The current environmental challenges that most middle-and low-income countries have been experiencing has led to new environmentally sustainable and economically viable sanitation solutions, such as waterless systems with source separation of human waste. We conducted a cross-sectional study in eThekwini municipality to explore the post-implementation challenges of urine diversion dehydration toilets (UDDTs) after a decade of installation and the adaptive processes necessary to increase the sustained use of the toilets. A structured questionnaire was administered to 17 499 households in 65 rural and per-urban areas of eThekwini using mobile phone technology. Results report low levels of satisfaction with the facilities as well as an association between perceived smell in the toilets and malfunctioning of the pedestal, and low use of UDDTs when a pit latrine is present in the dwelling perimeter. Conclusions relate to the importance of educational and promotional activities that stress the economic return derived from reusing urine and excreta in agricultural activities.
Despite decades of effort, around 2.8 billion people still rely on solid fuels to meet domestic energy needs. There is robust evidence this causes premature death and chronic disease, as well as wider economic, social, and environmental problems. Behavior change interventions are effective to reduce exposure to harm such as household air pollution, including those using health communications approaches. This article reports the findings of a project that reviewed the effectiveness of behavior change approaches in cleaner cooking interventions in resource-poor settings. The authors synthesized evidence of the use of behavior change techniques, along the cleaner cooking value chain, to bring positive health, economic, and environmental impacts. Forty-eight articles met the inclusion criteria, which documented 55 interventions carried out in 20 countries. The groupings of behavior change techniques most frequently used were shaping knowledge (n ¼ 47), rewards and threats (n ¼ 35), social support (n ¼ 35), and comparisons (n ¼ 16). A scorecard of behavior change effectiveness was developed to analyze a selection of case study interventions. Behavior change techniques have been used effectively as part of multilevel programs. Cooking demonstrations, the right product, and understanding of the barriers and benefits along the value chain have all played a role. Often absent are theories and models of behavior change adapted to the target audience and local context. Robust research methods are needed to track and evaluate behavior change and impact, not just technology disseminated. Behavior change approaches could then play a more prominent role as the ''special sauce'' in cleaner cooking interventions in resource poor settings.This article reports the findings of a review into the effectiveness of behavior change approaches in cleaner cooking interventions in resource-poor settings (Goodwin et al., 2014). The review produced evidence on the use of behavior change techniques (BCTs), a behavior change framework for clean cooking and a set of seven case studies, using a scorecard of effectiveness. The recommendations do not include an attempt to highlight or rank the most effective behavior change models or theories; rather, the review captures the key elements that make behavior change approaches more likely to succeed in ensuring the scale and sustainability of cleaner cooking interventions.
This study assesses the intermediate outcomes of the Tanzania National Sanitation Campaign (NSC) for schools. A cross-sectional study was designed as part of a process evaluation of the NSC in Tanzania on 70 primary schools and 54 regional and district education officers. Data was collected between August and December 2014 using questionaires, key informant interviews, and desk studies. The results showed that only 50% of schools met the Tanzania guideline of 50 boys per drop hole, while 43% met the guideline of 40 girls per drop hole. In addition, 53% of schools had a reliable water supply, 43% had some functional handwashing stations, but only 29% and 19% had water and soap available at the stations, respectively. Overall, the implementation of the NSC in schools was found to be effective, though poor planning and coordination, inadequate funding, and low technical capacity were identified as barriers to achieve the intended objectives. The study recommends stronger and coordinated stakeholder partnerships with clearly defined roles including cost sharing.Government and other stakeholders should also consider the impact of increasing funding for both software and hardware components to improve the enabling environment, and to develop a standardised monitoring mechanism for sustainable school water, sanitation and hygiene.
In recent years there has been a growing body of knowledge exploring the benefits of using sanitation-derived nutrients. Such studies aim to uncover strategies that facilitate nutrient recovery from urine and faecal sludge for agricultural use. This paper presents the findings of a study which assessed the willingness to handle and use urine in agriculture among people living in rural areas of eThekwini Municipality, South Africa. Results show that less than 5% of participants are using urine as a fertiliser. This could be attributed to limited awareness of the value of urine in agriculture since only 9.7% are aware that urine contains essential nutrients that can support plant growth. Furthermore, health concerns, smell and the opinions of others are identified as barriers to the handling of urine. The study therefore recommends that participatory field trials and promotional activities are conducted to improve users’ awareness and acceptance. The outcome of this research is of importance to help inform low- and middle-income countries’ governments as they address urban and environmental challenges such as access to adequate sanitation, poverty and food security.
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