Search Results (250)

Background: Kigali, Rwanda’s rapidly growing capital, faces major challenges in household-level Fecal Sludge Management (FSM), with over 89% of households using pit latrines and only 48% accessing unshared sanitation. FSM services are limited, costly, and poorly executed, leading to frequent illegal dumping. Objective: This review analyzes the literature on sanitation in Kigali to identify key gaps, synergies, and recommendations for improvement. Methods: Following PRISMA 2020 guidelines, 73 relevant publications were selected from various scientific and governmental sources. Publications were included only if they were published from 2013 to 2024 and had information on sanitation in Kigali. NOS and JBI tools were utilized to assess the quality of included publications. Results: Data were categorized into four themes, (1) access to sanitation, (2) FSM services, (3) public health, and (4) sanitation governance, and analyzed using thematic, narrative, and descriptive methods. Findings reveal a dysfunctional FSM service chain, weak policy enforcement due to overlapping responsibilities, underfunding, and limited private sector participation. These issues contribute to poor sanitation, inadequate hygiene, and prevalence of diarrheal diseases and Tropical Neglected Diseases, especially among young children. Conclusions: The review recommends strengthening governance and clarifying roles, enforcing adaptable regulations, promoting public–private partnerships, and managing the full FSM service chain more effectively. Future research should focus on developing context-specific technologies and financing strategies to support sustainable FSM solutions in Kigali. Full article

Urban water, defined as water not used for agriculture or to support natural ecosystems, is increasingly impacted by anthropogenic pollution. Among the key concerns are emerging contaminants (ECs), a diverse group of largely unregulated chemical compounds that pose growing threats to both water and the life it supports. This review critically examines the challenges associated with the presence of ECs in urban water through two complementary approaches that together offer both scientific and policy-oriented insights. The first approach focuses on evaluating the difficulties in classifying, characterizing, detecting, monitoring, enforcing policies, and assessing the risks of ECs. The second approach focuses on assessing whether current efforts in research, public awareness, regulation, treatment, recycling, and international collaboration align with the United Nations Sustainable Development Goals (SDGs), particularly SDG 6 (clean water and sanitation), SDG 11 (sustainable cities and communities), and SDG 12 (responsible consumption and production). Current efforts to address the challenges posed by ECs and to achieve SDG targets remain insufficient, particularly in the areas of treatment and recycling. Globally, only 56% of household wastewater is treated safely, and industrial wastewater treatment in low-income countries remains severely lacking, with coverage under 30%. Globally, the effective management of ECs is hindered by outdated and inadequate treatment infrastructure, low recycling rates, and the technical complexity of handling multi-contaminant waste streams. In developing regions, these challenges are compounded by weak regulatory enforcement and limited public awareness. To effectively address ECs in urban water and fully meet the SDG targets, more integrated and globally coordinated efforts are necessary. Full article

Background: Access to safe and reliable water and sanitation remains a critical public health and development challenge, with rural and low-income communities being disproportionately affected by inadequate services and heightened exposure to waterborne diseases. Despite global efforts and infrastructure-based progress indicators, significant disparities persist, and these often overlook users’ perceptions of water quality, reliability, and safety. This study explores the determinants of household satisfaction with drinking water in rural areas, comparing subjective user feedback with official access data to reveal gaps in current monitoring approaches and support more equitable, user-centered water governance. Methods: This study was conducted in Kazakhstan’s Atyrau Region, where 1361 residents from 86 rural villages participated in a structured survey assessing household access to drinking water and perceptions of its quality. Data were analyzed using descriptive statistics and multinomial logistic regression to identify key predictors of user satisfaction, with results compared against official records to evaluate discrepancies between reported experiences and administrative data. Results: The field survey results revealed substantial discrepancies between official statistics and residents’ reports, with only 58.1% of respondents having in-house tap water access despite claims of universal coverage. Multinomial logistic regression analysis identified key predictors of user satisfaction, showing that uninterrupted supply and the absence of complaints about turbidity, odor, or taste significantly increased the likelihood of higher satisfaction levels with drinking water quality. Conclusions: This study underscores the critical need to align official water access statistics with household-level experiences, revealing that user satisfaction—strongly influenced by supply reliability and sensory water quality—is essential for achieving equitable and effective rural water governance. Full article

The Sustainable Development Goals seek to achieve universal, adequate, and equitable access to drinking water and sanitation by the year 2030. Yet, significant and persistent disparities in water and sanitation access exist, with rural and low-income households in Sub-Saharan Africa exhibiting some of the lowest levels. This paper uses household surveys from rural villages in Zambia’s Western Province to identify, highlight, and examine spatial barriers to improved water and sanitation. Most households included in the study area drink unimproved water, including surface water, and either use unimproved sanitation facilities or practice open defecation. Access to improved water sources and improved sanitation in the study area lags behind the rest of rural Zambia. Beyond the distance to urban areas that makes piped water and sanitation expensive, the location of these villages in the Barotse Floodplain necessitates seasonal migration, which creates barriers to universal access to improved water and sanitation. Full article

Background/Objectives: Childhood stunting remains a critical public health issue in low- and middle-income countries. Despite Malaysia’s economic growth, there is limited large-scale evidence on the determinants of stunting among children from infancy to primary school age. This cross-sectional study, part of South East Asian Nutrition Surveys II (SEANUTS II), aimed to determine sociodemographic and environmental risk factors for stunting among 2989 children aged 0.5–12 years. Methods: Children were recruited from four regions in Peninsular Malaysia (Central, East Coast, 2022–2030Northern, Southern). Standing height or recumbent length was measured, and stunting was classified based on WHO criteria (height-for-age Z-score below −2 standard deviations). Parents reported information on socioeconomic status, sanitation facilities, and hygiene practices. Multivariate binary logistic regression was used to determine the determinants of stunting. Results: Stunting prevalence was 8.9%, with infants (aOR = 2.92, 95%CI:1.14–7.52) and young children (aOR = 2.92, 95%CI:1.80–4.76) having higher odds than school-aged children. Key biological predictors included low birth weight (aOR = 2.41; 95%CI:1.40–4.13) and maternal height <150 cm (aOR = 2.24; 95%CI:1.36–3.70). Chinese (aOR = 0.56; 95%CI:0.35–0.88) and Indian children (aOR = 0.16; 95%CI:0.05–0.52) had a lower risk of stunting compared to Malays. Conclusions: This study highlights the ongoing challenge of childhood stunting in Malaysia, with age, birth weight, ethnicity, and maternal height identified as key determinants. These findings call for early identification of at-risk households and targeted support, especially through education and financial aid to foster healthy child growth. Full article

Decentralized sanitation in rural areas urgently requires accessible and nature-based solutions to achieve Sustainable Development Goal 6 (clean water and sanitation for all). However, monitoring studies of such ecotechnologies in disperse communities remain limited. This study evaluated the performance of an evapotranspiration tank (TEvap), designed with community participation, for the treatment of domestic sewage in a rural Quilombola household in the Brazilian Cerrado. The system (total area of 8.1 m², with about 1.0 m² per inhabitant) was monitored for 218 days, covering the rainy season and the plants’ establishment phase. After 51 days, the TEvap reached operational equilibrium, maintaining a zero-discharge regime, and after 218 days, 92.3% of the total system inlet volumes (i.e., 37.47 in 40.58 m³) were removed through evapotranspiration and uptake by cultivated plants (Musa spp.). Statistical analyses revealed correlations that were moderate to strong, and weak between the blackwater level and relative humidity (Pearson correlation coefficient, r = 0.75), temperature (r = −0.66), and per capita blackwater contribution (r = 0.28), highlighting the influence of climatic conditions on system efficiency. These results confirm the TEvap as a promising, low-maintenance, and climate-resilient technology for decentralized domestic sewage treatment in vulnerable rural communities, with the potential to support sanitation policy goals and promote public health. Full article

Currently, the management, availability, and equitable access to water are some of the most critical environmental challenges in many countries, including Mexico. The Household Water Insecurity Experience Scale (HWISE) offers a more comprehensive and accurate assessment of water insecurity (WI) as well as its relationship to poverty, at the local, state, and national levels, than traditional usage indicators do. Therefore, this study aims to estimate the association between water insecurity and household wellbeing in Mexico, as well as the role of geographic factors. Methods: We analyzed data from 11,512 households that had previously participated in a representative survey at the national, regional, and urban/rural levels. We conducted descriptive and bivariate analyses on the variables of interest according to household WI status. Multivariate logistic regression models were used to determine the association between WI and the geographic, household, and household head variables of interest. Results: The factors associated with a greater odds ratio of household WI were low wellbeing conditions (OR = 1.74, p < 0.01), no running water in the home (OR = 2.71, p < 0.01), a monthly household income less than 6000 Mexican pesos (less than 352 dollars) (OR = 2.31, p = 0.006), living in an urban area (OR = 1.93, p = 0.001), and living in the Mexico State (OR = 3.92, p < 0.01), Mexico City (OR = 3.19, p < 0.01), or Central Pacific (OR = 3.27, p < 0.01) regions. Conclusions: Currently, multiple factors threaten household water security. These findings can inform decision-makers about the driving factors behind gaps in water access, availability, and use in Mexican households, thereby ensuring the “availability and sustainable management of water and sanitation for all”. Full article

This study aimed to apply the integrated WASH assessment tool and assess the performance of WASH services in three Internally Displaced Person (IDP) camps in Rakhine State, Myanmar. The tool was applied in a unique non-household setting that is vulnerable to annual storms and storm-induced flooding, while also facing the complexity of political and social constraints. The assessment focused on nine components of the tool: water, sanitation, hygiene, financial, institutional, environmental impacts, technical, social, and climate change. Afterwards, the overall WASH services performance of the three IDP camps was determined. The assessment revealed good performance in water, financial, institutional, and social components across all camps. However, environmental impact, technical, and climate change components showed the need for improvement due to recurrent climate hazards, and their impacts on WASH facilities, such as latrine destruction, saltwater intrusion into handpumps, and increased diarrhea cases. Based on the findings, the study recommends constructing disaster-resilient latrines, reinforcing handpumps with watertight materials, elevating wellheads to prevent contamination, and forming emergency response teams with appropriate training. Overall, Ohn Taw Gyi (South) and Kaung Doke Khar (2) camps had a good level of WASH performance with a 6.38 sum of net scores of components (SAS), and with 6.06 SAS, respectively. Thet Kae Pyin camp had a moderate level of performance with 5.35 SAS. The application of the assessment tool provided valuable data to support evidence-based decision-making. It serves as a useful resource for WASH professionals, humanitarian organizations, and local governments to evaluate service performance and ensure sustainable service provision in their areas. Full article

The universalization of basic sanitation remains a challenge. For the development of sanitation infrastructure projects, it is essential to use water consumption data that accurately reflect reality, ensuring greater precision. This study aimed to determine the per capita contribution to fecal sewage (Cp) in six quilombola residences in Goiás (Brazil). The research was conducted in two phases: (a) a literature review on Cp in similar communities (CpL) and (b) the determination of Cp in six residences from different rural communities (CpP), varying in the number of inhabitants (8, 8, 5, 2, 1, and 1 persons in households R1 to R6, respectively). Flow measurements were obtained using a volumetric flowmeter (nominal flow rate of 1.5 m³/h) installed in the water pipeline supplying the toilet(s) of each household. A dearth of Cp data was observed in the literature, particularly for rural areas. Research on this topic remains in its infancy, as evidenced by the small number of publications (nine papers) published between 2006 and 2022, of which 44.4% reported on-site measurements. In the present study, the CpP ranged from 12.10 L/cap.day to 21.79 L/cap.day, with a mean of 16.22 L/cap.day (CV = 0.239). These calculated values lie within the lower (9.9 L/cap.day) and upper (51.5 L/cap.day) ranges reported in the literature. Generally, estimated data are higher than values calculated from flowrate measurements, highlighting the importance of direct measurements—which can also help reduce construction costs. Therefore, it is recommended that flowrate measurements and Cp calculations be expanded to residences with diverse demographic and geographic characteristics, also incorporating meteorological data, to obtain more accurate results. Full article

Background: Adequate water, sanitation, and hygiene (WaSH) are critical to maintaining good health and hygiene. However, health is a function of many health determinants, and WASH services alone may not be sufficient to improve health outcomes. Objective: To identify whether the presence of WaSH services is associated with fewer children under five years of age experiencing symptoms of diarrhea in Katoma, Geita, Tanzania. Method: A cross-sectional study was conducted to collect health data, demographics, and other variables, such as WASH, food insecurity, education of the mother, vaccination data, and household income data, for 452 households with children under five. Surveys were completed in-person through interviews. Health outcome data included being sick with diarrhea or symptoms. Data analysis was performed using SAS OnDemand for Academics. Multivariate logistic regression and mixed-effects logistic regression models were employed to determine the association between the covariates and sickness of inclusion children and all the children involved in the study, respectively. Results: The findings suggest that WASH services alone do not have a significant impact on diarrhea, but other determinants of health, including the education of the mother, showed a significant impact on health outcomes among children with at least one WASH service. These demographic variables were also associated with lower food insecurity and poverty. The findings highlight the need to (1) include other covariates when analyzing WASH data to understand health outcomes; and (2) improve education attainment for women to maximize health benefits for their children. Full article

This paper examines the financial health risks that private sector water, sanitation, and hygiene (WASH) businesses in rural Vietnam face. It investigates the challenges faced by water operators and sanitation suppliers involved in donor-funded development projects aimed at supporting poor and vulnerable households. Through surveys and focus group discussions with 15 suppliers who worked in public–private partnerships, this research examines the financial risk factors affecting water and sanitation suppliers and their impact on financial viability through two case studies. For water operators, the risks primarily involve infrastructure management, operational costs, and revenue instability. In the sanitation sector, risks center around fluctuating material prices, limited business expansion capital, and household affordability. This study highlights the dual role of government and donor subsidies, which enhance service accessibility but potentially distort market dynamics. It also underscores the need for targeted financial and policy interventions, including better access to microfinance, regulatory improvements, and human resource development. The findings aim to inform strategies for government, donors, and private sector actors in similar WASH development contexts to enhance financial sustainability, ensuring inclusive WASH services in underserved areas. This paper contributes to policy discussions by proposing mechanisms to balance public–private collaboration while fostering market resilience and equitable access to WASH services in emerging economies similar to that of Vietnam. Full article

Women’s reproductive decisions and life trajectories are shaped by an interplay of biological, social, and ecological factors. While Life History Theory (LHT) has traditionally been applied in biological sciences to examine reproductive trade-offs, its integration with Life Course Theory (LCT) and empowerment frameworks offers a novel approach to understanding how structural and environmental conditions shape women’s reproductive behaviours and household roles. This study applies Categorical Principal Component Analysis (CATPCA) to identify key profiles of women’s lives in two ecologically distinct rural communities in Timor-Leste—Ossu and Natarbora—and examines how these patterns relate to early life conditions. Building on a longitudinal study conducted in these communities, our findings reveal four distinct profiles: (1) Tech and Sanitation, linked to household labour-saving technology and higher education; (2) Traditional, reflecting large household size and livestock ownership; (3) Contraception, associated with fertility control, particularly among younger cohorts; and (4) High Fertility, characterised by more births, greater child mortality, and being born in high-altitude regions. By combining LHT, LCT, and the empowerment framework, this study analyses how reproductive strategies and household ecology intersect with structural inequalities. These findings offer key insights for policies aimed at improving women’s autonomy, access to resources, and reproductive health in rural Timor-Leste. Full article

Background/Objectives: Anemia adversely affects children’s cognitive and motor development and remains a global public health problem. This study aimed to identify the individual, feeding, household, and community determinants of anemia among children in Mozambique. Methods: We used pooled datasets of two Mozambique representative population-based surveys: the 2011 and 2022–2023 Demographic and Health Surveys. A total sample of 8143 children aged 6–59 months with available hemoglobin testing was included. Multilevel mixed-effects analysis was performed using STATA (18.0). Results: Over a decade, the prevalence of anemia in children aged 6–59 months remained high, increasing slightly from 69.1% in 2011 to 72.9% in 2022. Children aged 6–11 months were less likely to have anemia than children from other age groups (aOR = 0.77, 95% CI = 0.62–0.96). Children who suffered from illnesses (aOR = 1.44, 95% CI = 1.18–1.75), received vitamin A supplements (aOR = 0.76, 95% CI = 0.63–0.93), lived in female-headed households (aOR = 1.16, 95% CI = 1.01–1.32), and who lived in households with unimproved drinking water sources (aOR = 1.40, 95% CI = 1.19–1.65) were more likely to have anemia than their peers. Overall, 16% of the variability in anemia prevalence was attributed to differences between clusters (ICC = 0.16). Conclusions: Childhood anemia remains a critical public health challenge in Mozambique, with prevalence rates exceeding the average for sub-Saharan Africa. Multisectoral approaches to enhance essential supplies’ provision and the primary healthcare monitoring of children at risk favored more investments in rural development and sustainable agriculture, water sanitation, and social care and gender-sensitive work policies that can help tackle childhood anemia. Full article

Sewer networks are essential in supporting the sustainable development of rural settlements. However, many municipalities face difficulties due to inadequate or missing sanitation systems. Thus, the contamination of municipal water supplies has become a pressing issue. In the present study, the process of the sewer network establishment and its impacts on groundwater was assessed in the case of a Hungarian settlement. It was found that, following the realization of wastewater agglomeration in 2015, 85% of households in the municipality were connected by 2023. Results indicate that uninsulated septic tanks used before the sewer system resulted in a high rate of sewage leakage. 3D models using RockWorks software show a groundwater dome of more than 1 m in the vicinity of the septic tank. The discharge had a significant impact on groundwater quality; high NH₄⁺ concentrations (>90 mg/L) within the vicinity of the tank and above the limit value (0.5 mg/L) in the total area were detected. Na⁺ and NO₃⁻ concentrations above the contamination limit also reflect the severe impact of wastewater discharge. Significant positive changes in groundwater quality have been detected following sewerage. Our results highlight the importance of similar investments and draw attention to the positive changes that can be achieved. However, a very significant decrease in water levels was detected both in the vicinity of the septic tank and at the municipal level, which, in addition to precipitation patterns, is mainly attributable to the cessation of sewage outflow. Between 2013 and 2022, the average groundwater level declined by 3.8 m in the settlement. Therefore, long-term monitoring of the investment is essential. Full article

The Sustainable Development Goals (SDGs) build on the Millennium Development Goals (MDGs) and aim to promote sustainable global development by addressing poverty, inequality, and environmental sustainability. Among the key objectives of the SDGs, Goal 6 targets universal access to safely managed drinking water and sanitation by 2030, recognizing the critical link between water, sanitation, hygiene (WASH), and public health. However, global challenges persist, particularly in rural areas, where infrastructure deficits and socio-economic barriers hinder progress. In regions like rural Kazakhstan, where sanitation monitoring is limited and much of the water grid is substandard, addressing these gaps is essential to meet SDG 6 targets. For this purpose, we used structured questionnaires to assess water access, sanitation services, and a multinomial logistic regression analysis to examine the factors influencing households’ willingness to pay (WTP) for individual water supply systems in Atyrau households. Water sources, sanitation availability, and household practices were investigated offering insights into sustainable water and sanitation management. Indoor taps served 44.2% of households, while 60.5% used centralized systems for drinking water. Daily interruptions affected 19.9%, with 23.0% dissatisfied with quality. Outdoor toilets were used by 79.6%, and 43.7% relied on pit-filling. While 82.5% of respondents favored free individual water supply installations, only 11.6% were willing to pay the $426 installation cost, highlighting financial constraints. Consequently, there are persistent challenges in ensuring safe drinking water and sanitation in rural areas of Kazakhstan. Infrastructure gaps, poor water quality, and reliance on outdoor toilets pose health risks. Financial constraints further limit access. Targeted investments, improved oversight, and community engagement are critical for sustainable solutions aligned with the SDGs. Full article