Challenges of Access to WASH in Schools in Low- and Middle-Income Countries: Case Study from Rural Central Kazakhstan.

Safe water and sanitation, which give rise to appropriate hygiene, are fundamental determinants of individual and social health and well-being. Thereby, assessing and widening access to sustainable, durable water and sanitation infrastructure remains a global health issue. Rural areas are already at a disadvantage. Poor access to water, sanitation, and hygiene (WASH) can have a major negative effect on students in rural schools. Thus, the paper aims to assess the current condition and the challenge to access WASH in rural Kazakh schools. The study was conducted in three rural schools in Central Kazakhstan. Data were gathered through a survey among pupils, observations of the WASH infrastructure and maintenance, and a face-to-face interview with school administrators. The mean survey response rate was 65% across schools. Results indicated there was no alternative drinking-water source in schools, and 15% of students said they had access to water only occasionally. Half of the students reported that the water was unsafe to drink because of a poor odor, taste, or color. The toilet in school 3 was locked with a key, and a quarter of the students reported there was no access to a key. Moreover, not having gender-separated toilet facilities was a challenge because of the traditional gender norms. Despite the effective regulations and measures of handwashing taken during COVID-19, 27.7% of the students answered that soap was not offered daily in classrooms. Additionally, warm water was only provided in school 2. About 75% of students did not have access to drying materials continuously. The study shows that having the schools' infrastructure is not enough when characteristics, such as availability, accessibility, maintenance, operation, quality of services, education, and practices, are ignored. Cooperation between local education authorities, school administration, and parents should be encouraged to the achievement of the sustainable development goals (SDGs) by 2030.

Early life risk factors of motor, cognitive and language development: a pooled analysis of studies from low/middle-income countries.

OBJECTIVE: To determine the magnitude of relationships of early life factors with child development in low/middle-income countries (LMICs). DESIGN: Meta-analyses of standardised mean differences (SMDs) estimated from published and unpublished data. DATA SOURCES: We searched Medline, bibliographies of key articles and reviews, and grey literature to identify studies from LMICs that collected data on early life exposures and child development. The most recent search was done on 4 November 2014. We then invited the first authors of the publications and investigators of unpublished studies to participate in the study. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Studies that assessed at least one domain of child development in at least 100 children under 7 years of age and collected at least one early life factor of interest were included in the study. ANALYSES: Linear regression models were used to assess SMDs in child development by parental and child factors within each study. We then produced pooled estimates across studies using random effects meta-analyses. RESULTS: We retrieved data from 21 studies including 20 882 children across 13 LMICs, to assess the associations of exposure to 14 major risk factors with child development. Children of mothers with secondary schooling had 0.14 SD (95% CI 0.05 to 0.25) higher cognitive scores compared with children whose mothers had primary education. Preterm birth was associated with 0.14 SD (-0.24 to -0.05) and 0.23 SD (-0.42 to -0.03) reductions in cognitive and motor scores, respectively. Maternal short stature, anaemia in infancy and lack of access to clean water and sanitation had significant negative associations with cognitive and motor development with effects ranging from -0.18 to -0.10 SDs. CONCLUSIONS: Differential parental, environmental and nutritional factors contribute to disparities in child development across LMICs. Targeting these factors from prepregnancy through childhood may improve health and development of children.

Exploring the determinants of open defecation in Nigeria using demographic and health survey data.

There is increasing global attention to the threats of open defecation (OD) to human health and dignity, and the environment. With at least a quarter of Nigerians (25.1%) or 46 million people practicing OD in 2015, Nigeria ranks third in the world in OD prevalence after India and China. This study explores the socio-economic, demographic and geographic factors that influence and determine the practice of OD among Nigerian households. Data was obtained from 2013 Nigeria Demographic and Health Survey and analyzed using descriptive and inferential statistics. The results indicate that about 32% of Nigerian households, 8% in urban areas and 24% in rural areas, practiced OD in 2013. The practice is significantly influenced (p < 0.001) by households' place of residence (χ2 (1) = 2126.2), geo-political region (χ2 (5) = 1962.6) and wealth index (χ2 (4) = 4622.7), as well as by household head's education level (χ2 (3) = 1253.3), ethnicity (χ2 (3) = 1926.2) and gender (t = -7.1992). The article also discusses the implications of the findings for environmental and public health and recommends that facilitating ownership of latrines by households and communities, and behavioral change interventions are necessary towards substantially reducing or eliminating OD in Nigeria.

O direito humano à água e ao esgotamento sanitário como instrumento para promoção da saúde de populações vulneráveis / The right to water and sanitation as a tool for health promotion of vulnerable groups

Resumo O conceito de promoção da saúde, baseado nos determinantes sociais, alinha-se com princípios dos direitos humanos como: participação social, responsabilidade, transparência e não discriminação. O Direito humano à água e ao esgotamento sanitário (DHAES) foi aprovado em 2010 pela Assembleia Geral das Nações Unidas e Conselho de Direitos Humanos, e visa garantir acesso à água e ao esgotamento sanitário sem discriminação para toda a população. Dito isso, o presente artigo tem como objetivo analisar de que forma o referencial dos direitos humanos, em especial do DHAES, pode ser mobilizado para fortalecer a promoção da saúde de populações vulneráveis. Para isso, inicia apresentando a relação entre saúde e direitos humanos, em seguida demonstra como o conceito de vulnerabilidade social se baseia nestes, e finaliza mostrando a relação entre o DHAES e a promoção da saúde de grupos vulneráveis.

Abstract The concept of health promotion, which is based on social determinants, is aligned with principles of human rights such as social participation, accountability, transparency and non-discrimination. The Human Right to Water and Sanitation (HRWS) was approved in 2010 by the United Nations General Assembly and the Human Rights Council and it aims to ensure access to water and sanitation, without discrimination, for all. This article aims to analyze how the human rights framework, and more specifically the HRWS, can be used to strengthen the health promotion of vulnerable groups. The article begins by presenting the relationship between health and human rights. It then demonstrates how the concept of social vulnerability is based on human rights and, finally, it shows the relationship between the HRWS and the promotion of the health of vulnerable groups.

The human right to water and sanitation: a new perspective for public policies / Direito Humano à agua e ao esgotamento sanitário: uma nova perspectiva para as políticas públicas

Abstract The recognition of the human right to water and sanitation (HRtWS) by the United Nations General Assembly and Human Rights Council in 2010 constituted a significant political measure whose direct consequences are still being assessed. Previous to this date, the HRtWS and its link to a healthy life and adequate standard of living had been recognised in diverse legal and judicial spheres worldwide, in some cases under the pressure of the initiatives of strong social movements. However, while the HRtWS is recognised by the UN State Members, it constitutes a concept in construction that has not been approached and interpreted in consensual ways by all concerned stakeholders. The present article presents a formal definition of this right with a base in human rights regulation. It attempts to dialogue with the different existing perspectives regarding the impact of its international recognition as a human right. It then elucidates the progressive development of the HRtWS in law and jurisprudence. Finally, it considers the urgency and challenge of monitoring the HRtWS and discusses important implications for public policies.

Resumo O reconhecimento do direito humano à água e ao saneamento (HRtWS) pela Assembleia Geral das Nações Unidas e pelo Conselho de Direitos Humanos, em 2010, constitui uma medida política significativa cujas consequências diretas ainda estão sendo avaliadas. Anterior a esta data, a relação entre HRtWS com uma vida saudável e um padrão de vida adequado já havia sido reconhecida em diversas esferas legais e jurídicas em todo o mundo, em alguns casos devido à pressão das iniciativas de movimentos sociais fortes. No entanto, mesmo que o HRtWS tenha sido reconhecido pelos Estados Membros das Nações Unidas, ele constitui um conceito em construção que não tem sido abordado e interpretado de maneira consensual por todos os atores interessados. O presente artigo apresenta uma definição formal desse direito com base no regulamento de direitos humanos. Tenta dialogar com as diferentes perspectivas existentes sobre o impacto do seu reconhecimento internacional como um direito humano. Em seguida, esclarece o desenvolvimento progressivo dos HRtWS na lei e na jurisprudência. Por último, considera a urgência e o desafio de monitorar os HRtWS e discute implicações importantes para políticas públicas.

Desafios para a universalização dos serviços de água e esgoto no Brasil / Challenges for providing universal access to water and sewer services in Brazil

The present article discusses the challenges that must be met to achieve universal access to water and sewer services in Brazil. First, the principles concerning the topic in Brazilian law are presented, as well as theoretical aspects including concepts relating to universalization and the standards of service employed. The main challenges for the universalization of water and sewer services in Brazil include the definition and establishment of public policies and designation of responsibility for the provision and regulation of these services. Despite the significant amount of resources available for universalization in Brazil, institutional issues in this sector hinder the broadening of the coverage, inhibiting the investments in sanitation infrastructure.