Important CLTS in Mali study with response by W-P Schmidt | Report on private sector in WINS | FSM in Malawi and Zambia
Dan Campbell
Effect of a community-led sanitation intervention on child diarrhoea and child growth in rural Mali: a cluster-randomised controlled trial.
Lancet Global Health, Nov 2015. Authors: Amy J Pickering, Habiba Djebbari, Carolina Lopez, Massa Coulibaly,
Maria Laura Alzua
Link: http://goo.gl/PM0Hvf
Background - Community-led total sanitation (CLTS) uses participatory approaches to mobilise communities to build their own toilets and stop open defecation. Our aim was to undertake the first randomised trial of CLTS to assess its effect on child health in
Koulikoro, Mali.
Findings - Children in CLTS villages were taller (0·18 increase in height-for-age Z score, 95% CI 0·03–0·32; 2415 children) and less likely to be stunted (35% vs 41%, PR 0·86, 95% CI 0·74–1·0) than children in control villages. 22% of children were underweight
in CLTS compared with 26% in control villages (PR 0·88, 95% CI 0·71–1·08), and the difference in mean weight-for-age Z score was 0·09 (95% CI –0·04 to 0·22) between groups. In CLTS villages, younger children at enrolment (<2 years) showed greater improvements
in height and weight than older children.
Interpretation - In villages that received a behavioural sanitation intervention with no monetary subsidies, diarrhoeal prevalence remained similar to control villages. However, access to toilets substantially increased and child growth improved, particularly
in children <2 years. CLTS might have prevented growth faltering through pathways other than reducing diarrhoea.
Seven trials, seven question marks. Lancet Global Health, Nov 2015. Author: Wolf-Peter Schmidt.
Link: http://goo.gl/i6lXg9
All seven sanitation trials published so far might underestimate the true health effect of sanitation because they were undertaken in rural villages, whereas sanitation interventions could be more effective in dense urban slums. Completing a trial in this setting,
however, would be difficult. Additionally, the timeline to implement and assess the interventions might have been unrealistically short to achieve a health effect. Improving sanitation takes years rather than months, but there are clear ethical and logistical
barriers to undertaking longer-term trials.10 Therefore, the study by Pickering and colleagues might be as good as it gets, and their results provide much needed encouragement in this important area of public health. Additional evidence would be desirable,
but might not be achieved.
Engaging private sector actors in WASH in School work, 2015. Partnerships in Practice, Ltd. Authors: Tiberghien J-E.1, Albert M.2, Moersberger H.2 , and Schädler M.2
Link: http://goo.gl/4bPCeK
The study focuses on international and domestic private companies and their foundations. It examines these partners, reveals their incentives to join WinS multisector partnerships, uncovers trends and patterns in their contributions, and the benefits they derive from such partnerships. The paper underlines the need to diversify the contributions made by private partners to foster more sustainable programmes. It argues for an engagement based on strategic CSR rather than philanthropic incentives. Structural obstacles constraining the development of more ambitious partnerships are identified, and pragmatic recommendations to overcome them provided.
A comparative study of faecal sludge management in Malawi and Zambia: Status, challenges and opportunities in pit latrine emptying. Authors: Rochelle Holm, James Madalitso Tembo, Bernard Thole
Link: http://goo.gl/6LRKKh
This review paper covers the issues of pit latrine emptying national policies and regulations with a focus on Malawi and Zambia. With 2.4 billion people worldwide still lacking improved sanitation facilities, developing countries need to look at policy, regulation and practice for household sanitation service provision with a new lens. What happens “next,” when improved sanitation facilities eventually become full? An emphasis on faecal sludge management has multiplied this important issue in the past few years. The authors compare the pit latrine emptying situation in Malawi and Zambia with a focus on status, challenges and opportunities.