Exploring the relationship between sanitation and mental and social well-being: A systematic review and qualitative synthesis.

The WHO defines health not as the absence of disease but as a "state of complete physical, mental, and social well-being." To date, public health research on sanitation has focused mainly on the impact of sanitation on infectious diseases and related sequelae, such as diarrhea and malnutrition. This review focuses on the mental and social well-being implications of sanitation. We systematically searched leading databases to identify eligible studies. Qualitative studies were assessed using a 17-point checklist adapted from existing tools, while quantitative studies were assessed using the Liverpool Quality Appraisal Tool. We followed a best-fit framework synthesis approach using six a priori well-being dimensions (privacy, shame, anxiety, fear, assault, and safety), which were examined using line-by-line coding. Two additional dimensions (dignity and embarrassment) inductively emerged during coding for a total of eight well-being outcomes. We then synthesized coded text for each dimension into descriptive themes using thematic analysis. For quantitative studies, we extracted any measures of association between sanitation and well-being. We identified 50 eligible studies covering a variety of populations and sanitation contexts but many studies were conducted in India (N = 14) and many examined the sanitation experience for women and girls (N = 19). Our synthesis results in a preliminary conceptual model in which privacy and safety, including assault, are root well-being dimensions. When people perceive or experience a lack of privacy or safety during open defecation or when using sanitation infrastructure, this can negatively influence their mental and social well-being. We found that perceptions and experiences of privacy and safety are influenced by contextual and individual factors, such as location of sanitation facilities and user's gender identity, respectively. Privacy and safety require thorough examination when developing sanitation interventions and policy to ensure a positive influence on the user's mental and social well-being.

A Global Perspective on Drinking-Water and Sanitation Classification: An Evaluation of Census Content.

Following the recent expiry of the United Nations' 2015 Millennium Development Goals (MDGs), new international development agenda covering 2030 water, sanitation and hygiene (WASH) targets have been proposed, which imply new demands on data sources for monitoring relevant progress. This study evaluates drinking-water and sanitation classification systems from national census questionnaire content, based upon the most recent international policy changes, to examine national population census's ability to capture drinking-water and sanitation availability, safety, accessibility, and sustainability. In total, 247 censuses from 83 low income and lower-middle income countries were assessed using a scoring system, intended to assess harmonised water supply and sanitation classification systems for each census relative to the typology needed to monitor the proposed post-2015 indicators of WASH targets. The results signal a lack of international harmonisation and standardisation in census categorisation systems, especially concerning safety, accessibility, and sustainability of services in current census content. This suggests further refinements and harmonisation of future census content may be necessary to reflect ambitions for post-2015 monitoring.

Impact of a letter-grade program on restaurant sanitary conditions and diner behavior in New York City.

OBJECTIVES: We evaluated the impact of the New York City restaurant letter-grading program on restaurant hygiene, food safety practices, and public awareness. METHODS: We analyzed data from 43,448 restaurants inspected between 2007 and 2013 to measure changes in inspection score and violation citations since program launch in July 2010. We used binomial regression to assess probability of scoring 0 to 13 points (A-range score). Two population-based random-digit-dial telephone surveys assessed public perceptions of the program. RESULTS: After we controlled for repeated restaurant observations, season of inspection, and chain restaurant status, the probability of scoring 0 to 13 points on an unannounced inspection increased 35% (95% confidence interval [CI]=31%, 40%) 3 years after compared with 3 years before grading. There were notable improvements in compliance with some specific requirements, including having a certified kitchen manager on site and being pest-free. More than 91% (95% CI=88%, 94%) of New Yorkers approved of the program and 88% (95% CI=85%, 92%) considered grades in dining decisions in 2012. CONCLUSIONS: Restaurant letter grading in New York City has resulted in improved sanitary conditions on unannounced inspection, suggesting that the program is an effective regulatory tool.

Minority health and small numbers epidemiology: a case study of living conditions and the health of children in 5 foreign Romá camps in Italy.

OBJECTIVE: We sought to test methods for generating epidemiological evidence on health conditions of small, dispersed minority communities. METHODS: We used community-based mixed methods including a cross-sectional survey in 5 purposely selected settlements of Khorakané Romá (Gypsies of Muslim culture) in Italy to study the living conditions and health status of children aged from birth to 5 years. RESULTS: In the 15 days prior to the survey, 32% of the children had suffered diarrhea and 55% had had a cough. Some 17% had experienced respiratory difficulties during the past year. Risk factors associated with these outcomes included years spent living at the camp, overcrowding, housing conditions, use of wood-burning stoves, presence of rats, and issues related to quality of sanitation and drains. Qualitative information helped define the approach and the design, and in the interpretation and consolidation of quantitative results. CONCLUSIONS: Guided by the priorities expressed by dispersed minority communities, small studies with little resources can provide a solid base to advocate for evidence-based participatory planning. Exact intervals appeared to be robust and conservative enough compared with other intervals, conferring solidity to the results.

Pesquisa e desenvolvimento na área de saneamento no Brasil: necessidades e tendências / Research and development on environmental sanitation in Brazil: needs and trends

O artigo aborda um conjunto de dimensões envolvidas na pesquisa e desenvolvimento em saneamento, contextualizadas na realidade nacional. São discutidos os antecedentes históricos do tema, o sentido e os fins da pesquisa na área, os objetos e os métodos da investigação. Os temas da formação de recursos humanos, da divulgação, da transferência de tecnologia, do fomento e da avaliação da pesquisa são introduzidos, destacando a necessidade de seu aprofundamento. Apresenta-se uma proposta de protocolo para classificação e seleção de P&D na área e este é aplicado em caráter de exercício. O trabalho conclui pela constatação de diversas carências no tema, resultando nas necessidades de: inventário das iniciativas e programas existentes que fomentam a pesquisa na área; avaliação da base social sobre a qual esta se sustenta; debate sobre os objetos da investigação e sua base conceitual de suporte; debate metodológico; prospecção sobre temas de investigação, a partir de protocolo e metodologia apropriados. Finaliza-se com a proposta de elaboração de um plano diretor de pesquisas em saneamento, que forneça as bases e respalde uma futura política de pesquisas na área.

Development of an evaluation criteria for rural water supply and environmental sanitation programme in project and non-project villages--a case study.

The Rural Water Supply and Sanitation (RWSS) in project and non-project villages of Mysore Taluk has been evaluated and discussed in this paper. The study area covered two villages (Yelwala and Kadakola) where Integrated Water Supply Scheme (IRWSS) was implemented under World Bank Project and two non-project villages (Belwadi and Byathahalli) closer to them. Pre and post scenarios of the project and non-project villages were investigated in terms of water quality analysis and also grading of villages has been done on the basis of water supply, sanitation, hygienic awareness and practices. Matrix methodology was used to evaluate the indicators from the survey data gathered from all studied villages. Finally, the villages were graded on the basis of cumulative value obtained for each village. Water quality analysis depicted turbidity, total dissolved solids and hardness being high and iron deficiency was also observed in water samples of all the villages. It was concluded that the present method of evaluation of rural water supply and sanitation project could be effectively applied to different upcoming projects.

Montserrat. Managing health care in a volcanic crisis

The volcano on Montserrat, after being dormant for over 400 years, has been active for the past two years, last erupting on 27 June, 1997. With the capital, Plymouth, in the unsafe zone, major dislocation of people, facilities and services has occurred. The Health Department is splintered over five sites across an eight mile span and the temporary 30 bed hospital, sited at a primary school, is separated from its Casualty and Out-patient Department and Operating Theatre by 0.25 mile. In order to maintain continuity of care for communities, efforts have been made to keep evacuated clients and their community health workers as close together as possible. The mass emigration has depleted the health services, creating severe stress for those remaining. Elderly relatives have frequently been left behind, necessitating the establishment of special geriatric care facilities to cater to their needs. Increased and continuous health surveillance and mass media education have been integral to the prevention of major disease outbreak - particularly with added challenges to food safety, and management of liquid and solid waste disposal. Cooperation from neighbouring states, particularly Antigua, Barbados and Guadeloupe, as well as from the United Kingdom, has been critical in the management of the continuing crisis.(Au)

Evaluacion de intervenciones de agua en Bolivia. Informe de Actividad No.4 / En

Los objetivos de la evaluacion eran determinar el impacto y el efecto de las intervenciones de agua en terminos del mejoramiento de la situacion de salud de los beneficiarios,medir el grado en que las diversas intervenciones realizadas bajo los proyectos/actividades han contribuido al logro del Objetivo Estrategico de la USAID en materia de salud familiar

Evaluacion de intervenciones de agua en Bolivia. Informe de Actividad No.4 / En

Los objetivos de la evaluacion eran determinar el impacto y el efecto de las intervenciones de agua en terminos del mejoramiento de la situacion de salud de los beneficiarios,medir el grado en que las diversas intervenciones realizadas bajo los proyectos/actividades han contribuido al logro del Objetivo Estrategico de la USAID en materia de salud familiar

Assessment of sanitation conditions by qualitative sanitation measurement.

Survey of sanitation conditions by qualitative sanitation measurement were carried out in three districts, Chachoengsao Province, Thailand. The sanitation of each household was assessed in terms of positive stool examination and scores of seven main sanitary activities which were used to classify each household's sanitation as hygienic or non-hygienic. Stool collections were made from each household's housewife and examined for pathogenic bacteria and parasites. It was found that in the qualitative measurement of the household's sanitation as hygienic or non-hygienic, most sanitary activities were highly associated with the results of stool examination. From consideration of the sensitivity, specificity and kappa coefficient of significant sanitary activities as predictors and the result of stool examination was used as gold standard, it was apparent that a package of all main sanitary activities was the most appropriate measurement in the survey to assess sanitation conditions in the community.

Plan Nacional de Agua Potable y Alcantarillado Sanitario 1992-2000: "Agua para Todos" / sss

El presente documento es un Plan Nacional de Agua Potable y Alcantarillado Sanitario que tiene como objetivo general, elevar la calidad de vida de la población a través de la dotación, el mejoramiento y la sustentación de los servicios de agua potable y saneamiento. Entre los objetivos específicos; establecer nuevas estrategias en el abastecimiento de agua potable y saneamiento; lograr una efectiva participación de las empresas e instituciones responsables de los abastecimientos de servicio; desarrollar proyectos que permitan aumentar la cobertura y mejorar la calidad de los servicios en las áreas urbana y rural, preferentemente en las zonas más deprimidas; garantizar y promover la sustentabilidad y calidad de los mismos mediante programas de apoyo que logren el desarrollo institucional de las entidades del sector

Abastecimiento de agua y saneamiento de bajo costo: inodoro de sello hidraúlico con descarga manual reducida / sss

El presente documento tiene como obejtivo principal desarrollar y difundir tecnologías apropiadas y de bajo costo, que permitan mejorar las condiciones sanitarias de las poblaciones; se investigó y se seleccionó la aplicación del inodoro casero o taza campesina, de la letrina mejorada, el calentador solar, el conjunto mínimo de servicios básicos, el ariete hidraúlico, em molino de viento y la bomba manual