the likelihood of AMR development and spread.

We would like to thank staff from the Sanitation and Hygiene Applied Research for Equity (SHARE) project, Emory University’s Center for Global Safe Water, Sanitation, and Hygiene, and Global Water 2020 for suggesting AMR as a topic and for contributing content to this issue.

Overviews 
Antimicrobial Resistance: An Emerging Water, Sanitation and Hygiene Issue. World Health Organization (WHO), 2015. This briefing note provides an overview on the role of water and waste in combating AMR and identifies key areas to explore related to risk assessment management, policy, and research.

No Time to Wait: Securing the Future from Drug-Resistant Infections. WHO, April 2019. AMR is a global crisis that threatens a century of progress in health and achievement of the Sustainable Development Goals. Because the drivers of AMR lie in humans, animals, plants, food, and the environment, a sustained One Health response is essential to engage and unite all stakeholders around a shared vision and goals.

Differential Drivers of Antimicrobial Resistance Across the World. Accounts of Chemical Research, March 2019. Researchers show that high population densities in cities that suffer from poor sanitation and solid-waste disposal can potentially impact the dissemination of resistance.

Global Antimicrobial Resistance: A Complex and Dire Threat with Few Definite Answers. Tropical Medicine and International Health, March 2019. Global AMR data and projections are simply alarming. Despite widespread recognition of the issue's magnitude and urgency, the key drivers of global AMR dissemination, and how best to contain it, remain poorly defined.

The Economics of Antimicrobial Resistance and the Role of Water and Sanitation Services. WASHeconomics, January 2019. Water, wastewater, and feces play a key role in the carriage of microorganisms and their genetic material. For example, water can act as a reservoir of antimicrobial-resistant bacteria and exposure route to humans (and animals).

Anthropological and Socioeconomic Factors Contributing to Global Antimicrobial Resistance: A Univariate and Multivariable Analysis. Lancet Planetary Health, September 2018. This study explored the factors contributing to the rise in AMR. The study determined that cutting back on antibiotic use is not enough to counteract the problem, and instead identified improvements in sanitation, access to clean water, and good governance, as well as increased public health care expenditures and better regulation of the private health sector as necessary to reduce global AMR.

Infection Prevention, Control and Surveillance: Limiting the Development and Spread of Drug Resistance. Review on Antimicrobial Resistance, March 2016. This review examines the role of clean water and effective sanitation in preventing the spread of infections in the community and reducing AMR. It also discusses ways to prevent and control infections in health care facilities.

Health Care Facilities/Hygiene Issues 
Quick Fix for Care, Productivity, Hygiene and Inequality: Reframing the Entrenched Problem of Antibiotic Overuse. BMJ Global Health, August 2019. Individuals, caregivers, and health workers in low- and middle-income countries often find themselves using and prescribing antibiotics because of infections caught due to unsanitary conditions in health care settings and at home, as well as in anticipation of such infections.

Fecal Pollution Can Explain Antibiotic Resistance Gene Abundances in Anthropogenically Impacted Environments. Nature Communications, January 2019. Discharge of treated sewage leads to release of antibiotic-resistant bacteria, resistance genes, and antibiotic residues to the environment.

Prevention First: Tackling AMR through Water, Sanitation and Hygiene. One Health, July 2017. This article focuses on three neglected elements of WASH and AMR in health care facilities and the environment. It highlights the importance of WASH for mothers and newborns, and on synergizing WASH policies and approaches to support the continuum of care from health care settings to the home.

The Role of Water, Sanitation and Hygiene (WASH) in Healthcare Settings to Reduce Transmission of Antimicrobial Resistance. Infection Prevention and Control, July 2016. Hand hygiene has been cited as the single most important practice to reduce health facility–acquired infections, and improved hand hygiene practices have been associated with a sustained decrease in the incidence of AMR infections in health care settings. WASH also plays a role; cleaning surfaces and bedding helps prevent transmission of health care–associated infections.

One Health Studies 
Critical Importance of a One Health Approach to Antimicrobial Resistance. EcoHealth, June 2019. This article advocates for a comprehensive One Health research agenda to address AMR that incorporates human, animal, environmental, ecosystem, and wildlife perspectives and identifies key priorities for research.

Global Trends in Antimicrobial Resistance in Animals in Low- and Middle-Income Countries. Science, September 2019. Regions affected by the highest levels of AMR should take immediate actions to preserve the efficacy of antimicrobials that are essential in human medicine by restricting their use in animal production.

One Health—Its Importance in Helping to Better Control Antimicrobial Resistance. Tropical Medicine and Infectious Disease, January 2019. Numerous countries and several international agencies have now included a One Health approach within their action plans to address AMR. Necessary actions include: improvements in antimicrobial use; identifying alternatives to antimicrobials; better regulation and policy; and improving surveillance, stewardship, infection control, sanitation, and animal husbandry.

Evidence Needed for Antimicrobial Resistance Surveillance Systems. WHO Bulletin, January 2019. Evaluating the added value of One Health approaches for antimicrobial resistance surveillance is not a simple task, but it should not be set aside because of its complexity.

Water/Wastewater-Related Aspects 
State of the Art on the Contribution of Water to Antimicrobial Resistance. European Commission, January 2019. The aim of this report is to discuss the mechanisms of antibiotic action and antibiotic resistance focusing on potential effects in water, which researchers recognize as a significant reservoir of antibiotics and antibiotic-resistance genes.

Persistence of Antibiotic Resistance Genes and Bacterial Community Changes in a Drinking Water Treatment System: From Drinking Water Source to Tap Water. Science of The Total Environment, March 2018. Antibiotic resistance genes (ARGs) are emerging contaminants that have become a public concern. This study aimed to investigate the occurrence and diversity of ARGs, and variation in the composition of bacterial communities in source water, drinking water treatment plants, and tap water in the Pearl River Delta region, South China.

Bogotá River Anthropogenic Contamination Alters Microbial Communities and Promotes Spread of Antibiotic Resistance Genes. Nature Scientific Reports, August 2019. In this work, researchers characterized aquatic microbial communities samples collected at three sites along the Bogotá River and from wastewater at three city hospitals, and investigated community profiles and ARGs as a function of anthropogenic contamination.

Identification of Risk Factors Associated with Carriage of Resistant Escherichia coli in Three Culturally Diverse Ethnic Groups in Tanzania: A Biological and Socioeconomic Analysis. The Lancet Planetary Health, November 2018. Households that shared water sources with larger livestock herds and wildlife showed increased odds of carrying resistant E. coli, which probably reflects both contact and water-mediated transmission to people. The mechanism underlying the association between milk and AMR appears to be related to basic transmission.

Molecular Characterization and Antimicrobial Resistance Pattern of Escherichia coli Recovered from Wastewater Treatment Plants in Eastern Cape South Africa. International Journal of Environmental Research and Public Health, June 2018. The study reveals that water samples recovered from the final effluents of wastewater treatment plants may likely be one of the major sources of antibiotic resistance in E. coli.

Wastewater Used for Urban Agriculture in West Africa as a Reservoir for Antibacterial Resistance Dissemination. Environmental Research, September 2018. Wastewater in West Africa harbors a wide diversity of common and specific virulence factors, and studies show that urban agriculture is likely to promote dissemination of bacterial resistance.

Other Water Pollutants: Antimicrobial Resistance. 2018. This chapter in Water and Sanitation‐Related Diseases and the Changing Environment: Challenges, Interventions, and Preventive Measures discusses sources of antibiotic‐resistant bacteria in the environment, specifically in wastewater; the types of wastewater treatment ;and their effect on reducing antibiotics and resistant organisms.

Other Studies 
Towards a Research Agenda for Water, Sanitation and Antimicrobial Resistance. Journal of Water and Health, January 2017. This article discusses the conclusions of a WHO workshop to develop a strategic research agenda on WASH and AMR.

Critical Knowledge Gaps and Research Needs Related to the Environmental Dimensions of Antibiotic Resistance. Environment International, May 2018. The environment plays important roles in the development of antibiotic resistance. This article discusses critical knowledge gaps and research needs on aspects of evolution, transmission, and interventions.

Complexities in Understanding Antimicrobial Resistance Across Domesticated Animal, Human, and Environmental Systems. Annals of the New York Academy of Sciences, March 2019. In this article, the authors review research on the non-foodborne spread of AMR, with a focus on domesticated animals and the environment and possible exposures to humans.

Population-Level Mathematical Modeling of Antimicrobial Resistance: A Systematic Review. BMC Medicine, April 2019. Few ecological studies explore the transmission of AMR from the environment (water, soil, etc.) to potential hosts, despite the increasing evidence of a link between antimicrobial contamination of the environment, and the development and transfer of resistance to human pathogens.

Urban Slums: A Supportive Ecosystem for Typhoidal Salmonellae. Journal of Infectious Diseases, July 2018. Typhoid fever continues to kill thousands of people each week. With worsening AMR, this mortality burden could suddenly increase.

Websites 
World Health Organization: Antimicrobial Resistance – This website contains fact sheets, WHO’s Global Action Plan, and other resources on AMR.

If you would like to feature your organization's materials or suggest other content for upcoming issues of Water Currents, please send them to Dan Campbell, Knowledge Creation/WASH Specialist, at dcampbell@waterckm.com.

For past issues of Water Currents, visit Globalwaters.org.
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Water Currents: Transboundary Waters - September 5, 2019

Water Currents: Transboundary Waters - September 5, 2019 A main objective of the U.S. Government Global Water Strategy is to reduce conflict through the promotion of cooperation on shared waters 
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September 5, 2019 – Transboundary Waters

The Lower Mekong River region is home to more than 240 million people in Cambodia, Laos, Myanmar, Thailand, and Vietnam. USAID supports a number of activities to facilitate its joint management. Photo Credit: Pakprim Oranop na Ayuthaya, USAID/Vietnam

According to the United Nations (UN), transboundary waters—the aquifers and lake and river basins shared by two or more countries—account for an estimated 60 percent of global freshwater flow and are home to more than 40 percent of the world’s population. Depleted and degraded transboundary water supplies have the potential to cause social unrest and spark conflict among countries.

A main objective of the U.S. Government Global Water Strategy (GWS) is to promote cooperation on shared—or transboundary—waters and to diffuse potential conflicts over water between countries. A key development result in USAID’s Water and Development Plan (appended to the GWS) is to improve the management of water resources in water-stressed basins that are the source of important drinking water supplies.

Under the GWS and the USAID Water and Development Plan, the U.S. Government works to prevent transboundary water conflict and to improve the management of water resources in shared river basins by promoting the development of agreements and other approaches that support the cooperative management of shared water resources that are critical to the health and livelihoods of millions of people, and to the economies of many nations.

This issue contains recent studies and resources that discuss gender, monitoring, conflict resolution, and other topics related to the management of transboundary waters.

Learning 
Governance for Transboundary Freshwater Security. IW Learn, 2019. This massive open online course will cover transboundary governance as it relates to law, negotiations, management, geographical and biophysical constraints, and sustainable financing mechanisms. The course will launch at the end of 2019. Those interested in participating can receive an email alert when the course is active.

Overviews 
Blue Peace Index. Economist Intelligence Unit, 2019. The Blue Peace Index assesses management of shared water resources across five pillars: policy & legal frameworks, institutional arrangements & participation, water management instruments, infrastructure & financing, and cooperation. The inaugural 2019 index measures 24 countries around five basins: Amazon, Mekong, Sava, Senegal, and Tigris-Euphrates.
 
Transboundary Waters Factsheet. UN, August 2018. This factsheet highlights the benefits of transboundary water management to international trade, climate change adaptation, economic growth, food security, improved governance, and regional integration.
 
Transboundary Waters: Cooperation from Source to Sea. Stockholm International Water Institute (SIWI), October 2018. Evidence of the linkages among terrestrial, freshwater, and marine environments suggests the need to strengthen source-to-sea connections in transboundary water cooperation.
 
Promoting Development in Shared River Basins: Tools for Enhancing Transboundary Basin Management. World Bank, 2018. Transboundary freshwater systems create inevitable linkages and interdependencies between countries. This report identifies a series of tools to help realize and/or increase mutual benefits for riparian countries; mitigate transboundary harm; and promote cross-border coordination to reduce the risk of tensions and conflict that may occur.
 
Identifying, Assessing and Communicating the Benefits of Transboundary Water Cooperation: Lessons Learned and Recommendations. UNECE, August 2018. Experience has shown that identifying, assessing, and communicating the benefits of transboundary water cooperation is highly relevant to promoting such cooperation; and benefit assessments can be conducted in transboundary basins with different governance, socio-economic, and environmental profiles.

Gender Issues 
Tapping Our Potential: Women’s Water Leadership in the Nile Basin. SIWI, August 2019. In the Nile Basin, SIWI and partners established a growing network of women water professionals active in transboundary water management under the Women and Water Diplomacy in the Nile platform to enhance the collective capacity of women throughout the basin and to support their engagement in decision-making and peace-building processes in the basin.
 
Exploring Gender Dimensions of Water Insecurity and Governance in the Lower Mekong Region (LMR). Stockholm Environment Institute, January 2019. This policy brief identifies how experiences of water insecurity in the LMR are gendered. It then scopes out the current trends and policy landscape of water governance in the LMR from a gender equality perspective.
 
How Important is Gender in Transboundary Groundwater Governance? A Question for the Ramotswa Aquifer in Southern Africa. wH2O: The Journal of Gender and Water, March 2019. The paper assesses how legal instruments on gender and transboundary water resources influence equality for women and men in terms of reach of water access, benefits of water use, and empowerment.
 
Sharing Experience on Gender Mainstreaming in Transboundary Water Bodies. UNESCO World Water Assessment Program, March 2019. Panelists in this webinar discuss different experiences with gender mainstreaming and analyze how transboundary water projects in particular benefit from a focus and investment on gender.

Gender and Water Governance in the Mekong Region. Oxfam, February 2019. This report is an assessment of current water governance policies and institutional arrangements in the Mekong region from a gender equality perspective. Based on this assessment, the report identifies strategic opportunities for gender-responsive actions to address current gender gaps.

Transboundary Water Assessments and Monitoring  
Mapping Monthly Water Scarcity in Global Transboundary Basins at Country-Basin Mesh Based Spatial Resolution. Scientific Reports, February 2018. Results showed that around 1.6 billion people living within the 328 country-basin units out of the 560 assessed in this study endure severe water scarcity at least one month a year, while a billion people in 175 country-basin units go through severe water scarcity at least three months each year.
 
Transboundary Aquifers of Africa: Review of the Current State of Knowledge and Progress towards Sustainable Development and Management. Journal of Hydrology: Regional Studies, December 2018. This knowledge review of work on transboundary aquifers in Africa also includes an overview of assessments and management efforts that have taken place over the last half century.
 
The Nile Basin Waters and the West African Rainforest: Rethinking the Boundaries. WIREs Water, September 2018. This focus article presents the state of the West African rainforest, its role in atmospheric moisture transport to the Nile Basin, and the potential impact of its deforestation on the Nile Basin's water regime, as well as options for improving transboundary water governance.
 
Monitoring of Transboundary Water Cooperation: Review of Sustainable Development Goal Indicator 6.5.2 Methodology. Journal of Hydrology, August 2018. Researchers analyze the methodology for assessing Sustainable Development Goal (SDG) Indicator 6.5.2, examine the defining of operational cooperative arrangements, and identify the strengths and limitations of the method for measuring transboundary water cooperation.

Progress on Transboundary Water Cooperation: Global Baseline for SDG Indicator 6.5.2. UN Water, August 2018. This publication highlights the current status and trends in transboundary water cooperation and considers whether the international community is on track to implement integrated water resources management at all levels, especially transboundary, by 2030.

Other Studies and Reports  
New Beginnings in Transboundary Water Cooperation. USAID Sustainable Water Partnership (SWP), 2018. The Mara River Basin is becoming a model case study of approaches and tools that foster effective transboundary water cooperation. In this webinar, SWP staff discuss transboundary water governance frameworks, water allocation planning, stakeholder participation and ownership, and on-the-ground implementation to improve water security.
 
Stagnant Rivers: Transboundary Water Security in South and Southeast Asia. Water, December 2018. In developing countries, a decision-making group often comprised of politicians, bureaucrats, and engineers dominate the management and governance of rivers. These groups perpetuate a technocratic paradigm toward the management of transboundary water, with limited genuine international cooperation.
 
Transboundary Water Conflict Resolution Mechanisms: Substitutes or Complements. Water, June 2019. This paper examines various transboundary water conflict resolution mechanisms, revealing how they complement each other. The complementarity permits researchers and practitioners to develop more comprehensive mechanisms to analyze the different elements of the transboundary water conflict resolution process.
 
Advancing Integrated Water Resource Management Across the Kura River Basin through Implementation of the Transboundary Agreed Actions and National Plans. UN Development Program, July 2019. This report examines links between human activities and environmental degradation, as well as potential impacts of such global threats as climate change and disasters on water resources in the Kura River Basin.
 
Hydro-Economic Modelling for Basin Management of the Senegal River. Food and Agriculture Organization of the UN, 2018. Hydro-economic models have emerged as an effective tool for studying various water resources management problems around the globe, such as reservoir operation, transboundary water management, water-food-energy nexus, climate change adaptation, investment planning, etc.

Organizations/Projects 
USAID Sustainable Water Partnership (SWP) - SWP is a five-year cooperative agreement that supports USAID thought leadership, innovation, and action in global water security by integrating water security issues into overseas mission programming through relevant, mission-specific initiatives. SWP has also published toolkits that discuss various aspects of water security planning and implementation.
 
USAID Regional Water Management Forum – The forum improves regional transboundary water management and promotes sustainable management practices in Central Asia through two activities: the Partnership for Enhanced Engagement in Research (PEER) and Smart Waters. PEER established a university-led forum to improve management of shared water resources. Smart Waters is building a cadre of water managers to share best practices, collaborate, and manage water resources sustainably.
 
Conjunctive Surface-Groundwater Management of Shared Waters: A New USAID Project – The project is working simultaneously in three shared watercourse/aquifer systems in Africa: the Ngotwane River/Ramotswa system (Botswana and South Africa); the Limpopo River/Tuli-Karoo system (Botswana, South Africa, and Zimbabwe); and the Shire River system (Malawi and Mozambique).
 
International Centre for Water Cooperation (ICWC)  – ICWC is the first UNESCO Category II Centre in Sweden, and the first in the world to focus on transboundary water management in connection with peace, conflict, and regional development. Such centers are established and funded by member states to contribute to the achievement of UNESCO’s objectives.
 
Global Water Partnership (GWP) Transboundary Water Cooperation – Transboundary water cooperation/management is critical to GWP’s mission to advance governance and management of water resources for sustainable and equitable development.
 
Transboundary Water Management Organizations – This webpage from the International Water Law Project contains links to more than 20 organizations involved in the management of shared waters.

If you would like to feature your organization's materials or suggest other content for upcoming issues of Water Currents, please send them to Dan Campbell, Knowledge Creation/WASH Specialist, at dcampbell@waterckm.com.

For past issues of Water Currents, visit Globalwaters.org.
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Water Currents: Water Security – August 6, 2019

Water Currents: Water Security – August 6, 2019
This issue of Water Currents looks at water security, the focal point of the U.S. Government Global Water Strategy.
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August 6, 2019 – Water Security

The USAID-funded Sustainable Water Partnership is working with local representatives in Kenya and Tanzania to utilize data, science, and modeling tools to protect water security in the Mara River Basin. Photo credit: Bobby Neptune

The U.S. Government Global Water Strategy sets water security as its overarching goal. The strategy envisions a water-secure world, where people and nations have the water they need to be healthy, prosperous, and resilient. Achieving water security requires understanding how complicated and interconnected social, environmental, political, and economic factors shape access to safe drinking water and sustainable management of water resources.
 
This issue of Water Currents shares current research and perspectives on various aspects of water security. A special thanks to USAID’s Sustainable Water Partnership (SWP) team for co-curating this issue. For updates about SWP, sign up for their monthly newsletter or visit their website.

Water Security and WASH
Effect of Deforestation on Access to Clean Drinking Water. Proceedings of the National Academy of Sciences, April 2019. Researchers in Malawi found that heavy deforestation in the country during the last decade has had the same effect on access to clean drinking water as that of a 9 percent decrease in rainfall.

Systems Thinking and WASH: Tools and Case Studies for a Sustainable Water Supply. Practical Action, February 2019. This book explores the different applications of systems thinking used by an interdisciplinary group of WASH researchers and practitioners, while helping to imagine different ways to understand and work with communities, development agencies, and governments.

Water Security and Water Safety Plans (WSP)
Capacity Building and Training Approaches for Water Safety Plans: A Comprehensive Literature Review. International Journal of Hygiene and Environmental Health, February 2019. The authors propose a WSP training taxonomy and discuss it in relation to the stages of learning (introduction, practice, and reinforcement). They highlight the relevance of auditing for evaluating change over time and call for robust methods to monitor WSP capacity development.

A Guide to Equitable Water Safety Planning: Ensuring No One is Left Behind. WHO, April 2019. This document describes how, with relatively modest efforts, the WSP approach can bring tangible improvements in water quality and availability to all users.

Water Safety Planning: What Have We Learned So Far? WHO, May 2019. WSPs have been implemented in at least 93 countries, with 46 countries reporting they have policies or regulations in place that promote or require water safety plans.

Water Security and Water Resources Management
Water Security in Practice: The Quantity-Quality-Society Nexus. Water Security, December 2018. The complex interactions of water quantity, water quality, and associated societal interactions influence water security in practical society, prompting a growing call to consider water security in a more integrated manner.

The Future of Water: A Collection of Essays on ‘Disruptive’ Technologies that May Transform the Water Sector in the Next 10 Years. Inter-American Development Bank, April 2019. In this report, experts identify what they believe to be the key technological changes that will transform the sector and whether they have the potential to become disruptive.

Synthesizing Water Quality Indicators from Standardized Geospatial Information to Remedy Water Security Challenges: A Review. Environment International, July 2018. This review highlights the water security conundrum and provides an overview of methods for integrating geolocated qualitative data with quantitative data into a water quality index.

How Important Is Gender in Transboundary Groundwater Governance? A Question for the Ramotswa Aquifer in Southern Africa. wH2O The Journal of Gender and Water, February 2019. The authors of this paper assess how legal instruments on gender and transboundary water resources influence equality for women and men.

Water Security and Hydrology
Can We Constrain Uncertainty in Hydrologic Cycle Projections? AGU, April 2019. Understanding how precipitation changes with warming is critically important for anticipating and responding to climate change, but climate models still disagree on many aspects of the relationship between the two.

Global Patterns and Dynamics of Climate–Groundwater Interactions. Nature, January 2019. Adaptation strategies must account for the hydraulic memory of groundwater systems, which can buffer climate change impacts on water resources in many regions but may also lead to long-term impacts on river flows and groundwater-dependent ecosystems.

Hydrologic Modeling: Progress and Future DirectionsGeoscience Letters, May 2018. Starting with a brief history of hydrologic modeling, this paper discusses progress in hydrologic modeling since the advent of computers and what the future may have in store.

Water Security and Climate
Defining 'Water Resilience': Debates, Concepts, Approaches, and Gaps. WIREs Water, December 2018. Resilience-informed water governance literature remains fragmented and predominantly centered on conventional approaches and framings of water planning.

Climate Risk Informed Decision Analysis (CRIDA): Collaborative Water Resources Planning for an Uncertain Future. International Centre for Integrated Water Resources Management, October 2018. The CRIDA approach provides a framework to enable water managers and policy makers to assess the impact of climate uncertainty on their water resources and adapt accordingly.

Preparing to Adapt: The Untold Story of Water in Climate Change Adaptation ProcessesGlobal Water Partnership, December 2018. This report investigated whether countries intended to invest not only in infrastructure but also in the necessary management and governance structures needed to manage water under the challenges associated with a changing climate.

DOs and DON'Ts for Using Climate Change Information for Water Resource Planning and Management: Guidelines for Study Design. Climate Services, September 2018. Incorporating climate change information into water resource planning is challenging, as that information is constantly evolving. This review consists of nine guidelines for water managers and planners that highlight practices for incorporating climate change information into their planning processes.

What Climate Models Get Wrong About Future Water Availability. EOS, April 2019. The wide range of scenarios presented by climate models can make it difficult for cities, states, and countries to plan ahead. A new study suggests a way to reduce uncertainty using precipitation patterns from the past.

Water Security and Nature-Based Solutions
Emerging Lessons for Mainstreaming Ecosystem-Based Adaptation: Strategic Entry Points and Processes. GIZ, 2019. Ecosystem-based adaptation (EBA) is a nature-based solution that harnesses biodiversity and ecosystem services to reduce vulnerability and build resilience to climate change. This report highlights the emergence of some related concepts such as ecosystem-based disaster risk reduction and common patterns for mainstreaming processes of EBA.

Is Ecosystem-Based Adaptation Effective? Perceptions and Lessons Learned from Thirteen Project Sites. International Institute for Environment and Development, 2019. The results of this report show that stakeholders perceive EBA as able to improve the resilience or adaptive capacity of local communities or reduce their vulnerability to climate change.

Integrating Green and Gray—Creating Next Generation Infrastructure. World Bank; World Resources Institute (WRI), March 2019. Integrating nature into mainstream infrastructure systems can result in lower costs and more resilient services. The World Bank and WRI are calling for green infrastructure, such as mangroves and wetlands, to play a bigger role in traditional infrastructure planning.

Core Principles for Successfully Implementing and Upscaling Nature-Based Solutions. Environmental Science and Policy, August 2019. This critical analysis of the principles of nature-based solutions can inform the review and revision of those principles, while serving as the foundation for the development of standards for the successful implementation of these solutions.

Incorporating Environmental Flows into ‘Water Stress’ Indicator 6.4.2—Guidelines for a Minimum Standard Method for Global Reporting. Food and Agriculture Organization of the United Nations (FAO), 2019. These guidelines can help countries participate in the assessment of the sustainable development goal on water stress by contributing data and information on environmental flows.

Environmental Flows Technical Guidance Manual. SWP, October 2018. USAID missions and partners can use this manual to better understand the importance of environmental flow regimes and their benefits to water security and sustainable development outcomes.

Water Security and Fragility
Water Management in Fragile Systems: Building Resilience to Shocks and Protracted Crises in the Middle East and North Africa. FAO; World Bank, March 2018. Fragility has become the reality in several countries of the Middle East and North Africa. This paper discusses the relationship between fragility and water and explores how it should be addressed.

Water, Security, and Conflict. WRI; Pacific Institute, August 2018. This paper summarizes the current understanding of water and security threats and their links to conflict, migration, and food insecurity.

Water Security in the Protracted Crises and Post-Conflict Reconstruction of the Middle East. Overseas Development Institute, April 2018. Sustainable, equitable, and resilient water services should be supported over the short- and long-term during protracted crises and for post-crisis reconstruction in the Middle East and North Africa.

Water as a Tool for Resilience in Times of Crisis. New Security Beat, May 2019. This blog post features a write-up and recording of “Water as a Tool for Resilience in Times of Crisis,” an event sponsored by the Wilson Center, Winrock International, SWP, and USAID.

Water Security in an Uncertain Future: Enhancing Water Resources Management and Planning by Reducing Climate- and Weather-Related Risks. ClimateLinks, May 2019. At a meeting in April, a panel of experts discussed lessons learned from three ongoing USAID-funded projects that are working to inform water management decision-making processes and leverage investments for resilience and water security.

The Intersection of Global Fragility and Climate Risks. USAID, September 2018. This study examines highly fragile states with exposure to multiple climate hazards.

Turbulent Waters: Pursuing Water Security in Fragile Contexts. World Bank, March 2017. This report discusses how water security is more difficult to achieve in fragile contexts due to a range of factors, including weak institutions and information systems, strained human and financial resources, and degraded infrastructure.

Water Security Toolkits

The Sustainable Water Partnership has published six toolkits on water security:

Toolkit #1 - Improving Water Security, 2017. The first in this series of toolkits provides a brief introduction to water security, as well as a detailed walk through a five-step water security improvement (WSI) process.

Toolkit #2 – Water Security Assessment, 2017. Conducting a water security assessment is an essential step in the process of addressing water risks. It establishes a common and agreed-upon information base on the severity and extent of water risks, now and in the near future.

Toolkit #3 – Water Security Planning, 2017. Water security planning must follow eight WSI guiding practices. These include: A pragmatic focus on specific water risks; engagement and mobilization of water risks; and a “systems thinking” approach to address causes and not just symptoms.

Toolkit #4 – Funding Water Security, 2018. Financing can come from government taxes, user tariffs, international aid transfers, and private sector investments. The type of water security activity often determines the type of financing that will be most readily available.

Toolkit #5 – Water Security Implementation, 2018. The success of a WSI process depends on the implementation of activities or measures defined through collaborative planning and decision-making with the purpose of addressing and mitigating priority water risks now and in the future.

Toolkit #6 – Monitoring the Improvement of Water Security, 2018. The overall goal of M&E is to improve decision-making and performance over time to achieve better results. It also empowers and builds the capacity of all actors through transparency and accountability.

If you would like to feature your organization's materials or suggest other content for upcoming issues of Water Currents, please send them to Dan Campbell, Knowledge Creation/WASH Specialist, at dcampbell@waterckm.com.

For past issues of Water Currents, visit Globalwaters.org.
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Water Currents: Peri-Urban Sanitation - June 11, 2019

Water Currents: Peri-Urban Sanitation - June 11, 2019
This issue of Water Currents highlights recent studies and resources on fecal sludge management, container-based sanitation, shared sanitation.
Bringing you some of the latest water sector research, resources, and news.
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June 11, 2019 – Peri-Urban Sanitation

Waste collected from Sanergy Fresh Life Toilets is taken daily to a central processing facility outside of Nairobi, Kenya. Wheelbarrows and handcarts facilitate waste collection in informal settlements, where the only roads are narrow and unpaved. Photo credit: Sanergy

A central goal of the U.S. Government Global Water Strategy is to facilitate sustainable access to safe drinking water and sanitation services, and promote the adoption of key hygiene behaviors. Such improvements are especially important in underserved peri-urban areas that often lack access to these services.

This issue of Water Currents highlights recent studies and resources on fecal sludge management, container-based sanitation, shared sanitation, and other topics. As noted in USAID’s Water and Development Plan included in the U.S. Global Water Strategy, separating individuals and communities from human waste, properly treating fecal waste, and promoting key behaviors that lessen the risk of illness are critical sanitation and hygiene interventions that reduce diarrheal disease, child mortality, malnutrition, neglected tropical diseases, and other waterborne illnesses, such as cholera. The first six studies are from the Creating Demand for Peri-Urban Sanitation (SanDem) project, which aims to better understand how to improve the quality of peri-urban sanitation using demand-side/behavior change approaches in Lusaka, Zambia.

We would like to thank staff from Sanitation and Hygiene Applied Research for Equity (SHARE) for contributing content to this issue. SHARE generates evidence to improve policy and practice worldwide to achieve universal access to effective, sustainable, and equitable sanitation and hygiene.         

Creating Demand for Peri-Urban Sanitation (SanDem) Studies
Theory-Driven Formative Research on On-Site, Shared Sanitation Quality Improvement among Landlords and Tenants in Peri-Urban Lusaka, Zambia. International Journal of Environmental Health Research, November 2018. Researchers conducted in-depth, on-site interactive interviews with landlords and tenants in a neighborhood in peri-urban Lusaka to understand on-site, shared sanitation quality improvement behaviors and preferences.

The Social Dynamics around Shared Sanitation in an Informal Settlement of Lusaka, Zambia. Journal of Water, Sanitation and Hygiene for Development, December 2018. This study explored the social dynamics affecting collective management of shared sanitation in the Bauleni compound of Lusaka, Zambia. The social dynamics illuminated here provide an important basis for the development of a behavioral intervention targeted towards improving urban sanitation.

Assessing Peri-Urban Sanitation Quality Using a Theoretically Derived Composite Measure in Lusaka, Zambia. Journal of Water, Sanitation and Hygiene for Development, July 2018. Researchers created the Peri-Urban Healthy Toilet Index for measuring on-site, peri-urban sanitation quality. They used it to assess sanitation quality in a peri-urban area in Lusaka, Zambia.

Using a Theory-Driven Creative Process to Design a Peri-Urban On-Site Sanitation Quality Improvement Intervention. BMC Public Health, May 2019. This article describes the development of a behavior change intervention to improve on-site, peri-urban sanitation quality in Lusaka, Zambia, using the Behavior Centered Design framework.

Effect of a Behaviour Change Intervention on the Quality of Peri-Urban Sanitation in Lusaka, Zambia: A Randomised Controlled Trial. The Lancet Planetary Health, April 2019. Researchers tested a scalable, demand-side behavior change intervention to motivate landlords to improve the quality of shared toilets within their plots, finding it could improve the structural quality and cleanliness of shared sanitation without subsidy or provision of the relevant infrastructure.

Understanding Demand for Higher Quality Sanitation in Peri-Urban Lusaka, Zambia through Stated and Revealed Preference Analysis. Social Science & Medicine, May 2019. Interventions leveraging landlords' profit motives could lead to significant improvements in peri-urban sanitation quality, reduced diarrheal disease transmission, and increased well-being without subsidies or infrastructure investments by governments or NGOs.

Overviews
Scaling Market Based Sanitation: Desk Review on Market-Based Rural Sanitation Development Programs. USAID Water, Sanitation, and Hygiene Partnerships and Learning for Sustainability (WASHPaLS) Project, June 2018. This desk review describes the current state of knowledge in market-based sanitation (MBS) and establishes a framework to analyze, design, and improve MBS interventions. It is based on a survey of approximately 600 documents on MBS and interviews with sector experts and program personnel.
 
‘Top-Down’ Planning for Scalable Sustainable Sanitation in High-Density Low-Income Urban Areas: Is It More Appropriate than ‘Bottom-Up’ Planning? Journal of Water, Sanitation and Hygiene for Development, January 2018. The authors state that if the sanitation target of the Sustainable Development Goals is to have any chance of success, then a community-sensitive, top-down planning approach must be adopted for sanitation provision in high-density, low-income urban areas.

Transition Management for Improving the Sustainability of WASH Services in Informal Settlements in Sub-Saharan Africa—An Exploration. Sustainability, November 2018. This paper identifies five dimensions that contribute to unsustainability of WASH services in informal settlements in sub-Saharan Africa and makes recommendations based on these challenges.

Urban Sanitation: Where to Next? 40th WEDC International Conference, July 2017. The authors explain that with better understanding and decision-support tools, it is time to embrace urban complexity; to place sanitation back into the wider human-technology-environment systems of the city; and to plan for integrated basic services in the domestic and peri-domestic domains.

The Sanitation Cityscape Conceptual Framework: Understanding Urban Sanitation Systems. IRC, 2019. This paper, drafted for the IRC WASH systems symposium, describes the Sanitation Cityscape Framework and how it locates sanitation service delivery within a wider urban systems framework.

Container-Based Sanitation
Container-Based Sanitation: One Way to Reach the Last Mile for Sanitation Services. Water Blog, February 2019. Container-based sanitation (CBS) consists of an end-to-end service—i.e., one provided along the entire sanitation service chain—that collects excreta hygienically from toilets designed with sealable, removable containers and which strives to ensure that the excreta is safely treated and disposed of or reused.

Health Risks for Sanitation Service Workers along a Container-Based Urine Collection System and Resource Recovery Value Chain. Environmental Science & Technology, May 2019. CBS within a comprehensive service system value chain offers a low-cost sanitation option with potential for revenue generation, but may increase microbial health risks to sanitation service workers.

Exploring Exposure Risk and Safe Management of Container-Based Sanitation Systems: A Case Study from Kenya. Waterlines, October 2018. The analysis identified nine critical control points where exposure risks may be either prevented or reduced via the implementation of relevant control measures.

Fecal Sludge Management
Scheduled Emptying Services as an Entry Point for Change. SNV, February 2019. The aim of this paper is to inform sector thinking and practice on fecal sludge emptying. It shares examples from SNV’s programs in Indonesia, Nepal, and Bangladesh.

Methods to Reliably Estimate Faecal Sludge Quantities and Qualities for the Design of Treatment Technologies and Management Solutions. Journal of Environmental Management, October 2018. The demand for infrastructure to manage fecal sludge is increasing. However, no reliable method exists to estimate total accumulated quantities and qualities. This study proposes an approach that averages out complexities to estimate conditions at a centralized to semi-centralized scale required for management and treatment technology solutions.

Formally Engaging the Private Sector for Fecal Sludge Management Services: Experiences from Six African Cities. 41st WEDC Conference, July 2018. In sub-Saharan Africa, the Partnership Cities Project supported six grantees to develop urban on-site sanitation service across the sanitation value chain. This paper presents the findings from a review of these projects.

Gender Issues
Exploring the Complex Relationship Between Women’s Sanitation Practices and Household Diarrhea in the Slums of Nairobi: A Cross-Sectional Study. BMC Infectious Diseases, March 2019. Meeting health targets to reduce the prevalence of diarrheal diseases in informal settlements requires paying particular attention to the needs of women living in these environments.

Not Just Any Toilet – Women’s Solutions to Sanitation in Informal Settlements in Nairobi. Development in Practice, September 2018. The purpose of this study was to provide women with an opportunity to share their perspectives on and solutions to sanitation challenges in informal settlements. The findings highlight the need to address women-specific burdens associated with sanitation in such settlements.

Women’s Sanitation Practices in Informal Settlements: A Multi-Level Analysis of Factors Influencing Utilisation in Nairobi, Kenya. Global Public Health, October 2018. This study investigated factors associated with women’s common sanitation patterns. The findings suggest that the availability of toilets alone may not be enough to eliminate sanitation-related health risks in informal settlements.

A Mixed-Methods Study of Women’s Sanitation Utilization in Informal Settlements in Kenya. PLoS One, March 2019. Women living in informal settlements are disproportionately affected by lack of access to sanitation. A majority of women in this study utilized an unsafe method of disposal at least once in a 24-hour period that increased their risk of direct exposure to waste and harmful pathogens.

Health Aspects
Guidelines on Sanitation and Health. World Health Organization, 2018. This set of guidelines summarizes the evidence on the effectiveness of a range of sanitation interventions. It identifies gaps in the evidence base to guide future research efforts.

Urban Sanitation Coverage and Environmental Fecal Contamination: Links Between the Household and Public Environments of Accra, Ghana. PLoS One, July 2018. This study examined associations between sanitation and fecal contamination in public environments in four low-income neighborhoods in Accra, Ghana. Findings suggest that clustering of contained household sanitation, even when shared, may be associated with lower levels of fecal contamination in the immediate area.

Relationships Between Shared Sanitation Facilities and Diarrhoeal and Soil-Transmitted Helminth Infections: An Analytical Review. Journal of Water, Sanitation and Hygiene for Development, April 2019. This paper presents an analytical review of studies on the relationship between the use of shared sanitation and the prevalence of diarrheal disease and soil-transmitted helminth infections.

Water and Sanitation Challenges and Impact on Health in Informal Settlements. Future Health Systems, December 2018. A review of the current state of water and sanitation challenges in informal settlements recommends a wider provision of public toilets with guiding rules and regulations that can be implemented by key trusted community representatives selected by residents.

Bacterial Contamination on Latrine Surfaces in Community and Household Latrines in Kathmandu, Nepal. International Journal of Environmental Research and Public Health, January 2019. A study that measured and compared bacterial contamination on community and household latrine surfaces in Kathmandu, Nepal, found that well-maintained community latrines may be as clean, or cleaner, than household latrines, supporting the use of community latrines in a low-income country setting.

Institutions/Water Utilities
USAID Financial Institutions Reform and Expansion–Debt and Infrastructure Project Ex-Post Evaluation. USAID Water Communications and Knowledge Management Project (CKM), September 2018. From 1994 to 2011, USAID's Financial Institutions Reform and Expansion–Debt and Infrastructure Project activity partnered with India’s central, state, and municipal governments to expand sustainable water and sanitation access to the poor. Water CKM evaluated the project seven years after it closed to assess its long-term sustainability.

Designing for Sustainability: Bringing Citywide Inclusive Sanitation to Debre Birhan, Ethiopia. USAID Sustainable WASH Systems (SWS) Learning Partnership, March 2019. This webinar discusses SWS efforts to work with local actors in Debre Birhan to strengthen local service delivery in coordination with a World Bank project that is providing substantial new sanitation infrastructure investment.

Cross-Subsidies for Improved Sanitation in Low Income Settlements: Assessing the Willingness to Pay of Water Utility Customers in Kenyan Cities. World Development, March 2019. The findings in this study suggest that cross-subsidies may offer a means to support financing of safe sanitation for low-income households.

Shared Sanitation
Shared Sanitation Management and the Role of Social Capital: Findings from an Urban Sanitation Intervention in Maputo, Mozambique. International Journal of Environmental Research and Public Health, October 2018. Researchers explored the determinants of shared sanitation management within the context of a larger-scale health impact evaluation of an improved, shared sanitation facility in Maputo, Mozambique. Social capital played a critical role in the success of both formal and informal management strategies.

Limited Services? The Role of Shared Sanitation in the 2030 Agenda for Sustainable Development. Journal of Water, Sanitation and Hygiene for Development, September 2017. The authors call for prioritizing investments in high-quality shared toilets in dense informal settlements where such toilets are the only viable option (short of rehousing) for improving sanitation services.

Other Resources
An Examination of Community-Led Total Sanitation’s (CLTS) Contributions toward Universal Sanitation. USAID Water, Sanitation, and Hygiene Partnerships and Sustainability Project (WASHPaLS), April 2018. The review offers a description of CLTS interventions and discusses circumstances in which CLTS works best, highlights the most promising implementation modalities, and describes instances where CLTS may not be suitable. 

Innovations for Urban Sanitation: Adapting Community-Led Approaches. Practical Action, 2018. This book addresses calls from practitioners for practical guidance on how to mobilize communities and improve different parts of the sanitation chain in urban areas. It offers a set of approaches to move toward safely managed sanitation services and provides examples of towns and cities in Africa, South Asia, and Southeast Asia.

Websites
Globalwaters.org – The USAID Water Office supports this website as a global knowledge resource for USAID staff, implementing partners, water specialists, and the broader international development community. The site provides users with the latest news, learnings, and resources from USAID and its partners, and is designed to facilitate knowledge-sharing and collaboration.

SaniPath – The SaniPath Rapid Assessment Tool aims to assess exposure to fecal contamination in urban, low-income settings. The tool is under development by the Center for Global Safe Water at Emory University with funding from the Bill & Melinda Gates Foundation.

If you would like to feature your organization's materials or suggest other content for upcoming issues of Water Currents, please send them to Dan Campbell, Knowledge Creation/WASH Specialist, at dcampbell@waterckm.com.

For past issues of Water Currents, visit Globalwaters.org.
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Water Currents: Menstrual Hygiene Day 2019 - May 23, 2019

Water Currents: Menstrual Hygiene Day 2019 - May 23, 2019
Celebrate Menstrual Hygiene Day on May 28 with USAID to help raise awareness and combats taboos associated with menstrual hygiene.
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May 23, 2019 – Menstrual Hygiene Day 2019

Half of schools in low-income countries lack adequate sanitation facilities that are critical to girls and female teachers and their menstrual hygiene management needs. Photo credit: Emily Mutai/USAID

Every May 28, Menstrual Hygiene Day (MH Day) raises awareness and combats taboos associated with menstrual hygiene with the goal of enabling women and girls to achieve their full potential. The theme of Menstrual Hygiene Day 2019—It's Time for Action—not only emphasizes the urgency of this public health issue, but also highlights the transformative power of improved menstrual hygiene to unlock economic and educational opportunities for women and girls.
 
Empowering women and girls and promoting gender equality are core operating principles of the U.S. Government Global Water Strategy and USAID Water and Development Plan. To alleviate a major constraint to women’s and girls’ participation in education and public life, USAID seeks to integrate menstrual hygiene management (MHM) interventions where practical and improve MHM in key settings, including schools.
 
As a contribution to MH Day 2019, this issue contains links to recent studies on “period poverty,” MHM and its impact on schooling/education, MHM in humanitarian situations, and other MHM–related topics.

Events
Menstrual Hygiene Day 2019 – This global advocacy platform for MH Day brings together the voices and actions of nonprofits, government agencies, individuals, the private sector, and the media to promote MHM for all women and girls. This website contains campaign materials for this year’s theme—It’s Time for Action—and a list of events and resources.

WASH Innovation Challenge on Menstrual Hygiene Management (MHM) and Incontinence – Elrha’s Humanitarian Innovation Fund is launching a challenge May 23, 2019, and will be seeking innovative projects exploring how to design safe and dignified MHM spaces in emergency camp settings and how to better engage with and understand the needs of people with incontinence in emergencies. Additional information will soon be posted on the Elrha’s website.

MHM Overviews
What Is the Point of a Period? Scientific American, May 2019. Age-old taboos against menstruation have led to a lack of research on how women's menstrual cycles work, with serious consequences for their health.

Period Poverty Impact on the Economic Empowerment of Women. Knowledge, Learning and Evidence for Knowledge, January 2019. Period poverty refers to a lack of access to sanitary products due to financial constraints. The problem exists in high as well as low- and middle-income countries.

Menstrual Hygiene Management Virtual Conference 2018 – This conference, held on October 30, 2018, as part of the Water and Health Conference at the University of North Carolina at Chapel Hill, included 11 web-based presentations and a short film. The presentations provided a broad range of perspectives from around the world, such as the unique challenges of girls in Mongolia during cold winter months when water is not available in schools, or the lack of adequate MHM guidance and facilities in schools in Indonesia, Nigeria, and the Solomon Islands.

Globalwaters.org/Menstrual Hygiene Management – This knowledge-sharing hub from the USAID Water Office includes a resource collection on MHM.

MHM Country/Regional Studies
Menstruation Hygiene Management and Work Attendance in a Developing Country. University of Göttingen, 2019. The authors of this study provide, for the first time, evidence of a strong causal impact of advanced MHM on work attendance. Access to advanced MHM materials reduced work absenteeism of women by about 21 percent in Burkina Faso.

A Rite of Passage: A Mixed Methodology Study about Knowledge, Perceptions and Practices of Menstrual Hygiene Management in Rural Gambia. BMC Public Health, March 2019. Strategies to encourage positive social norms toward menstruation in rural Gambia would help to promote more open discussions about it at the family, community, and national level, in turn supporting improvements in MHM in this and similar communities.

Menstrual Cup Interventions Follow-Up Study Report. WoMena Uganda, March 2019. This study discusses the results of a menstrual cup intervention in three rural districts of Uganda.

Menstrual Health Management in East and Southern Africa: A Review PaperUnited Nations Population Fund (UNFPA), June 2018. This literature review forms the basis for a situational analysis of the current state of MHM in eastern and southern Africa to guide UNFPA in the development of a strategic and holistic approach to MHM.

MHM and Education/Schooling
Effect of Menstruation on Girls and Their Schooling, and Facilitators of Menstrual Hygiene Management in Schools: Surveys in Government Schools in Three States in India, 2015. Journal of Global Health, June 2019. The survey showed an association between access to pain medication in school and use of disposable pads with lower absenteeism, and inadequate sanitary facilities with higher absenteeism during menstruation.

Pupil Absenteeism, Measurement, and Menstruation: Evidence from Western Kenya. Columbia University School of International and Public Affairs, March 2019. Researchers conducted a trial that provided sanitary products to schoolgirls to reduce absenteeism, concluding that access to sanitary pads reduces absenteeism by 5.4 percent.

Menstrual Hygiene Management of Adolescent School Girls and Nuns: A Knowledge, Attitude, and Practices Study in Bhutan. UNICEF, 2018. This report highlights the findings of a study of MHM knowledge, attitudes, and practices among adolescent schoolgirls and nuns in Bhutan as of 2017. The study is the first of its kind.

Menstrual Hygiene Management and School Absenteeism Among Adolescent Students in Indonesia: Evidence from a Cross-Sectional School-Based Survey. Tropical Medicine and International Health, December 2018. High prevalence of poor MHM and considerable school absenteeism due to menstruation among Indonesian girls highlight the need for improved interventions that reach girls at a young age and address knowledge, shame and secrecy, acceptability of WASH infrastructure, and menstrual pain management.

MHM and Humanitarian Situations
Pilot Study Findings on the Provision of Hygiene Kits with Reusable Sanitary Pads. United Nations Refugee Agency (UNHCR), December 2018. In collaboration with AFRIpads, UNHCR Sub-Office Mbarara implemented a three-month pilot intervention to test the acceptability of introducing reusable sanitary pads to schoolgirls in the refugee context.

Periods Don’t Stop in Emergencies: Addressing the Menstrual Hygiene Needs of Women and Girls. Humanitarian Innovation Fund, August 2018. This article discusses the challenges that women and girls face around menstrual hygiene in emergencies.

Exploring Menstrual Practices and Potential Acceptability of Reusable Menstrual Underwear among a Middle Eastern Population Living in a Refugee Setting. International Journal of Women’s Health, July 2018. Primary data analysis of narratives around the beliefs, behaviors, and practices of menstrual hygiene in this population revealed key themes related to the physical environment; the social environment; cleanliness, comfort, and health; and adaptation and coping.

Pilot Testing and Evaluation of a Toolkit for Menstrual Hygiene Management in Emergencies in Three Refugee Camps in Northwest Tanzania. Journal for International Humanitarian Action, June 2018.  This paper describes the development and pilot testing of the Menstrual Hygiene Management in Emergencies Toolkit in three camps hosting Burundian and Congolese refugees in northwest Tanzania.

Improving Menstrual Hygiene Management in Emergency Contexts: Literature Review of Current Perspectives. International Journal of Women’s Health, April 2018. The objective of this review was to collate, summarize, and appraise existing peer-reviewed and gray literature that describes the current scenario of MHM in emergency contexts to understand the breadth and depth of current policies, guidelines, empirical research, and humanitarian aid activities addressing populations’ menstrual needs.

Menstrual Hygiene Management in Emergencies Toolkit. Columbia University Mailman School of Public Health; International Rescue Committee, 2017. The toolkit provides streamlined guidance to support organizations and agencies seeking to rapidly integrate MHM into existing programming across sectors and phases.

MHM and Waste Disposal
Menstrual Hygiene Management and Waste Disposal in Low and Middle Income Countries—A Review of the Literature. International Journal of Environmental Research and Public Health, November 2018. A literature review showed that MHM and sanitation value chains often neglect the disposal of menstrual waste, leading to improper disposal and negative impacts on users, sanitation systems, and the environment.

Menstrual Hygiene, Management, and Waste Disposal: Practices and Challenges Faced by Girls/Women of Developing Countries. Journal of Environmental and Public Health, February 2018. At home, women dispose of menstrual products with other domestic waste. Outside of the home, they often flush them in public toilets without knowing the consequences of choking sewer pipelines.

Menstrual Waste Management: A Simple Guide. Ministry of Drinking Water and Sanitation, Government of India, 2019. This guide discusses composting and small-scale incineration of disposed menstrual hygiene products.

Inclusive MHM
Systematic Review of Menstrual Hygiene Management Requirements, Its Barriers and Strategies for Disabled People. PLoS One, February 2019. Researchers identified little evidence on the requirements of disabled people and their ability to manage menstruation. They identified only one intervention, along with a range of barriers. The consequences of failing to meet MHM needs of disabled people include shame, social isolation, and even sterilization.

Sanitation Secrets and Menstrual Hygiene Management: What Can Perimenopausal Women Tell Us? 41st International WEDC Conference, July 2018. The WASH sector has focused on the MHM needs of adolescent girls, while ignoring the MHM needs of a growing population of perimenopausal women, who commonly experience changes and irregularities in their menstruation.

If you would like to feature your organization's materials or suggest other content for upcoming issues of Water Currents, please send them to Dan Campbell, Knowledge Creation/WASH Specialist, at dcampbell@waterckm.com.

For past issues of Water Currents, visit Globalwaters.org.
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Water Currents: WASH and Neglected Tropical Diseases - May 7, 2019

Water Currents: WASH and Neglected Tropical Diseases - May 7, 2019
This issue features new NTD toolkits from the WHO and the International Coalition for Trachoma Control, as well as news from USAID’s NTD Program
Bringing you some of the latest water sector research, resources, and news.
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May 7, 2019 – WASH & Neglected Tropical Diseases

Community members learn about neglected tropical disease prevention and cures in Niger. Photo credit: Helen Keller International
Community members learn about neglected tropical disease prevention and treatment in Niger. Photo credit: Helen Keller International

The U.S. Government Global Water Strategy identifies poor hygiene and the lack of adequate water and sanitation as a leading cause of disease and death worldwide and a contributor to the spread of many neglected tropical diseases (NTDs).

The World Health Organization (WHO) WASH and NTD global strategy (2015–2020) emphasizes the urgent need to focus efforts on the provision of safe water, sanitation, and hygiene (WASH) to eliminate NTDs. Despite the urgency, according to the WHO strategy, WASH and NTDs have received little attention.

This issue features new NTD toolkits from the WHO and the International Coalition for Trachoma Control (ICTC), as well as news from USAID’s NTD Program, studies and reports with overviews on WASH and NTDs, and recently published updates on schistosomiasis, soil-transmitted helminths, and trachoma. It also includes links to some earlier but key WASH and NTD reports.

We would like to thank staff from Global Water 2020 for reviewing and providing content for this issue, as well as the International Coalition for Trachoma ControlSchistosomiasis Control Initiative, and SightSavers for providing content.

Events
10th Neglected Tropical Disease NGO Network Conference, September 17–19, 2019. The Neglected Tropical Disease NGO Network (NNN) and Royal Society of Tropical Medicine and Hygiene will co-convene the 10th annual NNN Conference in Liverpool, U.K., alongside the 11th European Congress on Tropical Medicine and International Health. The conference, themed “Our Vision Beyond 2020: Many Partners, One Voice,” also marks the 5th anniversary of the NNN WASH Working Group. The deadline for workshop submissions is Wednesday, May 15.

WASH and Neglected Tropical Diseases—Improving Inclusion and Health, August 27, 2019. The WHO, NNN, Sustainable Sanitation Alliance, German WASH Network, German Network Against NTDs, and the Ethiopian Federal Ministry of Health will convene a session on WASH and NTDs at this year’s World Water Week in Stockholm. The event will address WASH and NTD collaboration, present results and methods for WASH access and disease distribution, and share tools to support these multisectoral partnerships.

News
Taking Action to End NTDs. USAID Neglected Tropical Diseases Program, February 2019. Last year USAID announced a combined $500 million investment for two new five-year flagship awards that will lead the Agency’s next generation of NTD programming.

Toolkits
WASH and Health Working Together: A ‘How-To’ Guide for Neglected Tropical Disease Programmes. WHO; NNN, January 2019. This toolkit provides step-by-step guidance to NTD program managers and partners on how to engage and work collaboratively with the WASH community to improve delivery of WASH services to underserved populations affected by NTDs. It includes a series of tools to help build multisectoral partnerships and design, implement, and evaluate interventions. The WHO also hosted a recent webinar on the toolkit and Facebook Live Q&A.

Transition Planning for Facial Cleanliness and Environmental Improvement. ICTC, April 2019. This toolkit for transition planning is one of three planning documents ICTC recommends for program managers and implementing partners to support transition from elimination efforts to routine public services.

NTD General
Taking a Systems-Change Approach to Ending NTDs. Devex, November 2018. While NTDs are often portrayed as simple problems with easy solutions, the reality is far more complex. The prioritization of interventions such as mass drug administration over other critical interventions, including water and sanitation, will not solve the problem.

Guidelines on Sanitation and Health. WHO, October 2018. These guidelines provide comprehensive advice on maximizing the health impact of sanitation interventions. They summarize evidence on the links between sanitation and health, provide evidence-informed recommendations, and offer guidance for international, national, and local sanitation policies and program actions. Chapters 6 and 8, “Excreta-Related Pathogens” and “Evidence on the Effectiveness and Implementation of Sanitation Interventions” are particularly useful for those working on NTDs.

Fact Sheets on the Five Main WASH-Related NTDs. WHO, March and April 2019. Trachoma, Schistosomiasis, and Soil-Transmitted Helminth Infections (roundworm, whipworm, hookworm). These updated online resources provide a snapshot of each disease with information on prevalence, transmission, and strategies for control.

The Role of Community Participation for Sustainable Integrated Neglected Tropical Diseases and Water, Sanitation and Hygiene Intervention Programs: A Pilot Project in Tanzania. Social Science & Medicine, April 2018. In this paper, the authors present the results of a pilot undertaken between November 2015 and April 2016 that adopted a mixed-methods case study approach to implement an enhanced development governance model. They found that model was associated with a significant reduction in the prevalence of schistosomiasis and diarrhea.

Schistosomiasis
Schistosoma Haematobium Infection Status and its Associated Risk Factors among Pregnant Women in Munyenge, South West Region, Cameroon Following Scale-Up of Communal Piped Water Sources from 2014 to 2017: A Cross-Sectional Study. BMC Public Health, April 2019. In 2014, a study in Munyenge revealed a high prevalence of urogenital schistosomiasis (UGS) among pregnant women. This follow-up study investigated the prevalence and risk factors of UGS in pregnancy following scale-up of piped water sources from 2014 to 2017.

Schistosomiasis Infection in Pre-School Aged Children in Uganda: A Qualitative Descriptive Study to Identify Routes of Exposure. BMC Infectious Diseases, February 2019. Preschool children age 2–4 years are at a high risk of exposure to schistosomiasis while caretakers conduct activities in infested water bodies. Prevention interventions should target children in their early stages of life to control schistosomiasis in this vulnerable population.

Improving Spatial Prediction of Schistosoma Haematobium Prevalence in Southern Ghana through New Remote Sensors and Local Water Access Profiles. PLoS Neglected Tropical Diseases, June 2018. This study helps to understand localized drivers of schistosomiasis transmission, specifically how unsatisfactory water quality in boreholes perpetuates reliance on surface water bodies, indirectly increasing schistosomiasis risk and resulting in rapid reinfection.

The Effectiveness of Water Treatment Processes against Schistosome Cercariae: A Systematic Review. PLoS Neglected Tropical Diseases, April 2018. Researchers carried out a systematic review to summarize the existing knowledge on the effectiveness of water treatment for the removal or inactivation of cercariae, by processes including chlorination, filtration, UV disinfection, heating, and water storage. This is the first review of its kind and provides a concise summary of what is known to-date regarding water treatment against cercariae of different Schistosoma species.

Soil-Transmitted Helminths (STH)
Challenges and Opportunities for Control and Elimination of Soil-Transmitted Helminth Infection Beyond 2020. PLoS Neglected Tropical Diseases, April 2019. The STH community has largely avoided establishing an approach for addressing WASH or engaging with the WASH sector. However, the recent development of the WHO global strategy (2015–2020) provides an entry point and guidance for improved communication, coordination, and collaboration.

Predicted Short and Long-Term Impact of Deworming and Water, Hygiene, and Sanitation on Transmission of Soil-Transmitted Helminths. PLoS Neglected Tropical Diseases, December 2018. The impact of WASH interventions on STH transmission is hard to measure in the context of preventive chemotherapy programs and other variables. Still, researchers showed a clear added benefit of WASH to sustain the gains made by preventative chemotherapy treatment (PCT) in the long term, such that PCT may be scaled down or even stopped altogether.

What Mathematical Models Tell Us about the Impact of WASH on STH Control and Elimination. BugBitten, March 2019. This article summarizes the above study, which used mathematical model simulations to predict the short- and long-term impact of WASH interventions on STH control.

Tailoring Water, Sanitation, and Hygiene (WASH) Targets for Soil-Transmitted Helminthiasis and Schistosomiasis Control. Trends in Parasitology, January 2018. Soil-transmitted helminthiasis and schistosomiasis cannot be controlled without primary prevention strategies, underscoring the importance to the NTD agenda of developing appropriate WASH targets and indicators.

Effect of an Integrated Intervention Package of Preventive Chemotherapy, Community-Led Total Sanitation and Health Education on the Prevalence of Helminth and Intestinal Protozoa Infections in Côte d’Ivoire. Parasites & Vectors, February 2018. Researchers targeted an integrated package of interventions to five communities in Côte d’Ivoire. This paper describes how the interventions reduce the prevalence of helminth and intestinal protozoa infection.

Trachoma
Report of the 21th Meeting of the WHO Alliance for the Global Elimination of Trachoma by 2020. WHO, March 2019. The alliance recognizes the progress made toward eliminating trachoma, but still urges endemic countries to support a coordinated multisectoral approach for wider access to safe WASH to help achieve the 2020 elimination goal.

Impact of the Global Trachoma Mapping Project (GTMP). Ophthalmic Epidemiology, December 2018. The GTMP surveyed more than 1,546 districts and examined more than 2.6 million people across 29 countries in three years, making it the largest infectious disease survey ever undertaken. Articles in this issue discuss the epidemiology and prevalence of trachoma in Ethiopia, Nigeria, Senegal, Yemen, and other countries.

Making Gains Sustainable: Partnering with WASH to Stop the Transmission of Trachoma. Community Eye Health Journal, May 2018. The progress of countries toward the elimination of trachoma is increasing the importance of expanded partnerships and strategies to implement facial cleanliness and environmental improvements that further prevent the transmission of trachoma.

Sanitation and Water Supply Coverage Thresholds Associated with Active Trachoma: Modeling Cross-Sectional Data from 13 Countries. PLoS Neglected Tropical Diseases, January 2018. Findings support the plausibility of community-level or herd protection from trachoma with increasing water and sanitation coverage. The results suggest that access to adequate water and sanitation can be an important component in working toward the 2020 target of eliminating trachoma.

Interventions to Maximize Facial Cleanliness and Achieve Environmental Improvement for Trachoma Elimination: A Review of the Grey Literature. PLoS Neglected Tropical Diseases, January 2018. The WHO employs a "SAFE" strategy for the elimination of trachoma—Surgery for trichiasis, Antibiotics, Facial cleanliness, and Environmental improvement. Efforts are underway to scale up the facial cleanliness and environmental improvement (F&E) components of strategy. This review provides information regarding gaps in F&E intervention and delivery that relevant stakeholders can use to understand why some interventions have not worked as intended. 

Engaging Different Audiences in Behaviour Change Programmes. Bond, January 2019. Influencing behavior to prevent infection can be as important as treating it when trying to keep communities free of trachoma. This painful eye condition is extremely infectious, so improved sanitation and hand and face washing can make a huge difference in stopping its spread.

Earlier Publications
Water Sanitation and Hygiene for Accelerating and Sustaining Progress on Neglected Tropical Diseases: A Global Strategy 2015–2020. WHO, 2015. Meeting the global NTD roadmap targets requires an urgent focus on WASH, especially for NTDs where transmission is most closely linked to poor WASH conditions such as soil-transmitted helminthiasis, schistosomiasis, trachoma, and lymphatic filariasis.

All You Need for F&E: A Toolkit for Planning and Partnering. ICTC, August 2015. This toolkit aims to strengthen critical coordination and maximize impacts between trachoma program managers in the field and their WASH partners.

Global and Country WASH and NTD Manual. Children Without Worms, December 2013. This WASH and NTD manual serves as a practical guide to practitioners working to implement, support, and sustain WASH interventions at the country level.

Websites
USAID Neglected Tropical Diseases Program – This website includes information on the USAID NTD Program, including a donor landscape, fact sheets, and program evaluation, along with program news and updates.

WHO Neglected Tropical Diseases – WHO’s NTD website has a collection of NTD-related publications, events, data, and news.

Neglected Tropical Disease NGO Network – The NNN is a global forum of NGOs working to control NTDs and consists of various disease-specific and cross-cutting working groups, including a WASH working group. The website provides disease-specific information, resources, blogs, and news.

InfoNTDs – This website curates articles, e-journals, and e-books on cross-cutting issues in the NTD sector.

Uniting to Combat Neglected Tropical Diseases – This website houses an impact dashboard and Africa-specific NTD league table to track progress on NTDs.

If you would like to feature your organization's materials or suggest other content for upcoming issues of Water Currents, please send them to Dan Campbell, Knowledge Creation/WASH Specialist, at dcampbell@waterckm.com.

For past issues of Water Currents, visit Globalwaters.org.
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Water Currents: Learning from Failures - April 23, 2019

Water Currents: Learning from Failures - April 23, 2019
Many international development projects have unintended negative consequences. Without post-implementation evaluation...
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April 23, 2019 – Learning from Failures

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“Blunders, Bloopers and Foul-Ups: A WASH Game Show,” designed to get WASH professionals talking about failure was one of the events and presentations on Learning from Failure at the 2019 IRC WASH Systems Symposium. Photo courtesy of IRC.

Many international development projects have unintended negative consequences. Without post-implementation evaluation, these unintended consequences can go unnoticed by almost everyone—except the people who were supposed to benefit from the project. Even with evaluations, water, sanitation, and hygiene (WASH) professionals are often reluctant to share poor findings due to perceived repercussions. However, allowing others to learn from mistakes could help to prevent the same problems from happening again.
 
Several organizations, including USAID, @FSM_Fail, Improve International, the World Bank, and others, are pushing to change this attitude toward failure. They see learning from failure as a way to improve the success and sustainability of programs and projects in the WASH sector.
 
This issue features articles that talk about failure, how to identify and avoid future failures, and the role of finance in mitigating failure. It includes case studies from Tanzania, Nigeria, and Nepal, as well as studies that discuss learning from failure in rural water supply and urban sanitation systems. Also highlighted are studies that looked at both success and failure, including the first four (in a series of six) ex-post evaluations that discuss factors that affect the long-term sustainability of USAID WASH projects. A special thanks goes out to @FSM_Fail and Improve International for contributing content and reviewing this issue.

Learning from Failures – Overviews
Blunders, Bloopers and Foul-Ups: Sharing Failures in Water, Sanitation and Hygiene Programs. Engineering for Change, August 2018. Until a culture of sharing and learning from failures is more widely instilled in the WASH sector, practitioners will continue to make the same mistakes, possibly at the expense of those whom the programs are designed to benefit. This article describes how a “failure event” raised awareness of this topic.
 
The Nakuru Accord: Failing Better in the WASH Sector. University of Leeds WASH Blog, January 2019. In July 2018, an event at the Water Engineering Development Centre Conference in Nakuru, Kenya, “Blunders, Bloopers and Foul-ups: A WASH Game Show,” (mentioned above) inspired a call for WASH professionals to publicly commit to sharing their failures and learning from one another. The Nakuru Accord is that commitment.
 
Opinion: Want to Improve Development Outcomes? Anticipate the Failures. Here's How. Devex, February 2018. This article discusses “premortems,” a strategy in which a team imagines that a project has failed, and then works backward to determine what can lead to failure in order to address the issues before projects start.
 
WASH: Why Spend a Penny When There’s No ROI? Oxfam, March 2019. Investing in sustainable WASH solutions for fragile contexts can pose a serious challenge. Finance is available for creditworthy WASH enterprises, but how about those that operate in the red? This Oxfam webinar explores investing in models that provide massive social returns but fall short on financial returns.
 
Mistake Money, Premortems, and Other Ways to Incentivize Talking about Failure. CARE, December 2018. In this podcast, Susan Davis of Improve International discusses how we can incentivize talking about failure so we can make new mistakes rather than continue to repeat the old ones. Some tools she suggests are the Nakuru Accord, premortems, and innovative financing mechanisms—what she calls “Mistake Money.”
 
The Social Sector Must Recognise and Talk about Failure. Alliance, February 2019. With pressure to show returns on philanthropic capital, there’s little room to discuss failure. Mitigating huge organizational and programmatic risks, requires building a culture of admitting failure.
 
Ten Reasons Why Your WASH Project is Failing in Sub-Saharan Africa. Takudzwa Noel Mushamba, WASH Delegate at Swedish Red Cross, January 2019. In the last half a century, numerous externally funded/supported WASH initiatives have been implemented in sub-Saharan Africa. These projects have resulted in many positive changes, but there have also been major failures in some sectors and parts of the continent. These can often be attributed to one of 10 reasons.

Learning from Failures – Country Studies
Why Do So Many Water Points Fail in Tanzania? An Empirical Analysis of Contributing Factors. World Bank, February 2019. Researchers analyzed various factors that impact water point failure and measured the relative contributions of these determinants. They found that water points managed by village committees had a much higher likelihood of failure than those managed by private operators or water authorities.
 
An Evaluation of the Contributing Factors of Water Scheme Failures in Nigeria. World Bank, March 2018. Approximately 30 percent of all water schemes in Nigeria are likely to fail in the first year. This paper uses information from the 2015 Nigeria National Water and Sanitation Survey to identify the extent and timing of water scheme failure in the country and the factors affecting it. The results indicate that during the first year of operation, factors that can be controlled in the design, implementation, and operational stages contribute to the failure of 61 percent of the water schemes.
 
Why Are So Many Water Points in Nigeria Non-Functional?: An Empirical Analysis of Contributing Factors. World Bank, March 2018. The paper finds that more than 38 percent of all improved water points in Nigeria are nonfunctional, with nearly 27 percent likely to fail in the first year of construction and nearly 40 percent likely to fail in the long run (after eight to 10 years). The paper considers the reasons behind these failures, looking at whether they can or cannot be controlled.
 
Digging Deep Behind the Complexities of Sustainable Water Supply in Nepal. IRC WASH Symposium, March 2019. The research identified some common technical problems around pipes, pumps, deep wells, and electrical systems that have increased operation and maintenance (O&M) costs for rural water supply schemes. The collection of unscientifically calculated tariffs and unclear mechanisms to finance capital maintenance have led to insufficient O&M funds, rendering many schemes dysfunctional.
 
Development Malpractice in Ghana: How Stuff that Doesn’t Work Can Screw Up Stuff that Does. Stanford Social Innovation Review, April 2017. This story about several water interventions in northern Ghana illustrates some basic principles of development: there is a huge opportunity cost to failure; most “training” for end users is useless; and it’s all about follow-up.
 
Blockages to Service Sustainability of Water, Sanitation and Hygiene in Schools Case Study of Selected Public Schools in Kampala Uganda. Ontario International Development Agency International Journal of Sustainable Development, November 2018. Generating evidence on the cause of service failures and low sustainability of school WASH services is essential to improve the quality of education. This study assessed blockages to WASH service sustainability in Kampala’s public primary schools to inform the development of sustainable WASH in schools’ service delivery and management models.

Learning from Failures – Water Supply Systems
Risk Factors Associated with Rural Water Supply Failure: A 30-year Retrospective Study of Handpumps on the South Coast of Kenya. Science of the Total Environment, December 2017. This retrospective cohort study applies survival analysis to identify factors that predict failure risks for hand pumps installed on boreholes along the south coast of Kenya from the 1980s. Models suggest water point failure risks are higher and lifespans are shorter when water supplied is more saline, static water level is deeper, and groundwater is pumped from an unconsolidated sand aquifer.
 
The Need for a Standard Approach to Assessing the Functionality of Rural Community Water Supplies. Hydrogeology Journal, March 2018. Communal groundwater supplies are likely to remain the main source of improved water supplies for many rural areas in Africa and South Asia for decades to come. Understanding the poor functionality of existing communal supplies remains, therefore, a priority. A critical first step is to establish a sector-wide definition of borehole supply functionality and a standard method of its assessment.
 
Dry Pipes: Associations between Utility Performance and Intermittent Piped Water Supply in Low and Middle Income Countries. Water, August 2018. Intermittent piped water supply impacts at least 1 billion people around the globe. Given the environmental and public health implications of poor water supply, there is a strong practical need to understand how and why intermittent supply occurs, and what strategies may be used to move utilities toward the provision of continuous water supply.

Learning from Success and Failures
USAID Ex-Post Evaluations – This series of blogs, briefs, reports, and webinars discuss factors that affect the long-term sustainability of USAID WASH projects in urban and rural settings. The ex-post series aims to help inform a holistic understanding of what contributes to sustainability and guide improvements to future programming. The first four evaluations were completed in Madagascar, Indonesia, Ethiopia, and India. The final two evaluations will be completed in Senegal and Mozambique. 
 
Why Do Water Quality Monitoring Programs Succeed or Fail? A Qualitative Comparative Analysis of Regulated Testing Systems in Sub-Saharan Africa. International Journal of Hygiene and Environmental Health, July 2018. This study examines the conditions that promote successful water quality monitoring in Africa, with the goal of providing evidence for strengthening regulated water quality testing programs.
 
How Humans Get in the Way of Clean Water. Scientific American, January 2019. Many cheap and effective ways are available to provide safe water to the world’s poorest regions. But projects often fail due to inadequate planning, maintenance, or persuasive power.
 
Leading Factors of Success and Failure in Asian Development Bank Urban Sanitation Projects. Asian Development Bank (ADB), June 2018. This paper contributes to the stock of knowledge on the factors affecting the success or failure of ADB urban sanitation projects. It identifies factors of success and failure from 63 completed and evaluated projects implemented between 2003 to 2016.

    If you would like to feature your organization's materials or suggest other content for upcoming issues of Water Currents, please send them to Dan Campbell, Knowledge Creation/WASH Specialist, at dcampbell@waterckm.com.
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    Water Currents: World Water Day 2019, March 14, 2019

    Water Currents: World Water Day 2019, March 14, 2019
    March 22, 2019 is World Water Day (WWD). This year’s theme—Leaving No One Behind—emphasizes the transformative power of clean water...
    Bringing you some of the latest water sector research, resources, and news.
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    March 14, 2019 – World Water Day 2019

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    In Ethiopia’s Malle District in South Omo, a region inhabited mainly by pastoralists, children enjoy access to piped water for the first time from a simple hand scheme funded by the USAID Lowland WASH Activity. Photo credit: AECOM

    March 22, 2019 is World Water Day (WWD). This year’s theme—Leaving No One Behind—emphasizes the transformative power of clean water to drastically improve quality of life for the world’s underserved and marginalized populations.

    The U.S. Government seeks to create a water-secure world, where people and nations have the water they need to be healthy, prosperous, and resilient. To support this vision, USAID, through its Water and Development Plan appended to the U.S. Government Global Water Strategy, helps partner countries on their own development journey to self-reliance. Access to a safe drinking water supply is a key step on that journey. Our assistance helps partner countries—through their own systems—plan, finance, and deliver safe water and sanitation services for the neediest while sustainably managing water resources.

    This issue of Water Currents contains information on WWD 2019 as well as recent studies and resources on issues related to the WWD theme such as human rights and marginalized populations.

    World Water Day 2019
    World Water Day 2019: Water for All, Leaving No One Behind. The official World Water Day website provides background about this year’s theme; information about previous WWD themes; and a collection of posters/social media materials, stories, events, and other resources.

    Human Rights
    Human Rights-Based Approach to WASH and Health. WaterAid, 2018. A human rights-based approach to development is rooted in the central idea of empowerment. This brief explains how the approach seeks to change the relationship between development actors and poor or vulnerable people.

    Why a Human Rights Based Approach to Water and Sanitation Is Essential for the Poor. Water Blog, September 2018. The recognition of water and sanitation as a human right has dramatically changed how the water, sanitation, and hygiene (WASH) sector designs, plans, implements, and monitors policies and programs aimed at increasing access to these basic services.

    Special Rapporteur on the Human Rights to Safe Drinking Water and Sanitation. United Nations Human Rights. The Office of the High Commissioner for Human Rights created this site to feature news updates, annual reports, UN resolutions, and other publications from the Special Rapporteur.

    Having a Toilet Is Not Enough: The Limitations in Fulfilling the Human Rights to Water and Sanitation in a Municipal School in Bahia, Brazil. BMC Public Health, January 2019. A study of access to toilets in a public school in Brazil found insufficient quantity and quality of toilets. It also revealed the need to go beyond infrastructure and address the lack of maintenance, cultural elements, and student participation.

    Marginalized Populations—Refugees/Water Conflict
    Water @ Wilson: 50 Years of Water, Conflict, and Cooperation. Wilson Center, November 2018. The Woodrow Wilson Center held this event celebrating 50 years of working on water’s connection to conflict and cooperation. The event featured a panel of experts from USAID, NGOs, and academia for a comprehensive look at the first year of the U.S. Government Global Water Strategy and new research and practice on water, peace, and conflict.

    The Healthy Baby Flipbook: Piloting Home-Based Counseling for Refugee Mothers to Improve Infant Feeding and Water, Sanitation, and Hygiene (WASH) Practices. Global Health Action, January 2019. Researchers in this study piloted education materials for home-based counseling of refugee mothers along the Thailand–Myanmar border to improve appropriate infant-feeding WASH behaviors.

    Human Rights Day: WASH During Emergencies. CLTS Foundation Blog, December 2018. The main objective of any WASH intervention during emergencies is to reduce the transmission of fecal-oral diseases and exposure to disease-bearing vectors. Approaches to WASH in emergencies may vary according to need, culture, context, and the nature of the disaster or conflict.

    Updates to the Water Conflict Chronology. Pacific Institute, January 2019. The Water Conflict Chronology is the world’s most comprehensive open-source database on water-related violence. This update adds over 100 new entries identified from news reports, eyewitness accounts, and other conflict databases.

    A Multi-Criteria Assessment of Water Supply in Ugandan Refugee Settlements. Water, October 2018. This study investigated end-user water demand, freshwater availability, and the risks surrounding several groundwater supply alternatives in Ugandan refugee settlements.

    Assessing Conflict in Water Development: A Guide for Water and Peacebuilding Practitioners. Catholic Relief Services, March 2018. The purpose of this document is to provide a lens through which water development practitioners can identify and assess existing or future conflict associated with their projects and plan for mitigation activities early in the design process.

    Water Stress and Human Migration: A Global, Georeferenced Review of Empirical Research. Food and Agriculture Organization of the United Nations, 2018. This report assesses and maps 184 peer-reviewed, empirical research articles selected for their focus on linkages between water stress and human migration.

    Speaking of Water: Water Conflict Chronology. Circle of Blue, June 2018. In this podcast, “Speaking of Water” host Eileen Wray-McCann speaks with the Pacific Institute’s co-founder and President Emeritus Dr. Peter Gleick. They discuss the connections among resource issues, environmental issues, and the broad area of international security and conflict.

    Marginalized Populations—People with Disabilities
    Equality, Non-Discrimination and Inclusion Toolkit. WaterAid, 2018. This resource gives practical guidance on reducing inequalities in advocacy programs, provides a framework for making WASH initiatives more inclusive, and includes tools to put the theory into practice.

    Exploring the Links Between Water, Sanitation and Hygiene and Disability; Results from a Case-Control Study in Guatemala. PLoS One, June 2018. People with disabilities in Guatemala experience greater difficulties in accessing sanitation facilities and practicing hygienic behaviors than their peers without disabilities. Addressing this disparity will require more data collection and research.

    Access to Water and Sanitation Among People with Disabilities: Results from Cross-Sectional Surveys in Bangladesh, Cameroon, India and Malawi. BMJ Open, June 2018. An analysis of five cross-sectional, single or multidistrict, population-based surveys provides some of the first comparable quantitative data on the relationship between disability and WASH at the individual and household level.

    Evaluating Equity and Inclusion in Access to Water and Sanitation for Persons Living with HIV/AIDS in Wukro, Ethiopia. Water, September 2018. This study presents recommendations on how to specifically target the needs of persons living with HIV/AIDS to achieve equitable and inclusive access to water and sanitation for all.

    Marginalized Populations—Urban Poor
    Seeking New Ways to Expand Sanitation for the Urban Poor in West Africa. Global Waters on Medium, May 2018. The USAID West Africa Sanitation Service Delivery Project is working to create a more effective, efficient, and inclusive sanitation market for the urban poor in Benin, Côte d’Ivoire, and Ghana.

    Water and Sanitation in Dhaka Slums: Access, Quality, and Informality in Service Provision. The World Bank, 2018. An analysis finds that access to water and sanitation services in Dhaka slums is overall quite high, but these services are subject to important quality issues related to safety, reliability, and liability.

    A Journey of Institutional Change: Extending Water Services to Nairobi’s Informal Settlements. Water and Sanitation for the Urban Poor, October 2018. This brief sets out the process of institutional change that the Nairobi City Water & Sewerage Company undertook to extend services to the informal settlements of Nairobi.

    Increasing the Regular Use of Safe Water Kiosk Through Collective Psychological Ownership: A Mediation Analysis. Journal of Environmental Psychology, June 2018. In urban slums and dispersed rural communities, where access to safe water is especially limited, water kiosks are a relevant safe water source. However, irregular use by customers challenges their operational viability.

    Barriers to Access to Improved Water and Sanitation in Poor Peri-Urban Settlements of Abidjan, Côte d’Ivoire. PLoS One, August 2018. A cross-sectional study in six poor peri-urban settlements found that the presence of the household head’s wife at home was associated with greater access to clean water, thus highlighting the important role of women in ensuring access to clean water in these specific environments.

      If you would like to feature your organization's materials or suggest other content for upcoming issues of Water Currents, please send them to Dan Campbell, Knowledge Creation/WASH Specialist, at dcampbell@waterckm.com.
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      ☑ ☆ ✇ USAid Water Currents

      Water Currents: WASH and Gender, March 5, 2019

      Water Currents: WASH and Gender, March 5, 2019
      USAID recognizes that gender equality and women’s empowerment are vital to the success of any development intervention
      Bringing you some of the latest water sector research, resources, and news.
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      March 5, 2019 – WASH and Gender

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      Women in Antananarivo, Madagascar use a laundry block built with funding from USAID under the Water and Development Alliance a partnership with The Coca-Cola Company. Access to this laundry block gives the community a reliable water supply and provides an avenue for these women to earn money by washing laundry for others. Photo credit: USAID/WADA.

      USAID recognizes that gender equality and women’s empowerment are vital to the success of any development intervention. The Agency incorporates a gender-related component into all its activities, including those outlined in the U.S. Government Global Water Strategy and the USAID Water and Development Plan in support of the Strategy.

      Women and girls often bear primary responsibility for providing drinking water and sanitation to their families and are disproportionately affected when they have to travel to reach these services/facilities. Improved sanitation access is crucial to preserving the basic dignity of women and girls and reducing gender-based violence. Under USAID's Plan, water and sanitation programming will promote gender equality by increasing participation in leadership, consultation, education, and technical skills training. Menstrual hygiene management (MHM) is another critical way that water and sanitation activities can address women’s and girls’ empowerment by alleviating a major constraint to their participation in education and public life.
       
      This issue contains gender-related studies and reports from 2017 and 2018 on MHM, gender issues related to water collection and water security, male participation in sanitation, and other topics. A special thanks goes to the Institute of Development Studies (IDS) for contributing content to this issue.

      Events
      Call to Action: Supporting Women Through Water, March 21, 2019. In honor of both International Women’s Day and World Water Day, USAID will be co-hosting an event with the State Department, Global Water Challenge, and the Aspen Institute. Hosted at the George C. Marshall Center, this event will focus on the power of water access to improve livelihoods, particularly for women. The agenda will feature panels with diverse stakeholder representation, interviews and Q&A with sector experts, insight on innovative programming and cutting-edge research, as well as keynote remarks delivered by sector leaders. Please register here.

      Overviews
      Sylvia Cabus on Gender Mainstreaming in Water and Sanitation Programming. Globalwaters.org, October 2018. This Global Waters Radio podcast explores the connection between gender and water with the help of Sylvia Cabus, the senior gender advisor for USAID’s Office of Gender Equality and Women's Empowerment. Cabus delves into the many ways women’s lives are uniquely burdened by water and sanitation insecurity.
       
      The Ripple Effect: Empowering Women Through Water. Water and Development Alliance (WADA), August 2018. This video from a session at World Water Week 2018 features the WADA partners, the Coca-Cola Company, USAID, Gap, Ipsos, and the Global Water Challenge and highlights their efforts to empower women globally through water.
       
      Gender Equality in the 2030 Agenda: Gender-Responsive Water and Sanitation Systems. UN Women, July 2018. This issue brief explains how the promotion of gender-responsive water, sanitation, and hygiene can be a catalyst for change across the 2030 Agenda for Sustainable Development.
       
      Women as Change-Makers in the Governance of Shared WatersInternational Union for Conservation of Nature (IUCN), August 2018. The authors of this paper combine a survey of literature with a collection of case examples describing how women in Asia, Latin America, Europe, and Africa are leading change in governing shared waters.
       
      Impact Story: Gender in Water and Sanitation–Empowerment by Numbers. Stockholm Environment Institute (SEI), June 2018. An SEI project in Burkina Faso is developing a new Empowerment in WASH Index that identifies imbalances in decision-making power between men and women, or between different ethnic and socio-economic groups.
       
      Male Participation
      Learning Brief: Men and Boys in Sanitation. IDS, October 2018. The engagement of men and boys can help achieve sustainable behavior change and new social norms, including specific approaches and methods to stop men and boys from practicing open defecation.
       
      Engaging Men and Boys in Sanitation and Hygiene Programmes: Frontiers of CLTS 11. IDS, August 2018. Current efforts to improve sanitation and change social norms may not always engage men and boys in the most effective way. Engagement strategies should be modified to make efforts more successful, but the issue requires further study.
       
      ‘We Do Not Know’: A Qualitative Study Exploring Boys Perceptions of Menstruation in India. BMC Reproductive Health, December 2017. Findings from this study revealed that boys were keen for knowledge about menstruation, were largely sympathetic to female peers, and that males in general can become advocates in moving forward the MHM agenda.
       
      Menstrual Hygiene Management
      How Changed Attitudes Towards Menstruation Hygiene Impact Girls’ Rights. Plan International Cambodia, August 2018. This video from World Water Week discusses the lack of access to water for women and girls in many countries as well as the lack of resources and knowledge they need to manage their menstruation. For girls, the inability to deal with menstruation in school premises means they miss school each month or drop out altogether.

      Aakar Innovations Expands Innovative Sanitary Products to South Africa. Asia Gender Network News, November 2018. The Millennium Alliance, in which USAID is a partner, awarded funds to Aakar Innovations, a social enterprise that enables women and self help groups to produce and distribute affordable high-quality sanitary napkins within their communities while raising awareness of MHM. Aakar has now expanded to Africa and recently installed a biodegradable and low-cost sanitary pads manufacturing unit in South Africa.

      The Relationship Between Household Sanitation and Women’s Experience of Menstrual Hygiene: Findings from a Cross-Sectional Survey in Kaduna State, Nigeria. International Journal of Environmental Research and Public Health (IJERPH), May 2018. Findings suggest household sanitation influences women’s choices for MHM, but that existing indicators for improvement are not sensitive to menstrual needs.
       
      Menstrual Hygiene Management and Waste Disposal in Low- and Middle-Income Countries: A Review of the Literature. IJERPH, November 2018. The review showed that disposal of menstrual waste is often neglected in MHM and sanitation value chains, leading to improper disposal and negative impacts on users, the sanitation systems, and the environment.
       
      Access to Pads: Five Takeaways from Menstrual Hygiene Management (MHM) Research with Adolescent Girls and Young Women in India and Ethiopia. Population Services International (PSI), October 2018. With support from the Bill and Melinda Gates Foundation, PSI sought a deeper understanding of access to MHM products for girls and young women. This blog post discusses the findings from research that was conducted in two states in India and four cities in Ethiopia.
       
      A Qualitative Exploration of Menstruation-Related Restrictive Practices in Fiji, Solomon Islands and Papua New Guinea. PLoS One, December 2018. Participants in this study described a range of attitudes and beliefs that restrict the behavior of menstruating women and girls. Education initiatives guided by women and girls, implemented by local stakeholders, and grounded in a sound understanding of specific contexts are needed to help shift these attitudes.
       
      A Toolkit for Integrating Menstrual Hygiene Management into Humanitarian Response. Columbia University, Mailman School of Public Health, October 2017. An extensive desk review and field research helped shape this toolkit, which provides guidance to organizations and agencies seeking to integrate MHM into existing programming across sectors and phases.
       
      New Book Busts Myths about Menstruation Spread by Public Health Groups. NPR Goats and Soda, January 2019. Author Chris Bobel discusses the surprising amount of misinformation about menstrual hygiene management from charities and nonprofits in the health sector.

      Sanitation/Community-Led Total Sanitation
      Female-Friendly Public and Community Toilets: A Guide for Planners and Decision Makers. WaterAid; Water and Sanitation for the Urban Poor; UNICEF, October 2018. This guide explains the importance of making toilets female-friendly, detailing the essential and desirable features needed to make them so. It also suggests ways to increase gender sensitivity in town planning on sanitation.
       
      Shared Latrines in Maputo, Mozambique: Exploring Emotional Well-Being and Psychosocial Stress. BMC International Health and Human Rights, July 2018. Shared sanitation presents specific stressors to users, specifically those related to disgust, privacy, safety, and management. Properly managed and maintained shared sanitation can reduce these stresses.
       
      Gender, Women and Sanitation. Global Water Pathogen Project, August 2018. The main objectives of this report are to explain the nexus among gender, women, and sanitation, and discuss how to decrease inequalities between men and women in the sanitation sector.
       
      Toilets Not Taxes: Gender Inequity in Dar es Salaam’s City Markets. International Centre for Tax and Development, November 2018. Researchers examined market taxation in Dar es Salaam from a gender perspective, finding an unexpected gender issue—toilet fees. Female traders pay up to 18 times more for their daily use of the market toilets than they pay as market tax.
       
      Innovations for Urban Sanitation: Adapting Community-Led Approaches. IDS, June 2018. This report offers guidance for practitioners to move toward safely managed sanitation services, citing examples from Africa, South Asia, and Southeast Asia.
       
      Out of Order: The State of the World's Toilets 2017. WaterAid, November 2017. Almost one in three people lack access to a toilet. This report explores how the lack of decent toilets around the world prevents women and girls from fulfilling their potential.
       
      Gender and the Sanitation Value Chain: A Review of the Evidence. Bill and Melinda Gates Foundation, February 2018. The current understanding of gendered differences in sanitation is limited by a lack of research and data. Emerging evidence, however, clearly shows how gender differences along the sanitation value chain result in disproportionately negative outcomes for women. 
       
      Assessing Women’s Negative Sanitation Experiences and Concerns: The Development of a Novel Sanitation Insecurity Measure. IJERPH, July 2017. Researchers developed a sanitation insecurity measure to evaluate how sanitation insecurity affects health and to determine if and how sanitation interventions ameliorate women’s concerns and negative experiences associated with sanitation.

      Water Collection and Security
      Carrying Water May Be a Major Contributor to Disability from Musculoskeletal Disorders in Low Income Countries: A Cross-Sectional Survey in South Africa, Ghana and Vietnam. Journal of Global Health, June 2018. Cervical spinal conditions are globally one of the more common causes of disability. Findings suggest that water carrying, especially by head, is a major contributor to musculoskeletal disease in low income countries.
       
      Gender and Community Mainstreaming in Fog Water Collection Systems. Water, October 2018. Fog water systems are implemented within or near communities, eliminating or reducing the need to travel far distances for the collection of water during times of scarcity, thus decreasing the burden of water collection on women and girls.
       
      Gender Dimensions of Community-Based Groundwater Governance in Ethiopia: Using Citizen Science as an Entry Point. CGIAR Research Program on Water, Land and Ecosystems (WLE), October 2018. The leading role played by women in obtaining and safeguarding water is not usually reflected at the institutional level. Addressing this imbalance could lead to the equal participation of men and women in sustainable groundwater management.
       
      A Novel Household Water Insecurity Scale: Procedures and Psychometric Analysis Among Postpartum Women in Western Kenya. PLoS One, June 2018. The lack of a standardized instrument for quantifying household-level water insecurity prevents an understanding of its prevalence and consequences. This gap prompted researchers to develop a household water insecurity scale for use in Kenya.
       
      Water Insecurity and Gendered Risk for Depression in Rural Uganda: A Hotspot Analysis. BMC Public Health, September 2018. Residing in a water insecurity hotspot is associated with greater risk for depression among women, but not among men, pointing to the need for focused depression screening among women residing in water insecure households.

      Other Studies/Resources
      Impact of Social Capital, Harassment of Women and Girls, and Water and Sanitation Access on Premature Birth (PTB) and Low Infant Birth Weight (LBW) in India. PLoS One, October 2018. The relationship between adverse birth outcomes and sanitation access, domestic water fetching, crime, and gender-based harassment suggests stress as a possible mechanism by which WASH access affects PTB and LBW among Indian women.
       
      Gender Dimensions of Community-Based Groundwater Governance in Ethiopia: Using Citizen Science as an Entry Point. International Water Management Institute, November 2018. A study exploring gender aspects of community-based groundwater governance found that women place a high value on groundwater and could be motivated to play a greater role in its governance.
       
      Toolkit: Understanding and Addressing Equality, Non-Discrimination and Inclusion in Water, Sanitation and Hygiene (WASH) Work. WaterAid, November 2018. This toolkit provides guidance on reducing WASH-related gender inequalities and includes practical activities, tools, and checklists.
       
      Transgender-Inclusive Sanitation: Insights from South Asia. Waterlines, April 2018. Three case studies of recent initiatives to make sanitation inclusive for transgender people in South Asia provide insights that can help guide future practice.
       
      What Women and Men Want: Considering Gender for Successful, Sustainable Land Management Programs. CGIAR WLE, 2018. The Nairobi Water Fund (NWF) in Kenya is a public-private partnership designed by The Nature Conservancy as a payment for ecosystem services. This case study explores different barriers that men and women face when implementing sustainable land management under the NWF.
       
      Frontiers of CLTS: Innovations and Insights – IDS has published eleven issues on a range of CLTS topics. Gender-related issues include:
      If you would like to feature your organization's materials or suggest other content for upcoming issues of Water Currents, please send them to Dan Campbell, Knowledge Creation/WASH Specialist, at dcampbell@waterckm.com.
      Subscribe
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      Water Currents: Water Quality – February 12, 2019

      Water Currents: Water Quality – February 12, 2019
      This issue of Water Currents includes research and technical resources on water quality.
      Bringing you some of the latest water sector research, resources, and news.
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      February 12, 2019 – Water Quality 

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      Children in Chiang Mai, Thailand, attend the Youth Water Quality Monitoring Camp, sponsored by the USAID-funded Lower Emissions in Asia Forests Project. Photo credit: Somsak Soonthornnawaphat

      Globally, at least 2 billion people use a drinking water source contaminated with feces. More than 1,300 children under 5 years of age die every day from diarrhea linked to unsafe water and poor sanitation. The U.S. Government Global Water Strategy and the USAID Water and Development Plan in support of the strategy include a focus on increasing sustainable access to safe drinking water, recognizing it as crucial to lifting people out of poverty and especially important for unlocking educational and economic opportunities for women and girls.

      This issue of Water Currents looks at water quality—specifically drinking water—and includes research and technical resources on water safety plans, water quality monitoring, and chemical and microbial hazards in water. A special thanks goes out to the staff of Sattva for contributing to this issue. Sattva is a key member of the SAFEBillion initiative, a collaborative effort to create solutions for access to clean drinking water, free from arsenic and fluoride.

      Standards and Guidance
      Guidelines for Drinking-Water Quality (GDWQ). World Health Organization (WHO), 2017. This is the fourth edition of the Guidelines and it builds on over 50 years of guidance by WHO on drinking-water quality. The report also includes fact sheets on a broad range of chemicals that can affect water quality.

      Developing Drinking-Water Quality Regulations and Standards. WHO, 2018. This document provides practical guidance to support the development or revision of customized national or subnational drinking water quality regulations and standards.

      Safely Managed Drinking Water: Thematic Report on Drinking Water 2017. WHO; UNICEF, 2017. WHO/UNICEF’s Joint Monitoring Programme for Water Supply and Sanitation (JMP) introduced “safely managed drinking water services” as a new standard of drinking water quality in its 2017 report, which examines this new designation in the context of the 2030 Agenda for Sustainable Development.

      A Global Overview of National Regulations and Standards for Drinking-Water Quality. WHO, 2018.  The WHO GDWQ provides a standard for many countries when setting national drinking water quality regulations. This global review summarizes information from 104 countries and territories on values specified in national drinking water quality standards for aesthetic, chemical, microbiological, and radiological parameters.

      Water Safety Plans (WSP)
      USAID Africa BureauWater Quality Assurance Plan (WQAP) Template – WQAPs are the preferred method for ensuring water quality in projects involving the provision of drinking water. USAID recommends that new initial environmental examinations for drinking water provisioning activities require implementing partners to develop, implement, and report on a WQAP.

      Water Safety Plans: An Online Distance Learning Program, March 11–May 10, 2019. UNC Water Institute. The Water Institute is offering a nine-week online course on risk management for drinking water supplies aimed at those in the water industry with management, engineering, or operational responsibilities.

      Global Status Report on Water Safety PlansWHO, 2017. Using information gathered from 118 countries representing every region of the globe, this report provides a picture of WSP uptake worldwide.

      Potable Reuse: Guidance for Producing Safe Drinking-Water. WHO, 2017. This guide describes how to apply appropriate management systems to produce safe drinking water from municipal wastewater. It provides information on specific aspects of potable reuse, including the quality and protection of source wastewaters, types of control measures, monitoring considerations, and public acceptance.

      Water Quality Monitoring
      Why Do Water Quality Monitoring Programs Succeed or Fail? A Qualitative Comparative Analysis of Regulated Testing Systems in Sub-Saharan Africa. International Journal of Hygiene and Environmental Health, July 2018. Water quality monitoring programs require institutional commitment, a skilled and reliable staff, and adequate transportation to achieve targets. Equipment, procurement, infrastructure, and enforcement also contribute to strong monitoring performance.

      Locally Produced Hydrogen Sulphide Detecting Water Quality Test Kits Increase Household Level Monitoring in Rural Tanzania. Journal of Water and Health, June 2018. A lack of affordable, field-based water quality tests for rural water sources prompted an NGO in rural Tanzania to design, produce, and evaluate a new H2S water quality test kit. The H2S test garnered wide acceptance, with 94 percent of those surveyed willing to buy the test in the future.

      Safe Water in Towns and Peri-Urban Areas: Challenges of Self-Supply and Water Quality Monitoring. Rural Water Supply Network (RWSN) Secretariat, May 2018. Millions of people in towns and cities across sub-Saharan Africa depend on groundwater day to day—but is it safe to drink? In this webinar, two experts present the latest updates on their research into urban groundwater monitoring.

      Chemical Hazards in Drinking Water
      Chemical Hazards in Drinking Water. WHO, 2017. The WHO Guidelines for Drinking-Water Quality cover a broad range of chemicals that can affect drinking water quality. These fact sheets provide new or revised background  for selected chemical hazards in drinking water.

      Geogenic Contamination Handbook. Eawag, June 2017. This digital resource offers information and guidelines for practitioners dealing with arsenic- and fluoride-contaminated drinking water in developing countries.

      Cost and Efficiency of Arsenic Removal from Groundwater: A Review. United Nations University, 2018. Currently, a wide range of technologies exists to remove arsenic from water. However, despite ongoing research on such technologies, their widespread application remains limited. To bridge this gap, this review aims to compare the effectiveness and costs of various arsenic remediation technologies
      while considering their practical applicability.

      Prediction Modeling and Mapping of Groundwater Fluoride Contamination Throughout India. Environmental Science & Technology, July 2018. Researchers created a highly accurate prediction map of fluoride concentrations throughout India that can be used by authorities in conjunction with detailed groundwater utilization information to prioritize areas in need of mitigation measures.

      Microbial Hazards Associated with Drinking Water 
      Livestock Ownership and Microbial Contamination of Drinking-Water: Evidence from Nationally Representative Household Surveys in Ghana, Nepal and Bangladesh. International Journal of Hygiene and Environmental Health, January 2018. Owning livestock can increase the risk of drinking water contamination. Addressing human sanitation without factoring in livestock excreta is not sufficient to prevent drinking water contamination.

      Bacterial Contamination of Drinking Water in Guadalajara, Mexico. International Journal of Hygiene and Environmental Health, January 2019. Guadalajara is a rapidly growing urban center with more than 5 million residents where household storage of drinking water is nearly ubiquitous. This pilot study in July 2018 examined the microbiological quality of drinking water in the city.

      The Association Between Domestic Animal Presence and Ownership and Household Drinking Water Contamination Among Peri-Urban Communities of Kisumu, Kenya. PLoS One, June 2018. Interventions to prevent drinking water contamination have often focused on preventing exposure to human waste. In many cases though, the infectious agent may be of zoonotic rather than human origin, suggesting that unsafely managed animal waste may contribute to contamination.

      Treatment Methods
      Household Water Treatment and Cholera Control. Journal of Infectious Diseases, October 2018. Household water treatment (HWT) has been shown to improve the microbiological quality of stored water and reduce the disease burden. A systematic review of published and gray literature examined the outcomes and impacts of HWT in preventing disease—specifically cholera.

      The Effect of SODIS Water Treatment Intervention at the Household Level in Reducing Diarrheal Incidence Among Children Under 5 Years of Age. Trials, July 2018. A solar disinfection intervention substantially reduced the incidence of diarrhea among under-5 children in a rural community of northwest Ethiopia, underscoring the need for such interventions in rural communities.

      Alternative Drinking-Water Disinfectants: Bromine, Iodine and Silver. WHO, 2018. Although chlorine has been used as the disinfectant of choice for public drinking water supplies for the past century, a number of other compounds can be used for water treatment. This series reviews the state of the knowledge on the application, efficacy, and toxicity of bromine, iodine, and silver as drinking water disinfectants.

      Biochar Adsorbent for Control of Synthetic Organic Contaminants in Affordable Decentralized Water Treatment. CAWST, November 2017. This webinar discusses biochar adsorbents and the public health consequences of chemical exposure that are now comparable to or greater than those of widespread infectious diseases such as HIV/AIDS, tuberculosis, and malaria.

      Lead-Lag Series and Staged Parallel Operational Strategies Improve the Performance and Cost-Effectiveness of Bonechar for Control of Fluoride in Groundwater. Journal of Water, Sanitation and Hygiene for Development, October 2018. Bonechar is a promising low-cost sorbent for fluoride that can be produced using local materials. However, the sorption capacity of bonechar is low relative to the quantities of fluoride that must be removed to meet health criteria.

      Other Resources
      Evidence of Economically Sustainable Village-Scale Microenterprises for Arsenic Remediation in Developing Countries. Environmental Science & Technology, January 2019. Natural arsenic contamination of groundwater affects more than 50 countries and up to 200 million people. The results from field data and cost modeling provide clear evidence of economic growth and job creation for systems managed by villagers’ committees through collection of monthly tariffs.

      Challenges to Sustainable Safe Drinking Water: A Case Study of Water Quality and Use Across Seasons in Rural Communities in Limpopo Province, South Africa. Water, February 2018. Researchers aimed to provide a comprehensive analysis of water quality in a low-resource setting in Limpopo Province, South Africa. They found that increased water quantity in the wet season correlates with increased treated water from municipal taps and a decrease in the average contaminant levels in household water.

      What is the Microbial Quality of Drinking Water in Africa?  Aquaya Institute, January 2018. The JMP has classified protected dug wells as improved water sources, but researchers frequently found them to be as contaminated as unimproved water sources. Water tested from rainwater catchment systems, boreholes, and protected springs also contained non-negligible levels of contamination, illustrating that source type is not an adequate substitute for water quality.

      Websites/Organizations
      USAID Globalwaters.org – This website is a global knowledge resource for USAID staff, implementing partners, and the broader community working in the international development water sector. A keyword search on “water quality” retrieves information on more than 200 USAID reports and projects.

      WASH-Toxics Interdisciplinary Working Group – WASH-Toxics aims to: raise the problem of hazardous chemical contaminants to prominence in the global WASH sector; stimulate targeted innovation of affordable treatment technologies; and generate feedback from experts regarding technical merit and real-world applicability of proposed solutions in an iterative design process.

      International Network on Household Water Treatment and Safe Storage (HWTS) – The HWTS Network is a WHO and UNICEF initiative that brings together key stakeholders worldwide to promote and scale up the adoption of practices and technologies that improve the quality of household drinking water for vulnerable populations.
      If you would like to feature your organization's materials or suggest other content for upcoming issues of Water Currents, please send them to Dan Campbell, Knowledge Creation/WASH Specialist, at dcampbell@waterckm.com.
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      Water Currents: Water Utilities - December 12, 2018

      Water Currents: Water Utilities - December 12, 2018 Today, more than half the world’s population is living in cities; by 2050, two-thirds of the world’s projected population will be urban. 
      Bringing you some of the latest water sector research, resources, and news.
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      December 12, 2018 – Water Utilities 

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      Under the Local Sustainability and Innovation Component of IUWASH PLUS, technicians install open source hardware to measure water pressure in the water utility of Bekasi City, Indonesia. Photo credit: USAID/IUWASH PLUS.

      Today, more than half the world’s population is living in cities; by 2050, two-thirds of the world’s projected population will be urban. The U.S. Government Global Water Strategy states that this rapid pace of urbanization requires increased attention to urban services and water utilities.

      Even as utilities strive to serve growing populations, water availability in cities is projected to shrink by as much as two-thirds by 2050. The ability of utilities to provide a safely managed water service—and to reach the unserved—will be underpinned by their investment in efficiency improvement, policy and institutional capacity development, access to financing, and ability to respond to climate change—even more than infrastructure investments. 

      Studies and reports in this issue address the management and operational issues of water utilities as well as their operating environment. A special thanks to the staff of DAI, the World Bank, and Asian Development Bank for suggesting water utilities as a topic for this issue and contributing content.

      Sector Reform and Transformation
      Water Utility Turnaround Framework: A Guide for Improving Performance. The World Bank, November 2018. Using a comprehensive turnaround framework is the best approach to improve water utilities' performance, efficiency, and ability to access finance, including commercial finance. Evidence shows that utilities with access to commercial finance are more likely to achieve the UN Sustainable Development Goals.  

      Joining Forces to Transform Water and Sanitation Utilities. The World Bank, November 2017. The World Bank produced this feature to help promote the “Water Utilities Aggregation Toolkit,” which discusses how water and sanitation utilities can work together to successfully deliver specific policy outcomes. The story includes links to the main report and an online version of the toolkit.

      Non-Revenue Water 
      The Use of Performance-Based Contracts for Non-Revenue Water Reduction. The World Bank, August 2018. Performance-based contracts (PBCs) for non-revenue water (NRW) reduction are designed for outsourcing technical, commercial, and construction activities related to NRW reduction, while providing the contractor with incentives to achieve the desired results. This operational manual describes the process for planning and implementing an NRW-PBC.
       
      Performance-Based Contracts for Non-Revenue Water Management – This webpage from the International Water Association (IWA) provides information on how NRW affects water utilities and provides case studies and other information that deal with NRW issues.

      Building Capacity
      Boosting the Effectiveness of Water Operators’ Partnerships, Global Water Operators’ Partnerships Alliance (GWOPA), September 2018. This fact sheet documents the partnership between the Vietnamese water utility Da Nang Water Supply Company and the Dutch company, VEI, between 2007 and 2010.
       
      Forging Partnerships Among Water and Wastewater Operators. Asian Development Bank (ADB), August 2017. The selected case briefs in this report provide insight on the various partnerships created through the ADB’s Water Operators Partnerships (WOP) Program to improve local water utility operations and service delivery provision.
       
      WOP Facilitation Tool: Training of Mentors. GWOPA, September 2017. This series of modules facilitates learning via participant interaction and storytelling, aiming to help WOP participants understand mentoring and the roles of each participant, and link their mentoring to a change process and the WOP cycle.
       
      Placing Women at the Center of Water Supply Management in Kenya. Global Waters Stories, September 2018. A USAID assessment of 13 water utilities in Kenya found that none met the minimum requirement of 30 percent female representation . USAID worked with each utility to develop gender equity action plans that include training on gender equality awareness and recruitment of female leaders and employees.

      Water Quality
      Dry Pipes: Associations Between Utility Performance and Intermittent Piped Water Supply in Low and Middle Income Countries. Water, August 2018. Leveraging data from the International Benchmarking Network for Water and Sanitation Utilities, researchers found 42 variables that can factor into intermittent water supply. They provide recommendations and data needs for improved global indicators of utility performance related to intermittent supply.
       
      Measuring the Impacts of Water Safety Plans in the Asia-Pacific Region. International Journal of Environmental Research and Public Health, June 2018. This study investigates the effectiveness of water safety plans (WSPs) in 99 water supply systems across 12 countries in the Asia-Pacific region. WSPs are associated with infrastructure improvements at the vast majority of participating sites, as well as increased financial support at 37 sites.
       
      Strengthening Operations & Maintenance Through Water Safety Planning: A Collection of Case Studies. WHO, September 2018. These case studies contribute to a growing body of information on the outcomes of water safety planning and may be useful in building support for WSPs among water sector senior managers, operational staff, and other stakeholders.
       
      Detailed Review of a Recent Publication: Intermittent Water Supply Jeopardizes Water Quality and Costs Users and Utilities Money. UNC Water Institute, December 2017. This issue of the WaSH Policy Research Digest includes a literature review, which concludes that measuring and categorizing intermittency is a challenge that still needs to be addressed.

      Water Security 
      Beyond Scarcity: Water Security in the Middle East and North Africa (MENA). The World Bank, November 2017. MENA’s current water challenges go far beyond age-old constraints of water scarcity. This report explores how countries in the region can anticipate and act to strengthen water security, rather than waiting to react to the inevitable disruptions of water crises.
       
      Asian Water Development Outlook 2016: Strengthening Water Security in Asia and the Pacific. ADB, 2016. This report provides a snapshot of water security status in the Asia-Pacific region.
       
      Water Scarce Cities: Thriving in a Finite World. The World Bank, 2018. Using information from the Water Scarce Cities Initiative, this report compiles innovative approaches to inspire a new kind of urban water security. The report is an evidence-based advocacy piece to guide water security approaches and shares the experiences of 19 water-scarce cities and territories from five continents.

      Institutional/Policy Aspects
      Aligning Institutions and Incentives for Sustainable Water Supply and Sanitation Services. The World Bank, May 2018. The objective of this study is to analyze how integrated policy, institutional, and regulatory interventions can help align incentives for more sustainable water supply and sanitation service delivery.
       
      Performance of Water Utilities in Africa. The World Bank, March 2017. A World Bank assessment identified and analyzed the main features of water utility performance in Africa, with the objective of informing bank and government policies and projects on the drivers of utility performance.
       
      Strengthening Governance of Local Water and Sanitation Utilities for Improved Service Delivery. The World Bank, June 2017. This report provides an overview of World Bank capacity-building activities in Egypt to improve rural sanitation services. It draws lessons learned that can be replicated by other similar programs in the region and beyond.
       
      The Challenge of Effective Policy Implementation in Nigerian Urban Water Utilities. Water Science and Technology: Water Supply, November 2017. Effective policy implementation remains a challenge for urban water utilities in Nigeria. Researchers found that policies and legislation developed were of commendable standards, but the implementation process was predominantly hindered by five factors. The authors discuss the management of these factors to achieve the intended results from water legislation and policies.

      Measuring Performance 
      International Benchmarking Network for Water and Sanitation Utilities (IBNET) – IBNET provides statistics on water and sanitation utilities performance and supports and promotes good benchmarking practice among water and sanitation services.
       
      AquaRating: Transforming the Management of Water and Sanitation Utilities – AquaRating focuses the challenges water and sanitation utilities face in a comprehensive way, evaluating their performance through indicators and management practices, establishing an international standard, and relying on information verified by independent auditors accredited by AquaRating.

      Evaluations 
      Indonesia Environmental Service Program (ESP) Evaluation. Water CKM Project, August 2017. Seven years after ESP ended, an evaluation team examined the sustainability of the program’s capacity building efforts with Indonesian municipal water utilities and financial mechanisms to improve utility management and expand water access in urban areas. In addition to the report, the team produced an evaluation brief and webinar that presents the key report findings.
       
      Middle East and North Africa (MENA) Water Sector Evaluation: Performance Evaluation Report. USAID, March 2018. USAID’s Middle East Bureau funded this evaluation of water sector activities in the MENA region to provide lessons learned and recommendations for future programming in anticipation of limited funding scenarios.

      Case Studies
      Cross-Subsidies for Improved Sanitation in Low Income Settlements: Assessing the Willingness to Pay of Water Utility Customers in Kenyan Cities. World Development, March 2019. Findings from this study suggest that in a sector that struggles to provide universal access to sanitation services, cross-subsidies may offer a means to support financing of safe sanitation for low-income households.
       
      The Dhaka Water Services Turnaround. ADB, December 2017. This publication looks at water utility key success factors such as the zonal approach to rehabilitating and managing urban water services, trenchless technology for expeditiously laying pipes, and how to connect the urban poor—and keep them connected—through community-managed approaches.
       
      How One Water Utility in Sierra Leone Has Set an Example for Water Companies in Africa. IWA, May 2017. The Guma Valley Water Company of Sierra Leone has become the first water company in Africa to get an AquaRating certificate, setting an example for other water companies in Africa. It is the second in the world after the water supply company of Quito in Ecuador.

      A Journey of Institutional Change: Extending Water Services to Nairobi’s Informal Settlements. Water & Sanitation for the Urban Poor, October 2018. This topic brief sets out the process of institutional change undergone by Nairobi City Water & Sewerage Company to extend services to the informal settlements of Nairobi.
      If you would like to feature your organization's materials or suggest other content for upcoming issues of Water Currents, please send them to Dan Campbell, Knowledge Creation/WASH Specialist, at dcampbell@waterckm.com.
      Subscribe
      USAID Water Team, Bureau for Economic Growth, Education and Environment.
      1300 Pennsylvania Avenue, NW, Washington, DC 20523
      Sent by waterteam@usaid.gov

      You are receiving this email because of your interest in content related to the USAID water sector, including newsletters, webinars, and other updates. Want to change how you receive these emails?
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      Disclaimer: This newsletter is intended to monitor and share current news and research relevant to the water sector. Items included in this publication are not endorsements and do not represent the views of USAID or the U.S. Government, unless stated otherwise.

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