Informing pandemic management in Germany with trustworthy living evidence syntheses and guideline development: lessons learned from the COVID-19 evidence ecosystem.

OBJECTIVES: We present the 'COVID-19 evidence ecosystem' (CEOsys) as a German network to inform pandemic management and to support clinical and public health decision-making. We discuss challenges faced when organizing the ecosystem and derive lessons learned for similar networks acting during pandemics or health-related crises. STUDY DESIGN AND SETTING: Bringing together 18 university hospitals and additional institutions, CEOsys key activities included research prioritization, conducting living systematic reviews (LSRs), supporting evidence-based (living) guidelines, knowledge translation (KT), detecting research gaps, and deriving recommendations, backed by technical infrastructure and capacity building. RESULTS: CEOsys rapidly produced 31 high-quality evidence syntheses and supported three living guidelines on COVID-19-related topics, while also developing methodological procedures. Challenges included CEOsys' late initiation in relation to the pandemic outbreak, the delayed prioritization of research questions, the continuously evolving COVID-19-related evidence, and establishing a technical infrastructure. Methodological-clinical tandems, the cooperation with national guideline groups and international collaborations were key for efficiency. CONCLUSION: CEOsys provided a proof-of-concept for a functioning evidence ecosystem at the national level. Lessons learned include that similar networks should, among others, involve methodological and clinical key stakeholders early on, aim for (inter)national collaborations, and systematically evaluate their value. We particularly call for a sustainable network.

"Community strengthening through citizen monitoring of water quality: A systematic review".

Citizen participation in decision-making is a fundamental democratic pillar of democracy. However, the degree of citizen involvement and recognition by governmental institutions may be conditioned by the level of competence and knowledge demonstrated. Therefore, carrying out collective projects can contribute to strengthening citizen engagement in water management issues. Nonetheless, there is limited knowledge about the various types of citizen engagement and the practices that have facilitated greater inclusion in decision-making regarding water resources. This study aims to identify and analyze practices that strengthen water community organizations through citizen monitoring-based involvement. A systematic literature review was conducted using the PRISMA method. The research was guided by the following questions: What are the differences in the level of citizen involvement and the degree of transformation facilitated by citizen monitoring of water quality (CMWQ) between the global North and South? What practices strengthen community organizations in decision-making based on CMWQ? Moreover, what challenges do community water organization structures community water organization structures face when based on CMWQ? A total of 161 publications were identified for the analysis of critical themes. After applying the eligibility criteria, 33 documents were selected for content analysis. The reviewed monitoring exercises indicate that the highest level of citizen organization achieved by participants is commonly recognized as "Water Committees". One practice that strengthens these committees is the generation of collaboration agreements among different types of allies, based on a shared objective. However, in the Global South and at the institutional level, there is still resistance to water quality data generated by citizen monitors, especially in regions with large-scale open-pit mining projects. To sustain the efforts of community figures, monitoring programs with public funding need to be established, and public policies supporting these initiatives at the institutional level must be implemented.

Roles, Responsibilities, and Functions of Village Health, Sanitation, and Nutrition Committees in India: A Qualitative Evidence Synthesis.

National Health Mission instituted the Village Health, Sanitation, and Nutrition Committees (VHSNCs) in 2005, with an aim of ensuring health and well-being for local communities in India. There is a lack of concrete evidence on the functioning of VHSNCs at a national level. Thus, this study was undertaken to outline the roles, responsibilities, and functions of VHSNCs in India. We conducted a comprehensive data search in Medline, Cochrane Library, ScienceDirect, EMBASE, and Google Scholar between 2005 and August 2021. All peer-reviewed qualitative studies that reported the roles, responsibilities, functions, and good practices of VHSNCs from India were included in our review. Critical Appraisal Skills Programme checklist was used to assess the quality of individual studies. In total, we included 15 studies (including 1100+ VHSNCs) from various states of India. Our review highlighted that the majority of the VHSNCs functioned without a clear-cut definition of roles and responsibilities had irregular meetings and workforce shortage. There was a lack of inclusivity, accountability, and delay in the processing of untied funds. The included studies have showed that VHSNCs were involved health promotional activities such as formulation and implementation of village health plans, delivery of services through public distribution systems, ensuring safe drinking water and sanitary supervision, and identification and referral of malnourished children. Our review highlights the crucial role that VHSNCs play in improving the health outcomes of rural populations and underscores the need for continued support and capacity-building efforts to ensure their effectiveness.

Burden and trends of infectious disease mortality attributed to air pollution, unsafe water, sanitation, and hygiene, and non-optimal temperature globally and in different socio-demographic index regions.

BACKGROUND: Environmental factors greatly impact infectious disease-related mortality, yet there's a lack of comprehensive global studies on the contemporary burden and trends. This study aims to evaluate the global burden and trends of infectious disease mortality caused by air pollution, unsafe water, poor sanitation, and non-optimal temperature across Socio-Demographic Index (SDI) regions from 1990 to 2019. METHODS: This observational study utilized data from the Global Burden of Diseases Study to examine mortality rates from infectious diseases attributed to environmental risk factors between 1990 and 2019, including air pollution, unsafe water, sanitation, handwashing facilities (UWSH), and non-optimal temperatures. Age-standardized mortality rates (ASMRs) and estimated annual percentage change (EAPC) were utilized to present infectious disease mortality, and its trajectory influenced by environmental risk factors over the years. Nonlinear regression was conducted to explore the association between the SDI and ASMRs across regions from 1990 to 2019. RESULTS: In 2019, global infectious disease deaths linked to air pollution, UWSH, and non-optimal temperature reached a startling 2,556,992. Disease mortality varied widely across SDI regions, with the highest number of deaths due to air pollution and UWSH in Low SDI regions, and deaths from non-optimal temperature primarily in High SDI regions. Age disparities emerged, with children under five and the elderly most affected. However, an increasing mortality trend was observed among seniors (65-69, 75-79, and over 80) in High SDI regions due to enteric infections linked to UWSH. Globally, a consistent decrease in ASMR was seen from 1990 to 2019 for all diseases connected to these factors, except for respiratory infections linked to non-optimal temperature. CONCLUSIONS: Our study underscores the significant impact of air pollution, UWSH, and non-optimal temperatures on global infectious disease mortality, particularly among vulnerable groups such as children and the elderly. It's important to tackle these challenges with targeted interventions aiming to enhance environmental quality, improve water and sanitation systems, and control extreme temperatures. In addition, international cooperation is essential for bridging regional disparities and driving global public health initiatives forward, thereby helping achieve Sustainable Development Goals more effectively.

Leveraging wastewater-based epidemiology to monitor the spread of neglected tropical diseases in African communities.

Neglected tropical diseases continue to cause a significant burden worldwide, with Africa accounting for more than one-third of the global burden. Over the past decade, progress has been made in eliminating, controlling, and eradicating these diseases in Africa. By December 2022, 47 out of 54 African countries had eliminated at least one neglected tropical disease, and more countries were close to achieving this milestone. Between 2020 and 2021, there was an 80 million reduction in people requiring intervention. However, continued efforts are needed to manage neglected tropical diseases and address their social and economic burden, as they deepen marginalisation and stigmatisation. Wastewater-based epidemiology involves analyzing wastewater to detect and quantify biomarkers of disease-causing pathogens. This approach can complement current disease surveillance systems in Africa and provide an additional layer of information for monitoring disease spread and detecting outbreaks. This is particularly important in Africa due to limited traditional surveillance methods. Wastewater-based epidemiology also provides a tsunami-like warning system for neglected tropical disease outbreaks and can facilitate timely intervention and optimised resource allocation, providing an unbiased reflection of the community's health compared to traditional surveillance systems. In this review, we highlight the potential of wastewater-based epidemiology as an innovative approach for monitoring neglected tropical disease transmission within African communities and improving existing surveillance systems. Our analysis shows that wastewater-based epidemiology can enhance surveillance of neglected tropical diseases in Africa, improving early detection and management of Buruli ulcers, hookworm infections, ascariasis, schistosomiasis, dengue, chikungunya, echinococcosis, rabies, and cysticercosis for better disease control.

The Missing Piece of the Puzzle: How Different Water-related Public Concerns Contribute to Water Governance in China.

Public participation is crucial to improving the performance of water governance systems, especially in a governance model dominated by a top-down hierarchical structure. Public concerns, as a vital form of public participation, have been acknowledged as an essential component in contributing to water governance. However, few studies explore the varying effects of diverse public concerns in leading to different water governance outcomes. This study addresses this gap by exploring the direct and indirect effects of water-related public concerns on water pollution control and governments' pollution mitigating actions, using citizens' water-related posts crawled from China's social media. Results show that public water-related concerns contribute to water governance both through its direct effects on reducing water pollution and indirect effects by promoting policy actions. Specifically, the concerns related to water pollution hazards, water pollution monitoring, prevention products, and water pollution control measures have more positive impacts on water pollution reduction compared to other types of concern. Meanwhile, public concerns demonstrate stronger effects in triggering economic-related and infrastructure-related water pollution mitigation actions. This study provides nuanced insights to understand the role of public participation in improving water governance, the findings of which are insightful to enhance accountability of water governance systems through a bottom-up approach.

Global Water Challenges in Sub-Saharan Africa and how to strengthen science-policy dialogues on transboundary governance and cooperation.

The United Nations Water Conference 2023 highlighted the need for concrete actions to boost integrated water resources management for achieving the Sustainable Development Goals and called for strategies to enhance cooperation among stakeholders. Technical cooperation between countries and institutions in transboundary systems, e.g., on environmental data collection, is an effective way to promote international diplomacy and prevent disputes between riparian states. Still, establishing collaborations to inform bilateral dialogues on the identification of environmental challenges, their causes, and development priorities may be a difficult task in itself. This is particularly true in the African context because of limited resources and lack of data. In this paper, we analyse the case of nine transboundary river basins in Sub-Saharan Africa to identify which water-management challenges are perceived as most important by the different riparian countries from a policy and scientific perspective. Our insights are based on the most up-to-date scientific papers, open access reports and technical literature, river basin authority's strategy papers, projects' summary reports, and national policy documents. We also complement these sources with the pieces of information we gained through collaborations with regional and local experts, and management bodies (such as river basin authorities). We highlight the current water-related conflicts and the gap between the priorities identified by the scientific community and different riparian countries on how to tackle hydro-climatic change and improve food and energy security, human and environmental health. Based on our experience, we discuss some keys to building trust among stakeholders, strengthening cooperation, and identifying shared water-governance measures in transboundary river basins. They are: (i) connect science and policy to provide sound knowledge for the right questions, (ii) value local knowledge and exploit the complementarity of different perspectives, (iii) consider multiple spatial scales and multi-level stakeholders to leave no one behind, (iv) promote a culture which values trade-offs and handles complexity, and (v) co-create data and knowledge to facilitate stakeholder dialogue from problem definition to intervention identification.

Water, Sanitation, and Hygiene (WASH) practices among residents of different slum settlements in a ward of Kolkata: A mixed-methods study.

BACKGROUND: Access to safe water, sanitation, and hygiene (WASH) is the most basic need for mankind. Poor WASH practices are associated with various waterborne diseases, especially in developing countries such as India. The aim of the study was to assess WASH practices among residents of different slum settlements in a ward of Kolkata, identify the factors associated with WASH practice, and explore the barriers faced by the families and municipal staff in providing adequate WASH services to the community. MATERIALS AND METHODS: An observational study, cross-sectional in design with a convergent parallel mixed-methods approach, was conducted in different slum settlements in a ward of Kolkata. Quantitative data were collected by face-to-face interview, spot observation, and measuring the living area, door, and window spaces. Key informant interviews were conducted with the medical officer, ward vector-control coordinator, and municipal waste handlers, in addition to in-depth interviews with respondents who had unsatisfactory WASH practices. SPSS version 25.0 was used to analyze the quantitative data. Qualitative data were analyzed thematically using Atlas.ti 22. RESULTS: The overall WASH practices were considered satisfactory in 58.8% of the households. Education of the respondents up to the secondary level, presence of overcrowding, and inadequate ventilation in the house had statistically significantly higher odds of unsatisfactory practice. Poor living conditions, difficulty in collecting and storing water, waterlogging, blocked sewage drains, common toilets for men and women, and lack of motivation were the primary obstacles identified by the residents. CONCLUSION: Unsatisfactory WASH practices were observed among a high proportion of the slum population. Community engagement and education regarding WASH in communities is strongly recommended along with improvement of infrastructure and capacity building.

Microplastics in marine ecosystems: A comprehensive review of biological and ecological implications and its mitigation approach using nanotechnology for the sustainable environment.

Microplastic contamination has rapidly become a serious environmental issue, threatening marine ecosystems and human health. This review aims to not only understand the distribution, impacts, and transfer mechanisms of microplastic contamination but also to explore potential solutions for mitigating its widespread impact. This review encompasses the categorisation, origins, and worldwide prevalence of microplastics and methodically navigates the complicated structure of microplastics. Understanding the sources of minute plastic particles infiltrating water bodies worldwide is critical for successful removal. The presence and accumulation of microplastics has far reaching negative impacts on various marine creatures, eventually extending its implications to human health. Microplastics are known to affect the metabolic activities and the survival of microbial communities, phytoplankton, zooplankton, and fauna present in marine environments. Moreover, these microplastics cause developmental abnormalities, endocrine disruption, and several metabolic disorders in humans. These microplastics accumulates in aquatic environments through trophic transfer mechanisms and biomagnification, thereby disrupting the delicate balance of these ecosystems. The review also addresses the tactics for minimising the widespread impact of microplastics by suggesting practical alternatives. These include increasing public awareness, fostering international cooperation, developing novel cleanup solutions, and encouraging the use of environment-friendly materials. In conclusion, this review examines the sources and prevalence of microplastic contamination in marine environment, its impacts on living organisms and ecosystems. It also proposes various sustainable strategies to mitigate the problem of microplastics pollution. Also, the current challenges associated with the mitigation of these pollutants have been discussed and addressing these challenges require immediate and collective action for restoring the balance in marine ecosystems.

Exploring local perceptions and drivers of engagement in biodiversity monitoring among participants in payments for ecosystem services schemes in southeastern Mexico.

Payments for ecosystem services (PES) are widely applied incentive-based instruments with diverse objectives that increasingly include biodiversity conservation. Yet, there is a gap in understanding of how to best assess and monitor programs' biodiversity outcomes. We examined perceptions and drivers of engagement related to biodiversity monitoring through surveys among current PES participants in 7 communities in Mexico's Selva Lacandona. We conducted workshops among survey participants that included training and field deployment of tools used to monitor biodiversity and land cover, including visual transects, camera traps, acoustic recorders, and forest cover satellite images. We conducted pre- and postworkshop surveys in each community to evaluate changes in respondents' perceptions following exposure to biodiversity monitoring training and related field activities. We also reviewed existing research on participatory environmental management and monitoring approaches. One quarter of current PES participants in the study area participated in our surveys and workshops. The majority stated interest in engaging in diverse activities related to the procedural aspects of biodiversity monitoring (e.g., planning, field data collection, results dissemination) and acknowledged multiple benefits of introducing biodiversity monitoring into PES (e.g., knowledge and capacity building, improved natural resource management, and greater support for conservation). Household economic reliance on PES was positively associated with willingness to engage in monitoring. Technical expertise, time, and monetary constraints were deterrents. Respondents were most interested in monitoring mammals, birds, and plants and using visual transects, camera traps, and forest cover satellite images. Exposure to monitoring enhanced subsequent interest in monitoring by providing respondents with new insights from their communities related to deforestation and species' abundance and diversity. Respondents identified key strengths and weaknesses of applying different monitoring tools, which suggests that deploying multiple tools simultaneously can increase local engagement and produce complementary findings and data. Overall, our findings support the relevance and usefulness of incorporating participatory biodiversity monitoring into PES.

Explorando las percepciones locales y los impulsores de la participación en el monitoreo de la biodiversidad entre participantes de esquemas de pagos por servicios ambientales en el sureste de México Resumen Los pagos por servicios ambientales (PSA) son instrumentos basados en incentivos ampliamente aplicados cuyos diversos objetivos incluyen cada vez más la conservación de la biodiversidad. Sin embargo, existe una brecha en la comprensión de cómo evaluar y monitorear los resultados de los programas en materia de biodiversidad. Examinamos las percepciones y los impulsores de la participación relacionados al monitoreo de la biodiversidad a través de encuestas entre participantes actuales de PSA en siete comunidades de la Selva Lacandona de México. Realizamos talleres entre los participantes de las encuestas que incluyeron capacitación y despliegue en campo de herramientas utilizadas para monitorear la biodiversidad y la cobertura del suelo, incluidos transectos visuales, cámaras trampa, grabadores acústicos e imágenes satelitales de la cobertura forestal. Realizamos encuestas antes y después del taller en cada comunidad para evaluar los cambios en las percepciones de los participantes tras su involucramiento en la capacitación de monitoreo de biodiversidad y las actividades de campo relacionadas. También revisamos la investigación existente sobre enfoques de monitoreo y gestión ambiental participativa. Una cuarta parte de los participantes actuales de PES en el área de estudio participaron en nuestras encuestas y talleres. La mayoría declaró interés en participar en diversas actividades relacionadas con los aspectos procesales del monitoreo de la biodiversidad (por ejemplo, planificación, recopilación de datos de campo, difusión de resultados) y reconoció múltiples beneficios de introducir el monitoreo de la biodiversidad en los PSA (por ejemplo, creación de conocimientos y capacidades, mejora de la gestión de los recursos naturales, y mayor apoyo a la conservación). La dependencia económica de los hogares de los PSA se asoció positivamente con la voluntad de participar en el monitoreo. Los factores inhibidores fueron la experiencia técnica, el tiempo y las limitaciones monetarias. Los encuestados estaban más interesados en monitorear mamíferos, aves y plantas y en utilizar transectos visuales, cámaras trampa e imágenes satelitales de la cubierta forestal. La exposición al monitoreo aumentó el interés posterior en el monitoreo al brindar a los encuestados nuevos conocimientos de sus comunidades relacionados con la deforestación y la abundancia y diversidad de especies. Los encuestados identificaron fortalezas y debilidades clave al aplicar diferentes herramientas de monitoreo, lo que sugiere que implementar múltiples herramientas simultáneamente puede aumentar la participación local y producir hallazgos y datos complementarios. En general, nuestros hallazgos respaldan la relevancia y utilidad de incorporar el monitoreo participativo de la biodiversidad en los PSA.

Addressing the global challenge of coastal sewage pollution.

Coastal environments, essential for about half of the world's population living near coastlines, face severe threats from human-induced activities such as intensified urbanization, aggressive development, and particularly, coastal sewage pollution. This type of pollution, comprising untreated sewage discharging nutrients, pathogens, heavy metals, microplastics, and organic compounds, significantly endangers these ecosystems. The issue of sewage in coastal areas is complex, influenced by factors like inadequate sewage systems, septic tanks, industrial and agricultural runoff, and natural processes like coastal erosion, further complicated by oceanic dynamics like tides and currents. A global statistic reveals that over 80 % of sewage enters the environment without treatment, contributing significantly to nitrogen pollution in coastal ecosystems. This pollution not only harms marine life and ecosystems through chemical contaminants and eutrophication, leading to hypoxic zones and biodiversity loss, but also affects human health through waterborne diseases and seafood contamination. Additionally, it has substantial economic repercussions, impacting tourism, recreation, and fisheries, and causing revenue and employment losses. Addressing this issue globally involves international agreements and national legislations, but their effectiveness is hindered by infrastructural disparities, particularly in developing countries. Thus, effective management requires a comprehensive approach including advanced treatment technologies, stringent regulations, regular monitoring, and international cooperation. The international scientific community plays a crucial role in fostering a collaborative and equitable response to this pressing environmental challenge.

Analysis of recent land management initiatives in Nicaragua from the perspective of the "ecosystem approach".

In the world there are approximately 608 million farms, of which 84% are small farms and produce 35% of the food of the world population. Training programs have been promoted by different organizations to achieve a more sustainable and efficient agricultural practice. Within this context, this article has classified a set of smallholders located in central Nicaragua with regard to how they apply Land Use Management Initiatives (LUMI). The aim is to outline their weaknesses and strengths and thus identify key elements that can contribute to improving soil resource management. We focus on the LUMI carried out in Nicaragua in the municipalities of El Tuma-La Dalia, El Cuá and Waslala between 1992 and 2022. To conduct this study, eight LUMI were identified and analysed, and 25 indicators linked to the Malawi Principles were extracted and selected for the design of a survey in order to collect land use management information from 455 farms in the study area. Simple random sampling was used to select the farms. Subsequently, the collected data were analysed using descriptive statistics and Multivariate Analysis techniques. The results reveal that in the study area, the LUMI incorporate between one and five Malawi Principles. The multivariate analysis techniques employed identified three clusters of farms, with either Active, Moderate or Improvable ecosystem management. The study area as a whole displays strengths in social participation, local capacity building, soil and environmental conservation practices, with the farm as the main source of income. Weaknesses lie in the fact that indicators referring to household income and productivity are less frequent. In terms of farm management, the results revealed that combined male and female management was similar in percentage to male-only management. The results highlight the need to continue with the implementation of environmental goals linked to the design of initiatives that promote productivity, income and gender equity in farm management in an integrated manner. At the same time, existing local capacities for sustainable soil and ecosystem management should be brought together and strengthened.

The immunology ecosystem in South Africa: striking an equitable balance between fostering discovery, promoting translation and capacity building.

In the vast and diverse continent of Africa, the field of immunology holds immense significance as it navigates the complex landscape of infectious diseases and public health challenges. In this article, we speak with Professor Clive Gray, who provides powerful and valuable insights into the unique research opportunities and immunological advancements supported by Africa's unique blend of social, economic and environmental factors and also discusses the societal and cultural challenges that need to be overcome for equitable research to be achieved across the continent.

Frontier issues in international ocean governance: Japan's discharge of nuclear contaminated water into the sea.

This paper aimed at explore international ocean governance issues through the perspective of Japan's nuclear contaminated water discharge to the sea. This paper analyzes the core issue of Japan's plan to discharge nuclear contaminated water into the ocean from the perspectives of Japan's international legal obligation, law enforcement issues, and judicial issues after integrated analyzing academic research paper and cases. Japan has obligations such as timely notification, information disclosure, environmental impact assessment, and avoidance of transboundary harm. Intergovernmental and non-governmental international organizations, such as IAEA, IMO and WHO should play a role in setting up an international group of experts to carry out monitoring and assessment, and whose positions and attitudes are important references for judging Japan's behavior. Cases heard before ICJ, ITLOS, and advisory opinion proceeding could provide reference from the judicial perspective on the issue of transboundary harm and proof of damages. Furthermore, this paper discusses the response strategies that the international community especially the opponents may adopt, including promoting the adoption of relevant treaties, take a combination of requesting advisory opinion and file arbitration, establish effective international monitoring mechanism, and engage in close communication with stakeholders.

Exploring power building capacity at the ecosystem level: A case study of a justice-oriented organizational network.

Community organizing and base building groups operate as part of a larger ecosystem of organizations, each with complementary capacities necessary to build power and achieve social change. Analytic approaches to assessing power in organizational networks can generate data to inform strategy, identify gaps, and help nurture organizational ecosystems that support communities in building and exercising power. This article uses a network of 43 justice-focused organizations in the Bay Area, California and their 267 reported connections as a case study to assess the feasibility of measuring power building capacities using social network analyses. We evaluated network capacity for different power-building capacities and explored the relationships between organizations' positions in the network and their access to capacity. We found that justice-focused organizations were more likely than their connections to have mature capacity for creating alliances and coalitions and for research/legal strategies, whereas their connections were more likely to report mature capacity for community organizing. Most participants in the network were connected within one degree to an organization that was mature in organizing and base building. These results highlight the potential to assess community power building capacities within networks of organizations to identify ecosystem strengths and weaknesses and opportunities for strategic development.

Cultivating an ecosystem: A qualitative exploration of sustainability in long-standing community-based participatory research (CBPR) partnerships.

Background: While sustainability is crucial to the success of community-based participatory research (CBPR) partnerships, there is a lack of conceptual clarity on what defines sustainability and what characterizes sustainability-promoting practices in long-standing (in existence ≥ 6 years) CBPR partnerships. Objectives: The aim of this article is to explore the definition of sustainability, as well as practices that influence sustainability from the perspectives of academic and community experts in long-standing CBPR partnerships. Methods: This qualitative analysis is part of Measurement Approaches to Partnership Success (MAPS), a participatory mixed methods validity study that examined "success" and its contributing factors in long-standing CBPR partnerships. Thematic analysis of 21 semi-structured interviews was conducted, including 10 academic and 11 community experts of long-standing CBPR partnerships. Results: The key defining components of sustainability we identified include: distinguishing between sustaining the work of the partnership and ongoing relationships among partners; working towards a common goal over time; and enduring changes that impact the partnership. We further identified strengthening and capacity building practices at multiple levels of the partnership that served to promote the sustainability of the partnership's work and of ongoing relationships among partners. Conclusions: Sustainability can be understood as supporting an ecosystem that surrounds the beneficial relationships between academic and community partners. Ongoing evaluation and application of practices that promote the sustainability of partnership activities and relationships may strengthen the long-term effectiveness of CBPR partnerships in advancing health equity.

Improving Access to Safe Water in Rural Schools of Kenya: Qualitative Multisectoral Insights.

BACKGROUND: Comprehensive strategies in water, sanitation, and appropriate hygiene behaviors can improve school enrolment and improve gender parity disparities. Lack of safe drinking water negatively impacts the social capital of people, especially school-going children in rural areas. In this study, we systematically evaluated and documented evidence on the barriers and facilitators in the access and adoption of safe water practices in rural schools in Laikipia County, Kenya. METHODS: An ethnographic formative, collaborative implementation research design was used in an iterative and participatory process to evaluate community, socio-economic, and health system-related factors affecting water, hygiene, and sanitation strategies. Qualitative data was collected using key informant interviews (n=5) and focus groups (n=3) from various multisectoral participants. Directed content analysis was used to develop codes, categories, and themes from textual data. Data was organized according to the Promoting Action on Research Implementation in Health Services framework. RESULTS: The findings were classified and described under three key elements: context, evidence, and facilitation. Contextual elements showed an association of diarrhea outbreaks with unsafe hygiene practices compounded by water scarcity. The evidence elements were indicative of the applicability of water backpacks in strengthening handwashing, storage, and transport of water. Facilitation elements indicated evidence of gaps in synergy between the school health and public health systems, necessitating multisectoral collaboration and social capital capacity building. CONCLUSION: The national and county governments play an imperative role in ensuring access and continuous supply of safe drinking water in schools. This is fundamental in efforts towards reducing social inequalities of health among school-going children and building their social capital. Participatory, collaborative, multisectoral interventions and decision-making are crucial, leveraging on creating local ownership, in meeting the water consumption needs of children and communities in water-scarce regions.

Application of Artificial Intelligence in the Management of Drinking Water: A Narrative Review.

Waterborne illnesses are a significant concern worldwide. The management of water resources can be facilitated by artificial intelligence (AI) with the help of data analytics, regression models, and algorithms. Achieving the Sustainable Development Goals (SDGs) of the 2030 Agenda for Sustainable Development of the United Nations depends on understanding, communicating, and measuring the value of water and incorporating it into decision-making. Various barriers are used from the source to the consumer to prevent microbiological contamination of drinking water sources or reduce contamination to levels safe for human health. Infrastructure development and capacity-building policies should be integrated with guidelines on applying AI to problems relating to water to ensure good development outcomes. Communities can live healthily with such technology if they can provide clean, economical, and sustainable water to the ecosystem as a whole. Quick and accurate identification of waterborne pathogens in drinking and recreational water sources is essential for treating and controlling the spread of water-related diseases, especially in resource-constrained situations. To ensure successful development outcomes, policies on infrastructure development and capacity building should be combined with those on applying AI to water-related problems. The primary focus of this study is the use of AI in managing drinking water and preventing waterborne illness.