Policy Diffusion in the Rural Sanitation Sector: Lessons from Community-Led Total Sanitation (CLTS)

Zuin, Valentina; Delaire, Caroline; Peletz, Rachel; Cock-Esteb, Alicea; Khush, Ranjiv; Albert, Jeff

doi:10.1016/j.worlddev.2019.104643

Cited by 60 publications

(43 citation statements)

References 59 publications

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“…CLTS increases toilet construction with community participation, 69,70 so that the CLTS program is more optimal, it requires high-level political commitment, integration of sanitation programs into health programs, improvement of community hygiene and coordination multi-sector. 71 Multi-sector cooperation is needed for optimal program implementation.…”

Section: The Personal Hygiene Improvement Programmentioning

confidence: 99%

Hygiene and Sanitation Challenge for COVID-19 Prevention in Indonesia

Purnama

Susanna²

2020

Kesmas: National Public Health Journal

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The case of Covid-19 in Indonesia continues to increase, transmitted directly and indirectly. Hygiene and sanitation approaches are needed for prevention. the purpose of this review is to review how the transmission COVID-19, the challenges of Indonesia, and the policy of COVID-19 prevention with hygiene and sanitation approaches. The results show Indonesia's challenges namely urban area density, air pollution, and smokers, low hand washing habits, low access to clean water and drinking water, open defecation behavior, limited personal protective equipment. COVID-19 control policy with the hygiene sanitation approach is carried out with 4 factors namely personal protect equipment, health education, personal hygiene, and sanitation.

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Section: The Personal Hygiene Improvement Programmentioning

confidence: 99%

Hygiene and Sanitation Challenge for COVID-19 Prevention in Indonesia

Purnama

Susanna²

2020

Kesmas: National Public Health Journal

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“…2016 ). Different forms of CLTS have now spread to nearly 60 countries, but little of its diffusion is guided by robust scientific evidence ( Zuin et al. 2019 ).…”

Section: Introductionmentioning

confidence: 99%

“…Increasing implementation research finds that the innovation’s effectiveness in sustaining villages that cease open defecation depends on a variety of household, community, policy environment, and program implementation factors, such as financial resources, access to construction materials, social cohesion, and strong local leadership ( Venkataramanan et al. 2018 ; Zuin et al. 2019 ).…”

Section: Introductionmentioning

confidence: 99%

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The Applications of Implementation Science in Water, Sanitation, and Hygiene (WASH) Research and Practice

Haque

Freeman

2021

Environ Health Perspect

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Background: Delivery of high quality, at-scale, and sustained services is a major challenge in the water, sanitation, and hygiene (WASH) sector, made more challenging by a dearth of evidence-based models for adaption across contexts in low- and middle-income countries. Objective: We aim to describe the value of implementation science (IS) for the WASH sector and provide recommendations for its application. Methods: We review concepts from the growing field of IS—defined as the “scientific study of methods to promote the systematic uptake of research findings and other evidence-based practices into routine practice, and hence, to improve the quality and effectiveness of health services”—and we translate their relevance to WASH research, learning, and delivery. Discussion: IS provides a suite of methods and theories to systematically develop, evaluate, and scale evidence-based interventions. Though IS thinking has been applied most notably in health services delivery in high-income countries, there have been applications in low-income settings in fields such as HIV/AIDS and nutrition. Expanding the application of IS to environmental health, specifically WASH interventions, would respond to the complexity of sustainable service delivery. WASH researchers may want to consider applying IS guidelines to their work, including adapting pragmatic research models, using established IS frameworks, and cocreating knowledge with local stakeholders. https://doi.org/10.1289/EHP7762

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“…Improvements were observed in multiple indicators of hygiene and sanitation over time, likely reflecting the efforts of national strategies and programs ( 18 , 39 , 40 ). All indicators of poor WASH were associated with higher anemia prevalence each year in this analysis, consistent with previous studies linking poor sanitation to anemia in Nepal, although the strength and statistical significance of each factor's association with anemia differed ( 36 , 41 ).…”

Section: Discussionmentioning

confidence: 99%

The Risk Factors for Child Anemia Are Consistent across 3 National Surveys in Nepal

Pasqualino

Thorne‐Lyman

Manohar

et al. 2021

Current Developments in Nutrition

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Background Anemia is an etiologically heterogeneous condition affecting over half of preschool-aged children in South Asia. An urgent need exists to elucidate context-specific causes of anemia to effectively address this issue. Objective This study investigated national trends and stability in the prevalence of child anemia and associated risk factors from 2013–2016. Design Same-season national surveys were administered in 2013, 2014 and 2016 in 63 sites across 21 districts, selected using multi-stage random sampling, representing the mountains, hills and Tarai. Among consenting households with children 6–59 months, a random sample of capillary blood was selected each year for anemia assessment using a Hb 201+ hemoglobinometer, with n = 835, 807, and 881 children assessed, respectively. Prevalence of child anemia, defined as hemoglobin <11.0 g/dL with adjustment for altitude, was estimated each year and disaggregated by region and child age. Prevalence ratios were estimated using log-binomial regression models with robust standard errors or robust Poisson regression when models failed to converge. Interaction terms between each risk factor and year were created to test for consistencies in associations over time. Results The national prevalence of child anemia decreased from 63.3% (95% CI: 59.0%, 67.5%) in 2013 to 51.9% (95% CI: 46.5%, 57.2%) in 2014 and increased to 59.3% (95% CI: 54.7%, 63.8%) in 2016. Across years, prevalence was highest in the Tarai (58.4–70.2%), followed by the mountains (53.0–61.1%) and hills (37.5–51.4%). Nationally and across time, child age and maternal anemia were significantly associated with child anemia. Child diarrhea and stunting, maternal thinness, and poor water and sanitation conditions also showed consistent trends towards higher anemia prevalence. Conclusions Anemia affects more than half of Nepalese children 6–59 months. Although prevalence varies year-to-year, the stability of observed risk factors suggests the need to focus on reducing gastrointestinal infection, promoting adequate household sanitation, and improving maternal and child health.

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Policy Diffusion in the Rural Sanitation Sector: Lessons from Community-Led Total Sanitation (CLTS)

Cited by 60 publications

References 59 publications

Hygiene and Sanitation Challenge for COVID-19 Prevention in Indonesia

Hygiene and Sanitation Challenge for COVID-19 Prevention in Indonesia

The Applications of Implementation Science in Water, Sanitation, and Hygiene (WASH) Research and Practice

The Risk Factors for Child Anemia Are Consistent across 3 National Surveys in Nepal

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