Tag: Health

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Water, sanitation and hygiene are crucial to maintain health and create sustainable livelihoods

More than 1.2 billion people lack access to clean drinking water.

SEI and SweDev are introducing colleagues from SEI’s Development and Aid Policy Team as part of an interview series. In this interview with Ylva Rylander, Lead Communications Officer for SweDev at SEI, Nelson Ekane highlights solutions to sanitation and hygiene challenges.

Nelson Ekane, SEI Research Fellow and SweDev member, is specializing in multi-level sanitation governance, perception of risk and risk communication.

Nelson Ekane, SEI. Photo: SEI / Christin Philipson.

With his extensive experience and roots in Cameroon, Nelson has a profound understanding of the challenges associated with sanitation and hygiene in the Sub-Saharan region, and what solutions that are required to tackle these challenges.

Q: What do you consider to be the biggest social, cultural, and political challenges in the countries of your research in terms of sanitation and hygiene?

Inadequate water and sanitation facilities and poor hygiene practices impose costs on society. These inadequacies take a toll on human health, particularly among children under five years of age and the vulnerable groups in society. Poor health impairs the productive ability of people and keeps them away from school and work. These have implications for human and economic development and undoubtedly exacerbates poverty.

Q: Has Covid-19 made governments and people more aware of the need to provide rural, urban and peri-urban areas with sufficient sanitation equipment, access to clean water, etc.?

The Covid-19 pandemic presents both challenges and opportunities. In terms of challenges, access to water and soap for handwashing at critical times remains a critical issue in areas of water scarcity and lower socio-economic status in developing countries. The pandemic has the potentials to worsen the burden of disease in these contexts.

In terms of opportunities, the pandemic made salient the problem of inadequate sanitation and hygiene. Handwashing with water and soap is increasingly being promoted as one of the key preventive measures against the virus. The pandemic forces governments to intensify efforts to improve access to water and sanitation facilities particularly in underserved areas. It is left to see if these efforts are sustained in the long-term.

Sanitation in India and Sub-Saharan Africa

In 2014 Rwanda officially launched a six-month national campaign to improve personal, domestic, and public places’ hygiene. The same year, the Indian government introduced the Total Sanitation Campaign and relaunched it as Swachh Bharat in 2014.

Q: Are the root causes of sanitation and hygiene issues in Sub-Saharan Africa the same as in India, and are there different challenges preventing proper sanitation and hygiene?

Rwanda and India are different contexts but similar in what they lack – access to functional and decent toilet facilities for all. The root causes of this inadequacy are not the same. In the case of India, the socio-economic and cultural differences within the country are vast. Open defecation is still prevalent in some parts of both countries, particularly in India where people hold steadfast to certain cultural and traditional norms and practices which in some cases compromise their health and well-being.

Political leadership and commitment to address the problem is strong in both countries. However, the approaches in addressing the problem are different. For instance, Community Led Total Sanitation (CLTS) is widely used in the total sanitation campaign in India while in Rwanda, Community Health Clubs (CHCs) are implemented as part of the Community Based Environmental Health Promotion Programme (CBEHPP) improve community health by reducing the disease burden related to inadequate sanitation, poor hygiene practices, and unsafe drinking water.

Examples of successful implementation

Q: Can you provide an example of a successfully implemented sanitation and hygiene efforts in Sub-Saharan Africa, and what they key components of its success were?

Rwanda is one of the countries making good progress in improving access to water and sanitation services. Progress in Rwanda is attributed to the following: political leadership and commitment in combination with top-down authority and oversight to ensure accountability and improve sector performance; implementation of the CHC approach with assistance from the districts has enabled many households gain access to decent water, sanitation and hygiene facilities. Much is, however, still to be done to introduce and mainstream systems that sustainably manage wastes with possibilities for reuse.

Q: In terms of development aid, what is needed from organizations that want to contribute to improving the hygiene and sanitation issues in sub-Saharan Africa (SSA)?

Sanitation remains a low priority in the national budgets of many countries including Rwanda despite proclamations of political commitments to tackle the problem. The dependence of national governments on external funding and the lack of national ownership and follow-up of programmes, particularly when external funding ends, compromise sustainability of programmes. Policy fragmentation and coordination problems are rife in some countries as increasing numbers of non-state actors, notably international, local NGOs, and private operators take up key roles in filling the resource and service delivery gaps.

Countries having sustainable access to basic water and sanitation services for all as an important objective of their political project should be supported in realizing their visions. These countries should be encouraged to mobilize funds from national budgets to support the campaign. Both Rwanda and India are examples of countries where the problem is being articulated as part of the political project with the aim to promote a healthy and productive society.

The future of sanitation

Q: How do you see research on sanitation and hygiene developing over the next few years? Will the hygiene and sanitation issues be solved in a foreseeable future?

In regions/countries, particularly those in Africa still grappling with the challenges of providing equal access to basic water and sanitation services, emphasis needs to be placed on building institutions that reflect the reality of these countries i.e., taking into consideration the economic, social, political, and cultural specificities. This needs to be accompanied by careful organization of various actors in society to focus on achieving clear goals and obtaining concrete results. This would need rethinking the planning system in the countries. From a planning point of view, most of the Countries in SSA for example inherited a colonial planning system which was not intended to be inclusive. This planning system has evolved according to the same rules established when it was introduced and partly explains the present inequality in service delivery in these countries.

Sanitation and hygiene are behavioural matters largely influenced by context and culture. These factors pose multiple barriers to behaviour change, particularly in the developing context. Barriers to behaviour change relate to cognition (thought or understanding), attitudes (feelings or emotions), and intentions to change (actions). Systematic analysis of these barriers is required to improve understanding of what encourages the behaviours and practices that are being discouraged. Practices and behaviours embedded in cultural norms, codes of conduct and religion change slowly over very long periods.

Written by Nelson Ekane, SEI Research Fellow, Ylva Rylander, Communications Officer for SweDev at SEI and Jenny Wickman, former SEI employee.

Climate change: a threat to human wellbeing and health of the planet, says IPCC

Human-induced climate change is causing dangerous and widespread disruption in nature and affecting the lives of billions of people around the world, despite efforts to reduce the risks. People and ecosystems have been hard hit, said scientists in the latest Intergovernmental Panel on Climate Change (IPCC) report, released today on February 28.

About the IPCC: History, working groups and Reports

The Intergovernmental Panel on Climate Change (IPCC) is the UN body for assessing the science related to climate change. It was established by the United Nations Environment Programme (UNEP) and the World Meteorological Organization (WMO) in 1988 to provide political leaders with periodic scientific assessments concerning climate change, its implications and risks, as well as to put forward adaptation and mitigation strategies. In the same year, the UN General Assembly endorsed the action by the WMO and UNEP in jointly establishing the IPCC. It has 195 member states.

The Working Group II (WGII) contribution to the IPCC Sixth Assessment Report (AR6) assesses the impacts of climate change, looking at ecosystems, biodiversity, and human communities at global and regional levels. It also reviews vulnerabilities and the capacities and limits of the natural world and human societies to adapt to climate change.

The report builds on the WGII contribution to the Fifth Assessment Report (AR5) of the IPCC, three Special Reports, and the Working Group I (WGI) contribution to the AR6 cycle. The Summary for Policymakers of the IPCC Working Group II report, Climate Change 2022: Impacts, Adaptation and Vulnerability was approved on Sunday, February 27 2022, by 195 member governments of the IPCC, through a virtual approval session that was held over two weeks starting on February 14.

“This report shows that climate change is a grave and mounting threat to our wellbeing and a healthy planet”.

Hoesung Lee, Chair of the IPCC

Report 2022 numbers and structure

A call for nomination of authors was sent to IPCC member governments on 15 September 2017. 270 experts from 67 countries were invited to take on their roles in the WGII contribution to the IPCC Sixth Assessment Report. The Report relies on 675 contributing authors, and on more than 34,000 scientific papers.

They assessed the impacts of climate change on ecosystems and human communities at global and regional levels, their vulnerabilities, adaptation capacities and limits as well as options for achieving climate-resilient development. The Report results in 18 Chapters, 7 Cross-Chapter Papers, and 2 Annexes.

To avoid mounting loss of life, biodiversity and infrastructure, ambitious, accelerated action is required to adapt to climate change, at the same time as making rapid, deep cuts in greenhouse gas emissions. During today’s Press conference launch, Antonio Guterres said:

“The scientific evidence is unequivocal: climate change is a threat to human wellbeing and the health of the planet. Coal and other fossil fuels are choking humanity”.

António Guterres, United Nations Secretary-General

Text adapted from original IPCC Press Release‘s statements and report launch.

Fight against tuberculosis set back 12 years by Covid pandemic, report finds

This article was originally published on Global Development, The Guardian

The Covid-19 pandemic has resulted in nearly a 25% decrease in diagnosis and treatment of tuberculosis around the world, according to research published in March 2021 by a coalition working to end TB.

Twelve months of Covid-19 has reversed 12 years of global progress against tuberculosis, worse than previously estimated.

“Due to the impact of the Covid pandemic on services, the number of people diagnosed and treated for TB in the worst-affected countries has dropped back to 2008 levels, said Stop TB Partnership’s executive director, Lucica Ditiu. A modelling study published last year estimated a setback of five to eight years.”

“The effect on countries has depended on their existing disease burden. Data from India and South Africa showed people infected with both TB and Covid-19 are three times more likely to die than those infected with TB alone, meaning preventive steps such as contact tracing and testing are essential in keeping rates low.”

Every year TB infects 10 million people and kills 1.5 million, more than any other infectious disease. Although Covid-19 overtook TB in 2020 as the most common cause of death from an infectious disease, TB still kills more people than Covid in low- and middle-income countries.

“Some countries have fought hard to reverse the setbacks. India’s health ministry, after seeing a 70% drop in TB notifications in the first four months of 2020, integrated TB outreach into Covid-19 programming.”

TB did not disappear when the Covid-19 pandemic hit. Instead, people got distracted, health workers were redirected and health systems became overwhelmed, said India’s minister of health, Harsh Vardhan.

This article was originally published by Kate Hodal on Global Development, The Guardian.