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Envtl Health - Coggle Diagram
Envtl Health
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WASH
Water, Sanitation & Hygiene
History
- 60s = WHO push for strategic targets to improve water supplies (quant)
- 70s = start thinking of supply WITH sanitation, "water & sanitation for all" slogan UN Water Res Conference (arg)
- 80s = designated as the Interna. Drinking Water Supply & Sanitation Decade
--> increased inv in supply bc directly linked to sanitation (if not at decent standard then almost impossible to improve broad health reqs)
- 90s = "Water as a priority for life - to be treated as econ good" + creation of World Water Council (non-profit think tank) & the Global Water Partnership (WB) to facilitate action on Integrated Water Res Mngt
- 2000s = UNICEF & IRC - School Sanitation & Hygiene Educ prog / Community Water Supply Mngt (increased collab) - start using "WASH" term
--> Today mainly about water quality BUT took 60-70 years to start thinking about it beyond quant
Conceptual Framework
- Quant of water --> Eye & Skin Infections
- Qual of water
- Sanitation --> Worm infections
- (Hygiene Behavior) --> Respi infections + Eye & Skin Infections
==> All 4 can lead to Diarrhea ==> Which can cause Malnutrition
Importance of sanitation
- Difficult to measure health impact as long as sanitation not part of health packages
- W/ sanitation intro = 7 years of life expectancy gain
Risk Factors & SDHs/Motivators
--> Only 1 mention of health
- Gender & Age
- User rights = who's allowed to use it & when?
- Privacy & safety concerns = who can see you? Can you escape?
- Easier due to age or illness
--> Hygiene Poverty = challenges for girls in school to perform dignified & safe hygiene
- Social norms
- 'Private' VS 'pub' sanitation
- Sharing = w/ whom, how many?
- Issues of ownership / mngt
- Institutional sanitation
- Urban VS rural
- Econ
- Prestige (leave a legacy to children)
- Comfort (reduce flies & odors)
- Dangers (ie snakes)
- Clean house
- Reduce healthcare expenses
- More modern / feel royal
- Increase tenants rent
- Cultural - Local usage & cleaning practices
- wipe or wash
- sitting or squatting
- indoor or outdoors
- preferred distance from house
- wet or dry tech
- on-site or off-site
- cleansing materials
--> E.g. 'fish-pond-latrines' in Vietnam discouraged by gvt hygiene promo
- Protect from enemies
--> Must consider spec context before making a sanitation intervention at school or household level
:green_book: Prampram in Ghana
Used mobile phone system to get data from users on defecation behavior
- Time preference = Mainly morning
- Location preference = beach, bush, pub VIP, pers/pub flush & shared VIP
Challenges for sustainable sanitation in Ghana
- Pop growth (significant)
- Dependency on latrine donations (on
external agencies + weakened private sector)
- Sanitation neglected = Lack of attention & support to sanitation from donors & local authorities
--> Educ campaigns failed to nurture support for sanitation
- Focus on latrine construction, not maintenance (causing smells)
- Limited att. to local context = high focus on standard sanitation techs
- Lack of infra invs due to lack of land rights (e.g. urban slums)
Improving WASH promo progs
:!: Remember:
- Very context specific
- Must accomodate gender, age & disability
- High difficulty in research defecation behavior (taboo)
- High difficulty in finding support (few people care)
What to think about
- Key msg / behavior change issue to focus on (through solid analysis)
- Target audience (& sub-grps)
- Methods of msg delivery / Comms approaches (to increase uptake)
- Who delivers the msg
Some approaches to promo
- Hygiene educ (incl. in schools & through mass media info campaigns)
- Eductainment & (media) placement/social marketing (ie soap)
- Participatory community hygiene pb iding, priority setting & solution implementation
- Integrated promo as part of general health progs
- Ind comms w/ health practitioner (eg after sickness or GP visits)
Largest sanitation taboo = Menstruation practices & norms
--> Girls & women are forced to use poor & unsafe sanitation during menstruation = dangerous, unhygienic, unhealthy & undignified
- Taboos and stigma attached to exposing menstrual blood
- Lack of water for cleaning & washing
- Lack of school sanitation!!
- Lack of waste management systems (menstrual pads)
- No rights for girls to use toilets during menstruation
:green_book: Poor WASH + suboptimal nutrition = important risk factors for morbidity & mortality of under-5 children