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• (Article) Menstrual hygiene management and reproductive tract infections: a comparison between rural and urban India

  01.04.2019
  The objective of the research was to compare factors associated with menstrual hygiene management (MHM) between urban and rural ever-married women in India, and its effect on reproductive tract infections (RTIs). A cross-sectional study was performed analysing data from the Indian District Level Household and Facility Survey 2007–08 (DLHS-3). The respondents were ever-married women between 15 and 49 years of age (N = 577,768). A quarter of women from urban areas use improved methods compared with only 4.3 per cent in rural areas. Cloth had the highest prevalence of usage in both areas. Socio-demographic factors associated with the usage of improved methods were almost the same between localities. Women using improved methods were less likely to suffer from RTIs across localities, except for urinary tract infections (UTIs) in rural areas; UTIs (adjusted odds ratio (AOR) = 0.95 – 1.03 in rural areas and AOR = 0.80 – 0.88 in urban areas). Findings reiterate the complexity of MHM and the need for immediate attention from the government and other agencies to ensure that girls and women have hygienic practices during their menstrual periods which will help prevent RTIs related to poor MHM.

• (Article) Process learning on partnerships: building functioning research and practice organizational relationships

  01.01.2019
  Implementers and researchers are responding to increasingly strong incentives to work together closely. Donors are placing a higher value on data, rigour, and evidence of impact from development assistance projects. This is seen in policy debates emphasizing value for money, and funding contingent on results and performance. In response, implementing organizations are increasingly collaborating with researchers. Such arrangements incur costs (financial and other), but the return on investment is high. Investments in relationship building, open and frequent communications, a clear understanding of partners’ objectives and non-negotiable requirements, and a mind-set of problem solving are important priorities in setting productive implementation science partnerships. We document process learning from developing a partnership between an implementing organization, Plan International, and a research institute, the Water Institute at the University of North Carolina. We make the case that: effective partnerships have preconditions for success; building institutional respect takes time and incremental changes to business as usual; establishing a partnership early with a long start-up period is advisable; accountability and research relevancy increase through shared roles during project design and results interpretation; and research message development requires regular review meetings with increasing frequency toward the end of a project.

• (Article) Incontinence in Zambia: initial investigation into the coping strategies of sufferers and carers

  01.07.2018
  There is little information on the management of incontinence in low-income settings. This article provides some initial insights, of particular relevance to water, sanitation, and hygiene (WASH) and health practitioners, into the coping strategies used by sufferers and carers in Zambia. Incontinence is rarely reported to medical professionals in Zambia, possibly due to a reluctance to disclose as a result of the stigma associated with the condition. Management and treatment of incontinence is subsequently limited, and both coping strategies and treatment received are determined by affordability and accessibility. If the global community is to achieve the Sustainable Development Goals of universal sanitation (Goal 6) and well-being (Goal 3), future studies and programmes on incontinence in Zambia will need to involve collaborations between WASH and health practitioners that investigate how to reduce the stigma associated with the condition and increase awareness, and how to improve the availability and affordability of management and treatment, considering the potential preference for traditional medicine in rural communities.

• (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.

• (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.

• (Article) Strengthening market systems that provide water and hygiene items for cholera mitigation and emergency preparedness in Haiti

  01.10.2018
  In the context of the cholera epidemics in Haiti, a pre-crisis market analysis (PCMA) was conducted in Artibonite to study the supply of and demand for various water- and hygiene-related items. The objective was to inform current and future assistance modalities, whilst avoiding a negative impact on local markets and supporting local businesses. The market analysis found that the majority of households already purchase soap from local traders, but very few have handwashing facilities in their home. A good uptake of chlorine-based disinfection products was observed, including specific products to treat water for drinking. In addition, an extensive local supply of calcium hypochlorite (HTH), traditionally used by water services operators, was found to be available to individuals on Haitian markets. The market for water containers was also found to be strong, with the recycling of buckets and jerry cans used to import vegetable oil and other products. However, buckets with a tap, which are recommended for safer water handling and distributed during emergencies, were not available in the market. The findings from the PCMA are being used to strengthen market systems and supply chains to enable households to access water and hygiene commodities in Artibonite rather than to provide in-kind commodities directly as part of humanitarian responses. A marketing scheme was successfully piloted to encourage the purchase of water treatment products while promoting the installation of taps on households’ buckets. But another initiative to link water committees, national authorities and the wholesaler of HTH stalled due to disagreements about the role of authorities in supplying the product.

• (Article) Assessing emotional motivators for handwashing with soap in emergencies: results from three Asian countries

  01.01.2019
  This paper examines how emotional motivators can be used to promote handwashing with soap (HWWS) among mothers affected by an emergency. The impact of using emotional motivators along with other behaviour determinants for behaviour change in development settings has been well documented; however there is limited evidence for the use of motives for HWWS in emergency contexts. Oxfam, in partnership with Unilever’s Lifebuoy soap and Unilever’s Chief Sustainability Office (CSO), collected data in three countries affected by crises – Nepal (2015), Pakistan (2014), and the Philippines (2015) – to determine motivating factors and barriers around HWWS among mothers. Methods used for the assessment included household survey, structured observation, key informant interview, focus group discussion, and behavioural trials. Post-emergency handwashing knowledge and practice was also measured along with the most effective communication channels to reach the target group. The findings reveal that all mothers were motivated by affiliation and nurture; additionally, in Nepal and Pakistan mothers were motivated by purity and mothers in the Philippines were motivated by handwashing drivers related to shame. Barriers to HWWS in emergencies relate to socio-cultural beliefs and the absence of handwashing hardware.

• (Article) From new evidence to better practice: finding the sanitation sweet spot

  01.10.2017
  A growing body of evidence shows that there is a strong causal link between exposure to poor sanitation and detrimental health, human capital, and economic outcomes. At the same time a number of recent impact evaluations of specific sanitation interventions show mixed results. This heterogeneity in findings raises the questions of whether and how the demonstrated benefits of improved sanitation can be consistently achieved through regular project implementation. This paper attempts to show that the benefits of improved sanitation can be consistently achieved through investing in interventions that address the drivers of latrine use and by divesting from interventions that do not address the drivers of latrine use.

• (Article) The handpump choice is yours: a pilot study in Rumphi District, Malawi

  01.10.2017
  In sub-Saharan Africa, moving towards the Sustainable Development Goals will require an approach to water and sanitation service delivery for many rural communities where handpumps still dominate infrastructure. This paper reviews a case study of allowing users (local government and communities) in Rumphi District, Malawi, to choose a handpump model based on information about the life-cycle costs. The results indicate that there is some awareness within communities and within the local government of several handpump options for the rural water supply in the study area. Given a choice of different handpump models in the treatment communities, each community chose the rope pump. Allowing communities to choose the type of handpump model, with input from both local government and donors on low cost borehole drilling, should be considered as an innovative approach to rural water service delivery.

• (Article) Relationship between water, sanitation, hygiene, and nutrition: what do Link NCA nutrition causal analyses say?

  01.10.2017
  Defined by UNICEF as ‘the outcome of insufficient food intake and repeated infectious diseases’, undernutrition is one of the world’s most serious problems, with long-lasting harmful impacts on health and devastating consequences for social and economic development. The three main underlying causes of undernutrition, namely unsuitable or insufficient food intake, poor care practices, and infectious diseases, are directly or indirectly related to inadequate access to water, sanitation facilities, and hygiene practices (WASH). There is a growing base of evidence showing the links between poor WASH conditions, especially exposure to poor sanitation, and stunting (low height for age ratio). However, the effects of WASH interventions on wasting (low weight for height ratio) and the impact of environmental enteric dysfunction (chronic infection of small intestine caused by extended exposure to faecal pathogens) on undernutrition should be explored further. Action Against Hunger (Action Contre la Faim) promotes a participatory nutrition causal analysis, the Link NCA methodology, which is used to analyse complex, dynamic, locally specific causes of undernutrition. This article aims to assess the main findings from 12 most recent Link NCA studies, conducted from the beginning of 2014 until the end of 2016. Results show that inadequate WASH conditions are often identified as major contributors to undernutrition in the study areas. The article also provides lessons learned and a set of practical recommendations for better alignment and integration of WASH and nutrition interventions.

• (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.

• (Article) Does women’s participation in water committees affect management and water system performance in rural Vanuatu?

  01.07.2017
  Greater participation of women in water management and decision-making is expected to improve outcomes for both women and the wider community. Global evidence indicates that women’s participation in Water User Committees (WUCs) has been limited; yet their involvement in management has correlated with more effective water systems. This analysis of water inventory data from Vanuatu considers how women’s participation in WUCs affects water management and system functionality. Women represent only 16 per cent of committee membership; however, their involvement in key WUC roles was associated with more effective water management, including regular meetings and revenue collection, and improved functioning of water systems. This evidence of women’s involvement is proving useful in advocacy efforts to improve the gender balance in WUCs, and targets for female membership are being considered for inclusion in water supply legislation.

• (Article) How is microfinance being regulated in Latin America?

  01.12.2015
  Microfinance regulation is a complex and constantly evolving topic, comprising many and very diverse issues which, moreover, are treated differently by legal systems. This paper suggests a novel comprehensive analysis structure that may serve as a benchmark to analyse different regulation frameworks for microfinance, based on the international guidelines provided by the Association of Supervisors of Banks of the Americas, the Basel Committee for Banking Supervision, and the Consultative Group to Assist the Poor. This structure is then used to compare and relate the regulations of 17 Latin American and Caribbean countries.

• (Article) Green microfinance strategy for entrepreneurial transformation: validating a pattern towards sustainability

  01.12.2015
  This paper illustrates a shifted microfinance modality that adopted greening principles towards sustainability. The empirical context of the research was a green microfinance programme implemented by an NGO microfinance institution at two study sites in Bangladesh. The research conceived and tested a microfinance model underpinned by ‘ecological modernization’ and ‘innovation and entrepreneurship’ theories. Field studies were carried out between January 2012 and June 2013 in order to match the ‘theoretical realm’ with the ‘observational realm’. A case study and participatory methods were the primary means of studying the modality and operations of the green microfinance strategy. The study compared the ecological outcomes of green microfinance-assisted enterprises and traditional microcredit-assisted enterprises and measured their greenhouse gas (GHG) emissions. Cool Farm Tool software was used to quantify GHGs. Comparison with a designed experiment shows that micro-enterprises employing green strategies emit less GHGs than the ones with traditional strategies. The research revealed that the microfinance-based greening interventions help to ensure ecological outcomes for micro-enterprises; thus, the combination of the embedded economic and social elements of the classic microfinance model with the new ecological elements supports sustainability.

• (Article) Fostering economic opportunities for youth in Africa: a comprehensive approach

  01.06.2015
  Youth unemployment and working poverty are large and growing development challenges. The barriers faced by young women and men in accessing sustainable livelihoods are many, so supporting their successful transition into employment and entrepreneurship requires a comprehensive and holistic approach. This article reflects on the evolving approach of The MasterCard Foundation-supported programmes in sub-Saharan Africa, within the broader context of wider research and evidence. It suggests that combining training in a range of market-relevant skills, with access to job and business opportunities and appropriate financial services, can foster economic opportunities for youth. It emphasizes the importance of recognizing the role of mixed livelihoods in contexts where formal jobs are lacking, and of supporting youth engagement in agriculture and agribusiness as viable livelihood opportunities. And it highlights that the challenge can only be adequately addressed via the meaningful engagement of a range of stakeholders, including the private sector, government and civil society, and, especially, youth themselves.

• (Article) Microcredit: from hope to scepticism to modest hope

  01.03.2015
  After its introduction in the late 1980s and its fast expansion thereafter modern microfinance, and specifically microcredit, raised the hope that it could combine access to (semi-) formal credit for the poor with financial sustainability of the new microfinance institutions, and that it would contribute to increased micro-entrepreneurial activity, consumer welfare, and the empowerment of women. More recently scepticism about the operation of microfinance institutions and their impact has arisen. Based on the literature, we discuss the possibility of combining outreach to the poor with financial sustainability, microfinance crises, and the findings of recent impact studies. Our conclusion is that microfinance is not a panacea for development, but that it is a tool poor households can use in their fight for survival.

• (Article) Improving the food security of the extremely poor by linking them to markets

  01.03.2015
  This article draws lessons from ACDI/VOCA, CARE, and World Vision-implemented food security programmes to answer three questions: how can push/pull activities better integrate the extremely poor into 1) output and 2) input markets? And 3) how can push/pull programme activities help improve intra-household gender dynamics and financial decision-making to improve the food and nutrition security of household members? In output markets the lessons include: 1) that market development and savings group interventions can be implemented by the same officer; and 2) projects should move early to have a private sector provider take over the village savings and loan associations. While there are constraints in the input markets, there are also push strategies for increasing production, including direct delivery of inputs to farmers, vouchers to increase demand, and Farmer Business Group development to increase collective input buying and pull strategies such as linkages with buyers for the selling of products and tapering down subsidies. Intrahousehold gender equitable decision-making can positively impact the food security of the household members. Mixed gender Village Economic and Social Associations are efficient in tackling intra-household decision-making. This allows the provision of flexible and efficient financial services as well as an opportunity to engage husbands and wives in gender-related dialogues.

• (Article) Empowerment in action: savings groups improving community water, sanitation, and hygiene services

  01.03.2015
  With 748 million people worldwide lacking adequate water, sanitation, and hygiene (WASH) services (WHO/UNICEF, 2014), increased access to these services is a significant global challenge. Savings groups (SGs) combined with social empowerment strategies can be used to engage communities meaningfully in addressing development challenges such as access to clean water and a functioning latrine. As participants in PCI's SG initiative entitled Women Empowered (WE), women have independently identified WASH needs in their communities and have organized and carried out collective actions to improve their situation. This paper highlights results from a qualitative study in which PCI looked at SGs within two international development programmes in urban and rural Guatemala. The paper explores key opportunities in implementing an integrated, social and economic empowerment strategy and how changes in self-efficacy and leadership can lead to positive community impact. PCI found that participation by women in rural and urban Women Empowered SGs contributes to increased decision-making abilities and leadership, as well as increases in collaborative, collective actions at the community-level. Moreover, when one integrates SGs as a component of larger, multi-intervention development programmes, one can create a facilitative environment which encourages SGs to participate as active development partners rather than passive development recipients.

• (Article) Bringing together push and pull through local entrepreneurs

  01.03.2015
  Despite significant efforts in agriculture market development, millions of smallholder farmers remain isolated from markets, due to remoteness and low farm productivity. Push/pull approaches to market development suggest a dual strategy for bringing smallholders into agricultural markets: 1) reduce producer vulnerability and build capacities, based on market requirements; and 2) facilitate relationships for producers to deal in consistent, growing markets. While simple in concept and effective as an approach, the execution of push/pull is complex. In particular, it is difficult to connect push (producer capacity) and pull (market) elements, resulting in unsustainable market linkages. When applying a push/pull approach in areas where the Aga Khan Foundation (AKF) works, AKF has noted that local entrepreneurs can link push and pull effectively and for the long term. This case study reviews how entrepreneurs link push and pull in AKF's market development programme in southern Tanzania. It outlines learning on how local entrepreneurs bridge gaps between producers and firms, taking the case of remote farmers accessing inputs (seed, fertilizer, implements, and pesticide) from larger suppliers. The paper describes the challenge of linking push and pull, outlines AKF's experience in southern Tanzania, and follows with points for discussion on incorporating local entrepreneurs into push/pull programmes.

• (Article) Making markets work for women: how push and pull strategies can support women's economic empowerment

  01.03.2015
  In many countries, the inability of women to negotiate pervasive social, legal, and cultural barriers inhibits their participation in the productive sphere, particularly their entry into market systems as producers and entrepreneurs. The paper draws on case studies from projects implemented by the Mennonite Economic Development Associates (MEDA) in Ghana, the Entrepreneurship and Community Development Institute (ECDI) in Pakistan, and Zardozi in Afghanistan to show how practitioners can maximize ‘push’ and ‘pull’ strategies to increase the scale, impact, and sustainability of women's economic empowerment programming. Despite differences in country contexts, value chains, and sectors, the authors illustrate the importance of ‘push’ strategies in helping women to overcome the persistent gender-based discrimination that undermines women's understanding of markets, access to networks, self-confidence, and business success. They also show how deliberate ‘pull’ strategies that use commercially based incentives can increase women's incomes and business sustainability. The authors conclude that a blend of push and pull strategies will provide the most reach and impact for women's economic empowerment projects, ensuring income growth and gender equality dividends for families and communities.