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(Journal Article) Measurement of handwashing behaviour in Multiple Indicator Cluster Surveys and Demographic and Health Surveys, 1985–2008
01.10.2015
With this paper, we aim to describe handwashing worldwide, as measured in Multiple Indicator Cluster Surveys (MICS) and Demographic and Health Surveys (DHS) in low- and middle-income countries between 1985 and 2008, and to explain the strengths, weaknesses and evolution of this data collection to inform future survey development. We searched reports of DHS and MICS conducted before 2009 and analysed data on handwashing measurements. We examined data according to geographic region, as well as demographic characteristics such as wealth quintile, education of the household head, and rural/urban location. Before 2009, eight MICS and 40 DHS included handwashing-related measurements, using a variety of self-reports and rapid observations. Internal triangulation of findings from surveys that collected multiple types of measurement shows that self-reports to closed questions overestimate behaviour. Observation-based data suggest low handwashing rates in many low- and middle-income countries with high prevalence of water and sanitation-related diseases, and high inter- and intra-country disparities. However, due to the widely disparate nature of the pre-2009 handwashing-related measurements, much of the data cannot be compared between countries, and only an incomplete picture of global rates can be formed. Efforts to increase the prevalence of handwashing with soap and water need to be strengthened in many low- and middle-income countries, especially among poorer, rural populations and where the household head has less formal education. Closed questions asking for self-reports of handwashing behaviour should be avoided. Findings support instead the inclusion of uniform observation-based measurements, as were integrated as core modules of MICS and DHS in 2009. -
(Journal Article) Impacts of emergencies on water and wastewater systems in congested urban areas
01.01.2022
The impacts of emergencies on society and structures are often reported in the media, but the impact of these emergencies on the water and wastewater system is less publicized. The safe operation of these systems is critical during hazardous events and the recovery process to ensure safe and clean water for the public. This need is magnified in congested urban areas where the number of people affected is greatest. A critical aspect to the safe operation of these systems during emergencies is a timely response by municipal leaders. Municipalities must develop plans to prevent and/or mitigate the damage to water systems during emergencies, which will speed the recovery process when these events occur. This paper discusses the impacts of hurricanes and flood events on the water and wastewater systems of densely populated urban areas and presents measures that could be taken to prevent and mitigate the impacts of these events in the future.