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• (Journal Article) Global assessment of grant-funded, market-based sanitation development projects

  01.07.2020
  Evidence on the performance of market-based sanitation (MBS) interventions is needed to support renewed focus on using them to deliver sanitation services at scale. We conducted a comprehensive review of WASH grant-funding since 1980 to identify household sanitation supply projects using an MBS approach, assessed project characteristics and outcomes (population impacted), and reviewed project strategies against three key factors for scaling MBS (customer and business finance; availability and viability of local entrepreneurs; appropriate toilet product and business models). For a subset with higher outcomes, we assessed project strategies more fully against nine MBS strategies considered good practice, and the programme’s ability to leverage household investment. Of 103 sanitation supply projects in eight global databases, 49 qualified as MBS and occurred in 22 countries across sub-Saharan Africa, South/Southeast Asia, and Latin America. Cumulatively, 27.6 million people, nearly all rural, gained access to basic sanitation via markets across these projects. ‘Large-scale’ MBS projects exceeding 50,000 people gaining basic sanitation (n = 27) compared with those that did not (n = 22) were longer and significantly more likely to address all three key factors (74 per cent vs. 41 per cent; p = 0.019), but on average applied only six of nine good practice strategies. Outcomes and programme leverage were higher in South/Southeast Asia than in sub-Saharan Africa. However, African projects tended to have shorter duration, fewer reached ‘large-scale’, and rarely employed a sales and marketing strategy. We discuss implications for improving the design and performance of MBS interventions globally and particularly in sub-Saharan Africa.

• (Journal Article) Global assessment of grant-funded, market-based sanitation development projects

  01.07.2020
  Evidence on the performance of market-based sanitation (MBS) interventions is needed to support renewed focus on using them to deliver sanitation services at scale. We conducted a comprehensive review of WASH grant-funding since 1980 to identify household sanitation supply projects using an MBS approach, assessed project characteristics and outcomes (population impacted), and reviewed project strategies against three key factors for scaling MBS (customer and business finance; availability and viability of local entrepreneurs; appropriate toilet product and business models). For a subset with higher outcomes, we assessed project strategies more fully against nine MBS strategies considered good practice, and the programme’s ability to leverage household investment. Of 103 sanitation supply projects in eight global databases, 49 qualified as MBS and occurred in 22 countries across sub-Saharan Africa, South/Southeast Asia, and Latin America. Cumulatively, 27.6 million people, nearly all rural, gained access to basic sanitation via markets across these projects. ‘Large-scale’ MBS projects exceeding 50,000 people gaining basic sanitation (n = 27) compared with those that did not (n = 22) were longer and significantly more likely to address all three key factors (74 per cent vs. 41 per cent; p = 0.019), but on average applied only six of nine good practice strategies. Outcomes and programme leverage were higher in South/Southeast Asia than in sub-Saharan Africa. However, African projects tended to have shorter duration, fewer reached ‘large-scale’, and rarely employed a sales and marketing strategy. We discuss implications for improving the design and performance of MBS interventions globally and particularly in sub-Saharan Africa.

• (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) 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) 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) 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) 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) 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) 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) 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) 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) 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) 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) 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) 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) 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) Addressing women’s needs in water access for economic use: the case of Wukro town, Ethiopia

  01.07.2020
  In urban areas where water is not adequately supplied, women’s efforts to make a living out of water-intensive businesses face many challenges. The study examined how small-scale businesses run by women in Wukro town, Ethiopia are impacted by inadequate supply of water, and what coping strategies are employed. The lived experiences of women involved in small-scale water-intensive businesses, such as traditional beer brewing and coffee shops, were examined. In addition to these women, the perspectives and experiences of selected key informants as well as the officers at the local water utility have been assessed. Whether or not these women secure support from the social networks in their neighbourhood has also been considered. The study revealed that the unreliable supply of water in the town has impacted women involved in small business. It was indicated that some women manage to do well either by borrowing water from neighbours or purchasing from providers. In contrast, others who run businesses in rented houses with limited social networks expressed that they are struggling. Suggestions are made for the water utility to revise its working guidelines related to the provision of water services and to implement a gendered perspective in water management practices.

• (Journal Article) Addressing women’s needs in water access for economic use: the case of Wukro town, Ethiopia

  01.07.2020
  In urban areas where water is not adequately supplied, women’s efforts to make a living out of water-intensive businesses face many challenges. The study examined how small-scale businesses run by women in Wukro town, Ethiopia are impacted by inadequate supply of water, and what coping strategies are employed. The lived experiences of women involved in small-scale water-intensive businesses, such as traditional beer brewing and coffee shops, were examined. In addition to these women, the perspectives and experiences of selected key informants as well as the officers at the local water utility have been assessed. Whether or not these women secure support from the social networks in their neighbourhood has also been considered. The study revealed that the unreliable supply of water in the town has impacted women involved in small business. It was indicated that some women manage to do well either by borrowing water from neighbours or purchasing from providers. In contrast, others who run businesses in rented houses with limited social networks expressed that they are struggling. Suggestions are made for the water utility to revise its working guidelines related to the provision of water services and to implement a gendered perspective in water management practices.

• (Journal Article) Addressing women’s needs in water access for economic use: the case of Wukro town, Ethiopia

  01.07.2020
  In urban areas where water is not adequately supplied, women’s efforts to make a living out of water-intensive businesses face many challenges. The study examined how small-scale businesses run by women in Wukro town, Ethiopia are impacted by inadequate supply of water, and what coping strategies are employed. The lived experiences of women involved in small-scale water-intensive businesses, such as traditional beer brewing and coffee shops, were examined. In addition to these women, the perspectives and experiences of selected key informants as well as the officers at the local water utility have been assessed. Whether or not these women secure support from the social networks in their neighbourhood has also been considered. The study revealed that the unreliable supply of water in the town has impacted women involved in small business. It was indicated that some women manage to do well either by borrowing water from neighbours or purchasing from providers. In contrast, others who run businesses in rented houses with limited social networks expressed that they are struggling. Suggestions are made for the water utility to revise its working guidelines related to the provision of water services and to implement a gendered perspective in water management practices.

• (Journal Article) Addressing women’s needs in water access for economic use: the case of Wukro town, Ethiopia

  01.07.2020
  In urban areas where water is not adequately supplied, women’s efforts to make a living out of water-intensive businesses face many challenges. The study examined how small-scale businesses run by women in Wukro town, Ethiopia are impacted by inadequate supply of water, and what coping strategies are employed. The lived experiences of women involved in small-scale water-intensive businesses, such as traditional beer brewing and coffee shops, were examined. In addition to these women, the perspectives and experiences of selected key informants as well as the officers at the local water utility have been assessed. Whether or not these women secure support from the social networks in their neighbourhood has also been considered. The study revealed that the unreliable supply of water in the town has impacted women involved in small business. It was indicated that some women manage to do well either by borrowing water from neighbours or purchasing from providers. In contrast, others who run businesses in rented houses with limited social networks expressed that they are struggling. Suggestions are made for the water utility to revise its working guidelines related to the provision of water services and to implement a gendered perspective in water management practices.