System Approaches to Water, Sanitation, and Hygiene: A Systematic Literature Review

Abstract

Endemic issues of sustainability in the water, sanitation, and hygiene (WASH) sector have led to the rapid expansion of ‘system approaches’ for assessing the multitude of interconnected factors that affect WASH outcomes. However, the sector lacks a systematic analysis and characterization of the knowledge base for systems approaches, in particular how and where they are being implemented and what outcomes have resulted from their application. To address this need, we conducted a wide-ranging systematic literature review of systems approaches for WASH across peer-reviewed, grey, and organizational literature. Our results show a myriad of methods, scopes, and applications within the sector, but an inadequate level of information in the literature to evaluate the utility and efficacy of systems approaches for improving WASH service sustainability. Based on this analysis, we propose four recommendations for improving the evidence base including: diversifying methods that explicitly evaluate interconnections between factors within WASH systems; expanding geopolitical applications; improving reporting on resources required to implement given approaches; and enhancing documentation of effects of systems approaches on WASH services. Overall, these findings provide a robust survey of the existing landscape of systems approaches for WASH and propose a path for future research in this emerging field.

A Review of Antimicrobial Resistance in Poultry Farming within Low-Resource Settings

“…More importantly, AMR remains critically understudied within the context of LMICs [ 48 , 49 ]. In resource-limited settings, which comprise the majority of LMIC poultry farming systems, poultry production commonly occurs among small-scale, family operations with limited biosecurity due to constraints in hygiene and sanitation [ 50 , 51 , 52 , 53 ]. Additionally, to facilitate economic growth, developmental organizations often promote the intensive small-scale poultry farming [ 39 , 54 , 55 ].…”

A System Dynamics Model of the Community-Based Rural Drinking Water Supply Program (PAMSIMAS) in Indonesia

“…According to the system approach perspective, each factor plays its role in the system, and ignoring one aspect of them will hinder the sustainability of the water services. This emphasizes the need for improving the whole system [14]. However, since many factors are related to the water board, e.g., external contribution, portion O&M, water board performance, etc., we confirm a previous study arguing that strong community institutions (mainly referring to water board performance) are necessary to keep the piped system functioning over time [32,33].…”

Water, sanitation, and hygiene (WASH) in healthcare facilities of 14 low- and middle-income countries: to what extent is WASH implemented and what are the ‘drivers’ of improvement in their service levels?

“…Similar conclusions were also drawn in Maina et al (2019)'s paper on extending the WASH-FIT model to the WASH-FAST model, in which the researchers found that when some key WASH-related tasks in their study hospitals in Kenya were delegated to WASH committees, these had a substantial influence on the monitoring of WASH and resource allocation. The combined 'hardware and software' approach through the integration and efficient collaboration with the local population in WASH interventions is also frequently and effectively utilised in non-institutional settings in the communities, such as household/community sanitation initiatives or water hardware management and rehabilitation (Klug et al 2017;Valcourt et al 2020).…”