Delivering water, sanitation and hygiene interventions to women and children in conflict settings: a systematic review

Abstract

<jats:sec><jats:title>Background</jats:title><jats:p>Access to safe water and sanitation facilities and the adoption of effective hygiene practices are fundamental to reducing maternal and child morbidity and mortality globally. In armed conflict settings, inadequate water, sanitation and hygiene (WASH) infrastructure poses major health risks for women and children. This review aimed to synthesise the existing information on WASH interventions being delivered to women and children in conflict settings in low-income and middle-income countries (LMICs) and to identify the personnel, sites and platforms being used to deliver such interventions.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We conducted a systematic search for publications indexed in four databases, and grey literature was searched through the websites of humanitarian agencies and organisations. Eligible publications reported WASH interventions delivered to conflict-affected women or children. We extracted and synthesised information on intervention delivery characteristics, as well as barriers and facilitators.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>We identified 58 eligible publications reporting on the delivery of WASH interventions, mostly in Sub-Saharan Africa. Non-Governmental Organization (NGO)/United Nations (UN) agency staff were reported to be involved in delivering interventions in 62% of publications, with the most commonly reported delivery site being community spaces (50%). Only one publication reported quantitative data on intervention effectiveness among women or children.</jats:p></jats:sec><jats:sec><jats:title>Discussion</jats:title><jats:p>This review revealed gaps in the current evidence on WASH intervention delivery in conflict settings. Little information is available on the delivery of water treatment or environmental hygiene interventions, or about the sites and personnel used to deliver WASH interventions. Limited quantitative data on WASH intervention coverage or effectiveness with respect to women or children are important gaps, as multiple factors can affect how WASH services are accessed differently by women and men, and the hygiene needs of adolescent girls and boys differ; these factors must be taken into account when delivering interventions in conflict settings.</jats:p></jats:sec><jats:sec><jats:title>PROSPERO registration number</jats:title><jats:p>CRD42019125221</jats:p></jats:sec>

Modalities and preferred routes of geographic spread of cholera from endemic areas in eastern Democratic Republic of the Congo

“…The latter also negatively impact the health system and other infrastructures that lose the capacity to provide even basic services [ 16 ]. As a result, conflict-affected populations are at increased risk of food insecurity, shortages of potable water, and poor sanitation and hygiene practices in host sites due to rapid and massive relocation [ 17 , 18 ]. It has been shown previously that a one-day interruption in water supply is followed by a substantial increase in the incidence rate of suspected cholera cases within 12 days [ 48 ].…”

“…War and conflict lead to massive population displacement, the collapse of health systems, and the breakdown of surveillance, early warning and response systems [ 16 ]. Conflict-affected populations are at risk of exposure to inadequate access to water, sanitation, and hygiene (WASH) facilities and resources [ 17 , 18 ], which further increases the risk of epidemics [ 19 ]. While the impact of conflicts on the geographic spread of cholera was demonstrated elsewhere [ 20 – 22 ], epidemic reactivations of cholera in health zones (HZs) were suggested to be favored by conflicts in eastern DRC [ 9 ].…”

Delivering nutrition interventions to women and children in conflict settings: a systematic review

“…This systematic review on nutritional interventions is a part of series of reviews in conflict settings which includes delivery of mental health, sexual and reproductive health and other interventions in conflict settings. [11][12][13][14][15][16][17][18] This review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (online supplemental appendix 1), 19 and its protocol is registered with PROSPERO (the international prospective register of systematic reviews, www. crd.…”

One Health Paradigm to Confront Zoonotic Health Threats: A Pakistan Prospective

“…In Pakistan, water supplies have been adversely influenced by climate change, chemical and biological pollutants due to pipe cracks, poor sewage systems, and a lack of water quality control testing systems ( Aziz, 2005 ). Governments and NGOs have adopted different rules and regulations to control the risk of water contamination such as the WASH interventions, Water and Sanitation Extension Programs (WASEP) projects, Oxfam GB, Quantitative Microbiological Risk Assessment (QMRA), Punjab Saaf Pani project, and the Changa Pani scheme ( Nanan et al, 2003 ; Baig et al, 2012 ; Ahmed et al, 2020a , c ; Als et al, 2020 ). WASEP projects are particularly enforced at the rural level to enhance or rectify water supplies for consumers ( Nanan et al, 2003 ).…”