Short-term WASH interventions in emergency responses in low- and middle-income countries

Abstract

The International Initiative for Impact Evaluation (3ie) is an international grant-making NGO promoting evidence-informed development policies and programmes. We are the global leader in funding, producing and synthesising high-quality evidence of what works, how, why and at what cost. We believe that better and policy-relevant evidence will make development more effective and improve people's lives. 3ie systematic reviews 3ie systematic reviews examine available high-quality evidence on the effects of social and economic development interventions in low-and middle-income countries. These reviews follow scientifically recognised review methods, and are peer reviewed and quality assured according to internationally accepted standards. 3ie is providing leadership in demonstrating rigorous review methodologies, such as using theory-based designs, for combining different types of evidence suited to respond to the complex and dynamic contexts and challenges of development. 3ie also publishes summary reports based on the full reviews that are designed for use by policymakers and programme managers. About this summary report InterventionsEmergency WASH interventions differ from development interventions because of the speed, scale and approach that are taken in emergency response activities. The needs of emergency-affected populations are often immediate, requiring rapidly increasing access to water and sanitation services. These situations also require the promotion of activities that may be unfamiliar to the population (e.g. treating water with chlorine for the first time). The main components of emergency WASH interventions include water, sanitation and hygiene interventions. Within the spectrum of WASH, 13 specific interventions common in emergencies have been included in this review: pumping wells flooded with saltwater; well disinfection; large-scale source treatment; small-scale source treatment; chlorine-based household water treatment; filtration-based household water treatment; other household water treatment; latrines and latrine alternatives; hygiene promotion; hygiene kits; environmental hygiene; and multiple WASH interventions carried out as a package. This review aims to assess the effectiveness of these interventions. MethodsA comprehensive and systematic search strategy was developed to identify published and grey literature. Studies were identified by using keywords to search nine peer-reviewed databases and more than 50 responding agency websites. Direct solicitation of individuals and agencies was also conducted through global email lists, conferences and personal contacts.Identified studies were screened by title, abstract and then full text. To be considered for inclusion, interventions needed to be WASH projects carried out within 12 months of a disaster or outbreak, less than 12 months in duration, occurring in a low-and middle-income country (L&MIC) and restricted to 1995-2016. Quantitative (experimental and non-experimental designs) and qualitative methodological designs were eligible, and bo...

From Vaccine to Pathogen: Modeling Sabin 2 Vaccine Virus Reversion and Evolutionary Epidemiology

“…Although long-term investments in infrastructure are prohibitively expensive, relatively simple measures such as the installation of sanitary latrines and drinking water tubewells have been effective at reducing fecal contamination in Matlab, Bangladesh (35). Optimistically, short-term sanitation interventions may be effective if implemented similarly to an emergency response campaign (36), especially if they are targeted at vaccine recipients and their immediate household community members (21). These targeted, short-term sanitation interventions could alleviate some of the challenges associated with non-compliance, long-term adherence failure, and poor implementation that reduce the efficacy of standard WASH interventions (37, 38).…”