This report provides a comprehensive summary of global progress on improving water, sanitation, hygiene, waste management and environmental cleaning (WASH) in health care facilities and is intended to stimulate solution driven country and partner actions to further address major gaps. It provides practical steps to improving WASH in health care facilities, selected country case studies illustrating bottlenecks, gaps, and successful strategies, and recommendations for addressing gaps and sustaining services.
Poverty and health
Global progress report on water, sanitation and hygiene in health care facilities: fundamentals first
World Health Organization: WHO, Geneva, 2020
Public Water and Covid-19: Dark Clouds and Silver Linings
McDonald D; Spronk S; Chavez D: Municipal Services Project, Transnational Institute and Latin American Council of Social Sciences (CLACSO): MSP, 2020
Covid-19 has again demonstrated the significance of safe, accessible and affordable water for all and the enormous disparities in service provision while at the same time dealing a blow to public water and sanitation operators around the world due to massive drops in revenues, rapidly rising costs and concerns about health and safety in the workplace. This book provides the first global overview of the response of public water operators to this crisis, shining a light on the complex challenges they face and how they have responded in different contexts. It looks specifically at ‘public’ water and asks how public ownership and public management have enabled (or not) equitable and democratic emergency services, and how these COVID-19 experiences could contribute to expanded and sustainable forms of public water services in the future
Evaluating the African food supply against the nutrient intake goals set for preventing diet-related non-communicable diseases: 1990 to 2017 trend analysis
Gebremedhin S; Bekele T: Plos One 16(1), 2021
The authors evaluated African food balances against the recommendations for macronutrients, free sugars, types of fatty acids, cholesterol and fruits and vegetables over 1990 to 2017, with regional, sub-regional and country-level estimates. In Africa the energy supply increased by 16.6% from 2,685 in 1990 to 3,132 kcal/person/day in 2017. However, the energy contribution of carbohydrate, fat and protein remained constant and almost within acceptable range around 73, 10 and 9%, respectively. In 2017, calories from fats surpassed the 20% limit in upper-middle- or high-income and Southern Africa countries. Energy from free sugars remained constant around 7% but the figure exceeded the limit of 10% in upper-middle- or high-income countries (14.7%) and in Southern (14.8%) and Northern (10.5%) sub-regions. Between 1990 and 2017 the availability of dietary cholesterol per person surged by 14% but was below the upper limit of 300 mg/day. The supply of fruits and vegetables increased by 27.5% from 279 to 356 g/capita/day, but remained below the target of 400 g/capita/day in all sub-regions. While most population intake goals were found to be within acceptable range, the supply of fruits and vegetables are suboptimal and the increasing energy contributions of free sugars and fats are emerging concerns in specific sub-regions.
It is painful and unpleasant: experiences of sexual violence among married adolescent girls in Shinyanga, Tanzania
Mwanukuzi C; Nyamhanga T: Reproductive Health 18(1), 1-7, 2021
This article reports on a qualitative study of 20 married girls aged 12-17 years' experiences of sexual violence in the Shinyanga Region, Tanzania where there is high prevalence (59%) of child marriage. The study identified four analytical themes regarding the experience of sexual violence, namely: forced sex; rape; struggling against unpleasant and painful sex; and inculcation of the culture of tolerance of sexual violence. The study found that married adolescent girls suffer sexual coercion in silence, increasing their risk of acquiring sexually transmitted infections and or unwanted pregnancies. The authors make recommendations for sexual violence prevention strategies .
Possible causalities between malnutrition and academic performances among primary schoolchildren: a cross-sectional study in rural Madagascar
Aiga H; Abe K; Randriamampionona E; Razafinombana A: BMJ Nutrition, Prevention & Health 0, 1-12, doi:10.1136/ bmjnph-2020-000192, 2021
A cross-sectional household survey in Antananarivo-Avaradrano district, Madagascar in November to December 2017 in 404 first and second grade pupils 5–14 years of age enrolled in 10 public primary schools explored the link between their nutritional status and academic performances. Not being stunted and attendance rate were identified to be possible causes of higher mathematical proficiency because they satisfied all conditions for a causality. A hypothetical causal path indicates that ‘not being stunted’ is likely to have caused higher ‘attendance rate’ and thereby higher ‘mathematical proficiency’ in a two-step manner.
Hostile Environment(s) – Designing Hostility, Building Refugia
Pezzani L: ar/ge kunst, Bolzano, unibz – Faculty of Design and Art in collaboration with Z33 – House of Contemporary Art, Design & Architecture, Hasselt, 2020
Hostile Environment(s) – Designing Hostility, Building Refugia is an expanded programme investigating the political ecology of migration and border violence. Through a series of lectures, workshops, screenings, commissioned texts and other materials delivered both online and in-person it provides an index and archive of materials that are regularly be updated with new content. The term “hostile environment” draws from legislation in UK, denying migrants from Africa and other countries deemed to be illegal access to work, housing, services and education. Far from being an exceptional condition, however, this process of making (urban) space unlivable for some resonates with the ways in which certain “natural” terrains (oceans, deserts, mountains) have been structured to deter and expel migrants. These materials seeks to capture these interconnected processes, investigating how certain forms of racialized violence have become as pervasive as the climate.
Prevalence and patterns of gender-based violence across adolescent girls and young women in Mombasa, Kenya
Bhattacharjee P; Ma H; Musyoki H; Cheuk E; et al: BMC Women's Health 20(229), 1-11, doi: https://doi.org/10.1186/s12905-020-01081-8, 2020
This study sought to estimate the prevalence of gender-based violence (GBV) in adolescent girls and young women (AGYW) through a cross-sectional survey in Mombasa, Kenya in 2015. The main perpetrators of violence were intimate partners for young women engaged in casual sex, and both intimate partners and regular non-client partners for young women engaged in transactional sex. For young women engaged in sex work, first-time and regular paying clients were the main perpetrators of physical and sexual violence. Alcohol use, ever being pregnant and regular source of income were associated with physical and sexual violence though it differed by subgroup and type of violence. AGYW in these settings experience high vulnerability to physical, sexual and police violence. However, they are not a homogeneous group, and the variation in prevalence and predictors of violence needs to be understood to design effective programmes to address violence.
Inequalities in access to water and soap matter for the COVID-19 response in sub-Saharan Africa
Jiwani S; Antiporta D: International Journal for Equity in Health 19(82) doi: https://doi.org/10.1186/s12939-020-01199-z, 2020
This paper explored the inequalities in access to water and soap for the COVID-19 responses since December 2019. . Although access to clean water and soap is universal in high-income settings, it remains a basic need many do not have in low- and middle-income settings. according to data from Demographic and Health Surveys of 16 countries in sub-Saharan Africa, using the most recent survey since 2015. The authors propose that interventions such as mass distribution of soap and ensuring access to clean water, along with other preventive strategies should be scaled up to reach the most vulnerable populations.
Socioeconomic inequalities in food insecurity and malnutrition among under-five children: within and between-group inequalities in Zimbabwe
Lukwa A; Siya A; Zablon K; Azam J; et al: BMC Public Health 20(1199), doi: https://doi.org/10.1186/s12889-020-09295-z, 2020
The authors explored socioeconomic inequalities trend in child health using Demographic Health Survey data sets of 2010\11 and 2015. Food insecurity in under-five children was determined based on the World Health Organisation dietary diversity score. Theil indices for nutrition status showed socioeconomic inequality gaps to have widened, while food security status socioeconomic inequality gaps contracted for the period under review. The study concluded that unequal distribution of household wealth and residence status play critical roles in driving socioeconomic inequalities in child food insecurity and malnutrition. Child food insecurity and malnutrition are greatly influenced by where a child lives and their parental wealth.
Water, sanitation, hygiene, and waste management for SARS-CoV-2, the virus that causes COVID-19
World Health Organisation, WHO/2019-nCoV/IPC_WASH/2020.4, July 2020
The provision of safe water, sanitation and waste management and hygienic conditions are essential for protecting human health during all infectious disease outbreaks, including of COVID-19. Ensuring evidenced-based and consistently applied WASH and waste management practices in communities, homes, schools, marketplaces, and healthcare facilities will help prevent human-to-human transmission of COVID-19. This guidance provides additional details on risks associated with excreta and untreated sewage, hand hygiene, protecting WASH workers and supporting the continuation and strengthening of WASH services, especially in underserved areas.