Pub Date : 2024-07-01DOI: 10.1371/journal.pwat.0000261
Evan A. Thomas
{"title":"Turning global water security research into policy and action","authors":"Evan A. Thomas","doi":"10.1371/journal.pwat.0000261","DOIUrl":"https://doi.org/10.1371/journal.pwat.0000261","url":null,"abstract":"","PeriodicalId":93672,"journal":{"name":"PLOS water","volume":"48 48","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141689691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-14DOI: 10.1371/journal.pwat.0000252
Tanvi Bhatkal, Lyla Mehta, Roshni Sumitra
Sanitation is fundamental for health and wellbeing yet cities, especially in the global South, face challenges in providing safely managed sanitation systems. Global and national sanitation campaigns tend to focus on the visible aspects of being ‘on grid’ in terms of toilet construction and connections but rarely address the dangerous, invisible aspects of being ‘off grid’ such as poor or unsafe excreta disposal and inadequate faecal sludge management (often considered to be second or third generation sanitation challenges). These, however, tend to disproportionately affect poor and marginalised people in off-grid locations in rapidly urbanising areas. This review paper engages critically with the growing literature on the challenges of faecal sludge management and circular economy solutions. Through the lens of exclusion and marginality, we review debates regarding access to safely managed sanitation, the burden of sanitation workers and safely recovering value from shit. We argue that sanitation systems often reproduce and exacerbate existing societal hierarchies and discriminations in terms of unequal access to safely managed sanitation and the burden of maintaining sanitation infrastructures. It is thus important for future research on faecal sludge management and resource recovery from shit to focus on issues of marginality and exclusion.
{"title":"Neglected second and third generation challenges of urban sanitation: A review of the marginality and exclusion dimensions of safely managed sanitation","authors":"Tanvi Bhatkal, Lyla Mehta, Roshni Sumitra","doi":"10.1371/journal.pwat.0000252","DOIUrl":"https://doi.org/10.1371/journal.pwat.0000252","url":null,"abstract":"Sanitation is fundamental for health and wellbeing yet cities, especially in the global South, face challenges in providing safely managed sanitation systems. Global and national sanitation campaigns tend to focus on the visible aspects of being ‘on grid’ in terms of toilet construction and connections but rarely address the dangerous, invisible aspects of being ‘off grid’ such as poor or unsafe excreta disposal and inadequate faecal sludge management (often considered to be second or third generation sanitation challenges). These, however, tend to disproportionately affect poor and marginalised people in off-grid locations in rapidly urbanising areas. This review paper engages critically with the growing literature on the challenges of faecal sludge management and circular economy solutions. Through the lens of exclusion and marginality, we review debates regarding access to safely managed sanitation, the burden of sanitation workers and safely recovering value from shit. We argue that sanitation systems often reproduce and exacerbate existing societal hierarchies and discriminations in terms of unequal access to safely managed sanitation and the burden of maintaining sanitation infrastructures. It is thus important for future research on faecal sludge management and resource recovery from shit to focus on issues of marginality and exclusion.","PeriodicalId":93672,"journal":{"name":"PLOS water","volume":"45 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141338383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-13DOI: 10.1371/journal.pwat.0000192
Vicky Espinoza, J. Viers
Societies globally are struggling to meet freshwater demands while agencies attempt to address water access inequities under a rapidly changing climate and growing population. An understanding of dynamic interactions between people and water, known as sociohydrology, regionally could provide approaches to addressing local water mismanagement and water access inequity. In semi-arid California, local water agencies, primarily agricultural irrigation districts, are at the intersection of rethinking approaches to balance freshwater demands. More than 150 years of complex water governance and management have defined San Joaquin Valley irrigation districts and the region’s water access inequities and sociohydrologic instability. Older irrigation districts have higher surface water allocations and less groundwater dependence. About 60% of irrigation districts with pre-1914 water rights have twice the crop water demand in surface water allocations. In contrast, 86% of irrigation districts depend on groundwater, of which 12% rely exclusively on groundwater to supply irrigation demands. This study found that disadvantaged communities within irrigation districts do not have increased water access or better environmental conditions than those outside irrigation district boundaries, which underscores the need for inclusive water management structures to address the multifaceted water and environmental inequities. Groundwater overdependence across irrigation districts shows that imbalanced surface water allocations and inflexible crops could imperil agriculture and impact agricultural disadvantaged communities, especially under California’s SGMA and prolonged drought events. It is imperative that underserved communities are prioritized communities in achieving equitable water rebalance in California in addition to developing and implementing essential infrastructure and policy changes.
{"title":"The paradox of production: Surface water supply drives agricultural productivity but not prosperity in California’s San Joaquin Valley","authors":"Vicky Espinoza, J. Viers","doi":"10.1371/journal.pwat.0000192","DOIUrl":"https://doi.org/10.1371/journal.pwat.0000192","url":null,"abstract":"Societies globally are struggling to meet freshwater demands while agencies attempt to address water access inequities under a rapidly changing climate and growing population. An understanding of dynamic interactions between people and water, known as sociohydrology, regionally could provide approaches to addressing local water mismanagement and water access inequity. In semi-arid California, local water agencies, primarily agricultural irrigation districts, are at the intersection of rethinking approaches to balance freshwater demands. More than 150 years of complex water governance and management have defined San Joaquin Valley irrigation districts and the region’s water access inequities and sociohydrologic instability. Older irrigation districts have higher surface water allocations and less groundwater dependence. About 60% of irrigation districts with pre-1914 water rights have twice the crop water demand in surface water allocations. In contrast, 86% of irrigation districts depend on groundwater, of which 12% rely exclusively on groundwater to supply irrigation demands. This study found that disadvantaged communities within irrigation districts do not have increased water access or better environmental conditions than those outside irrigation district boundaries, which underscores the need for inclusive water management structures to address the multifaceted water and environmental inequities. Groundwater overdependence across irrigation districts shows that imbalanced surface water allocations and inflexible crops could imperil agriculture and impact agricultural disadvantaged communities, especially under California’s SGMA and prolonged drought events. It is imperative that underserved communities are prioritized communities in achieving equitable water rebalance in California in addition to developing and implementing essential infrastructure and policy changes.","PeriodicalId":93672,"journal":{"name":"PLOS water","volume":"44 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141345179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-11DOI: 10.1371/journal.pwat.0000257
Jane Wilbur, R. Dreibelbis, I. Mactaggart
One in six people worldwide experiences significant disability. Many of these people living in low-and middle-income countries (LMICs) are disproportionately affected by inadequate access to water, sanitation and hygiene (WASH) services, a fundamental necessity for health and well-being. This review aimed to examine the existing evidence on disability and WASH in LMICs, identify gaps and make recommendations to strengthen disability-inclusive WASH research, policies and practices to make significant progress by 2030. While evidence of WASH challenges faced by people with disabilities has grown in the last decade, revealing significant inequalities, there is a lack of controlled studies to assess the impact of disability-inclusive WASH interventions. This research gap makes it difficult to prioritise investments for scalable solutions. This review proposes three key recommendations: 1) Further expand research on WASH challenges faced by people with disabilities, prioritising climate risks, health impacts, and educational inequalities. 2) Design and test evidence-based disability-inclusive WASH interventions. 3) Rigorously evaluate these interventions to determine what successfully reduces WASH disparities for people with disabilities and their caregivers cost-effectively. This review is the first to synthesise available evidence across disability and WASH and offer a roadmap for future efforts to drive improvements in disability-inclusive WASH by 2030.
{"title":"Addressing water, sanitation and hygiene inequalities: A review of evidence, gaps, and recommendations for disability-inclusive WASH by 2030","authors":"Jane Wilbur, R. Dreibelbis, I. Mactaggart","doi":"10.1371/journal.pwat.0000257","DOIUrl":"https://doi.org/10.1371/journal.pwat.0000257","url":null,"abstract":"One in six people worldwide experiences significant disability. Many of these people living in low-and middle-income countries (LMICs) are disproportionately affected by inadequate access to water, sanitation and hygiene (WASH) services, a fundamental necessity for health and well-being. This review aimed to examine the existing evidence on disability and WASH in LMICs, identify gaps and make recommendations to strengthen disability-inclusive WASH research, policies and practices to make significant progress by 2030. While evidence of WASH challenges faced by people with disabilities has grown in the last decade, revealing significant inequalities, there is a lack of controlled studies to assess the impact of disability-inclusive WASH interventions. This research gap makes it difficult to prioritise investments for scalable solutions. This review proposes three key recommendations: 1) Further expand research on WASH challenges faced by people with disabilities, prioritising climate risks, health impacts, and educational inequalities. 2) Design and test evidence-based disability-inclusive WASH interventions. 3) Rigorously evaluate these interventions to determine what successfully reduces WASH disparities for people with disabilities and their caregivers cost-effectively. This review is the first to synthesise available evidence across disability and WASH and offer a roadmap for future efforts to drive improvements in disability-inclusive WASH by 2030.","PeriodicalId":93672,"journal":{"name":"PLOS water","volume":"63 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141358469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-11DOI: 10.1371/journal.pwat.0000239
Indira Bose, R. Dreibelbis, Rosemary Green, Kris A. Murray, Omar Ceesay, Sari Kovats
Climate change could pose a threat to water security for many communities, particularly in settings where rainfall patterns are becoming more varied and there is higher frequency of extreme events, such as heavy rainfall and droughts. Understanding how rainfall affects water security—including water access, water quality and water use behaviours—can inform investment in more climate-resilient infrastructure and safeguard against future health risks. This study aims to explore how households in rural Gambia experienced water security in relation to seasonal rainfall patterns and extreme weather events. Data collection focused on two communities (Kiang West and Basse) with differing access to water infrastructure, within which some villages had greater access to groundwater sources, such as solar-powered boreholes, and others primarily used uncovered wells. 46 participants were interviewed in Spring 2022 using multiple qualitative methods, including in-depth interviews and transect walks. We found that people’s experience of water security and rainfall (including seasonal rainfall, drought and heavy rainfall) was complex and varied according to the primary household water source. Both dry and rainy season posed challenges to household water security in terms of quality and quantity. Households with access to more resilient infrastructure, such as solar-powered boreholes, discussed a shift in the relationship between weather and water security, where they were less vulnerable to water shortages during dry conditions compared to those using wells. However, these sources did not fully resolve water security issues, as they experienced water shortages during cloudy conditions. Extreme weather events, such as heavy rainfall, heightened perceived water issues, as these events sometimes damaged water infrastructure and contaminated water sources. Seasonal workloads, that were higher in the rainy season, also jeopardised water security, as this limited time for water collection. Increased investment in infrastructure, maintenance, water-treatment and behavioural change is required to mitigate the risks.
气候变化可能会对许多社区的用水安全构成威胁，尤其是在降雨模式变得更加多变、暴雨和干旱等极端事件发生频率较高的环境中。了解降雨如何影响水安全--包括水的获取、水质和用水行为--可以为投资更具气候适应性的基础设施提供依据，并防范未来的健康风险。本研究旨在探讨冈比亚农村家庭如何体验与季节性降雨模式和极端天气事件相关的水安全问题。数据收集工作主要集中在两个社区（Kiang West 和 Basse），这两个社区的供水基础设施条件各不相同，其中一些村庄更容易获得地下水源，如太阳能井眼，而另一些村庄则主要使用无盖水井。2022 年春季，我们采用多种定性方法对 46 名参与者进行了访谈，包括深度访谈和横断面步行。我们发现，人们对水安全和降雨（包括季节性降雨、干旱和暴雨）的体验非常复杂，而且因家庭主要水源的不同而各异。旱季和雨季都对家庭用水安全的质量和数量构成挑战。使用太阳能井眼等抗灾能力较强的基础设施的家庭讨论了天气与水安全之间关系的转变，与使用水井的家庭相比，他们在干旱条件下更不容易受到缺水的影响。然而，这些水源并不能完全解决水安全问题，因为他们在阴天也会遇到缺水问题。暴雨等极端天气事件加剧了人们对水问题的认识，因为这些事件有时会破坏供水基础设施并污染水源。雨季的季节性工作量较大，也会危及水安全，因为这限制了取水时间。需要增加对基础设施、维护、水处理和行为改变的投资，以降低风险。
{"title":"Climate change, seasonality and household water security in rural Gambia: A qualitative exploration of the complex relationship between weather and water","authors":"Indira Bose, R. Dreibelbis, Rosemary Green, Kris A. Murray, Omar Ceesay, Sari Kovats","doi":"10.1371/journal.pwat.0000239","DOIUrl":"https://doi.org/10.1371/journal.pwat.0000239","url":null,"abstract":"Climate change could pose a threat to water security for many communities, particularly in settings where rainfall patterns are becoming more varied and there is higher frequency of extreme events, such as heavy rainfall and droughts. Understanding how rainfall affects water security—including water access, water quality and water use behaviours—can inform investment in more climate-resilient infrastructure and safeguard against future health risks. This study aims to explore how households in rural Gambia experienced water security in relation to seasonal rainfall patterns and extreme weather events. Data collection focused on two communities (Kiang West and Basse) with differing access to water infrastructure, within which some villages had greater access to groundwater sources, such as solar-powered boreholes, and others primarily used uncovered wells. 46 participants were interviewed in Spring 2022 using multiple qualitative methods, including in-depth interviews and transect walks. We found that people’s experience of water security and rainfall (including seasonal rainfall, drought and heavy rainfall) was complex and varied according to the primary household water source. Both dry and rainy season posed challenges to household water security in terms of quality and quantity. Households with access to more resilient infrastructure, such as solar-powered boreholes, discussed a shift in the relationship between weather and water security, where they were less vulnerable to water shortages during dry conditions compared to those using wells. However, these sources did not fully resolve water security issues, as they experienced water shortages during cloudy conditions. Extreme weather events, such as heavy rainfall, heightened perceived water issues, as these events sometimes damaged water infrastructure and contaminated water sources. Seasonal workloads, that were higher in the rainy season, also jeopardised water security, as this limited time for water collection. Increased investment in infrastructure, maintenance, water-treatment and behavioural change is required to mitigate the risks.","PeriodicalId":93672,"journal":{"name":"PLOS water","volume":"124 39","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141360595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-06DOI: 10.1371/journal.pwat.0000216
Cornelius K. A. Pienaah, Sulemana Ansumah Saaka, E. Batung, Kamaldeen Mohammed, Isaac Luginaah
The global community is not on track to achieve Sustainable Development Goal 6 (SDG 6) by 2030. Many low- and middle-income countries like Ghana still struggle with water insecurity. In semi-arid regions like Ghana’s Upper West, climate change has worsened water insecurity, leading to health and livelihood consequences. In UWR, limited studies have explored water insecurity in rural areas. This study fills a knowledge gap by investigating the determinants of water insecurity in Ghana’s Upper West Region (UWR) from a political ecology of health (PEH) perspective. It comprehensively explores the interplay of social, economic, political, environmental, and health-related factors contributing to water insecurity in the UWR. The results from binary logistic regression show that households in the wealthier category (OR = 0.475, p<0.05) and those that spent less than thirty minutes on a roundtrip to fetch water (OR = 0.474, p<0.01) were less likely to experience water insecurity. On the other hand, households that did not use rainwater harvesting methods (OR = 2.117, p<0.01), had to travel over a kilometer to access water (OR = 3.249, p<0.01), had inadequate water storage systems (OR = 2.290, p<0.001), did not treat their water (OR = 2.601, p<0.001), were exposed to water-induced infections (OR = 3.473, p<0.001), did not receive any water, hygiene, and sanitation education (OR = 2.575, p<0.01), and faced water scarcity during the dry season (OR = 2.340, p<0.001) were at a higher risk of experiencing water insecurity. To mitigate the risks of water insecurity and adverse health impacts, policymakers and practitioners must work together to educate households on effective water conservation, storage, and treatment techniques. It is recommended that households harvest rainwater as a coping strategy, construct appropriate storage systems, and treat their water. Communal self-help water investments should be encouraged and supported. Given the significant aquifers and semi-arid landscape of the UWR, investing in groundwater development should be a top priority.
{"title":"Household water insecurity experience in the Upper West Region of Ghana: Insights for effective water resource management","authors":"Cornelius K. A. Pienaah, Sulemana Ansumah Saaka, E. Batung, Kamaldeen Mohammed, Isaac Luginaah","doi":"10.1371/journal.pwat.0000216","DOIUrl":"https://doi.org/10.1371/journal.pwat.0000216","url":null,"abstract":"The global community is not on track to achieve Sustainable Development Goal 6 (SDG 6) by 2030. Many low- and middle-income countries like Ghana still struggle with water insecurity. In semi-arid regions like Ghana’s Upper West, climate change has worsened water insecurity, leading to health and livelihood consequences. In UWR, limited studies have explored water insecurity in rural areas. This study fills a knowledge gap by investigating the determinants of water insecurity in Ghana’s Upper West Region (UWR) from a political ecology of health (PEH) perspective. It comprehensively explores the interplay of social, economic, political, environmental, and health-related factors contributing to water insecurity in the UWR. The results from binary logistic regression show that households in the wealthier category (OR = 0.475, p<0.05) and those that spent less than thirty minutes on a roundtrip to fetch water (OR = 0.474, p<0.01) were less likely to experience water insecurity. On the other hand, households that did not use rainwater harvesting methods (OR = 2.117, p<0.01), had to travel over a kilometer to access water (OR = 3.249, p<0.01), had inadequate water storage systems (OR = 2.290, p<0.001), did not treat their water (OR = 2.601, p<0.001), were exposed to water-induced infections (OR = 3.473, p<0.001), did not receive any water, hygiene, and sanitation education (OR = 2.575, p<0.01), and faced water scarcity during the dry season (OR = 2.340, p<0.001) were at a higher risk of experiencing water insecurity. To mitigate the risks of water insecurity and adverse health impacts, policymakers and practitioners must work together to educate households on effective water conservation, storage, and treatment techniques. It is recommended that households harvest rainwater as a coping strategy, construct appropriate storage systems, and treat their water. Communal self-help water investments should be encouraged and supported. Given the significant aquifers and semi-arid landscape of the UWR, investing in groundwater development should be a top priority.","PeriodicalId":93672,"journal":{"name":"PLOS water","volume":"27 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141379760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-03DOI: 10.1371/journal.pwat.0000242
Elana M. G. Chan, A. Bidwell, Zongxi Li, S. Tilmans, A. Boehm
Public health policy impact evaluation is challenging to study because randomized controlled experiments are infeasible to conduct, and policy changes often coincide with non-policy events. Quasi-experiments do not use randomization and can provide useful knowledge for causal inference. Here we demonstrate how longitudinal wastewater monitoring of viruses at a small geographic scale may be used in a quasi-experimental design to evaluate the impact of COVID-19 public health policies on the spread of COVID-19 among a university population. We first evaluated the correlation between incident, reported COVID-19 cases and wastewater SARS-CoV-2 RNA concentrations and observed changes to the correlation over time, likely due to changes in testing requirements and testing options. Using a difference-in-differences approach, we then evaluated the association between university COVID-19 public health policy changes and levels of SARS-CoV-2 RNA concentrations in wastewater. We did not observe changes in SARS-CoV-2 RNA concentrations associated with most policy changes. Policy changes associated with a significant change in campus wastewater SARS-CoV-2 RNA concentrations included changes to face covering recommendations, indoor gathering bans, and routine surveillance testing requirements and availability.
{"title":"Public health policy impact evaluation: A potential use case for longitudinal monitoring of viruses in wastewater at small geographic scales","authors":"Elana M. G. Chan, A. Bidwell, Zongxi Li, S. Tilmans, A. Boehm","doi":"10.1371/journal.pwat.0000242","DOIUrl":"https://doi.org/10.1371/journal.pwat.0000242","url":null,"abstract":"Public health policy impact evaluation is challenging to study because randomized controlled experiments are infeasible to conduct, and policy changes often coincide with non-policy events. Quasi-experiments do not use randomization and can provide useful knowledge for causal inference. Here we demonstrate how longitudinal wastewater monitoring of viruses at a small geographic scale may be used in a quasi-experimental design to evaluate the impact of COVID-19 public health policies on the spread of COVID-19 among a university population. We first evaluated the correlation between incident, reported COVID-19 cases and wastewater SARS-CoV-2 RNA concentrations and observed changes to the correlation over time, likely due to changes in testing requirements and testing options. Using a difference-in-differences approach, we then evaluated the association between university COVID-19 public health policy changes and levels of SARS-CoV-2 RNA concentrations in wastewater. We did not observe changes in SARS-CoV-2 RNA concentrations associated with most policy changes. Policy changes associated with a significant change in campus wastewater SARS-CoV-2 RNA concentrations included changes to face covering recommendations, indoor gathering bans, and routine surveillance testing requirements and availability.","PeriodicalId":93672,"journal":{"name":"PLOS water","volume":"55 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141269766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-10DOI: 10.1371/journal.pwat.0000243
Sarah Lebu, L. Sprouse, J. Akudago, Felix R. B. Twinomucunguzi, Ruthie Rosenberg, Yvonne Sanyu Lugali, B. Aine, Jackqueline Tu-uyen Nguyen, Chimdi C. Muoghalu, Swaib Semiyaga, Barbara Evans, M. Manga
{"title":"The case for shared sanitation access in informal settlements: A dialogue on science, policy, and practice integration","authors":"Sarah Lebu, L. Sprouse, J. Akudago, Felix R. B. Twinomucunguzi, Ruthie Rosenberg, Yvonne Sanyu Lugali, B. Aine, Jackqueline Tu-uyen Nguyen, Chimdi C. Muoghalu, Swaib Semiyaga, Barbara Evans, M. Manga","doi":"10.1371/journal.pwat.0000243","DOIUrl":"https://doi.org/10.1371/journal.pwat.0000243","url":null,"abstract":"","PeriodicalId":93672,"journal":{"name":"PLOS water","volume":" 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140993454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-10DOI: 10.1371/journal.pwat.0000231
C. D. Schnorr, Kathryn W. Roberts, E.C. Payano, Paloma Martínez Guzmán, M. De St. Aubin, Matthew Lozier, Salomé Garnier, D. Dumas, Kelsey McDavid, C. T. Then Paulino, R. Skewes-Ramm, C. Craig, E. Zielinski Gutiérrez, William Duke, E. Nilles
Hand hygiene (HH) can reduce transmission of healthcare-associated infections (HAIs) in healthcare facilities and is especially important in low- and middle-income countries where HH infrastructure may be insufficient and the burden of HAIs is highest. At baseline, we assessed HH infrastructure and practices among healthcare workers (HCWs) at two large hospitals in the Dominican Republic during the COVID-19 pandemic. HCWs were observed for HH adherence (HHA) (defined as the use of alcohol-based hand rub (ABHR) or handwashing with soap and water) before and after patient contact and donning new gloves before patient contact. The baseline assessment was repeated following implementation of local production and distribution of ABHR and a HH promotion campaign. Descriptive analyses and regression models evaluated predictors of HHA and glove use. Cumulative HHA was 18.9%. While patient-care areas with a functional HH resource increased from 47% at baseline to 92% after the intervention, HHA declined from 23.0% to 16.7%. HHA was higher after patient contact (aOR = 5.88; 95% CI = 4.17–8.33), during a period of increased COVID-19 risk (aOR = 1.69; 95% CI = 1.05–2.77), during invasive patient contacts (aOR = 1.64; 95% CI = 1.23–2.17) and when gloves were not used (aOR = 1.25; 95% CI = 1.01–1.56). The negative association between glove use and HHA diminished when access to HH resources increased. New gloves were donned before 39.6% of patient contacts. Glove use was higher among nurses (aOR = 7.12; 95% CI = 3.02–16.79) and during invasive contacts (aOR = 4.76; 95% CI = 2.27–10.0). While access to HH resources increased after the interventions, HHA did not increase. HHA was lower when COVID-19 risk was lower. Findings from this study may guide future efforts to increase HHA among HCWs.
{"title":"Longitudinal changes in hand hygiene adherence among healthcare workers during the COVID-19 pandemic, Dominican Republic","authors":"C. D. Schnorr, Kathryn W. Roberts, E.C. Payano, Paloma Martínez Guzmán, M. De St. Aubin, Matthew Lozier, Salomé Garnier, D. Dumas, Kelsey McDavid, C. T. Then Paulino, R. Skewes-Ramm, C. Craig, E. Zielinski Gutiérrez, William Duke, E. Nilles","doi":"10.1371/journal.pwat.0000231","DOIUrl":"https://doi.org/10.1371/journal.pwat.0000231","url":null,"abstract":"Hand hygiene (HH) can reduce transmission of healthcare-associated infections (HAIs) in healthcare facilities and is especially important in low- and middle-income countries where HH infrastructure may be insufficient and the burden of HAIs is highest. At baseline, we assessed HH infrastructure and practices among healthcare workers (HCWs) at two large hospitals in the Dominican Republic during the COVID-19 pandemic. HCWs were observed for HH adherence (HHA) (defined as the use of alcohol-based hand rub (ABHR) or handwashing with soap and water) before and after patient contact and donning new gloves before patient contact. The baseline assessment was repeated following implementation of local production and distribution of ABHR and a HH promotion campaign. Descriptive analyses and regression models evaluated predictors of HHA and glove use. Cumulative HHA was 18.9%. While patient-care areas with a functional HH resource increased from 47% at baseline to 92% after the intervention, HHA declined from 23.0% to 16.7%. HHA was higher after patient contact (aOR = 5.88; 95% CI = 4.17–8.33), during a period of increased COVID-19 risk (aOR = 1.69; 95% CI = 1.05–2.77), during invasive patient contacts (aOR = 1.64; 95% CI = 1.23–2.17) and when gloves were not used (aOR = 1.25; 95% CI = 1.01–1.56). The negative association between glove use and HHA diminished when access to HH resources increased. New gloves were donned before 39.6% of patient contacts. Glove use was higher among nurses (aOR = 7.12; 95% CI = 3.02–16.79) and during invasive contacts (aOR = 4.76; 95% CI = 2.27–10.0). While access to HH resources increased after the interventions, HHA did not increase. HHA was lower when COVID-19 risk was lower. Findings from this study may guide future efforts to increase HHA among HCWs.","PeriodicalId":93672,"journal":{"name":"PLOS water","volume":" 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140993878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-06DOI: 10.1371/journal.pwat.0000158
Abraham Geremew, A. Nijhawan, B. Mengistie, Dinku Mekbib, Adrian Flint, Guy Howard
Climate change threatens the safety of water supplies globally, but small water supplies in rapidly growing and urbanizing towns in low- and middle-income countries are especially at risk. Despite the efforts of the Government of Ethiopia, research shows that that small-town water utilities in Ethiopia are poorly equipped to prioritize developing and maintaining climate-resilient water services. We applied the How tough is WASH framework for climate resilient water supplies to ten town water utilities in Eastern Ethiopia to identify their strengths and weaknesses in preparing for climate change. We found reports of weak institutional support from service authorities and exclusion of climate risk management from trainings, which cascades down to service providers in the form of lack of emergency response, inadequate staffing and financial mismanagement. This is consistent with previous studies on sustainability of town water utilities, and highlights the applicability of this tool into existing monitoring frameworks that have been proposed for town water utilities in Ethiopia. We also modified the How tough is WASH framework to capture these findings and better reflect the complexity of a utility-managed piped water supply.
气候变化威胁着全球的供水安全，但中低收入国家快速发展和城市化城镇中的小型供水设施尤其面临风险。尽管埃塞俄比亚政府做出了努力，但研究表明，埃塞俄比亚的小城镇供水公司在优先发展和维护适应气候的供水服务方面能力不足。我们将 "讲卫生运动有多艰难"（How tough is WASH）框架应用于埃塞俄比亚东部的十个城镇供水公司，以确定它们在应对气候变化方面的优势和劣势。我们发现有报告称，服务部门的机构支持薄弱，培训中也未提及气候风险管理，这就导致服务提供商缺乏应急响应、人员配备不足和财务管理不善。这与之前关于城镇供水设施可持续性的研究相一致，并突出了该工具在现有监测框架中的适用性，这些框架已被提议用于埃塞俄比亚的城镇供水设施。我们还修改了 "讲卫生运动有多艰难 "框架，以捕捉这些发现并更好地反映公用事业管理的自来水供应的复杂性。
{"title":"Climate resilience of small-town water utilities in Eastern Ethiopia","authors":"Abraham Geremew, A. Nijhawan, B. Mengistie, Dinku Mekbib, Adrian Flint, Guy Howard","doi":"10.1371/journal.pwat.0000158","DOIUrl":"https://doi.org/10.1371/journal.pwat.0000158","url":null,"abstract":"Climate change threatens the safety of water supplies globally, but small water supplies in rapidly growing and urbanizing towns in low- and middle-income countries are especially at risk. Despite the efforts of the Government of Ethiopia, research shows that that small-town water utilities in Ethiopia are poorly equipped to prioritize developing and maintaining climate-resilient water services. We applied the How tough is WASH framework for climate resilient water supplies to ten town water utilities in Eastern Ethiopia to identify their strengths and weaknesses in preparing for climate change. We found reports of weak institutional support from service authorities and exclusion of climate risk management from trainings, which cascades down to service providers in the form of lack of emergency response, inadequate staffing and financial mismanagement. This is consistent with previous studies on sustainability of town water utilities, and highlights the applicability of this tool into existing monitoring frameworks that have been proposed for town water utilities in Ethiopia. We also modified the How tough is WASH framework to capture these findings and better reflect the complexity of a utility-managed piped water supply.","PeriodicalId":93672,"journal":{"name":"PLOS water","volume":"1 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141006259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：