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(Journal Article) A call to action: organizational, professional, and personal change for gender transformative WASH programming
01.07.2020
The Sustainable Development Goals (SDGs) and targets aimed at improving access to water, sanitation, and hygiene (WASH) are also an opportunity for the transformation of gender norms. To facilitate this transformation, this paper makes a call to action for global and national efforts for organizational, professional, and personal change. Several NGOs are leading a process towards a more reflective and transformative approach. This paper presents a number of examples – from headquarters, and others from country offices and research institutes – of the changes under way to support a stronger connection between the ‘outer faces’ of WASH professionals in the sector and the individual, personal inner spaces. The paper concludes with a set of recommendations for personal and organizational change. -
(Journal Article) Transgender-inclusive sanitation: insights from South Asia
01.04.2018
This paper provides insights from initiatives to include transgender people in sanitation programming in South Asia. Three case studies of recent actions to make sanitation inclusive for transgender people (in India and Nepal) are presented, accompanied by reflections and recommendations to guide future practice. Practitioners are recommended to: engage with transgender people as partners at all stages of an initiative; recognize that the language of gender identity is not fixed, varying across cultures and between generations; and acknowledge that transgender people are not a single homogeneous group but rather have diverse identities, histories, and priorities. The case studies aim to raise awareness of the diversity of transgender identities, exploring the needs and aspirations of transgender women, transgender men, and third gender people in South Asia. -
(Journal Article) Effects of water source accessibility and reliability improvements on water consumption in eastern Nairobi
01.07.2017
Under the commitments of the UN Sustainable Development targets, there is increasing pressure on water utility providers in developing countries to improve their levels of service to consumers, especially for the rapidly growing numbers of people with lower incomes who reside in urban informal settlements. However, pressure on water resources in many regions is simultaneously increasing owing to factors such as pollution, agricultural needs, and climate change. It is therefore important to assess the impacts of improving water services on city-wide water resources. This study examines consumption data from the East African city of Nairobi, collected from households of a variety of residential neighbourhoods. The study suggests that average per capita water consumption is closely related to water source choice (i.e. tap in the dwelling, yard tap, or water vendor kiosks). Within categories of water source type, variables such as household wealth, cost of water, and education do not have significant effects on per capita consumption. It is noted that increased accessibility of water causes the upper bound of consumption to rise, but not the lower. It may therefore be theorized that having a tap in a dwelling is necessary but not sufficient to increase per capita consumption. Within the sample examined, there is no statistically significant difference in per capita consumption between water source types other than a tap in a dwelling, and it is therefore suggested that providing a yard tap to those currently without any form of water connection may have negligible impact on city-wide water consumption. -
(Journal Article) Menstrual hygiene management in disasters: the concerns, needs, and preferences of women and girls in Vanuatu
01.07.2021
In disaster settings, women and girls face additional challenges in safely managing menstruation with confidence and dignity. Assessing women’s and girls’ needs and preferences at country level prior to a disaster assists Red Cross National Societies with preparedness planning and development of local menstrual hygiene management (MHM) kits for pre-positioning. This study, conducted in Vanuatu, examined the experiences, concerns, needs, and preferences of women and girls in managing menstruation in disasters. Participants trialled one of four different sanitary products included in a MHM kit. Absorbency, security of fit, and odour were the main determinants of product acceptability. Water supply and safe disposal options influenced the preference for either reusable or disposable products. Access to sanitary products, distribution processes, water supply, and privacy were key concerns. Detailed recommendations within this paper will support the Vanuatu Red Cross in decision making and programming for MHM in disaster preparedness and response. -
(Journal Article) Agricultural finance that reaches people facing poverty, gender, and age barriers
01.03.2022
A high-tech, high-touch, high-impact (H3) approach to agricultural finance enables expansion of financial service markets to people facing poverty, gender, and age barriers to economic empowerment. This article explains the H3 approach and presents the case of Opportunity International’s Agricultural Finance Programme (AgFinance) in Africa. At the centre of the model are community-based farm advisors, providing high-touch/high-tech training in financial management, good agricultural practices, inclusion, and resilience. They also link farmers to financial service providers, input and equipment suppliers, and markets. In Malawi, where Opportunity has applied this model, outreach was high: 72 per cent of clients were living in extreme poverty, 57 per cent were women and 40 per cent youth. In 2021, the AgFinance programme facilitated loans to 68,262 borrowers with an outstanding balance of US$24.82 m. This outreach and scale demonstrates a market systems model – the H3 approach – with deep outreach at scale. -
(Journal Article) Trade-off between outreach and sustainability of microfinance institutions: evidence from sub-Saharan Africa
01.09.2017
The changing landscape of the microfinance industry, which is characterized by a decline in donor funding, has reignited debates regarding the ability of microfinance institutions to serve the poor while remaining sustainable. In this study, we examined the relationship between outreach and sustainability in the context of sub-Saharan Africa (SSA) and analysed the determinants of sustainability using data from 71 microfinance institutions (MFIs) across 10 countries. By applying correlation analysis and fixed effects regression, we found mixed evidence of a trade-off between the depth of outreach and operational self-sustainability. Furthermore, the results show that interest rate is a major determinant for MFI sustainability, which is consistent with the institutionalist view. Factors that significantly influence the sustainability of MFIs in SSA are the average loan size as a percentage of gross national income, gross loan portfolio, portfolio at risk, operating expenses to assets ratio, governance effectiveness, and the interest rate on loans granted to clients. The study recommends that managers of MFIs and decision makers in the region closely monitor their cost-side variables and improve productivity by adopting measures such as information communication techniques that enhance outreach at low cost. In addition, stepping up monitoring and incentivizing hard working staff could help improve both deposit mobilization and loan recovery. -
(Journal Article) Learning, acting, and learning (LAL) research on schools' menstrual hygiene management (MHM): Pakistan
01.01.2015
UNICEF Pakistan adopted a conceptual framework for global qualitative research to advance their ongoing exploratory research work on menstrual hygiene management (MHM) in 2013-14. The findings of qualitative research informed the design of certain interventions in schools to improve MHM. These interventions were implemented as action research so that the benefits of these interventions can be studied. Qualitative research gave an in-depth understanding of girls' needs and their preferences to address MHM-related issues. Data analysis of qualitative research helped a team of sanitation practitioners and social scientists in understanding different factors influencing MHM in girls' schools. A few simple and focused interventions were hence designed and implemented. Six weeks after the implementation of hard and soft activities on the ground the results were studied. Results showed significant improvement in MHM conditions in girls' schools. Girls and teachers welcomed the initiatives and there were indicators for future sustainability. Areas of improvement were also noted by UNICEF before taking these interventions to scale. This research was documented as ‘learning, acting, and learning’ (LAL: literally meaning ‘Red’ in the local language, Urdu) research. -
(Journal Article) Efficiency of additives and internal physical chemical factors for pit latrine lifetime extension
01.07.2018
Pit latrines are the most common form of on-site sanitation, but are blighted by the problem of pit fill-up. Little is known about what factors and conditions affect decomposition of pit content and thus govern pit filling, but the liquid–mass balance is the key factor. Under laboratory conditions the effect of inorganic and biological additives and the effect of physical chemical factors on solids hydrolysis of black water and human faeces were investigated to establish the potential of these to extend pit latrine lifetime. Additives did little or nothing to enhance net solids hydrolysis in batch tests or to reduce pit fill height in miniature simulated pit latrines. Physical chemical factors such as redox condition and initial pH increased solids hydrolysis, whereas temperature and substrate moisture did little. Since additives need contact with the substrate to act, measurements on faeces crust formation speed and strength were performed and showed that crusts formed within three hours and persisted after covering with fresh faeces or water. -
(Journal Article) Using a franchise structure to scale affordable housing internationally
01.09.2021
Capital investment as high as US$16 tn is required to address the shortage of adequate and affordable housing worldwide. Market-driven housing approaches that produce quality units, reduce dwelling costs, and provide access to a range of capital sources can help to solve this challenge. This article describes the experience of a social enterprise in Mexico that is taking its proven, market-driven housing solution to countries in Africa using a joint venture franchising company to execute a master franchising strategy. Its experience and the innovative approach it used to scale internationally offer useful insights and lessons for housing practitioners, policymakers, and researchers. -
(Journal Article) Beyond building: how social norms and networks shape mason construction practices in incremental homebuilding
01.09.2021
How do low-income households and masons make house construction decisions? A three-country study examined social norms, networks, and information flows that influence construction practices in Kenya, India, and Peru. The study used a suite of qualitative research strategies, including desk research, site observation, focus group discussions, and key informant interviews, to examine households and informal construction service providers, and the interactions between them. The research sought to answer the following questions: 1) How do households and individuals make housing decisions? 2) What are the information flows, key influences, and social norms that steer these decisions? and 3) How can programmes leverage knowledge about norms to improve the quality of home construction? Findings covered areas of gender, disaster resilience, and construction labour – this article focuses on the latter. Ultimately the paper argues that designing impactful programmes for low-income housing markets requires understanding and incorporating these social norms, networks, and information flows. -
(Journal Article) Are burial or disposal with garbage safe forms of child faeces disposal? An expert consultation
01.07.2015
The importance of safe handling and disposal of child faeces given its potential role in disease transmission are increasingly recognized. Household surveys demonstrate that the burying of child faeces (‘dig-and-bury’) is common in several countries, especially in sub-Saharan Africa and South-east Asia. Disposal with garbage is widely practised in middle- and high-income countries and is becoming increasingly common in urban areas of low-income countries. The safety of these two approaches is difficult to assess given the limited evidence available and we therefore sought the opinion of experts in the field of sanitation to support advocacy around the topic. We report the findings of an anonymous expert (Delphi) consultation on the safety of these two child faeces disposal methods. There was almost unanimous agreement these should be considered neither safe nor improved. A range of arguments was provided to support this position, including proximity of solid waste and burial sites to the home and children’s play areas and that neither practice would be acceptable for adults. The consultation also highlighted gaps in the current evidence base that should be addressed to gain a fuller insight into the risks involved in these two forms of sanitation with a view to providing both programmatic and normative guidance. In particular further work is needed to assess the potential for exposure to faecal matter in solid waste in low- and middle-income countries and to elucidate the predominant practices of child faeces burial including proximity to the home or infant play areas as well as depth of burial. -
(Journal Article) How a water trucking governance mechanism in the West Bank enhances equity and sustainability
01.01.2022
In the Oslo Accord-defined Area C of the West Bank, approximately 11,000 Palestinians are unserved by the water network, forced to rely on water trucking at extremely high prices. In response to this situation, Gruppo di Volontariato Civile (GVC), in partnership with UNICEF, created a programme to subsidize water trucking that alleviates water scarcity while enhancing the sustainability of water service delivery, equitability of tariffs, and predictability of demand. Established in 2014, the programme now covers all the water-vulnerable communities in the West Bank and has reached 35,000 people. The programme links humanitarian and development interventions by using a contiguum approach, where the humanitarian provision of trucked water is accompanied by the construction of water infrastructure and the creation of a multilevel water trucking governance system that defines the roles and responsibilities of all national, regional, and local actors in the water supply chain. By embedding water trucking into the Palestinian Water Authority’s normal activities, the programme is designed to escape a cycle of chronic emergency humanitarian response, in line with the national water sector reform agenda. Eventually, the international donor funding on which the programme depends should be phased out by implementing an equitable, universal water tariff schedule across the entire West Bank, with rates set high enough to subsidize the provision of reliable, safe, and affordable water to the vulnerable residents of Area C. -
(Journal Article) Taking Stock: Incompetent at incontinence – why are we ignoring the needs of incontinence sufferers?
01.07.2016
How would you cope if you had no control over how you urinated or defecated and regularly or constantly leaked urine or faeces? How would this make you feel? How would you deal with the smell, with the indignity? What if you were a young teenager, traumatized by very stressful events and returned to bed-wetting as a result? And what would you do if you didn’t have the money to buy spare underwear or incontinence protection products or those are simply not available to you? Could you manage if you were suddenly displaced in an emergency and did not have access to a toilet, shower or bathing facilities, or your usual materials and coping mechanisms? What if you lived in a camp and your toilet or bathing shelter was a 5 minute walk away and had a long line in front of it? Would you be able to stand in line at food distribution or water collection points, go to school, or look for or undertake work? -
(Journal Article) Uncovering the challenges to menstrual hygiene management in schools in Mali
01.01.2015
There is limited information on girls' menstrual hygiene practices and experiences at school in francophone sub-Saharan Africa. We conducted qualitative research to determine the challenges faced by school-aged girls in Mali, a culturally diverse and largely Muslim country. Research activities were conducted in eight urban and rural schools across the Sikasso and Koulikoro regions, including in-depth interviews with 26 girls and key informant interviews with 14 teachers and school directors. Results describe girls' practices for managing menstruation at school, their support systems and information channels, and their voiced recommendations for school WASH and education improvements. -
(Journal Article) Hygiene kit distribution and use in humanitarian response: summary of information from a systematic review and key informant interviews
01.10.2021
Hygiene kits are commonly distributed in humanitarian emergencies to provide dignity and safety, yet remain under-researched. We aimed to close evidence gaps by completing a systematic review and key informant interviews (KII) to assess current practice in hygiene kits distributions. Fourteen KIIs were conducted and >5,000 documents were screened, with nine meeting inclusion criteria. Existing evidence highlights that reported use of hygiene kit items is high, and standardization, beneficiary involvement in kit design, and post-distribution monitoring are needed. Emergent themes from KIIs were: hygiene kit design; logistics/procurement; field appropriateness/feedback; and recommendations. Unexpectedly, menstrual health management (MHM) and market-based programming (MBP) dominated the literature. Overall, hygiene kit distributions are governed by ‘best practice’ rather than ‘evidence base’. This limited evidence base is stark compared to more robust evidence for market-based programming. As a common definition of hygiene kits was lacking, we developed and present a hygiene kit typology. We recommend hygiene kit programming: 1) understands local context, cultural norms, and preferences by incorporating beneficiary consultation and feedback; 2) ensures item type and quantity is what beneficiaries need; 3) ensures hygiene kits are context-appropriate, and considers concurrent MHM and/or MBP programming; and 4) works with coordination mechanisms to harmonize kit materials, delivery, and monitoring. -
(Journal Article) Towards demand-driven services? The role of feedback mechanisms in agribusiness-based advisory services for smallholder farmers
01.09.2019
In many developing countries, agribusinesses are highly engaged in providing services to smallholder farmers, including agricultural advisory services or extension. As private service providers depend on farmers’ choice, eliciting farmer feedback and learning from farmers’ demands seem to become more important. However, the phenomenon of agribusiness-based advisory services has received relatively little attention in the study of advisory services. Little is known on whether and how agribusinesses operationalize the idea of demand-driven service provision. This is a critical oversight as agribusinesses are increasingly present as service providers and hence shape the prevailing service landscape for smallholder farmers. Based on a study of 29 agribusinesses providing advisory services to farmers in developing countries, this paper explores the extent to which agribusinesses provide demand-driven services based on farmer feedback and how they integrate and learn from such feedback. -
(Journal Article) Microfinance for sanitation: what is needed to move to scale?
01.07.2015
The sanitation sector is gradually realizing that the effectiveness of approaches such as Community-Led Total Sanitation (CLTS) is limited by inadequate access to finance. Households are not able to construct durable facilities and sanitation services are unable to develop so as to respond to demand. At the same time, there is fierce competition among microfinance services providers that is pushing institutions towards more remote customers and to offer innovative products. In addition, the rise of mobile banking and digital finance has lifted many poor people out of financial exclusion. These factors have created a nexus between microfinance and sanitation with high growth potential. However, the sanitation microfinance market remains small to date. Since 2010, the SHARE research consortium has investigated global experiences and lessons for using microfinance to develop sanitation services. A SHARE action-research in Tanzania triggered selected financial institutions to offer financial products for sanitation and generated lessons for scaling up sanitation microfinance. This article presents the findings from the SHARE research, in the context of broader developments in the microfinance markets and key findings from other donor-led initiatives. -
(Journal Article) Better together: improving food security and nutrition by linking market and food systems
01.09.2019
Market-based approaches to food security often increase agricultural productivity and income yet sometimes fail to enhance nutrition. When food security programming combines market and food systems with a specific focus on women and girls, economic and nutrition outcomes benefit. We identify distinctive and shared elements from market and food systems and highlight how they enhance nutrition outcomes when they are combined. We describe food security programming by CARE and World Vision in Bangladesh, Ethiopia, Madagascar, Zambia, and Zimbabwe, demonstrating nutrition gains in food insecure households. -
(Journal Article) Are ceramic water filters effective in preventing diarrhoea and acute malnutrition among under-five children in Sudan?
01.07.2020
Access to safe drinking-water at home is essential during the outpatient treatment of children with acute malnutrition due to their increased vulnerability to infections and disease. The study aimed to evaluate the effectiveness of ceramic water filters with safe storage in preventing diarrhoea and acute malnutrition among under-five children in Kassala state, Sudan. It was designed as an open-label randomized controlled trial, comparing two study groups. Data was collected through face-to-face interviews and direct observations, then processed and analysed using Epi Info 7.2.0.1. Use of water filters is a potential predictor of number of diarrhoea episodes per child (P < 0.001). The intervention group had a lower diarrhoea occurrence (P < 0.001), better monthly average weight gain (P = 0.012) and average mid-upper arm circumference increase (P = 0.001), and lower prevalence of acute malnutrition at the end of the study (P = 0.001) compared with the control group. Ceramic water filters with safe storage can be effective in preventing diarrhoea and acute malnutrition, and beneficial to children admitted to Community Management of Acute Malnutrition programmes in Kassala state. More research is needed to understand the pathways to achieving these outcomes. Other WASH interventions may be needed to interrupt the primary vectors of diarrhoea disease transmission in this setting. -
(Journal Article) The new reality: perspectives on future integrated WASH
01.01.2022
Over the next 10 years, the humanitarian and development fields will face significant changes as new skills, expanded technologies, and shifting funding streams prompt innovation in order to maintain impact. As the length of humanitarian crises expand relief response can no longer be viewed merely through the humanitarian lens, but current and future crisis responses increasingly require long-term development considerations. Integration across the humanitarian-development nexus will be vital to future emergency response. The interdisciplinary nature of the WASH sector makes it ideally placed to lead further integration with sectors like health, nutrition, livelihoods, child protection, and education. Integration of the WASH sector is not only possible but essential to face the challenges of future crises. COVID-19 is a wake-up call showing how quickly global humanitarian needs can change and the need for a more integrated response to emergencies. Tomorrow’s WASH practitioners will need to be proactive in developing new hard and soft skills and have broader multi-sectoral experience to succeed. Future integration will require stronger relationships between multi-mandated organizations, governments, and the private sector as well as new innovative funding sources, including impact investing, blended finance, and development impact bonds. We argue that there is a unique window of opportunity to bridge these gaps as COVID-19 brings the value of effective WASH programming forward as a foundational part of long-term resilience building. To indeed provide life-saving interventions as humanitarian works claim to do, we must start with a clear focus on the long-term developmental ends in mind.