Provision of Basic Water and Sanitation Services in South Africa through the Municipal Infrastructure Grant Programme

Although South Africa has made good progress in providing basic water and sanitation services to its citizens, there is still a large section of the population that has no access to these services. This paper reviews the performance of the government’s municipal infrastructure grant programme in providing basic water and sanitation services which are part of the constitutional requirements to the citizens. The method used to gather data and information was a desk top study which sought to review the progress made in rolling out the programme. The successes and challenges were highlighted and possible solutions were identified that can accelerate the elimination of the remaining backlogs and improve the level of service to the citizens. Currently, approximately 6.5 million citizens are without access to basic water services and approximately 10 million are without access to basic sanitation services.

Exploring the Applicability of a Rapid Health Assessment in India

ASER Centre, the research and assessment arm of Pratham Education Foundation sees measurement as the first stage of action. ASER uses primary research to push and give empirical foundations to policy discussions at a multitude of levels. At a household level, common citizens use a simple assessment (a floor-level test) to measure learning across rural India. This paper presents the evidence on the applicability of an ASER approach to the health sector. A citizen-led assessment was designed and executed that collected information from young mothers with children up to a year of age. The pilot assessments were rolled-out in two different models: Paid surveyors and student volunteers. The survey covered three geographic areas: 1,239 children in the Jaipur District of Rajasthan, 2,086 in the Rae Bareli District of Uttar Pradesh, and 593 children in the Bhuj Block in Gujarat. The survey tool was designed to study knowledge of health-related issues, daily practices followed by young mothers and access to relevant services and programs. It provides insights on behaviors related to infant and young child feeding practices, child and maternal nutrition and supplementation, water and sanitation, and health services. Moreover, the survey studies the reasons behind behaviors giving policy-makers actionable pathways to improve implementation of social sector programs. Although data on health outcomes are available, this approach could provide a rapid annual assessment of health issues with indicators that are easy to understand and act upon so that measurements do not become an exclusive domain of experts. The results give many insights into early childhood health behaviors and challenges. Around 98% of children are breastfed, and approximately half are not exclusively breastfed (for the first 6 months). Government established diet diversity guidelines are met for less than 1 out of 10 children. Although most households are satisfied with the quality of drinking water, most tested households had contaminated water.

An Integrated Solid Waste Management Strategy for Semi-Urban and Rural Areas of Pakistan

In Pakistan, environmental degradation and consequent human health deterioration has rapidly accelerated in the past decade due to solid waste mismanagement. As the situation worsens with time, establishment of proper waste management practices is urgently needed especially in semi urban and rural areas of Pakistan. This study uses a concept of Waste Bank, which involves a transfer station for collection of sorted waste fractions and its delivery to the targeted market such as recycling industries, biogas plants, composting facilities etc. The management efficiency and effectiveness of Waste Bank depend strongly on the proficient sorting and collection of solid waste fractions at household level. However, the social attitude towards such a solution in semi urban/rural areas of Pakistan demands certain prerequisites to make it workable. Considering these factors the objectives of this study are to: [A] Obtain reliable data about quantity and characteristics of generated waste to define feasibility of business and design factors, such as required storage area, retention time, transportation frequency of the system etc. [B] Analyze the effects of various social factors on waste generation to foresee future projections. [C] Quantify the improvement in waste sorting efficiency after awareness campaign. We selected Gujrat city of Central Punjab province of Pakistan as it is semi urban adjoined by rural areas. A total of 60 houses (20 from each of the three selected colonies), belonging to different social status were selected. Awareness sessions about waste segregation were given through brochures and individual lectures in each selected household. Sampling of waste, that households had attempted to sort, was then carried out in the three colored bags that were provided as part of the awareness campaign. Finally, refined waste sorting, weighing of various fractions and measurement of dry mass was performed in environmental laboratory using standard methods. It was calculated that sorting efficiency of waste improved from 0 to 52% as a result of the awareness campaign. The generation of waste (dry mass basis) on average from one household was 460 kg/year whereas per capita generation was 68 kg/year. Extrapolating these values for Gujrat Tehsil, the total waste generation per year is calculated to be 101921 tons dry mass (DM). Characteristics found in waste were (i) organic decomposable (29.2%, 29710 tons/year DM), (ii) recyclables (37.0%, 37726 tons/year DM) that included plastic, paper, metal and glass, and (iii) trash (33.8%, 34485 tons/year DM) that mainly comprised of polythene bags, medicine packaging, pampers and wrappers. Waste generation was more in colonies with comparatively higher income and better living standards. In future, data collection for all four seasons and improvements due to expansion of awareness campaign to educational institutes will be quantified. This waste management system can potentially fulfill vital sustainable development goals (e.g. clean water and sanitation), reduce the need to harvest fresh resources from the ecosystem, create business and job opportunities and consequently solve one of the most pressing environmental issues of the country.

Urban Waste Water Governance in South Africa: A Case Study of Stellenbosch

Due to climate change, population growth and rapid urbanization, the demand for water in South Africa is inevitably surpassing supply. To address similar challenges globally, there has been a paradigm shift from conventional urban waste water management “government” to a “governance” paradigm. From the governance paradigm, Integrated Urban Water Management (IUWM) principle emerged. This principle emphasizes efficient urban waste water treatment and production of high-quality recyclable effluent. In so doing mimicking natural water systems, in their processes of recycling water efficiently, and averting depletion of natural water resources.  The objective of this study was to investigate drivers of shifting the current urban waste water management approach from a “government” paradigm towards “governance”. The study was conducted through Interactive Management soft systems research methodology which follows a qualitative research design. A case study methodology was employed, guided by realism research philosophy. Qualitative data gathered were analyzed through interpretative structural modelling using Concept Star for Professionals Decision-Making tools (CSPDM) version 3.64.  The constructed model deduced that the main drivers in shifting the Stellenbosch municipal urban waste water management towards IUWM “governance” principles are mainly social elements characterized by overambitious expectations of the public on municipal water service delivery, mis-interpretation of the constitution on access to adequate clean water and sanitation as a human right and perceptions on recycling water by different communities. Inadequate public participation also emerged as a strong driver. However, disruptive events such as draught may play a positive role in raising an awareness on the value of water, resulting in a shift on the perceptions on recycled water. Once the social elements are addressed, the alignment of governance and administration elements towards IUWM are achievable. Hence, the point of departure for the desired paradigm shift is the change of water service authorities and serviced communities’ perceptions and behaviors towards shifting urban waste water management approaches from “government” to “governance” paradigm.

An Online Space for Practitioners in the Water, Sanitation and Hygiene Sector

The increasing availability and quality of internet access throughout the developing world provides an opportunity to utilize online spaces to disseminate water, sanitation and hygiene (WASH) knowledge to practitioners. Since 2001, CAWST has provided in-person education, training and consulting services to thousands of WASH practitioners all over the world, supporting them to start, troubleshoot, improve and expand their WASH projects. As CAWST continues to grow, the organization faces challenges in meeting demand from clients and in providing consistent, timely technical support. In 2012, CAWST began utilizing online spaces to expand its reach by developing a series of resources websites and webinars. CAWST has developed a WASH Education and Training resources website, a Biosand Filter (BSF) Knowledge Base, a Household Water Treatment and Safe Storage Knowledge Base, a mobile app for offline users, a live chat support tool, a WASH e-library, and a series of webinar-style online training sessions to complement its in-person capacity development services. In order to determine the preliminary outcomes of providing these online services, CAWST has monitored and analyzed registration to the online spaces, downloads of the educational materials, and webinar attendance; as well as conducted user surveys. The purpose of this analysis was to find out who was using the online spaces, where users came from, and how the resources were being used. CAWST’s WASH Resources website has served over 5,800 registered users from 3,000 organizations in 183 countries. Additionally, the BSF Knowledge Base has served over 1000 registered users from 68 countries, and over 540 people from 73 countries have attended CAWST’s online training sessions. This indicates that the online spaces are effectively reaching a large numbers of users, from a range of countries. A 2016 survey of the Biosand Filter Knowledge Base showed that approximately 61% of users are practitioners, and 39% are either researchers or students. Of the respondents, 46% reported using the BSF Knowledge Base to initiate a BSF project and 43% reported using the information to train BSF technicians. Finally, 61% indicated they would like even greater support from CAWST’s Technical Advisors going forward. The analysis has provided an encouraging indication that CAWST’s online spaces are contributing to its objective of engaging and supporting WASH practitioners to start, improve and expand their initiatives. CAWST has learned several lessons during the development of these online spaces, in particular related to the resources needed to create and maintain the spaces, and respond to the demand created. CAWST plans to continue expanding its online spaces, improving user experience of the sites, and involving new contributors and content types. Through the use of online spaces, CAWST has been able to increase its global reach and impact without significantly increasing its human resources by connecting WASH practitioners with the information they most need, in a practical and accessible manner. This paper presents on CAWST’s use of online spaces through the CAWST-developed platforms discussed above and the analysis of the use of these platforms.

A Practical Methodology for Evaluating Water, Sanitation and Hygiene Education and Training Programs

Many organizations in the Water, Sanitation and Hygiene (WASH) sector provide education and training in order to increase the effectiveness of their WASH interventions. A key challenge for these organizations is measuring how well their education and training activities contribute to WASH improvements. It is crucial for implementers to understand the returns of their education and training activities so that they can improve and make better progress toward the desired outcomes. This paper presents information on CAWST’s development and piloting of the evaluation methodology. The Centre for Affordable Water and Sanitation Technology (CAWST) has developed a methodology for evaluating education and training activities, so that organizations can understand the effectiveness of their WASH activities and improve accordingly. CAWST developed this methodology through a series of research partnerships, followed by staged field pilots in Nepal, Peru, Ethiopia and Haiti. During the research partnerships, CAWST collaborated with universities in the UK and Canada to: review a range of available evaluation frameworks, investigate existing practices for evaluating education activities, and develop a draft methodology for evaluating education programs. The draft methodology was then piloted in three separate studies to evaluate CAWST’s, and CAWST’s partner’s, WASH education programs. Each of the pilot studies evaluated education programs in different locations, with different objectives, and at different times within the project cycles. The evaluations in Nepal and Peru were conducted in 2013 and investigated the outcomes and impacts of CAWST’s WASH education services in those countries over the past 5-10 years. In 2014, the methodology was applied to complete a rigorous evaluation of a 3-day WASH Awareness training program in Ethiopia, one year after the training had occurred. In 2015, the methodology was applied in Haiti to complete a rapid assessment of a Community Health Promotion program, which informed the development of an improved training program. After each pilot evaluation, the methodology was reviewed and improvements were made. A key concept within the methodology is that in order for training activities to lead to improved WASH practices at the community level, it is not enough for participants to acquire new knowledge and skills; they must also apply the new skills and influence the behavior of others following the training. The steps of the methodology include: development of a Theory of Change for the education program, application of the Kirkpatrick model to develop indicators, development of data collection tools, data collection, data analysis and interpretation, and use of the findings for improvement. The methodology was applied in different ways for each pilot and was found to be practical to apply and adapt to meet the needs of each case. It was useful in gathering specific information on the outcomes of the education and training activities, and in developing recommendations for program improvement. Based on the results of the pilot studies, CAWST is developing a set of support materials to enable other WASH implementers to apply the methodology. By using this methodology, more WASH organizations will be able to understand the outcomes and impacts of their training activities, leading to higher quality education programs and improved WASH outcomes.

Training During Emergency Response to Build Resiliency in Water, Sanitation, and Hygiene

In April 2015, a magnitude 7.8 earthquake struck Nepal, killing, injuring, and displacing thousands of people. The earthquake also damaged water and sanitation service networks, leading to a high risk of diarrheal disease and the associated negative health impacts. In response to the disaster, the Environment and Public Health Organization (ENPHO), a Kathmandu-based non-governmental organization, worked with the Centre for Affordable Water and Sanitation Technology (CAWST), a Canadian education, training and consulting organization, to develop two training programs to educate volunteers on water, sanitation, and hygiene (WASH) needs. The first training program was intended for acute response, with the second focusing on longer term recovery. A key focus was to equip the volunteers with the knowledge and skills to formulate useful WASH advice in the unanticipated circumstances they would encounter when working in affected areas. Within the first two weeks of the disaster, a two-day acute response training was developed, which focused on enabling volunteers to educate those affected by the disaster about local WASH issues, their link to health, and their increased importance immediately following emergency situations. Between March and October 2015, a total of 19 training events took place, with over 470 volunteers trained. The trained volunteers distributed hygiene kits and liquid chlorine for household water treatment. They also facilitated health messaging and WASH awareness activities in affected communities. A three-day recovery phase training was also developed and has been delivered to volunteers in Nepal since October 2015. This training focused on WASH issues during the recovery and reconstruction phases. The interventions and recommendations in the recovery phase training focus on long-term WASH solutions, and so form a link between emergency relief strategies and long-term development goals. ENPHO has trained 226 volunteers during the recovery phase, with training ongoing as of April 2016. In the aftermath of the earthquake, ENPHO found that its existing pool of volunteers were more than willing to help those in their communities who were more in need. By training these and new volunteers, ENPHO was able to reach many more communities in the immediate aftermath of the disaster; together they reached 11 of the 14 earthquake-affected districts. The collaboration between ENPHO and CAWST in developing the training materials was a highly collaborative and iterative process, which enabled the training materials to be developed within a short response time. By training volunteers on basic WASH topics during both the immediate response and the recovery phase, ENPHO and CAWST have been able to link immediate emergency relief to long-term developmental goals. While the recovery phase training continues in Nepal, CAWST is planning to decontextualize the training used in both phases so that it can be applied to other emergency situations in the future. The training materials will become part of the open content materials available on CAWST’s WASH Resources website.

A Simple Epidemiological Model for Typhoid with Saturated Incidence Rate and Treatment Effect

Typhoid fever is a communicable disease, found only in man and occurs due to systemic infection mainly by Salmonella typhi organism. The disease is endemic in many developing countries and remains a substantial public health problem despite recent progress in water and sanitation coverage. Globally, it is estimated that typhoid causes over 16 million cases of illness each year, resulting in over 600,000 deaths. A mathematical model for assessing the impact of educational campaigns on controlling the transmission dynamics of typhoid in the community, has been formulated and analyzed. The reproductive number has been computed. Stability of the model steady-states has been examined. The impact of educational campaigns on controlling the transmission dynamics of typhoid has been discussed through the basic reproductive number and numerical simulations. At its best the study suggests that targeted education campaigns, which are effective at stopping transmission of typhoid more than 40% of the time, will be highly effective at controlling the disease in the community. 

Identification of Slum Areas for Improvement Inputs in Lafia Town, Nasarawa State

One of the United Nations Millennium Development targets is to 'achieve significant improvement in lives of at least 100 million slum dwellers, by 2020'. To monitor progress on this target a first step is to develop an operational definition to identify slum settlements. The indicators selected are: access to water and sanitation, sufficient living area, a house with durable material on a non-hazardous location and with tenure security. This paper describes the techniques of identifying slums and applied the techniques in identifying slum in Lafia town. The methodology used was selection of one district in Lafia town for this study and the district was zoned into four units. The total of 10% sample size out of 2,482 households of 250 questionnaires was administered using systematic sampling method based on proportion of houses at each zones as 90, 70, 40 and 50 respectively. The result shows that the area is a second order degeneration that needs a major improvement. Recommendations were made in this regard for urgent intervention in improving or upgrading of housing and infrastructural facilities

Water, Sanitation and Health in Developing Countries: How Far from Sustainable Development?

The availability of water in adequate quantity and quality is imperative for sustainable development. Worldwide, significant imbalance exists with regards to sustainable development particularly from a water and sanitation perspective. Water is a critical component of public health, and failure to supply safe water will place a heavy burden on the entire population. Although the 21st century has witnessed wealth and advanced development, it has not been realized everywhere. Billions of people are still striving to access the most basic human needs which are food, shelter, safe drinking water and adequate sanitation. The global picture conceals various inequalities particularly with regards to sanitation coverage in rural and urban areas. Currently, water scarcity and in particular water governance is the main challenge which will cause a threat to sustainable development goals. Within the context of water, sanitation and health, sustainable development is a confusing concept primarily when examined from the viewpoint of policy options for developing countries. This perspective paper aims to summarize and critically evaluate evidence of published studies in relation to water, sanitation and health and to identify relevant solutions to reduce public health impacts. Evidently, improving water and sanitation services will result in significant and lasting gains in health and economic development.